Four empirical studies investigated ICF-based participation trajectories and influencing contextual factors in outpatient neurorehabilitation in Austria and Germany. A rasch analysis of the DASS-21 was conducted to investigate a screening instrument targeting depressiveness as an influencing contextual factor in outpatient neurorehabilitation. The first study exploratively assessed participation-related outcome quality in four outpatient rehabilitation facilities in Vorarlberg, Austria. Improvement in the course of rehabilitation was shown. Due to a strong heterogeneity of the Austrian treatment concepts a comparison with German facilities was not feasible. In German outpatient neurological rehabilitation facilities, study 2 showed some improvements in participation during the course of rehabilitation, even though some participants showed no change or even reduced participation. Both “gender” and “net income” were identified as influencing contextual factors, although the influence of the factor “gender” requires further research. Study 3 showed that particularly low level of Depression Scores in the end of rehabilitation increased the probability of improved participation. Furthermore, there was no significant difference between initial Depression Scores of individuals with improved participation and individuals with reduced participation in the beginning of rehabilitation. As the majority of participants did not meet the full criteria of clinically significant depression, ...