While personal emotional problems relating to relationships have recently been acknowledged in the literature as an important component in the clinical course of compensable injury, there are few guidelines on how to detect them. Four broad questions have been suggested to guide the practitioner in clinical practice, and examples are given to illustrate the influence of the setting in which the injury occurred, the meaning of the injury for the patient, the possible influence of transference and counter-transference factors, and the importance of concurrent family problems. It is suggested that by addressing these questions, the clinician with no special knowledge of psychiatry will be better placed to determine whether psychological factors may be significant, and whether psychiatric referral is indicated.