Psychosocial care of adults with spinal cord injuries guide

This guide aims to ensure people who have SCI receive comprehensive and cost-effective psychosocial care that enhances their wellbeing and life goals. It is intended to elevate SCI rehabilitation practice and treatment.

Published: July 2023. Next review: 2028.

It will assist health professionals to make well-judged decisions about assessment, treatment, referral and living arrangements for people with SCI.

The guide is in three parts: Recommendations, Models of care and Background and methodology.

Recommendations

These recommendations build a foundation for delivering all the psychosocial interventions required throughout a person’s lifespan.

Download the recommendations (PDF 486.2 KB)

Models of care

This examination of several models of care, assists clinicians to provide the best possible rehabilitation programs for people with SCI, across different settings.

Download the models of care (PDF 656.0 KB)

Background and methodology

The development of this guide, including the changes to evidence, practice and outcomes since the first edition.

Download background (PDF 358.9 KB)

References

At a glance

Guiding principles

  • Provide psychosocial support over the lifespan
  • Use a person-centred approach
  • Promote a sense of support, safety and recovery
  • Screen for distress, cognitive and neuropsychological symptoms
  • Provide generous emotional and social support
  • Provide timely and targeted information
  • Use effective communication skills
  • Promote self-management and adjustment models
  • Provide support for caregivers and significant others

Recommendations

  • Integration within acute care and rehabilitation
  • Psychosocial assessment
  • Cognitive screening
  • Psychosocial evidence-based interventions
  • Peer support
  • Monitoring and follow-up
  • Staffing skill mix and professional development

Case studies

These case studies introduce a scenario and include reflection questions. They can be used for personal development or in group training.

Resources

A clinician’s guide to working with spinal cord injury: Emotional wellbeing toolkit
Understand and manage psychosocial issues associated with acute and long-term SCI.
Published: June 2016. Next review: 2027.

Brief psychosocial clinical assessment tool
Use these questions on psychosocial risk factors to assess clients.
Published: October 2017. Next review: 2027.

Improving transitions to community living for people with spinal cord injury in NSW: Final report
The key findings of research and stakeholder engagement with recommendations to improve care and support.
Published: October 2017.

References

These references support the three parts of the Psychosocial care of adults with spinal cord injuries guide.

