Primary objective: To evaluate the effectiveness of a brief acute neurobehavioural intervention, the First Steps Acute Neurobehavioural and Cognitive Intervention (FANCI), with persons who have traumatic brain injury (TBI). Research design: Prospective, controlled, repeated measures design. Methods and procedures: Seventy-two patients in acute TBI rehabilitation participated either as FANCI subjects or as control participants who watched videos to control for time and attention. Outcome measures included the Neurobehavioural Rating Scale-Revised (NRS-R), Functional Independence Measure (FIM™), a FANCI Learning Assessment (LA) and the Satisfaction with Life Scale (SWLS). Main outcomes and results: In comparison with controls, FANCI participants had significantly greater neurobehavioural (cognitive, emotional and behavioural) as well as FIM motor improvements. Significantly greater learning occurred and persisted over time for FANCI subjects as compared to controls. Pre-treatment cognitive and neurobehavioural status, length of coma and number of sessions completed were moderating variables for functional and cognitive outcomes. Conclusions: Persons with TBI can benefit from comprehensive, manualized neurobehavioural interventions, over and above standard rehabilitation care, even during the acute phase of recovery. © 2011 Informa UK Ltd All rights reserved.