The challenge to presenters at the Galveston Brain Injury Conference held in April 2005 was to discuss examples of the use of theory to motivate the design of treatments for cognitive deficits resulting from traumatic brain injury. This article considers the role of theoretical rationales as well as the new optimism embracing neurorehabilitation today. However, caution to respect the maturational process needed to adequately prepare treatment evidence for clinical application is affected.