  1. Kitchener BA, Jorm AF. Mental health first aid training for the public: evaluation of effects on knowledge, attitudes and helping behavior. BMC Psychiatry 2002; 2:10. doi: 10.1186/1471-244x-2-10
  2. Craig A, Tran Y, Arora M, et al. Investigating dynamics of the Spinal Cord Injury Adjustment Model: Mediation model analysis. J Clin Med, 2022, 11, 4557.
  3. Bonanno GA, Kennedy P, Galatzer-Levy IR, et al. Trajectories of resilience, depression, and anxiety following spinal cord injury. Rehabil Psychol 2012;57(3):236-247. doi: 10.1037/a0029256
  4. Craig A, Nicholson Perry K, Guest R, et al. Adjustment following chronic spinal cord injury: Determining factors that contribute to social participation. Br J Health Psychol 2015;20(4):807-823. doi: 10.1111/bjhp.12143
  5. Craig A, Tran Y, Middleton J. Psychological morbidity and spinal cord injury: a systematic review. Spinal Cord 2009;47(2):108-114. doi: 10.1038/sc.2008.115
  6. Guest R, Craig A, Nicholson Perry K, et al. Resilience following spinal cord injury: A prospective controlled study investigating the influence of the provision of group cognitive behavior therapy during inpatient rehabilitation. Rehabil Psychol 2015;60(4):311-321. doi: 10.1037/rep0000052
  7. World Health Organization. A glossary of terms for community health care and services for older persons. Kobe, Japan: WHO Centre for Health Development; 2004.
  8. Middleton JW, Dayton A, Walsh J, et al. Life expectancy after spinal cord injury: a 50-year study. Spinal Cord 2012;50(11):803-811. doi: 10.1038/sc.2012.55
  9. Craig A, Tran Y, Siddall P, et al. Developing a model of associations between chronic pain, depressive mood, chronic fatigue, and self-efficacy in people with spinal cord injury. J Pain 2013;14(9):911-920. doi: 10.1016/j.jpain.2013.03.002
  10. Craig A, Guest R, Tran Y, et al. Cognitive impairment and mood states after spinal cord injury. J Neurotrauma 2017;34(6):1156-1163. doi: 10.1089/neu.2016.4632
  11. Dorstyn D, Mathias J, Denson L. Efficacy of cognitive behavior therapy for the management of psychological outcomes following spinal cord injury: a meta-analysis. J Health Psychol 2011;16(2):374-391. doi: 10.1177/1359105310379063
  12. Geyh S, Nick E, Stirnimann D, et al. Biopsychosocial outcomes in individuals with and without spinal cord injury: a Swiss comparative study. Spinal Cord 2012;50(8):614-622. doi: 10.1038/sc.2012.21
  13. Krueger H, Noonan VK, Williams D, et al. The influence of depression on physical complications in spinal cord injury: behavioral mechanisms and health-care implications. Spinal Cord 2013;51(4):260-266. doi: 10.1038/sc.2013.3
  14. Savic G, DeVivo MJ, Frankel HL, et al. Long-term survival after traumatic spinal cord injury: a 70-year British study. Spinal Cord 2017;55(7):651-658. doi: 10.1038/sc.2017.23
  15. Shavelle RM, DeVivo MJ, Brooks JC, et al. Improvements in long-term survival after spinal cord injury? Arch Phys Med Rehabil 2015;96(4):645-651. doi: 10.1016/j.apmr.2014.11.003
  16. Bombardier CH, Azuero CB, Fann JR, et al. Management of mental health disorders, substance use disorders, and suicide in adults with spinal cord injury: Clinical practice guideline for healthcare providers. Top Spinal Cord Inj Rehabil 2021;27(2):152-224. doi: 10.46292/sci2702-152
  17. Dezarnaulds AI, Craig, A. Psychological adjustment after spinal cord injury. Useful strategies for health professionals. NSW Agency for Clinical Innovation. 3rd ed. Sydney: ACI, 2014:1-20.
  18. Middleton J, Nicholson Perry K, Craig A. Development of a guide for the psychosocial care of people with spinal cord injury: Introduction and practice implications. Int J Phys Med Rehabil 2014;2:226-231.
  19. National Health and Medical Research Council (NHMRC). NHMRC levels of evidence and grades for recommendations for developers of guidelines: NHMRC Canberra, Australia, 2009.
  20. Lee BB, Cripps RA, Fitzharris M, et al. The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate. Spinal Cord 2014;52(2):110-116. doi: 10.1038/sc.2012.158
  21. Wyndaele M, Wyndaele JJ. Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey? Spinal Cord 2006;44(9):523-529. doi: 10.1038/sj.sc.3101893
  22. Furlan JC, Sakakibara BM, Miller WC, et al. Global incidence and prevalence of traumatic spinal cord injury. Can J Neurol Sci 2013;40(4):456-464. doi: 10.1017/s0317167100014530
  23. NSW Agency for Clinical Innovation. Evidence and utilisation of spinal cord injury services NSW: Evidence series [Internet]. Sydney: ACI, 2020 [cited June 2023].
  24. Middleton JC, I.D. Introduction to physical injuries, recovery and adversity following motor vehicle crashes. In: Craig A, Guest R. Adversity after the crash: The physical, psychological and social burden of motor vehicle crashes. New York: Nova Science 2019:3-35.
  25. Kemp B, Campbell M. Health, functioning and psychosocial aspects of aging with disability. Final Report Rehabilitation Research and Training Center on Aging. Downey, CA: Rancho Los Amigos Medical Center; 1993.
  26. Charlifue S, Jha A, Lammertse D. Aging with spinal cord injury. Phys Med Rehabil Clin N Am 2010;21(2):383-402. doi: 10.1016/j.pmr.2009.12.002
