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Psychological Support in Rehabilitation

Original Editor - Ewa Jaraczewska based on the course by Arthur Pearce
Top Contributors - Ewa Jaraczewska, Jess Bell and Kim Jackson

Introduction

Many people experience a range of emotional responses to injury or illness. These responses can significantly impact a person's engagement with treatment, their progress, and outcomes. Understanding these responses enables healthcare professionals to provide comprehensive, empathetic care. Being able to recognise psychological barriers and facilitators to rehabilitation engagement helps healthcare professionals create effective therapeutic relationships and support patients through potentially challenging rehabilitation journeys. These positive relationships can improve rehabilitation outcomes and quality of life.

This article introduces common psychological responses to trauma or illness and explores how rehabilitation professionals can provide psychological support. It also highlights specific psychological interventions that can benefit patients navigating changes in their life situation.

Psychological Impact of Rehabilitation

Rehabilitation is "a set of interventions designed to optimise functioning and reduce disability in individuals with health conditions in interactions with their environment".[1]

The World Health Organization's (WHO) definition of rehabilitation "reflects a holistic approach that addresses not only (....) physical impairments, but also the psychological challenges that patients may face".[2]

Providing psychological care and support is essential in all rehabilitation settings.[3] Rehabilitation interventions vary and depend on an individual's psychological response to disability or injury. Therapeutic interventions should focus on enhancing well-being by considering personal and environmental factors and addressing impairments, limitations, and restrictions in mobility, activities of daily living, communication, and cognition.

Common Psychological Responses to Disability or Injury

"Many individuals, maybe even most individuals, experience a range of emotional responses following an injury or diagnosis that results in them being in a rehabilitation setting." -- Dr. Arthur Pearce[2]

The emotional impact of an injury or illness can vary greatly from person to person.[2] Adjusting to a new situation or change in function can be challenging.[2] Patients may experience a range of emotions, from disbelief to exhaustion, confusion, sadness, anxiety, agitation, numbness, dissociation, frustration, anger etc.[4] For some people, these emotions can develop into more complex, long-term issues like depression, anxiety, post-traumatic stress disorder, sleep deprivation or memory issues.

Depression

"Depressive disorder (also known as depression) is a common mental disorder. It involves a depressed mood or loss of pleasure or interest in activities for long periods."[5]

Depression is common in individuals who have sustained severe injuries. Depression can reduce motivation, which impacts a person's engagement in therapy. Consequently, it is linked to poorer outcomes and reduced quality of life.[2]

Condition-specific examples:

  • around 43% of individuals with traumatic brain injury are diagnosed with major depressive disorder, and those diagnosed tend to experience poorer overall outcomes[6]
  • post-stroke depression, which can manifest at any time during the stroke recovery process, affects 30-33% of stroke survivors[7]
  • people with spinal cord injury experience symptoms of depression and may have adverse psychosocial outcomes for up to 10 years post-injury[8]

Low Mood

"Low mood typically refers to a temporary state of feeling down or unmotivated, which can occur in response to life events or stress that all of us experience."[2]

It is common for individuals to experience periods of low mood especially if they are coping with physical symptoms or setbacks in rehabilitation. This is particularly common after life-altering health events that have long-term impacts.

Anxiety

"Anxiety is an emotion characterised by feelings of tension, worried thoughts, and physical changes like increased blood pressure."[9]

Anxiety is another common mental health challenge.[10] Anxiety can have many manifestations, including an excessive worry about the future, and in rehabilitation settings, an excessive fear of re-injury.[2] Anxiety can negatively affect quality of life. People with anxiety may find it difficult to focus and their anxiety may make their pain feel worse.

Condition-specific examples:

  • anxiety symptoms persist for at least one year in one-third of survivors of critical illness[11]
  • anxiety diagnoses and symptoms are most common in individuals with traumatic brain injury two to five years post-injury[12]

Post-Traumatic Stress Disorder

"Post-traumatic stress disorder (PTSD) is a psychiatric disorder caused by experiencing or witnessing traumatic or potentially life-threatening events, that has grown in prevalence due to global conflicts, natural disasters, and domestic violence."[13]

Patients recovering from sudden or life-threatening events may develop post-traumatic stress disorder. There is also evidence linking PTSD to major aging-related diseases.[14] Symptoms include flashbacks, avoidance, becoming excessively alert, and memory issues. These can negatively affect progress in rehabilitation as emotional distress may inhibit engagement in therapy. PTSD significantly impacts daily life and must be addressed by appropriately trained healthcare professionals.[13]

For more information on factors that influence psychological responses after a traumatic injury or illness, please see: Stress Response Following Serious Injury or Illness: A Biopsychosocial Approach.

