The overarching purposes of this research were to (a) explore an under-acknowledged and under-emphasized aspect of the sport-related concussion experience: psychosocial factors of the injury experience and (b) identify possible intervention opportunities to support the associated psychological and social needs. A collaborative inquiry (Bray et al., 2000) was employed to generate data on the psychosocial experience of concussions in elite sport and to co-develop support strategies from a sport psychology lens. This qualitative research project involved three phases during which psychological and social needs, as well as psychosocial factors that facilitated and/or hindered the concussion recovery process, were discussed through two lenses. The first lens was an experiential one, whereby elite athletes who became concussed as a result of their sport engagement shared their experiences (Phase A). The second lens was that of professional expertise, whereby mental performance consultants who work in elite sport and deliver psychosocial support to concussed elite athletes shared their perspectives and clients’ experiences (Phase B). Following the sharing of these perspectives, a community of practice (Wenger et al., 2002) of mental performance consultants was formed to collaboratively discuss how mental performance consultants might be able to support the aforementioned psychological and social needs, and ultimately, concussion recovery (Phase C). Phase A. Ten elite athletes (as defined by Swann et al., 2015) participated in semi-structured focus groups (Smith & Sparkes, 2016). Athletes discussed their experiences of injury, challenges, facilitators and barriers to recovery, support mechanisms, support that was lacking but desired, and what they would do to help someone else with a concussion. The transcripts from these focus groups (n = 5, M = 58.1 min, Range: 46-88 min), follow-up questions, and informal conversations were analyzed using thematic narrative analysis (Smith, 2016), contributing to an understanding of the athletes’ lived experiences. Phase B. Nine mental performance consultants from the Canadian Sport Psychology Association and/or Association for Applied Sport Psychology who were working in high-performance sport participated in three focus groups (M = 79 min, Range = 66-98 min). Mental performance consultants were asked about their time in the field and other aspects of their consulting experience (e.g., sports, integrated within teams or not), the types of interventions they have done with concussed athletes, their perceptions of psychosocial support during the phases of concussion management, and challenges to effective service delivery. Verbatim transcripts of these focus groups were sent to the consultants and member reflections were requested (Smith & McGannon, 2018). The generated data were thematically analyzed using a six-phase cyclical and iterative approach (Braun et al., 2016). Phase C. Eight mental performance consultants from various sport contexts formed a community of practice (Wenger et al., 2002; E. Wenger-Trayner & Wenger-Trayner, 2021). The group met over a period of four months (n = 8 meetings, M = 80 min, Range = 60-90 min). These meetings were intended to address the identified interests of the members of the community regarding support for concussed elite athletes. Concussion symptomatology, management efforts, and research were discussed; and professional scope of practice and intervention opportunities were explored through best practice discussions, client case studies, and engagements with two external experts. Mental performance consultants completed individual reflections (i.e., weekly reflective questions, value creation stories, personal value narratives; Wenger et al., 2011; E. Wenger-Trayner & Wenger-Trayner, 2015) resulting in 34 single-spaced pages of generated data, which were analyzed using the Value Creation Framework (E. Wenger-Trayner & Wenger-Trayner, 2015; 2021). The results of this multi-phase collaborative inquiry are presented in four articles. The first article offers a multi-systems perspective (Bronfenbrenner, 1977; 1979; 1992) on athletes’ concussion experiences by exploring two collaboratively created narratives (Wertz, 2011; Willis, 2019) from the engagements with athletes in Phase A. Five themes (i.e., athletic identity, (dis)trust in relationships, concussion protocols, sport culture, and timing related to major events and recovery) are discussed. The second article combines the perspectives of athletes from Phase A and mental performance consultants in Phase B to identify psychological and social needs across the concussion recovery process. Four psychological needs (i.e., acceptance, normality, confidence, self-efficacy) and two social needs (i.e., trust in relationships, social support) were identified by both populations. The third article was collaboratively written to practically present how and where mental performance consultants can support concussed athletes across the phases of the injury based on the discussions in Phase C. Scope of practice, collaboration opportunities, and intervention strategies are discussed across four phases of injury (i.e., pre-injury, injury onset, rehabilitation, return to sport). The fourth article reflects the mental performance consultants’ participatory experiences in Phase C by exploring the value of the community of practice as a professional development and knowledge translation tool. Positive value was experienced across all eight cycles of the Value Creation Framework. Through the general discussion and practical implications sections of this dissertation, these results are situated within the landscapes of concussion research and practice to highlight opportunities for transforming concussion protocols and broadening the overall lens through which the concussion experience can be examined.

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Concussion affects the adolescent population in large numbers, primarily because of the popularity of team sports that are played in middle and high school. This adolescent age group is more susceptible to the adverse effects of concussion due to physiological immaturity, and recovery for this population takes longer than in adults. Speech-language pathologists, who are trained to treat cognitive-communication deficits, are present in the majority of school systems throughout the United States, and could be a useful resource to manage and treat students who incur concussion. However, speech-language pathologists historically have not treated students with concussion, and may not be receiving adequate education regarding concussion in graduate programs. This study sought to ascertain the education, training, and experience regarding concussion of speech-language pathologists in Texas secondary schools. Anonymous survey responses were collected via an Internet survey platform, yielding 49 respondents for the final data pool. The answers provided by these respondents indicate Texas speech-language pathologists are not yet receiving adequate concussion education and training. Respondents reported low confidence levels in several key areas of concussion knowledge, and doubt regarding the speech-language pathologist's role in managing concussion. Recommendations include concussion-targeted graduate school curriculum as an extension of traumatic brain injury curriculum, increased continuing education efforts by ASHA regarding concussion and the speech-language pathologist's role in treating concussion, and further advocacy by ASHA for speech-language pathologists to be part of concussion management teams based in schools. / text