  27. DeVivo MJ, Chen Y. Trends in new injuries, prevalent cases, and aging with spinal cord injury. Arch Phys Med Rehabil 2011;92(3):332-338. doi: 10.1016/j.apmr.2010.08.031
  28. Kemp BJ. What the rehabilitation professional and the consumer need to know. Phys Med Rehabil Clin N Am 2005;16(1):1-18, vii. doi: 10.1016/j.pmr.2004.06.009
  29. New PW, Baxter D, Farry A, et al. Estimating the incidence and prevalence of traumatic spinal cord injury in Australia. Arch Phys Med Rehabil 2015;96(1):76-83. doi: 10.1016/j.apmr.2014.08.013
  30. Strauss DJ, Devivo MJ, Paculdo DR, et al. Trends in life expectancy after spinal cord injury. Arch Phys Med Rehabil 2006;87(8):1079-1085. doi: 10.1016/j.apmr.2006.04.022
  31. Trieschmann RB. The psychological, social, and vocational adjustment to spinal cord injury. Annu Rev Rehabil 1980;1:304-318.
  32. Craig A, Tran Y. Psychological aspects associated with spinal cord injury rehabilitation: New directions and best evidence: Nova Science Publishers. 2008.
  33. Craig A. Resilience in people with physical injury. The Oxford handbook of rehabilitation psychology. United Kingdom: Oxford University Press; 2012:474.
  34. Craig A, Nicholson Perry K, Guest R, et al. Prospective study of the occurrence of psychological disorders and comorbidities after spinal cord injury. Arch Phys Med Rehabil 2015;96(8):1426-434. doi: 10.1016/j.apmr.2015.02.027
  35. Craig A, Tran Y, Middleton J. Theory of adjustment following severe neurological injury: evidence supporting the spinal cord injury adjustment model. Horiz Neurosci Res 2017;29:117-139.
  36. Kennedy P, Lude P, Taylor N. Quality of life, social participation, appraisals and coping post spinal cord injury: a review of four community samples. Spinal Cord 2006;44(2):95-105. doi: 10.1038/sj.sc.3101787
  37. Murphy G, Young A. Vocational achievement following traumatic spinal cord injury. A Craig, Y Tran, (Eds.) Psychological aspects associated with spinal cord injury rehabilitation 2008:197-214.
  38. Dreer LE, Elliott TR, Shewchuk R, et al. Family caregivers of persons with spinal cord injury: Predicting caregivers at risk for probable depression. Rehabil Psychology 2007;52(3):351-357.
  39. Weitzenkamp DA, Gerhart KA, Charlifue SW, et al. Spouses of spinal cord injury survivors: the added impact of caregiving. Arch Phys Med Rehabil 1997;78(8):822-827. doi: 10.1016/s0003-9993(97)90194-5
  40. Pollard C, Kennedy P. A longitudinal analysis of emotional impact, coping strategies and post-traumatic psychological growth following spinal cord injury: a 10-year review. Br J Health Psychol 2007;12(Pt 3):347-362. doi: 10.1348/135910707x197046
  41. Charlifue S, Gerhart K. Community integration in spinal cord injury of long duration. NeuroRehabil 2004;19(2):91-101.
  42. Mpofu E, Craig A, Millington M, et al. Return to work practices and research with spinal cord injury: An Australian perspective. Australian J Rehabil Counselling 2015;21(1):65-76. doi: 10.1017/jrc.2015.1
  43. Hilton G, Unsworth C, Murphy G. The experience of attempting to return to work following spinal cord injury: a systematic review of the qualitative literature. Disabil Rehabil 2018;40(15):1745-1753. doi: 10.1080/09638288.2017.1312566
  44. Lidal IB, Huynh TK, Biering-Sørensen F. Return to work following spinal cord injury: a review. Disabil Rehabil 2007;29(17):1341-1375. doi: 10.1080/09638280701320839
  45. Dorstyn D, Roberts R, Murphy G, et al. Can targeted job-information for adults with spinal cord dysfunction be effectively delivered online? A pilot study. The J Spinal Cord Med 2019;42(1):94-101.
  46. Ramakrishnan K, Johnston D, Garth B, et al. Early access to vocational rehabilitation for inpatients with spinal cord injury: a qualitative study of patients' perceptions. Top Spinal Cord Inj Rehabil 2016;22(3):183-191.
  47. Alexander CJ, Sipski ML, Findley TW. Sexual activities, desire, and satisfaction in males pre- and post-spinal cord injury. Arch Sex Behav 1993;22(3):217-228. doi: 10.1007/bf01541767
  48. Biering-Sørensen F, Sønksen J. Sexual function in spinal cord lesioned men. Spinal Cord 2001;39(9):455-470. doi: 10.1038/sj.sc.3101198
  49. Brown DJ, Hill ST, Baker HW. Male fertility and sexual function after spinal cord injury. Prog Brain Res 2006;152:427-439. doi: 10.1016/s0079-6123(05)52029-6
  50. Sramkova T, Skrivanova K, Dolan I, et al. Women's sex life after spinal cord injury. Sex Med 2017;5(4):e255-e59. doi: 10.1016/j.esxm.2017.07.003
  51. Fisher TL, Laud PW, Byfield MG, et al. Sexual health after spinal cord injury: a longitudinal study. Arch Phys Med Rehabil 2002;83(8):1043-1051. doi: 10.1053/apmr.2002.33654
  52. Sipski ML, Alexander CJ. Sexual activities, response and satisfaction in women pre- and post-spinal cord injury. Arch Phys Med Rehabil 1993;74(10):1025-1029. doi: 10.1016/0003-9993(93)90056-g
  53. Craig A, Hancock K, Dickson H. Improving the long-term adjustment of spinal cord injured persons. Spinal Cord 1999;37(5):345-350. doi: 10.1038/sj.sc.3100829