Sleep Deprivation

Adequate sleep is crucial for cognitive function, emotional regulation, physical recovery, and overall well-being. Sleep deprivation can increase pain, affect decision-making, and increase a person's risk of depression and anxiety. There is a bidirectional relationship between sleep and emotional well-being or mental health; poor sleep can worsen mental health, and poor mental health can worsen sleep.[15] Sleep is, therefore, an important consideration in health and rehabilitation settings.

Condition-specific examples:

  • critically ill patients often experience disrupted sleep patterns during their illness and after being discharged from hospital[16]
  • sleep disturbances are common in individuals participating in cardiac rehabilitation, and it can significantly impact their quality of life and potentially lead to depression[17]
  • there is a correlation between sleep deficits or insomnia and increased incidence of depression and anxiety in individuals with spinal cord or traumatic brain injuries[17]

Memory Issues

Stress can affect a person's capacity to process and recall information. The release of cortisol, which is triggered by stress, directly affects the brain structures responsible for memory encoding, storage, retrieval, and emotional processes.[18] Memory issues are significant in rehabilitation where the recall of information is important.[2]

The Role of Healthcare Professionals in Supporting a Person's Mental Health

Healthcare providers play a pivotal role in supporting their patients' mental health. Depending on their scope of practice, they may be involved in: (1) assessing psychological factors, (2) acknowledging the sense of loss experienced by a patient, (3) implementing psychological interventions to address psychological factors, (4) providing emotional support throughout the rehabilitation process, and (5) educating families and others involved in the patient's care.[2]

The following sections discuss the role of healthcare professionals in supporting mental health challenges patients may face as a result of disability or injury.

1. Assessing Psychological Factors

A comprehensive psychological assessment is crucial for evaluating a person's mental health. Psychological factors to look out for include: disengagement, distress, eating and sleep issues, and, in severe cases, self-harm. Practitioners must understand their scope of practice and refer to specialists when needed.[2]

When considering rehabilitation specifically, it is important to identify the psychological and emotional aspects of a patient's pain experience. It is also important to recognise the impact of pain catastrophising, self-efficacy, resilience, locus of control, depression, and anxiety on a person's well-being.

Current diagnostic methodologies, treatments, and healthcare systems can all influence which clinical scales are used in assessment and treatment planning.[19] The following assessment tools can be used in clinical practice to identify mental health challenges.[2]

The PHQ-9 (Patient Health Questionnaire-9) screens for depression. A score of 5–9 indicates mild depression, 10–14 indicates moderate depression, 15–19 indicates moderately severe depression, and 20 or above suggests severe depression.

The GAD-7 (Generalised Anxiety Disorder-7) is used to assess anxiety. A score of 5–9 indicates mild anxiety, 10–14 indicates moderate anxiety, and 15 or above suggests severe anxiety.

The IES-R (Impact of Events Scale-Revised) measures symptoms of post-traumatic stress. A score of 24–32 indicates mild PTSD symptoms, 33–38 suggests moderate symptoms and 39 or above indicates severe PTSD symptoms and likely clinical concern.

2. Acknowledging a Person's Sense of Loss and Providing Supporting

A healthcare practitioner must acknowledge the profound sense of loss patients can experience when they navigate changes in function or feel a loss of identity. Healthcare professionals should understand and support patients throughout their rehabilitation journey. Soft skills, such as active listening, reflecting back, asking questions, and showing empathy, enable healthcare professionals to support a patient's physical and emotional needs during recovery.[2]

Active Listening

"In healthcare, (active) listening is essential to mutual engagement and other relational outcomes that mobilise the client towards pursuing goals."[20]

Active listening requires the listener to give the person speaking their full attention. The listener must be present and show an interest. This can be achieved by focusing on the person speaking, making eye contact, nodding, smiling, and avoiding interruptions.[2]

