Abstract
Dorstyn D, Mathias J, Denson L, Robertson M. Effectiveness of telephone counseling
in managing psychological outcomes after spinal cord injury: a preliminary study.
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
(SCI).
Design
Randomized controlled trial.
Setting
Spinal injuries unit of a rehabilitation center.
Participants
Adults (N=40) 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
in order to help assist them in adjusting to their disability. Referral to the inpatient
psychology service was therefore a key indicator of participants' baseline distress
levels and, consequently, their need for counseling support postdischarge.
Intervention
Seven telecounseling sessions were delivered over a 12-week period by a single psychologist
(D.D.). Pre- and postintervention data, plus a 3-month follow-up assessment, were
compared with that of an SCI control group who received standard care.
Main Outcome Measures
Psychosocial outcome was measured using the following: Depression Anxiety Stress Scale-21;
Mini International Neuropsychiatric Interview; Spinal Cord Lesion Emotional Wellbeing
and Coping Strategies Questionnaires; and the 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 postintervention. However, these treatment gains
were not statistically significant. Additionally, treatment effects were minimal at
3-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.
Key Words
List of Abbreviations:
ANOVA (analysis of variance), DASS-21 (Depression Anxiety Stress Scale-21), DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition), MDSS (Multidimensional Measure of Social Support), MINI (Mini International Neuropsychiatric Interview), SCI (spinal cord injury), SCL CSQ (Spinal Cord Lesion Coping Strategies Questionnaire), SCL EWQ (Spinal Cord Lesion Emotional Wellbeing Questionnaire)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 15, 2012
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
In-press corrected proof published online on Jul 28, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
