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Mr. Smith is a 70-year-old gentleman who had a left hemisphere stroke resulting in moderate Broca’s aphasia and mild to moderate apraxia of speech. After a brief course of acute rehabilitation, he was discharged home and continued to receive therapy as an outpatient. After 3 months of outpatient treatment, he was discharged from therapy because of lack of improvement and poor motivation. Encouraged by his wife, Mr. Smith came to our clinic for treatment 1 year later. During a phone conversation, his former clinician stated that she was puzzled by his lack of motivation. She stated that, while he appeared to be engaged in treatment early on and made some small improvements, he became progressively less adherent to his home practice assignments despite her attempts to encourage him or in response to changes she made to the treatment plan. During his first visit to our clinic, Mr. Smith acknowledged that he was less consistent with his home practice as time went on, but he was unsure why this was so. His wife believed it was because he was not improving as quickly as he had hoped.