Reflecting Back

When we reflect back, we paraphrase what the patient has said, repeating the main points of the patient's statement in a shortened form, using some of their own words.[21] An example of reflecting back could be as follows: "It sounds like you are feeling a lack of motivation because you do not think you will be able to use your arm ever again, even with the work we are doing." Reflecting back shows the patient that they have been heard and understood. It also allows healthcare professionals to check their understanding, ensuring they have correctly interpreted the patient's concerns.[2]

Asking Questions

Encouraging patients to share more by gently asking questions can help them challenge negative thoughts about their care and promote involvement in their rehabilitation. For instance, asking patients about their progress or what they have found most difficult can provide valuable insights for a healthcare provider.[2]

Showing Empathy

"Empathy in patient care involves acknowledging and validating [the patient's] emotions, fostering a collaborative relationship."[22]

Empathy can be achieved by actively listening to the patient's concerns and demonstrating understanding before offering information or guidance.[22] By recognising the importance of questions asked by the patient and providing respectful answers, healthcare professionals can show empathy and build a strong foundation for patient engagement and motivation. This patient-centred approach ensures that individuals feel supported and empowered throughout their healthcare journey.[22]

If you would like to learn about the six steps of empathic communication, please see: Using Empathy in Communication.

3. Implementing Interventions to Support Patients' Psychological Functions

The following sections highlight a range of general and specialised interventions that can be beneficial in rehabilitation settings.

When supporting a patient's psychological needs, always remember that healthcare professionals must work within their scope of practice. If a patient is experiencing challenges that are beyond your scope of practice and area of expertise, you must refer them to a specialist.[2]

General Interventions

Healthcare professionals can make adjustments to a patient's environment to improve patient comfort and sleep quality. In inpatient settings, healthcare professionals can change a patient's bedding, adjust the lighting in the room and control noise levels.[2] Establishing a consistent sleep schedule and a relaxing bedtime routine is also crucial for sleep quality.

Offering extra encouragement can empower and support patients. Encouraging small, achievable steps, validating patients' feelings, promoting self-compassion, being patient and showing understanding can build confidence, reduce negativity, and maintain patient engagement in therapy.

Healthcare professionals can teach patients simple relaxation techniques, such as deep breathing and progressive muscle relaxation to help patients relax and manage stress.

Specialised Psychological Interventions

There are a range of specialised psychological interventions that can benefit rehabilitation patients. These interventions require specific training. Patients with significant psychological challenges must be assessed by trained mental health professionals.

Cognitive behavioural therapy (CBT ) is a common treatment for a range of mental health conditions. It is effective for reducing pain catastrophising, enhancing self-efficacy, promoting an internal locus of control (see below), and managing sleep disorders. CBT helps a person address and change negative thoughts and behaviours, reduce emotional distress and improve coping. Specific forms of CBT target different types of issues.

This optional video shows a brief interaction between a patient with depression and a therapist using CBT:

[23]


Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that can help individuals manage difficult thoughts and feelings following life-altering injuries or accidents. This is significant as these thoughts can negatively affect rehabilitation progress. ACT consists of six core aspects, as illustrated in the hexaflex model below (see Figure 1).[24]

Figure 1. Six Core Processes of ACT. From: What is ACT? The Hexaflex Model and Principles Explained.

The following optional video explains the six core processes of ACT:

[25]

4. Providing Emotional Support

Providing emotional support to patients throughout the rehabilitation process is essential, particularly for patients with mental health challenges, such as low mood and pain catastrophising. Healthcare providers should offer tailored support using active listening to improve therapeutic outcomes.

In order to provide this individualised support, they must be aware of the psychological barriers and facilitators that are impacting their patient's engagement with rehabilitation.

Barriers in rehabilitation can include pain catastrophising and the impact of trauma. Facilitators can include self-efficacy, resilience and an internal locus of control.

Pain Catastrophising

Pain catastrophising is "an exaggerated negative mental set brought to bear during actual or anticipated pain experience”[26] or an “exaggerated threat appraisal of one’s symptoms”.[27]

Pain catastrophising is characterised by an exaggeration of and inability to manage pain-related thoughts. It is associated with feelings of helplessness and patients often predict or anticipate negative outcomes. High levels of pain catastrophising are associated with increased pain intensity, emotional distress, and disability.[2]

The Pain Catastrophizing Scale is a widely used instrument for measuring catastrophic thinking related to pain.[28]

Impact of Trauma

Psychological trauma, especially adverse childhood experiences (ACEs), significantly impacts rehabilitation. A trauma-informed approach to care is vital as it emphasises safety and trust. It promotes active listening and recognises the effects of trauma. Healthcare professionals must be aware that physical touch can trigger responses in trauma survivors. Therefore, obtaining informed consent, ensuring patient autonomy, being sensitive to gender dynamics, and understanding dynamic trauma responses are essential. Asking about a person's trauma history can help healthcare professionals provide better care, but it is not yet a standard practice in rehabilitation.[2]

If you would like to read more, please see: Trauma-Informed Care.

