Citation

Dorstyn D, Mathias J, Denson L, Robertson T. Arch. Phys. Med. Rehabil. 2012; 93(11): 2100-2108.

Affiliation

South Australian Spinal Cord Injury Service, Hampstead Rehabilitation Centre, Northfield, South Australia, Australia; School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.apmr.2012.06.002

PMID

22705237

Abstract

OBJECTIVE: To determine whether an individualized counseling intervention delivered by telephone - telecounseling - feasibly improves the emotional adjustment of adults with a newly acquired spinal cord injury. DESIGN: Randomized controlled trial. SETTING: Hampstead Rehabilitation Centre, Spinal Injuries Unit, South Australia, Australia PARTICIPANTS: Forty adults aged 18 or older who were recently discharged home from inpatient spinal rehabilitation were randomly assigned to a telecounseling Treatment or standard-care Control group. All participants had recently received psychological treatment as inpatients, to assist them adjust to their disability. Referral to the inpatient psychology service was therefore a key indicator of participants' baseline distress levels and, consequently, their need for counselling support post-discharge. INTERVENTION: Seven telephone counseling sessions were delivered over a 12-week period by a single psychologist (first author, DD). Pre- and post-intervention data, plus a three month follow-up assessment, were compared to that of a SCI Control group who received standard care. MAIN OUTCOME MEASURES: Psychosocial outcome was measured using: the Depression, Anxiety and Stress Scales; MINI International Neuropsychiatric Interview; Spinal Cord Lesion Emotional Well-being and Coping Strategies Questionnaires; and Multidimensional Measure of Social Support. Cost effectiveness and clinical feasibility were also evaluated. RESULTS: Telecounseling participants reported clinical improvements in depression and anxiety and aspects of SCI coping immediately post-intervention. However these treatment gains were not statistically significant. Additionally, treatment effects were minimal at the three month follow-up. Delivery related outcomes, including participation rate and cost analyses, were all positive. CONCLUSIONS: The results suggest that continued psychological services for individuals reporting distress during their inpatient rehabilitation is important and that such services can be delivered by telephone cost-effectively and efficiently. However, the long-term benefits of telecounseling, once ceased, were not demonstrated.

Language: en