This is the heart of it—the grey expanse where effort and limitation tangle. A patient’s course hinges on so much: the depth of their brain injury (a mild concussion vs. a severe stroke), their grit before the injury, their support network, and when we reach them.

Focusing only on behaviour may not fully account for the factors driving patient actions. Struggles often arise not from lack of effort but from a framework that does not align with psychological and practical realities. Clinicians might explore a broader approach that integrates habits and heuristics to support environments where sustainable change can develop.