Self-Efficacy

"Self-efficacy refers to an individual's belief in their capacity to execute behaviours necessary to produce specific, performance attainments or goals."[2]

People with high self-efficacy are more likely to engage in rehabilitation and achieve better outcomes. Both positive and negative early life experiences can shape self-efficacy.

Condition-specific examples:

  • individuals post-stroke with high self-efficacy tend to be more confident when performing daily activities, are more able to overcome obstacles, and have improved psychosocial function and overall well-being compared to those with lower self-efficacy[29]
  • higher self-efficacy is associated with better pain management, reduced disability, and improved rehabilitation outcomes in people with chronic pain[30]
Resilience

"Resilience is the ability to adapt positively in the face of adversity."[2]

Various factors contribute to a person's resilience, including their previous mental health difficulties, life experiences and adverse childhood experiences.[2] Individuals with higher levels of resilience tend to cope better with stressors, such as injury, illness and rehabilitation. They tend to exhibit lower levels of depression and anxiety, which leads to improved rehabilitation outcomes. Resilience has been associated with an increased ability to adapt and adjust in individuals with serious injuries, illness or multiple comorbidities.[31][32][33]

If you would like to learn more, please see: Resilience in Health.

Locus of Control

"Locus of control refers to an individual's belief about the extent to which they can control events affecting them."

Individuals with an internal locus of control believe they can control their health outcomes, leading to improved pain management and rehabilitation. They understand that their recovery is primarily their responsibility.[2]

Individuals with an external locus of control feel that external factors dictate their health. They may not fully understand the essential role they play in their recovery and may depend on healthcare professionals to achieve their rehabilitation goals.[2]

5. Educating Patient and Family

Patient and family education that focuses on managing the psychological and emotional difficulties that may arise during rehabilitation can be beneficial. By offering guidance and support, healthcare providers can help patients and their families navigate the challenges associated with rehabilitation and achieve positive outcomes.

Patient education should emphasise social connections and help a person reframe negative thoughts. Maintaining relationships and engaging in support groups is important. Patients should receive education on lifestyle factors, such as having regular meals, engaging in physical activity, getting enough sleep, and avoiding unhealthy substances. Asking patients to identify and objectively evaluate negative thoughts through journaling can also provide valuable psychological support.[2]

Healthcare professionals should also help caregivers understand that low mood is not a sign of weakness and that recovery from illness or injury is a gradual process. Caregivers need to learn to offer support without over-helping to foster independence. Acknowledging small wins while monitoring for serious mental health issues is key. Caregivers must also learn to prioritise their emotional health and seek help when needed.[2]

Red Flags for Serious Mental Health Concerns

All healthcare professionals need to recognise when patients are displaying signs of extreme distress and when increased support is needed. These warning signs can include:[2]

  • expressions of hopelessness
  • persistent refusal to engage in therapy
  • frequent emotional outbursts or complete withdrawal from rehabilitation
  • feeling guilty without a clear cause
  • spending a lot of time worrying
  • sleeping too much or too little
  • having changes in appetite
  • isolating from people or activities
  • experiencing fatigue
  • experiencing new, unexplained pain

If a patient refuses to engage in rehabilitation, rehabilitation professionals should consider the possibility of underlying psychological factors and refer them to a psychologist.[2]

Individuals with physical disabilities are at higher risk of suicide. Depression is the most common mental health diagnosis in suicide deaths.[34] Prompt referral for psychological support is crucial when rehabilitation patients express suicidal thoughts. Collaborating with mental health services ensures comprehensive and continuous support.[2]

The SAFE-T (Suicide Assessment Five-step Evaluation and Triage) framework provides a supportive, systematic, and safety-focused approach to managing suicide risk in rehabilitation settings. It includes five steps to evaluate and triage suicide risk. These are:

  1. Identification of risk factors
  2. Identification of protective factors
  3. Conducting a suicide inquiry
  4. Determining risk level/intervention
  5. Documenting[35]

If you want to see this framework, please see: SAFE-T: SuicideAssessment Five-step Evaluation and Triage.


