The presence of confabulation following brain damage can obstruct neuropsychological rehabilitation and management. A recent theoretical approach to confabulation emphasises that neurocognitive deficits are not sufficient to account for the content of confabulation. As a result, they are also insufficient to address the unique rehabilitation challenges that confabulation raises. Instead, confabulation could be best understood as the magnification of existing reconstructive memory processes, influenced by both neurocognitive and motivational factors. The paper reviews recent experimental findings showing that confabulations serve important functions of self-coherence and self-enhancement, despite their poor correspondence to reality. Case material is used to illustrate the meaningfulness of confabulation from the subjective perspective of the patient and to demonstrate that such a theoretical approach to confabulation can best inform management and rehabilitation efforts.