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Nicole L. Williams, Psy.D., is a 2025 graduate of the Psy.D. Program in Clinical Psychology at Antioch University, New England.

Dissertation Committee:

  • Monique Bowen, PhD, Chairperson
  • Rachel Chickarella, PhD, Committee Member
  • Shannon Jackson, PsyD, MSEd, Committee Member

Headshot of Dr. Nicole Williams, PsyD

Dr. Nicole L. Williams

Keywords

fear of reinjury, sport, trauma, distress reaction, psychological techniques, physical rehabilitation

Document Type

Dissertation

Publication Date

2025

Abstract

Musculoskeletal injuries and recovery from them play a vital role in both the physical and psychological wellbeing of the public. Existing research has been conducted primarily within the athlete population with rehabilitation from these injuries having a profound impact on the physical and mental health. One of the most frequent psychological responses related to sports injuries is a trauma response, which has been shown to hinder the rehabilitation process and to increase the likelihood for reinjury upon return to play. Embedded within the many inputs to trauma responses to these injuries are psychological distress reactions, in particular fear connected to concern about reinjury. Few techniques utilized to assist athletes specifically address the fear of reinjury response—the most common distress response. Researchers have found that addressing the psychological aspects potentially shortens the required amount of recovery time and increases performance upon returning to play. The current study is a systematic review of psychological techniques used during the rehabilitation phase, exploring those that have been shown to be effective and of applicable and specific use in addressing the fear of reinjury component. Following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), data from 14 studies was assessed for quality using the Methodological Index for Non-randomized Studies (MINORS) criteria. In this review, the mean MINORS assessment score for non-comparative studies was 9 out of 16, and 19 out of 24 for comparative studies. Results showed that imagery, goal setting, and social support were three of the most widely-utilized psychological techniques during the rehabilitation phase from musculoskeletal injuries. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu).

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ORCID No.: 0009-0009-8962-1746

Dr. Nicole Williams, wearing clear framed glasses

Nikki Williams, PsyD

Presentations and Publications:

2017: Antioch University New England, Keene, NH – Defining Trauma and Resilience Trauma Informed Approaches in Schools and Their Impact on Juvenile Delinquency

2016: Community Mental Health Affiliates, New Britain, CT - DBT University What The Heck Is A Dialectic? [Presented with Dr. Charles Atkins, MD]

2016: Community Mental Health Affiliates, New Britain, CT - DBT University How and What Skills [Presented with Elizabeth Smith, LCSW]

2014: Inter-Disciplinary.net, Montreal, CA - Persons and Sexualities Conference Sadomasochism: The Fine Line Publication (2014 Inter-Disciplinary.net online journal)

2012: Saint Joseph College, West Hartford, CT - 2012 Symposium Day Child Abuse Lingers into Adulthood

2011: Saint Joseph College, West Hartford, CT - 2011 Symposium Day Howard Hughes, A Lifetime Sufferer with Obsessive Compulsive Disorder and His Contributions to Society

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