Resources

References

  1. ↑ Rehabilitation. World Health Organization. Geneva 2024. Available from https://www.who.int/news-room/fact-sheets/detail/rehabilitation [last access 4.4.2025]
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 Pearce A. Psychological Support in Rehabilitation Course. Plus, 2025.
  3. ↑ Mills T., Marks E, Reynolds T, et al. Rehabilitation: Essential along the Continuum of Care. In: Jamison DT, Gelband H, Horton S, et al., editors. Disease Control Priorities: Improving Health and Reducing Poverty. 3rd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Nov 27. Chapter 15. Available from https://www.ncbi.nlm.nih.gov/books/NBK525298/ [last access 5.4.2025]
  4. ↑ Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma. Available from https://www.ncbi.nlm.nih.gov/books/NBK207191/ [last access 5.4.2025]
  5. ↑ Depressive disorder (depression). World Health Organization. Geneva. 2023. Available from https://www.who.int/news-room/fact-sheets/detail/depression [last access 5.4.2025]
  6. ↑ Carmichael J, Ponsford J, Gould KR, Spitz G. Characterizing depression after traumatic brain injury using a symptom-oriented approach. J Affect Disord. 2024 Jan 15;345:455-466.
  7. ↑ Arshad A, Shaikh AR, Ali SH, Shaikh UA, Bibi SK, Noor U, Wajahat K, Laique F, Umar M, Giri B. Ischemic stroke and post-stroke depression: the role of agomelatine. Exploration of Drug Science. 2025 Feb 25;3:100890.
  8. ↑ Kraft R, Dorstyn D. Psychosocial correlates of depression following spinal injury: A systematic review. J Spinal Cord Med. 2015 Sep;38(5):571-83.
  9. ↑ Anxiety. American Psychological Association. Available from https://www.apa.org/topics/anxiety [last access 5.4.2025]
  10. ↑ Chand SP, Marwaha R. Anxiety. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470361/
  11. ↑ Nikayin S, Rabiee A, Hashem MD, Huang M, Bienvenu OJ, Turnbull AE, Needham DM. Anxiety symptoms in survivors of critical illness: a systematic review and meta-analysis. Gen Hosp Psychiatry. 2016 Nov-Dec;43:23-29.
  12. ↑ Dehbozorgi M, Maghsoudi MR, Mohammadi I, Firouzabadi SR, Mohammaditabar M, Oraee S, Aarabi A, Goodarzi M, Shafiee A, Bakhtiyari M. Incidence of anxiety after traumatic brain injury: a systematic review and meta-analysis. BMC Neurol. 2024 Aug 22;24(1):293.
  13. ↑ 13.0 13.1 Verma A, Malik P, Panghal P. Unravelling the Cause and Consequences of Post Traumatic Stress Disorder: A Comprehensive Review. International Journal for Multidisciplinary Research (IJFMR).2024; 6(4).
  14. ↑ Sobczak S, Orgeta V, Beenakker M, Boks M, Boltri M, Cations M, Coeur E, Cook JM, Corveleyn X, Dorame A-N, van Dijk GC, Forresi B, Fréel S, Gómez-Bautista D, Günak MM, Havermans DCD, Hopwood M, Jiaqing O, Lawrence KA, Lee LO, Maercker A, Marsman A, Olivé I, Quaedflieg CWEM, Ruisch J, Thorp SR, Woudsma JS, Zabihi S, Olff M, on behalf of the Global Collaboration on Traumatic Stress. Post-traumatic stress disorder in older adults: a global collaboration on setting the future research agenda. Lancet Healthy Longev 2025.
  15. ↑ Nowakowski S, Kokonda M, Sultana R, Duong BB, Nagy SE, Zaidan MF, Baig MM, Grigg BV, Seashore J, Deer RR. Association between Sleep Quality and Mental Health among Patients at a Post-COVID-19 Recovery Clinic. Brain Sci. 2022 Apr 30;12(5):586.
  16. ↑ Georgopoulos D, Kondili E, Gerardy B, Alexopoulou C, Bolaki M, Younes M. Sleep Architecture Patterns in Critically Ill Patients and Survivors of Critical Illness: A Retrospective Study. Ann Am Thorac Soc. 2023 Nov;20(11):1624-1632.