  54. Peterson MD, Kamdar N, Whitney DG, et al. Psychological morbidity and chronic disease among adults with nontraumatic spinal cord injuries: a cohort study of privately insured beneficiaries. Spine J 2019;19(10):1680-1686. doi: 10.1016/j.spinee.2019.05.591
  55. Klyce DW, Bombardier CH, Davis TJ, et al. Distinguishing grief from depression during acute recovery from spinal cord injury. Arch Phys Med Rehabil 2015;96(8):1419-1425. doi: 10.1016/j.apmr.2015.02.018
  56. Fann JR, Bombardier CH, Richards JS, et al. Depression after spinal cord injury: comorbidities, mental health service use, and adequacy of treatment. Arch Phys Med Rehabil 2011;92(3):352-360. doi: 10.1016/j.apmr.2010.05.016
  57. Le J, Dorstyn D. Anxiety prevalence following spinal cord injury: a meta-analysis. Spinal Cord 2016;54(8):626. doi: 10.1038/sc.2016.69
  58. Migliorini C, Tonge B, Taleporos G. Spinal cord injury and mental health. Aust N Z J Psychiatry 2008;42(4):309-314. doi: 10.1080/00048670801886080
  59. Ullrich PM, Smith BM, Poggensee L, et al. Pain and post-traumatic stress disorder symptoms during inpatient rehabilitation among operation enduring freedom/operation Iraqi freedom veterans with spinal cord injury. Arch Phys Med Rehabil 2013;94(1):80-85. doi: 10.1016/j.apmr.2012.07.018
  60. Kennedy P, Rogers BA. Anxiety and depression after spinal cord injury: a longitudinal analysis. Arch Phys Med Rehabil 2000;81(7):932-937. doi: 10.1053/apmr.2000.5580
  61. Kennedy P, Evans MJ. Evaluation of post traumatic distress in the first 6 months following SCI. Spinal Cord 2001;39(7):381-386. doi: 10.1038/sj.sc.3101172
  62. Migliorini C, Sinclair A, Brown D, et al. Prevalence of mood disturbance in Australian adults with chronic spinal cord injury. Intern Med J 2015;45(10):1014-1019. doi: 10.1111/imj.12825
  63. Williams R, Murray A. Prevalence of depression after spinal cord injury: a meta-analysis. Arch Phys Med Rehabil 2015;96(1):133-140. doi: 10.1016/j.apmr.2014.08.016
  64. Dryden DM, Saunders LD, Rowe BH, et al. Depression following traumatic spinal cord injury. Neuroepidemiology 2005;25(2):55-61. doi: 10.1159/000086284
  65. Judd FK, Stone J, Webber JE, et al. Depression following spinal cord injury. A prospective in-patient study. Br J Psychiatry 1989;154:668-671. doi: 10.1192/bjp.154.5.668
  66. Craig A, Tran Y, Wijesuriya N, et al. Fatigue and tiredness in people with spinal cord injury. J Psychosom Res 2012;73(3):205-210. doi: 10.1016/j.jpsychores.2012.07.005
  67. Craig AR, Hancock K, Chang E, et al. Immunizing against depression and anxiety after spinal cord injury. Arch Phys Med Rehabil 1998;79(4):375-377.
  68. DeVivo MJ, Black K, Richards JS, et al. Suicide following spinal cord injury. Spinal Cord 1991;29(9):620-627.
  69. Kennedy P, Garmon-Jones L. Self-harm and suicide before and after spinal cord injury: a systematic review. Spinal Cord 2017;55(1):2-7. doi: 10.1038/sc.2016.135
  70. Soden RJ, Walsh J, Middleton JW, et al. Causes of death after spinal cord injury. Spinal Cord 2000;38(10):604-610. doi: 10.1038/sj.sc.3101080
  71. Judd FK, Brown DJ. Suicide following acute traumatic spinal cord injury. Paraplegia 1992;30(3):173-177. doi: 10.1038/sc.1992.50
  72. Stanford RE, Soden R, Bartrop R, et al. Spinal cord and related injuries after attempted suicide: psychiatric diagnosis and long-term follow-up. Spinal Cord 2007;45(6):437-443. doi: 10.1038/sj.sc.3102043
  73. Barat M, Dehail P, de Seze M. Fatigue after spinal cord injury. Ann Readapt Med Phys 2006;49(6):277-282, 365-9. doi: 10.1016/j.annrmp.2006.04.013
  74. Wijesuriya N, Tran Y, Middleton J, et al. Impact of fatigue on the health-related quality of life in persons with spinal cord injury. Arch Phys Med Rehabil 2012;93(2):319-324. doi: 10.1016/j.apmr.2011.09.008
  75. Craig A, Tran Y, Wijesuriya N, et al. A controlled investigation into the psychological determinants of fatigue. Biol Psychol 2006;72(1):78-87. doi: 10.1016/j.biopsycho.2005.07.005
  76. Craig A, Rodrigues D, Tran Y, et al. Daytime sleepiness and its relationships to fatigue and autonomic dysfunction in adults with spinal cord injury. J Psychosom Res 2018;112:90-98. doi: 10.1016/j.jpsychores.2018.07.007
  77. Berlowitz DJ, Spong J, Gordon I, et al. Relationships between objective sleep indices and symptoms in a community sample of people with tetraplegia. Arch Phys Med Rehabil 2012;93(7):1246-1252. doi: 10.1016/j.apmr.2012.02.016
  78. Tate D, Forchheimer M, Maynard F, et al. Predicting depression and psychological distress in persons with spinal cord injury based on indicators of handicap. Am J Phys Med Rehabil 1994;73(3):175-183. doi: 10.1097/00002060-199406000-00006
  79. Heutink M, Post MWM, Bongers-Janssen HMH, et al. The CONECSI trial: results of a randomized controlled trial of a multidisciplinary cognitive behavioral program for coping with chronic neuropathic pain after spinal cord injury. Pain 2012;153(1):120-128. doi: 10.1016/j.pain.2011.09.029
  80. Richards JS, Meredith RL, Nepomuceno C, et al. Psycho-social aspects of chronic pain in spinal cord injury. Pain 1980;8(3):355-366. doi: 10.1016/0304-3959(80)90079-2
