Concussion: PDF Worksheet, Tools and Exercises for Clinical Practice

Explaining concussion verbally in a first consultation rarely lands. Patients hear "mild TBI," register the word "mild," and promptly under-report symptoms, or they arrive primed by alarming online content and over-interpret every fluctuation as permanent damage. This concussion PDF worksheet provides a structured visual support you can walk through with the patient in session, replacing unanchored reassurance with a shared, concrete reference.

Why Concussion Psychoeducation Resists Verbal Explanation

The central difficulty is the mismatch between subjective severity and formal classification. "Mild" is a descriptor of injury type, not symptom burden, and patients do not hear it that way. Without a clear frame, the clinician ends up spending the session managing catastrophic appraisals rather than establishing a rehabilitation plan.

Equally challenging is symptom heterogeneity. Dizziness, photosensitivity, irritability, word-finding difficulty, and broken sleep feel to most patients like unrelated problems. Without a coherent map, they misattribute symptoms, which fuels health anxiety about persistent physical complaints and entrenches avoidance patterns. The consultation loses traction fast.

A third sticking point is the non-linear recovery trajectory. Patients interpret a bad afternoon as proof of permanent damage when it is simply a normal feature of post-concussion symptom variance. Getting this across at the oral level, without either minimising the patient's experience or alarming them further, is genuinely hard to do consistently session after session.

What the Fiche Contains: A Visual Map for In-Session Use

The fiche organises its content across six clearly labelled panels, moving logically from mechanism to management.

• Panel 1 establishes the neurophysiological rationale. A concussion is framed as "a working problem": brain cells temporarily use energy differently and pass messages out of sync, with nothing structurally broken. This framing targets catastrophising directly and gives you clinical language the patient can actually hold onto.
• Panel 2 maps the symptom timeline in two columns (first hours and days; days to weeks), including the less-obvious late presentations: irritability, mood lability, word-finding difficulty, and sleep disruption. Seeing these clustered visually normalises what otherwise feels like a constellation of unrelated complaints.
• Panel 3 presents a linear recovery timeline from day 0 to approximately one month, with the explicit note that "a bad afternoon is not a setback", a sentence worth pointing to rather than just saying.
• Panel 4 details a five-step graduated return to activity, from complete rest through to full engagement. Each step is described in plain behavioural terms, and the instruction to pause at any flare is explicitly decoupled from regression or damage.
• Panel 5 covers sleep hygiene, hydration, mood tolerance, and the social environment, including guidance on briefing family members and colleagues. This maps cleanly onto the sleep hygiene worksheet if disrupted sleep is the dominant concern.
• Panel 6 lists specific urgent red flags (worsening headache, repeated vomiting, seizures, new focal weakness) clearly separated from the slower-moving symptoms that warrant a routine follow-up. Patients who can distinguish these two categories present to emergency services less reflexively and to their clinician more reliably.

> Key takeaway: the fiche is a visual support that facilitates in-session explanation of concussion. You walk through it with the patient; they do not complete it independently. The clinical payoff is a shared vocabulary, faster psychoeducation, and a concrete take-home reference that competes with online searching.

When cognitive complaints are prominent, pair the fiche with strategies for memory problems. When mood symptoms dominate alongside physical complaints, it establishes the shared language needed before introducing anxiety psychoeducation tools or screening for emerging depressive features.

When and How to Propose the Fiche

The optimal moment is early: first or second consultation, once the clinical picture is clear and catastrophic appraisals are already visible in the room. For patients referred by a GP or neurologist with no prior psychoeducation, it can anchor the entire initial framing.

A workable introduction: "I'd like to go through something with you that maps exactly what you've been describing. It's not a test; it's a way for us to look at the picture together so you have something reliable to refer to between sessions."

Debrief priorities once you have walked through it together:

• Ask which symptoms in Panel 2 the patient recognises. This normalises presentation, reduces shame around mood and cognitive changes, and supports adaptive coping rather than avoidance.
• Locate the patient on the graduated return ladder (Panel 4): where do they currently sit, and what is the realistic next step?
• Address any residual catastrophic appraisals about the recovery curve directly. Cognitive restructuring tools can layer in from the second or third session once the psychoeducation is consolidated.

For patients with prominent health anxiety, the "working problem, not damage" framing in Panel 1 maps naturally onto a Theory A / Theory B discussion in subsequent sessions. For post-concussion presentations following assault or road traffic accidents, complement the fiche with common reactions to trauma once the acute recovery phase is underway, since PTSD features are frequently missed in the early medical management window.

The fiche does not replace formulation or the therapeutic relationship. It makes the first phase of psychoeducation faster, more consistent, and more likely to produce a patient who paces their own recovery rather than oscillating between collapse and overexertion.

Sources

• McCrory, P., Meeuwisse, W. H., Dvorak, J., Aubry, M., Bailes, J., Broglio, S., Cantu, R. C., et al. (2017). Consensus statement on concussion in sport: the 5th International Conference on Concussion in Sport held in Berlin, October 2016. British Journal of Sports Medicine.
• Centers for Disease Control and Prevention (CDC) (2025). Concussion Basics - HEADS UP. CDC.
• Centers for Disease Control and Prevention (CDC) (2023). Updated Mild Traumatic Brain Injury (mTBI) Management Guideline for Adults. CDC.