  17. ↑ 17.0 17.1 Saravanan K, Downey L, Sawyer A, Jackson ML, Berlowitz DJ, Graco M. Understanding the Relationships Between Sleep Quality and Depression and Anxiety in Neurotrauma: A Scoping Review. J Neurotrauma. 2024 Jan;41(1-2):13-31.
  18. ↑ Klier C, Buratto LG. Stress and long-term memory retrieval: a systematic review. Trends Psychiatry Psychother. 2020 Jul-Sep;42(3):284-291.
  19. ↑ Khandaker S, Chow D, Mafiah M. Psychological Factors Affecting Physical Disorders Part 1: Evaluation and Differential Diagnosis. Available from https://now.aapmr.org/psychological-factors-affecting-physical-disorders-part-1/ [last access 7.4.2025]
  20. ↑ King G. Central yet overlooked: engaged and person-centred listening in rehabilitation and healthcare conversations. Disabil Rehabil. 2022 Dec;44(24):7664-7676.
  21. ↑ Communicate effectively with patients to enhance recovery. Available from https://us.humankinetics.com/blogs/excerpt/communicate-effectively-with-patients-to-enhance-recovery? [last access 7.4.2025]
  22. ↑ 22.0 22.1 22.2 Piussi R, Ivarsson A, Johnson U, Senorski EH. Psychological factors in sports injury rehabilitation: how can a sports rehabilitation practitioner facilitate communication?. JOSPT Open. 2024 Jan;2(1):1-3.
  23. ↑ PsychotherapyNet. Cognitive Behavioral Therapy for Depression Video. Available from: http://www.youtube.com/watch?GrV3dR-_BVw [last accessed 8/4/2025]
  24. ↑ Schultz J. What Is ACT? The Hexaflex Model and Principles Explained. 2021. Available from https://positivepsychology.com/act-model/ [last access 7.4.2025]
  25. ↑ The Zen Social Worker. The 6 Core Processes of ACT Explained | What They Mean and How to Use Them. Available from: http://www.youtube.com/watch?TPvLEZFa14o [last accessed 8/4/2025]
  26. ↑ Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, Lefebvre JC. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001 Mar;17(1):52-64.
  27. ↑ Sullivan MJL, Tripp DA. Pain Catastrophizing: Controversies, Misconceptions and Future Directions. J Pain. 2024 Mar;25(3):575-587.
  28. ↑ Sullivan MJ, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychological assessment. 1995 Dec;7(4):524.
  29. ↑ Gangwani R, Cain A, Collins A, Cassidy JM. Leveraging Factors of Self-Efficacy and Motivation to Optimize Stroke Recovery. Front Neurol. 2022 Feb 24;13:823202.
  30. ↑ Martinez-Calderon J, Zamora-Campos C, Navarro-Ledesma S, Luque-Suarez A. The role of self-efficacy on the prognosis of chronic musculoskeletal pain: a systematic review. J Pain. 2018 Jan;19(1):10-34.
  31. ↑ Neils-Strunjas J, Paul D, Clark AN, Mudar R, Duff MC, Waldron-Perrine B, Bechtold KT. Role of resilience in the rehabilitation of adults with acquired brain injury. Brain Injury. 2017 Jan 28;31(2):131-9.
  32. ↑ Kornhaber R, Mclean L, Betihavas V, Cleary M. Resilience and the rehabilitation of adult spinal cord injury survivors: a qualitative systematic review. Journal of Advanced Nursing. 2018 Jan;74(1):23-33.
  33. ↑ Rebagliati GA, Sciumé L, Iannello P, Mottini A, Antonietti A, Caserta VA, Gattoronchieri V, Panella L, Callegari C. Frailty and resilience in an older population. The role of resilience during rehabilitation after orthopedic surgery in geriatric patients with multiple comorbidities. Functional Neurology. 2016 Sep 28;31(3):171.
  34. ↑ Lundin Å, Bergenheim A. Encountering suicide in primary healthcare rehabilitation: the experiences of physiotherapists. BMC psychiatry. 2020 Dec;20:1-3.
  35. ↑ SAFE-T. Suicide Assessment 5-Step Evaluation and Triage. Available from https://adaa.org/sites/default/files/SMA09-4432.pdf {last access 24.04.2025]
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