This paper introduces the concept of illness behavior to occupational therapists working with patients with acquired neurological impairments. The paper presents two case reports of patents with unequivocal severe brain trauma who demonstrated help-seeking and dependency behaviors that could not he accounted for by brain damage alone. Incorporating the illness behavior concept in an understanding of the patients’ behavior difficulties assisted in the development of an appropriate treatment plan and interventions. This paper emphasizes that severe neurological sequelae and illness behavior may coexist in the same patient. Without an understating of the personality and environmental factors that may influence recovery, rehabilitative efforts may be less than optimally effective.