Telepsychology Intervention for Individuals with Spinal Cord Injury and Depression
Abstract
Rationale / Objectives This clinical trial will test the effectiveness of tele-psychology in treating persons with spinal cord injury (SCI) and depression in the early period after injury. Depression among individuals with SCI is the most common psychological condition following an injury; 22% of civilians with SCI and 28% of Veterans with SCI experience depression after injury, which is higher than in the able-bodied population. Individuals with SCI face many barriers in receiving psychotherapy, such as lack of accessible transportation, unfamiliarity with community resources, difficulty scheduling an appointment with an SCI specialist, or stigma associated with seeking treatment for depression, which this project aims to address. Cognitive behavioral therapy (CBT), which helps people develop different ways of thinking and behaving to reduce their psychological distress, will be provided via iPad FaceTime application by a psychologist with expertise in working with persons with SCI. The proposed clinical trial aims to reduce depressive symptoms, to decrease associated symptoms of anxiety and to improve satisfaction with life through providing CBT via tele-psychology to individuals with SCI. Both short-term (following CBT treatment) and intermediate (3 months after CBT treatment) measures of depression, anxiety, and satisfaction with life will be used to assess the effectiveness of the tele-psychology intervention. Impact CBT via iPad FaceTime is expected to be a convenient and effective treatment for depression after SCI with short-term (14 weeks post-discharge) and intermediate (26 weeks post-discharge) benefits. This project would impact individuals with SCI, post-discharge from acute rehabilitation, through the provision of an innovative treatment for depression, easing the transition back to their home and community. Furthermore, CBT treatment will be provided in the comfort and privacy of the participant s home, therefore combating stigma, as well as physical and transportation-associated barriers. CBT via FaceTime does pose a potential confidentiality risk, but measures have been put in place to minimize this risk (i.e., private office for the psychologist and a private room at home for the participant, and secure data servers). Prior studies have shown a beneficial effect of CBT provided with tele-psychology among other populations. Telemedicine is rapidly advancing within the field of medicine; however, its impact on persons with SCI and the use of tele-psychology are not yet widespread. This proposed clinical trial can start to close this gap and determine whether CBT via iPad reduces depressive symptoms, reduces anxiety symptoms, and increases quality of life (as measured by satisfaction with life) as well as assess if tele-psychology is an effective and replicable method for providing psychological care. With evidence from this clinical trial elucidating the effectiveness of tele-psychology utilizing rapidly advancing technology, tele-psychology for individuals with SCI may become as usual and routine as in-person psychological treatment within several years. Contribution This project provides an innovative approach to treating depression and an exciting opportunity to understand the treatment effects of our proposed tele-psychological intervention for individuals with SCI. CBT treatment provided via iPad FaceTime tele-psychology for depression is a novel approach that can easily be disseminated to other SCI centers and community hospitals. Hence, medical teams will have an alternative option to consider during the discharge planning stages of rehabilitation and during their transition to home.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1810254
Entities
People
- Kazuko Shem
Organizations
- Santa Clara Valley Medical Center
- United States Army