Social skills often create a barrier to placement in less restrictive environments for persons with TBI. This case study illustrated the use of a positive talk program in the treatment of a person with long-standing social skill deficits. Occupational therapy intervention with speech-language consultation began with an evaluation of the cognitive barriers that influenced the client's social behavior. Work with the client's concrete concept formation, decreased memory, and poor generalization skills led to the development of the positive talk training program described. Through an understanding of the underlying cognitive deficits that influenced the client's behavior, the clinical team was able to develop an individual treatment plan. The intervention resulted in modification of behavior that would have required placing the client in a restricted environment. In the final analysis, the client's social skills improved to a level where he could be discharged to a less restrictive environment.