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Project

Internet-delivered cognitive behavioural therapy for persons with spinal cord injury: Randomized con

Funder: Craig H Neilsen Foundation

Funding period
USD 386 K
Funding amount
Abstract
Background: Psychological distress and pain are common secondary health conditions experienced by individuals with SCI. Over 37% of individuals with SCI expressed a need for emotional counselling; of these, only 43% felt that these needs were met. These results are discouraging as individuals with SCI who have more social and emotional support and greater access to services in their community tend to report fewer secondary health conditions. As several barriers exist for service delivery from both the providers’ and the users’ perspectives, there is a great need for cost effective solutions to improve long term outcomes among the SCI population in the community. Guided internet-delivered CBT (ICBT) offers an alternative approach for psychosocial service delivery in the community. Evidence for the effectiveness of ICBT has been reported in various health conditions. Objective: The primary objective of this study is to explore the efficacy of internet-delivered cognitive behaviour therapy (ICBT) course in reducing psychological distress and improve coping and quality of life among persons with spinal cord injury (SCI) compared to information only control group. The secondary objective is to examine barriers and facilitators to implementing ICBT in routine setting.Methods: The proposed two-arm randomized controlled trial will compare the efficacy of an ICBT program to information only among individuals with SCI across Canada through the Online Therapy Unit website (www.onlinetherapyuser.ca). Participants in the intervention group will receive an ICBT course delivered over 8-12 weeks and consisting of 5 modules. A trained guide will contact study participants by email or telephone weekly to address questions and provide encouragement in completing the self-study activities. Participants in the control group will receive weekly online information sheets regarding management of SCI. Participants will complete comprehensive self-report questionnaires consisting of demographic and injury-related questionnaires, as well as questionnaires relating to the primary outcome of depression; and secondary outcomes of anxiety, pain, quality of life, and service usage questionnaire. Outcomes will be assessed prior to treatment, post-treatment, and at 3- month follow-up. Treatment satisfaction and therapeutic alliance will be assessed post-treatment.Data Analysis: Generalized estimating equations will be used to examine significant effects of time, group, and time by group in the primary and secondary outcomes at post-treatment and 3-month follow-up. In order to determine the magnitude of the treatment effects, a Cohen’s d will be calculated. The two groups will be compared on percentage of improvement on primary outcomes, remission of depressive/anxiety symptoms (PHQ-9 and GAD-7 scores below 10), and recovery (50% reduction in symptoms). Conclusion: The study will provide access to health care service to SCI individuals with potential barriers to receiving standard treatment. This in turn may help to reduce health care costs and improve quality of life among the SCI population. (CHN: PSR chn:wdg)
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System

Categories
  • FOR (ANZSRC)

    1117 Public Health and Health Services

  • FOR (ANZSRC)

    1701 Psychology

  • RCDC

    Injury (total) Accidents/Adverse Effects

  • RCDC

    Injury - Trauma - (Head and Spine)

  • RCDC

    Mental Health

  • RCDC

    Neurosciences

  • RCDC

    Pain Research

  • RCDC

    Pain Conditions - Chronic

  • RCDC

    Depression

  • RCDC

    Health Services

  • RCDC

    Mind and Body

  • RCDC

    Rehabilitation

  • RCDC

    Spinal Cord Injury

  • RCDC

    Behavioral and Social Science

  • RCDC

    Clinical Research

  • RCDC

    Clinical Trials and Supportive Activities

  • RCDC

    Comparative Effectiveness Research

  • RCDC

    Neurodegenerative

  • HRCS HC

    Mental Health

  • HRCS RAC

    6.6 Psychological and behavioural

  • HRCS RAC

    7.1 Individual care needs

  • Health Research Areas

    Clinical

  • Broad Research Areas

    Public Health