Telepsychology for Individuals With Spinal Cord Injury: Protocol for a Randomized Control Study of Video-Based Cognitive Behavioral Therapy

Top Spinal Cord Inj Rehabil. 2022 Fall;28(4):56-67. doi: 10.46292/sci22-00010. Epub 2022 Nov 15.

Abstract

Background: A substantial proportion of individuals with spinal cord injury (SCI) experience depression, which has been negatively associated with recovery and community participation after injury. Despite significant barriers to seeking and receiving in-person mental health care, little research has focused on the efficacy of telepsychology among individuals with SCI.

Objectives: To describe the design and implementation of an ongoing single-center, randomized controlled, video-based cognitive behavioral therapy (CBT) intervention among individuals with SCI.

Methods: Participants within 1 year of SCI will be randomized 1:1 to intervention or usual care in a 24-week study. Intervention participants will engage in 10 sessions of CBT over 12 weeks with a licensed clinical psychologist, using iPads via Apple FaceTime. Primary outcomes are depressive symptomatology, anxiety, and life satisfaction (as measured by the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and Satisfaction with Life Scale, respectively) measured at three time points (baseline, 12 weeks, and 24 weeks). These and other measures are also assessed during monthly telephone surveys conducted between primary timepoints.

Results: Recruitment is ongoing. Forty-six participants have been enrolled thus far.

Conclusion: Telepsychology is a convenient, flexible, and effective alternative to traditional in-person services. We anticipate that intervention participants will experience improvements in depressive and anxiety symptoms and will have greater life satisfaction. Telepsychology interventions among individuals with SCI are tasked to maintain participant privacy, provide assistive technology and/or engage caregivers to minimize mobility limitations, and manage risk remotely. Challenges encountered include recruitment during the COVID-19 pandemic. Early intervention on symptoms of psychological morbidity using telepsychology may facilitate greater adaptation following SCI.

Keywords: cognitive behavioral therapy; evidence-based psychotherapy; mHealth; mobile health technology; spinal cord injury; telemedicine.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • COVID-19*
  • Cognitive Behavioral Therapy*
  • Humans
  • Pandemics
  • Randomized Controlled Trials as Topic
  • Self-Help Devices*
  • Spinal Cord Injuries*

Grants and funding

Financial Support This work was supported by the Assistant Secretary of Defense for Health Affairs and endorsed by the Department of Defense through the SCIRP (under award # W81XWH-17-SCIRP-CTA to Dr. Kazuko Shem; clinical trials registration - NCT03711760). Opinions, interpretations, conclusions, and recommendations are those of the author(s) and are not necessarily endorsed by the U.S. Department of Defense.