Spinal cord injury (SCI) results in autonomic, motor, and sensory impairments that can compromise mental health. Guidelines directing the management of mental health following SCI presently address clinical anxiety, depression, post-traumatic stress, substance use disorders, and suicide. However, evidence suggests that perhaps as many as 70% of individuals with SCI do not develop a clinically diagnosable mental health disorder. Therefore, the authors contend that understanding non-clinical cognitive and psychological aspects of adjustment post-SCI is paramount and that the application of this knowledge to the formulation of adjustment-enhancing interventions is crucial. To assist with this endeavour, we examine existing mental health guidelines targeting SCI, and present a narrative review of research on the under-represented topics of adjustment, coping, grief, and resilience. We include mild cognitive impairment, which reflects a common factor that can compromise adjustment. Loss and stress trigger processes of adjustment, coping, grief, and resilience. SCI involves loss and stress triggering these processes, arguably without exception. Our study applied a narrative review methodology searching Google Scholar and PsychInfo databases for terms adjustment, coping, grief, resilience, and cognitive impairment. Qualitative studies and quantitative studies were selected to capture bottom-up and top-down perspectives. Reference lists of retrieved papers were searched as appropriate. Reviewed literature suggested that existing guidelines concerning mental health following SCI neglect positive processes of adjustment and suggest this neglect contributes to a deficits-based view of mental health following SCI. Research into “positive” or adjustment-enhancing processes is mostly cross-sectional, heterogenous, and poorly positioned to inform future guideline-development. Researchers should achieve consensus over the operationalisation of essential processes and overcome a fixation with “outcomes” to better inform management of mental health after SCI.

This study explored the impact of a brief spiritual care training program upon the perceptions and self-reported practice of rehabilitation professionals working in traumatic injury. A qualitative ...

There is limited literature comparing the clinical and employment characteristics of clients accessing new employment with those resuming previous employment. To address this gap, a multi-centre observational study was conducted of all active clients with severe TBI from the 11 community rehabilitation services (n = 588) of the New South Wales Brain Injury Rehabilitation Program. Demographic, injury, clinical and vocational data were collected by treating clinicians employing a purpose-designed protocol. New employment constituted almost 40% of competitive employment outcomes. Clients accessing new employment were significantly more likely to be younger, single, less educated, with more severe injuries and more likely to be displaying challenging behaviours than those resuming pre-injury work. Kaplan-Meier analyses found time to RTW was significantly longer for new employment. Stability of new employment was significantly poorer with jobs twice as likely to break down compared to previous employment. New employment positions were also more likely to be part-time and unskilled compared to previous employment. The results found that placement into new employment made a substantial contribution to employment outcomes after TBI but requires more intensive and tailored programmes to meet the multiple clinical and workplace challenges.

Resilience contributes to positive adaptation after many health conditions, but little is known about its contribution to long-term recovery after stroke. This study investigated the lived experien...

People with traumatic brain injury (TBI) have an increased risk of suicide, suicide attempts and suicide ideation compared with the general population. Most suicide deaths and attempts involve self‐...

Numbers of traumatic brain injury (TBI) are increasing, and with suicidality post-injury presenting at 3–4 times higher than in the general population, understanding this is crucial in reducing a d...