  81. Craig A, Tran Y, Guest R, et al. Trajectories of self-efficacy and depressed mood and their relationship in the first 12 months following spinal cord injury. Arch Phys Med Rehabil 2019;100(3):441-447. doi: 10.1016/j.apmr.2018.07.442
  82. Guest R, Craig A, Tran Y, et al. Factors predicting resilience in people with spinal cord injury during transition from inpatient rehabilitation to the community. Spinal Cord 2015;53(9):682-686. doi: 10.1038/sc.2015.32
  83. Vogel LC, Klaas SJ, Lubicky JP, et al. Long-term outcomes and life satisfaction of adults who had pediatric spinal cord injuries. Arch Phys Med Rehabil 1998;79(12):1496-1503. doi: 10.1016/s0003-9993(98)90409-9
  84. Middleton J, Tran Y, Craig A. Relationship between quality of life and self-efficacy in persons with spinal cord injuries. Arch Phys Med Rehabil 2007;88(12):1643-1648. doi: 10.1016/j.apmr.2007.09.001
  85. Craig AR, Hancock K, Chang E. The influence of spinal cord injury on coping styles and self-perceptions two years after the injury. Aust N Z J Psychiatry 1994;28(2):307-312. doi: 10.1080/00048679409075644
  86. Craig AR, Hancock KM, Dickson HG. A longitudinal investigation into anxiety and depression in the first 2 years following a spinal cord injury. Paraplegia 1994;32(10):675-679. doi: 10.1038/sc.1994.109
  87. Gething L, Fethney J, Jonas A, et al. Life after injury: quality of life issues for people with traumatically-acquired brain injury, spinal cord injury and their family carers. Sydney: The University of Sydney; 2002.
  88. Haran MJ, Lee BB, King MT, et al. Health status rated with the Medical Outcomes Study 36-Item Short-Form Health Survey after spinal cord injury. Arch Phys Med Rehabil 2005;86(12):2290-2295. doi: 10.1016/j.apmr.2005.07.293
  89. Atkinson RA, Cullum NA. Interventions for pressure ulcers: a summary of evidence for prevention and treatment. Spinal Cord 2018;56(3):186-198. doi: 10.1038/s41393-017-0054-y
  90. Unalan H, Gençosmanoğlu B, Akgün K, et al. Quality of life of primary caregivers of spinal cord injury survivors living in the community: controlled study with short form-36 questionnaire. Spinal Cord 2001;39(6):318-322. doi: 10.1038/sj.sc.3101163
  91. North NT. The psychological effects of spinal cord injury: a review. Spinal Cord 1999;37(10):671-679. doi: 10.1038/sj.sc.3100913
  92. Hancock K, Craig A, Tennant C, et al. The influence of spinal cord injury on coping styles and self-perceptions: a controlled study. Aust N Z J Psychiatry 1993;27(3):450-456. doi: 10.3109/00048679309075802
  93. Chung MC, Preveza E, Papandreou K, et al. The relationship between posttraumatic stress disorder following spinal cord injury and locus of control. J Affect Disord 2006;93(1-3):229-232. doi: 10.1016/j.jad.2006.02.021
  94. Craig A, Wijesuriya N, Tran Y. The influence of self-efficacy on mood states in people with spinal cord injury. ISRN Rehabilitation 2013;2013.
  95. Kennedy P, Marsh N, Lowe R, et al. A longitudinal analysis of psychological impact and coping strategies following spinal cord injury. Br J Health Psychology 2000;5(2):157-172.
  96. van Diemen T, Crul T, van Nes I, et al. Associations between self-efficacy and secondary health conditions in people living with spinal cord injury: A systematic review and meta-analysis. Arch Phys Med Rehabil 2017;98(12):2566-2577. doi: 10.1016/j.apmr.2017.03.024
  97. Cotter I. Cognitive impairment following SCI: implications for rehabilitation. In Craig A and Tran Y (Eds). Psychological dynamics associated with spinal cord injury rehabilitation: New directions and best evidence. New York. Nova Science Publishers Inc. 2008:175-92
  98. Bradbury CL, Wodchis WP, Mikulis, et al. Traumatic brain injury in patients with traumatic spinal cord injury: clinical and economic consequences. Arch Phys Med Rehabil 2008;89(12 Suppl):S77-84. doi: 10.1016/j.apmr.2008.07.008
  99. Macciocchi S, Seel RT, Warshowsky A, et al. Co-occurring traumatic brain injury and acute spinal cord injury rehabilitation outcomes. Arch Phys Med Rehabil 2012;93(10):1788-1794. doi: 10.1016/j.apmr.2012.01.022
  100. Macciocchi S, Seel RT, Thompson N, et al. Spinal cord injury and co-occurring traumatic brain injury: assessment and incidence. Arch Phys Med Rehabil 2008;89(7):1350-1357. doi: 10.1016/j.apmr.2007.11.055
  101. Sikka S, Vrooman A, Callender L, et al. Inconsistencies with screening for traumatic brain injury in spinal cord injury across the continuum of care. J Spinal Cord Med 2019;42(1):51-56. doi: 10.1080/10790268.2017.1357105
  102. Kushner DS. Strategies to avoid a missed diagnosis of co-occurring concussion in post-acute patients having a spinal cord injury. Neural Regen Res 2015;10(6):859-861. doi: 10.4103/1673-5374.158329
  103. Silverberg ND, Iaccarino MA, Panenka WJ, et al. Management of concussion and mild traumatic brain injury: A synthesis of practice guidelines. Arch Phys Med Rehabil 2020;101(2):382-393. doi: 10.1016/j.apmr.2019.10.179
  104. Molina-Gallego B, Gómez-Cantarino S, Ugarte-Gurrutxaga MI, et al. Neuropsychological study in patients with spinal cord injuries. Healthcare (Basel) 2021;9(3) 241. doi: 10.3390/healthcare9030241
