| The Biopsychosocial Model should guide SCI rehabilitation, as it integrates biological, psychological and social dimensions of physical and mental health outcomes, and it has been successfully applied previously to SCI care.29,30 |
| Adjustment is a continuing non-linear cyclical process and can therefore be unpredictable and complex.31,32 |
| An overarching goal of SCI rehabilitation is to establish optimal independence for each individual person.33,34 |
| Psychosocial care should be regarded as the core business of all those involved in SCI care, and that adjustment should not be the sole responsibility of the person with SCI, but a combined effort of family, friends, the rehabilitation team, work, and so on.31,32 |
| Peer involvement and support should be standard feature in rehabilitation, that is, encouraging the use of peers as role models and mentors, as well as for sources of support.33,35 |
| A tiered approach to provision of services is necessary, that is, training in self-management strategies should be regarded as a core requirement for effective rehabilitation. However, more intensive and specialist interventions, as well as case management/more assertive approaches, may be required for complex cases and those at risk of poor outcomes. |
| Individuals with SCI should have uncomplicated access to mainstream specialized psychosocial services, such as treatment for substance abuse, chronic pain or traumatic brain injury, as well as mental health disorders. |
| Enhancement of relevant skills of staff working in mainstream areas is therefore required, including health professionals working in private practice and in rural and remote areas. |
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