SummaryThis paper is concerned with how psychosocial adjustment in aphasic patients is perceived by speech therapists, spouses or significant others and aphasic patients. Two important factors are considered, firstly the extent to which incongruity exists in different individuals' predictions of psychosocial adjustment to aphasia, and secondly degrees of optimism experienced by all the main parties. It is reported that in a sample of 21 aphasic patients a wide range of incongruence was found and that spouses and aphasic patients were more optimistic than speech therapists. Correlations between age and time since onset are discussed. The importance of these findings for counselling are considered and the need for longitudinal studies identified.