Ar. Craig et al., LONG-TERM PSYCHOLOGICAL OUTCOMES IN SPINAL-CORD INJURED PERSONS - RESULTS OF A CONTROLLED TRIAL USING COGNITIVE-BEHAVIOR THERAPY, Archives of physical medicine and rehabilitation, 78(1), 1997, pp. 33-38
Objective: Although there are many anecdotal reports that psychologica
l intervention is effective in enhancing adjustment to spinal cord inj
ury (SCI), there are little data to support this assertion. To date, r
eports of few longitudinal-based controlled trials that assessed psych
ological outcomes for SCI persons have been published. This study was
conducted to determine long-term efficacy of cognitive behavior therap
y during rehabilitation. Design: The study employed a nonrandomized co
ntrolled trial, and measures were taken on three occasions: before, im
mediately after, and 12 months after treatment. Setting, Outcome Measu
res, and Intervention: Anxiety, depressive mood, and self-esteem were
assessed in 28 SCI persons consecutively selected on admission to hosp
ital, who participated in specialized group cognitive behavior therapy
(CBT) during rehabilitation. Controls: The intervention group's respo
nses on the measures were compared with a control group of 41 SCI pers
ons who only received traditional rehabilitation services during their
hospitalization. Results: There were no overall group differences on
anxiety, depressive mood, and self-esteem, although there was a trend
for the treatment group to have greater levels of improvement in depre
ssion scores across time in comparison to the control group. However,
those in the treatment group who reported high levels of depressive mo
od before the CBT treatment were significantly less depressed 1 year a
fter injury, compared to similar persons in the control group. Conclus
ions: While it appears not everyone who experiences SCI needs CBT, at
least in the hospital phase of their rehabilitation, those who report
high levels of depressive mood benefited greatly from CBT. (C) 1997 by
the American Congress of Rehabilitation Medicine and the American Aca
demy of Physical Medicine and Rehabilitation