  105. Sandalic D, Craig A, Arora M, et al. A prospective cohort study investigating contributors to mild cognitive impairment in adults with spinal cord injury: study protocol. BMC Neurol 2020;20(1):341. doi: 10.1186/s12883-020-01899-7
  106. Distel DF, Amodeo M, Joshi S, et al. Cognitive dysfunction in persons with chronic spinal cord injuries. Phys Med Rehabil Clin N Am 2020;31(3):345-368. doi: 10.1016/j.pmr.2020.04.001
  107. McDermott LM, Ebmeier KP. A meta-analysis of depression severity and cognitive function. J Affect Disord 2009;119(1-3):1-8. doi: 10.1016/j.jad.2009.04.022
  108. Bloom O, Herman PE, Spungen AM. Systemic inflammation in traumatic spinal cord injury. Exp Neurol 2020;325:113143. doi: 10.1016/j.expneurol.2019.113143
  109. Wu J, Zhao Z, Kumar A, et al. Endoplasmic reticulum stress and disrupted neurogenesis in the brain are associated with cognitive impairment and depressive-like behavior after spinal cord injury. J Neurotrauma 2016;33(21):1919-1935. doi: 10.1089/neu.2015.4348
  110. Krause J. Self-reported problems after spinal cord injury: Implications for rehabilitation practice. Top Spinal Cord Injury Rehabil 2007;12(3):35-44.
  111. Siddall PJ, Cousins MJ. Persistent pain as a disease entity: implications for clinical management. Anesth Analg 2004;99(2):510-520, doi: 10.1213/01.Ane.0000133383.17666.3a
  112. Hunt C, Moman R, Peterson A, et al. Prevalence of chronic pain after spinal cord injury: a systematic review and meta-analysis. Reg Anesth Pain Med 2021;46(4):328-336. doi: 10.1136/rapm-2020-101960
  113. Siddall PJ, Loeser JD. Pain following spinal cord injury. Spinal Cord 2001;39(2):63-73. doi: 10.1038/sj.sc.3101116
  114. Norrbrink Budh C, Hultling C, Lundeberg T. Quality of sleep in individuals with spinal cord injury: a comparison between patients with and without pain. Spinal Cord 2005;43(2):85-95. doi: 10.1038/sj.sc.3101680
  115. Widerström-Noga EG, Duncan R, Felipe-Cuervo E, et al. Assessment of the impact of pain and impairments associated with spinal cord injuries. Arch Phys Med Rehabil 2002;83(3):395-404. doi: 10.1053/apmr.2002.28028
  116. Tang NK, Crane C. Suicidality in chronic pain: a review of the prevalence, risk factors and psychological links. Psychol Med 2006;36(5):575-586. doi: 10.1017/s0033291705006859
  117. Perry KN, Nicholas MK, Middleton JW. Comparison of a pain management program with usual care in a pain management center for people with spinal cord injury-related chronic pain. Clin J Pain 2010;26(3):206-216. doi: 10.1097/AJP.0b013e3181bff8f3
  118. Craig A, Guest R, Tran Y, et al. Pain catastrophizing and negative mood states after spinal cord injury: Transitioning from inpatient rehabilitation into the community. J Pain 2017;18(7):800-810. doi: 10.1016/j.jpain.2017.02.431
  119. Kennedy P, Hasson L. The relationship between pain and mood following spinal cord injury. J Spinal Cord Med 2017;40(3):275-279. doi: 10.1080/10790268.2016.1147680
  120. Widerström-Noga E, Anderson KD, Perez S, et al. Subgroup perspectives on chronic pain and its management after spinal cord injury. J Pain 2018;19(12):1480-490. doi: 10.1016/j.jpain.2018.07.003
  121. Budh CN, Osteråker AL. Life satisfaction in individuals with a spinal cord injury and pain. Clin Rehabil 2007;21(1):89-96. doi: 10.1177/0269215506070313
  122. Shojaei MH, Alavinia SM, Craven BC. Management of obesity after spinal cord injury: a systematic review. J Spinal Cord Med 2017;40(6):783-794. doi: 10.1080/10790268.2017.1370207
  123. Farkas GJ, Gater DR. Neurogenic obesity and systemic inflammation following spinal cord injury: A review. J Spinal Cord Med 2018;41(4):378-387. doi: 10.1080/10790268.2017.1357104
  124. Silveira SL, Winter LL, Clark R, et al. Baseline dietary intake of individuals with spinal cord injury who are overweight or obese. J Acad Nutr Diet 2019;119(2):301-309. doi: 10.1016/j.jand.2018.08.153
  125. Darouiche RO. Infection and spinal cord injury. Spinal cord medicine: principles and practice: Demos, New York 2010:263-269.
  126. Johnson RL, Gerhart KA, McCray J, et al. Secondary conditions following spinal cord injury in a population-based sample. Spinal Cord 1998;36(1):45-50. doi: 10.1038/sj.sc.3100494
  127. Failli V, Kopp MA, Gericke C, et al. Functional neurological recovery after spinal cord injury is impaired in patients with infections. Brain 2012;135(Pt 11):3238-3250. doi: 10.1093/brain/aws267
  128. Kopp MA, Watzlawick R, Martus P, et al. Long-term functional outcome in patients with acquired infections after acute spinal cord injury. Neurology 2017;88(9):892-900. doi: 10.1212/wnl.0000000000003652
  129. Berlowitz DJ, Brown DJ, Campbell DA, et al. A longitudinal evaluation of sleep and breathing in the first year after cervical spinal cord injury. Arch Phys Med Rehabil 2005;86(6):1193-1199. doi: 10.1016/j.apmr.2004.11.033
  130. Epstein LJ, Brown R. Sleep disorders in spinal cord injury. Spinal cord medicine: principles and practice: Demos, New York 2002:169-177.
  131. Jensen MP, Gould EM, Victor TW, et al. The relationship of changes in pain quality to pain interference and sleep quality. J Pain 2010;11(8):782-788. doi: 10.1016/j.jpain.2009.11.009
