The technologies used by humans to augment direct face-to-face communication have developed over many centuries. This development has particularly accelerated over the past two decades with the explosion of internet and social media communication systems such as e-mails, texts Twitter, Facebook, and Skype. Some of these developments have, also influenced how health care is delivered and will continue to do so in the future. This paper reviews the role new information technologies may play in augmenting psychological therapy when working with persons with acquired brain injury (ABI). There are several familiar pragmatic benefits to using these technologies in this clinical setting, including potentially widening the time between client consultations and compensating for cognitive difficulties. However, of both interest and innovation, these technologies may also facilitate third order reflexivity. This may be of considerable relevance to the practice of psychotherapy in this clinical population in view of the unique challenges work in this area brings to the practitioner. The main points covered in the paper are illustrated with a clinical case report. Finally, the potential risks and challenges to be managed in neuro-rehabilitation as well as psychotherapy are discussed and recommendation for everyday practice in this evolving area of clinical practice made