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Introduction: A number of options exist for the rehabilitation of memory after traumatic brain injury, and research suggests that the use of external memory aids is one of the best approaches. Unfortunately, there is very little evidence to guide therapists in training clients to use external memory aids and to ensure the sustainable use of the aids long term. Method: Grounded theory methodology was used to explore the question of how occupational therapists train clients to use external memory aids after a traumatic brain injury. Semi-structured interviews, with eight occupational therapists working in neurological rehabilitation, were conducted until data collection reached a saturation point. The data were analysed following the constant comparative method proposed by Strauss and Corbin. Findings: Analysis revealed four overlapping processes: developing client insight, getting client buy-in, getting others on board and making it real. Making it real emerged as the core process that encompassed and ran through the other three. It emphasised the need for occupational therapists to use meaningful, functional activities in order to establish an aid that fitted the client's real life. Conclusion: The processes uncovered by this study give occupational therapists working in the field of brain injury rehabilitation guidance for clinical practice.

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