Coping Effectiveness Training for people with spinal cord injury: Preliminary results of a controlled trial

Objectives. To develop and evaluate a brief group-based psychological inter vention for improving psychological adjustment and enhancing adaptive copin g following spinal cord injury. The Coping Effectiveness Training (CET) pro gramme is grounded on the cognitive theory of stress and coping of Lazarus & Folkman (1984), and represents an original adaptation of the theory to th e needs of this client group. Design. A controlled trial comparing patients receiving the CET interventio n to matched controls in measures:of psychological adjustment and coping wa s used. Methods. Nineteen intervention group participants and 19 matched controls w ere selected from in-patients at a;hospital-based spinal injury rehabilitat ion centre. Outcome measures of depression, anxiety and coping were collect ed before, immediately after and six weeks after the intervention. Results. Intervention group participants showed significantly greater reduc tions in levels of depression (P < .01) and anxiety (P < .05) compared to m atched controls immediately after the intervention and at six weeks follow- up. There was no evidence of a significantly greater change in the coping s trategies used by the intervention group. Participants highlighted their in teractions with other group members as the most helpful aspect of the inter vention. Conclusions. This evidence suggests that the CET intervention facilitated a significant improvement in psychological adjustment to spinal cord injury. It is proposed this may be understood in terms of changes in participants' appraisal of the implications of spinal cord injury and of the coping skil ls needed to continue living meaningful and satisfying lives.