Objective To examine the criteria used to assess psychological readiness to return-to-sport following concussion to support graduated stepwise recommendations.

Design Scoping review.

Setting MEDLINE, Embase, PsycINFO, SPORTDiscus, CINAHL were searched using database-specific MeSH terms and keywords. Reference lists were manually searched.

Participants Eligibility criteria included original publications describing psychological factors related to return-to-sport (at any level) following a diagnosed concussion. PRISMA-ScR guidelines were followed; two independent reviewers selected studies, extracted data, and assessed evidence level using Oxford Centre for Evidence-Based Medicine (OCEBM).

Outcome Measures Scale or measure employed (quantitative studies) and/or key thematic concepts (qualitative studies) related to psychological readiness to return-to-sport.

Main Results Of 1469 studies, 2 quantitative cohort studies (OCEBM level-3) representing 112 athletes (71% male; high-school and collegiate collision/contact athletes) and 2 qualitative studies representing 45 athletes (89% male; 89% football players; aged 9–25 years) were included. Quantitative assessments included the Tampa Scale of Kinesiophobia modified for concussion and a single-item Likert scale question each for fear of reinjury and fear of return-to-sport. Main qualitative themes included fear of replacement or letting down the team, stigma, knowledge of consequences, social support, and peer pressure as influential.

Conclusions Despite recommendations to assess psychological readiness to return-to-sport following concussion, there is insufficient evidence upon which to make clinical decisions. Future research should identify key concepts and themes using qualitative studies, with subsequent development and validation of a concussion-specific outcome measure to identify athletes who might benefit from psychological intervention to resume sporting activities.