  132. Craig A, Tran Y, Guest R, et al. Excessive daytime sleepiness in adults with spinal cord injury and associations with pain catastrophizing and pain intensity. Spinal Cord 2020;58(7):831-839. doi: 10.1038/s41393-020-0425-7
  133. Sabharwal S. Cardiovascular dysfunction in spinal cord disorders. Spinal Cord Medicine -Principles and Practice 2010:179-192.
  134. Davidson KW, Rieckmann N, Rapp MA. Definitions and distinctions among depressive syndromes and symptoms: implications for a better understanding of the depression-cardiovascular disease association. Psychosom Med 2005;67 Suppl 1:S6-9. doi: 10.1097/01.psy.0000162257.19266.fc
  135. Grigorean VT, Sandu AM, Popescu M, et al. Cardiac dysfunctions following spinal cord injury. J Med Life 2009;2(2):133-145.
  136. Phillips WT, Kiratli BJ, Sarkarati M, et al. Effect of spinal cord injury on the heart and cardiovascular fitness. Curr Probl Cardiol 1998;23(11):641-716. doi: 10.1016/s0146-2806(98)80003-0
  137. Heinemann AW, Doll MD, Armstrong KJ, et al. Substance use and receipt of treatment by persons with long-term spinal cord injuries. Arch Phys Med Rehabil 1991;72(7):482-487.
  138. Gentilello LM, Rivara FP, Donovan DM, et al. Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. Ann Surg 1999;230(4):473-480; discussion 80-3. doi: 10.1097/00000658-199910000-00003
  139. Kennedy P, Fisher K, Pearson E. Ecological evaluation of a rehabilitative environment for spinal cord injured people: behavioural mapping and feedback. Br J Clin Psychol 1988;27(3):239-246. doi: 10.1111/j.2044-8260.1988.tb00780.x
  140. Marcus CC, Barnes M. Healing gardens: Therapeutic benefits and design recommendations. New York: John Wiley and Sons; 1999.
  141. Anåker A, von Koch L, Sjöstrand C, et al. The physical environment and patients' activities and care: A comparative case study at three newly built stroke units. J Adv Nurs 2018 doi: 10.1111/jan.13690
  142. Horticulture, well-being, and mental health: From intuitions to evidence. XXVI International Horticultural Congress: Expanding roles for horticulture in improving human well-being and life Quality 639; 2002.
  143. Middleton J, Craig A. Psychological challenges in treating persons with spinal cord injury. Psychological dynamics associated with spinal cord injury rehabilitation: New directions and best evidence 2008:3-53.
  144. National Breast Cancer Centre and National Cancer Control Initiative. Clinical practice guidelines for the psychosocial care of adults with cancer [Internet]. Sydney: National Breast Cancer Centre; 2003 [cited July 2023]. Available from: https://www.canceraustralia.gov.au/sites/default/files/publications/pca-1-clinical-practice-guidelines-for-psychosocial-care-of-adults-with-cancer_504af02682bdf.pdf
  145. Mehta S, Orenczuk S, Hansen KT, et al. An evidence-based review of the effectiveness of cognitive behavioral therapy for psychosocial issues post-spinal cord injury. Rehabil Psychol 2011;56(1):15-25. doi: 10.1037/a0022743
  146. Craig AR, Hancock K, Dickson H, et al. Long-term psychological outcomes in spinal cord injured persons: results of a controlled trial using cognitive behavior therapy. Arch Phys Med Rehabil 1997;78(1):33-38. doi: 10.1016/s0003-9993(97)90006-x
  147. Craig A, Hancock K, Chang E, et al. The effectiveness of group psychological intervention in enhancing perceptions of control following spinal cord injury. Aust NZ J Psychiatry 1998;32(1):112-118. doi: 10.3109/00048679809062717
  148. Duchnick JJ, Letsch EA, Curtiss G. Coping effectiveness training during acute rehabilitation of spinal cord injury/dysfunction: a randomized clinical trial. Rehabil Psychol 2009;54(2):123-132. doi: 10.1037/a0015571
  149. Elliott TR, Kennedy P. Treatment of depression following spinal cord injury: an evidence-based review. Rehabil Psychol 2004;49(2):134-139.
  150. Kemp BJ, Kahan JS, Krause JS, et al. Treatment of major depression in individuals with spinal cord injury. J Spinal Cord Med 2004;27(1):22-28. doi: 10.1080/10790268.2004.11753726
  151. Kennedy P, Duff J, Evans M, et al. Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries. Br J Clin Psychol 2003;42(Pt 1):41-52. doi: 10.1348/014466503762842002
  152. Craig A, Guest R, Tran Y, et al. Depressive mood in adults with spinal cord injury as they transition from an inpatient to a community setting: secondary analyses from a clinical trial. Spinal Cord 2017;55(10):926-934. doi: 10.1038/sc.2017.41
  153. Post MW, van Leeuwen CM. Psychosocial issues in spinal cord injury: a review. Spinal Cord 2012;50(5):382-389. doi: 10.1038/sc.2011.182
  154. Kübler-Ross E. On death and dying. United Kingdom: Routledge; 1973. First published 1969.
  155. Buckelew SP, Frank RG, Elliott TR, et al. Adjustment to spinal cord injury: stage theory revisited. Paraplegia 1991;29(2):125-130. doi: 10.1038/sc.1991.17
  156. Kendall E, Buys N. An integrated model of psychosocial adjustment following acquired disability. J Rehabil Med 1998;64:16-20.
  157. Engel GL. The need for a new medical model: a challenge for biomedicine. Science 1977;196(4286):129-136. doi: 10.1126/science.847460
