**13. Psychological management of the patient with SCI**

Psychological management after SCI is essential for the patient in order to return to activities of daily living. After an injury, there are many psychological stages in the readjustment process: shock and denial, depression, anxiety, anger, negotiation, and adaptation.

Psychological rehabilitation should start in the intensive care unit because the patient can experience disorientation, depression, anxiety, and sensory and sleep deprivation.

Psychotherapy groups are helpful to provide emotional support, educate in the development of new skills, and minimize social aversion. Similarly, family psychotherapy groups make it easier for the family to adjust to the new situation since similar emotional reactions also occur in them [74].
