PurposeThis clinical focus article provides an overview of the relationship between narrative, identity, and social co-construction for persons with aphasia and of narrative treatment approaches targeting identity renegotiation. The intent is to provide speech-language pathologists (SLPs) with background on how these key concepts fit within the Life Participation Approach to Aphasia and to empower them to consider engaging in personal narrative co-construction with their clients. The idea of narrative identity is supported by the Living with Aphasia: Framework for Outcome Measurement, particularly within the Personal domain. A focus on identity through the co-construction of small and big stories can help SLPs prioritize supporting those living with aphasia in moving on with aphasia as part of their story. Emphasis is placed upon the interaction and relationship between the SLP and the client as critical to the social reconstruction and validation of identity through support of shared personal narratives. The PULSE framework is introduced as a foundation for supporting narrative and identity in clinical work with individuals living with aphasia. Evidence-based life story–focused interventions are reviewed.ConclusionStories are powerful tools in moving life forward post stroke and aphasia. Supporting the development of personal narratives that allow identity reconstruction falls within the scope of Life Participation Approach to Aphasia and the Living with Aphasia: Framework for Outcome Measurement. SLPs are well suited to support identity renegotiation in persons with aphasia through narrative construction.