A Scoping Review of Systemic Assessment for Clients Presenting in Adults with Traumatic Brain Injuries: Integrating Biopsychosocial and Family Systems Perspectives

The complexity of traumatic brain injury (TBI) requires coordination across professional disciplines and across stages of recovery. Further, the multidimensional consequences of TBI demand an appraisal method that extends beyond neurological and physical impairment. In spite of the recognition that TBI affects interconnected biological, psychological, social, functional and family domains, it remains unclear how these domains are brought together during assessment. This scoping review maps and synthesises the existing evidence on assessment across biological, cognitive, psychological, social, functional, family, caregiver and relational domains; establishes the extent of family and inter-disciplinary involvement; and determines integration gaps. The review was conducted within the context of adult TBI care and rehabilitation. A total of 26 publications were included in the study. The inclusion criteria was articles based on primary research and published between January 2000 to September 2026 involving adults with TBI, The studies selected were published in English language. The search strategy involved a systematic, comprehensive search of PubMed/MEDLINE, Europe PubMed Central, and Director of Open Access Journals (DOAJ). Thematic analysis was then utilized to identify common categories and patterns across the extracted information, undertaking narrative content analysis to categorize the information. The results reveal a strong convergence toward viewing TBI as a condition with consequences extending beyond the injured individual to the family and wider social environment. A second point of convergence relates to the nexus between functional, social, psychological, and family outcomes. However, few studies provided evidence relevant to integrated or systemic assessment, particularly by demonstrating relationships among patient functioning, caregiver/family psychosocial characteristics, family functioning, community participation, and rehabilitation outcomes. The most salient gap identified in the present review is the fragmentation of assessment across individual, family, and social domains. The key integration gap for future research is the absence of a fully integrated biopsychosocial-family systems model. A coneptual integration of systemic TBI assesment is proposed

Integration, Family Systems, Traumatic Brain Injury

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