  158. American Association of Spinal Cord Injury Psychologists and Social Workers (AASCIPSW). Standards for psychologists and social workers in SCI rehabilitation. AASCIPSW; 1995. 2nd edition.
  159. Mathew KM, Ravichandran G, May K, et al. The biopsychosocial model and spinal cord injury. Spinal Cord 2001;39(12):644-649. doi: 10.1038/sj.sc.3101233
  160. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer Publishing Company; 1984.
  161. Kielhofner G. A model of human occupation: Theory and application. United States: Lippincott Williams and Wilkins; 2002.
  162. Prochaska JO, Velicer WF, Rossi JS, et al. Stages of change and decisional balance for 12 problem behaviors. Health Psychology 1994;13(1):39.
  163. Shakespeare T, Watson N. Defending the social model. Disabil Soc 1997;12(2):293-300.
  164. Bombardier CH, Rimmele CT. Alcohol use and readiness to change after spinal cord injury. Arch Phys Med Rehabil 1998;79(9):1110-1115. doi: 10.1016/s0003-9993(98)90180-0
  165. Galvin LR, Godfrey HP. The impact of coping on emotional adjustment to spinal cord injury (SCI): review of the literature and application of a stress appraisal and coping formulation. Spinal Cord 2001;39(12):615-627. doi: 10.1038/sj.sc.3101221
  166. Janz NK, Becker MH. The health belief model: a decade later. Health Educ Q 1984;11(1):1-47. doi: 10.1177/109019818401100101
  167. Peter C, Müller R, Post MW, et al. Psychological resources, appraisals, and coping and their relationship to participation in spinal cord injury: a path analysis. Arch Phys Med Rehabil 2014;95(9):1662-1671. doi: 10.1016/j.apmr.2014.04.012
  168. NSW State Spinal Cord Injury Service Psychosocial Strategy (NSSCISPS). Emotional wellbeing toolkit: A clinicians guide to working with spinal cord injury. Sydney: NSW Agency for Clinical Innovation; 2016 [cited June 2023]. Available from: https://aci.health.nsw.gov.au/__data/assets/pdf_file/0005/326435/ACI-Emotional-wellbeing-toolkit-working-spinal-cord-injury.pdf
  169. Walker C, Mawson, E. Peer. Support for Chronic and Complex Conditions. A literature review. Victoria: Chronic Illness Alliance; 2019. Available from: Peer-Support-for-Chronic-and-Complex-Conditions-Lit-Rev-Feb-2019-FINAL.-docx.pdf (chronicillness.org.au)
  170. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 1977;84(2):191-215. doi: 10.1037//0033-295x.84.2.191
  171. Lorig KR, Mazonson PD, Holman HR. Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. Arthritis Rheum 1993;36(4):439-446. doi: 10.1002/art.1780360403
  172. GOV.UK. The expert patient programme – case study [Internet]. United Kingdom: Office of the Regulator of Community Interest Companies; Department for Business, Innovations and Skills; 2013 [cited June 2023]. Available from: https://www.gov.uk/government/case-studies/the-expert-patients-programme
  173. Kennedy P. Keyworker training. Goal planning and the needs assessment checklist (NAC). United Kingdom: National Spinal Injuries Centre, Stoke Mandeville Hospital; 2006.
  174. Duff J. Rehabilitation and goal planning approaches following spinal cord injury: facilitating adjustment. In Craig A and Tran Y (Eds.) Psychological aspects associated with spinal cord injury rehabilitation: new directions and best evidence. New York: Nova Science; 2008.
  175. Flinders Human Behaviour and Health Research Unit. The ‘Flinders Model’ of chronic condition self-management information paper 2006. South Australia: Flinders University [cited June 2023]. Available from: https://www.flindersprogram.com.au/wp-content/uploads/Flinders-Program-Information-Paper.pdf
  176. Kennedy P, Hamilton LR. The needs assessment checklist: a clinical approach to measuring outcome. Spinal Cord 1999;37(2):136-139. doi: 10.1038/sj.sc.3100745
  177. Meares S, Shores EA, Taylor AJ, et al. Validation of the Abbreviated Westmead Post-traumatic Amnesia Scale: a brief measure to identify acute cognitive impairment in mild traumatic brain injury. Brain Inj 2011;25(12):1198-1205. doi: 10.3109/02699052.2011.608213
  178. Loh E, Mirkowski M, Agudelo AR, et al. The CanPain SCI clinical practice guidelines for rehabilitation management of neuropathic pain after spinal cord injury: 2021 update. Spinal Cord 2022;60(6):548-566. doi: 10.1038/s41393-021-00744-z
  179. Siddall PJ, Middleton JW. A proposed algorithm for the management of pain following spinal cord injury. Spinal Cord 2006;44(2):67-77. doi: 10.1038/sj.sc.3101824
  180. Siddall PJ, Middleton JW. Spinal cord injury-induced pain: mechanisms and treatments. Pain Manag 2015;5(6):493-507. doi: 10.2217/pmt.15.47
  181. Nicholson Perry K, Middleton JW, Siddall P, et al. The problem of pain and its management. Psychological aspects associated with spinal cord injury rehabilitation: New Directions and Best Evidence 2009:155-174.
  182. Craig A, Guest R, Siddall P, et al. Pain management of injured persons following a motor vehicle crash. Ch.14, p.307-338. In Craig A and Guest R (Eds.) Adversity after the crash: The physical, psychological and social burden of motor vehicle accidents. New York: Nova Science; 2019.

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