Date Presented 03/22/24

This session will present findings of a preliminary mixed-methods study for videoconferencing acceptance and commitment therapy (ACT) accompanied by psychoeducation in distressed people with spinal cord injury (SCI). Promising findings warrant full-scale trials.

Primary Author and Speaker: Areum Han

Contributing Authors: Hon Yuen, Jereme Wilroy, Jeremy Jenkins

Living with spinal cord injury (SCI) can affect an individual’s mental health negatively and restrict participation in meaningful activities (Kraft & Dorstyn, 2015). However, a few studies of psychological interventions have been done for this population with inconsistent results (Li et al., 2017). Acceptance and commitment therapy (ACT) is an empirically supported approach that can promote mental health and participation in meaningful activities through acceptance and mindfulness processes and behavior change processes for valued living (Hayes et al., 2012). Using a one-group pretest−posttest design with phenomenology, this study aimed to evaluate the feasibility, acceptability, and preliminary effects of 6 weekly videoconferencing ACT sessions with two mini-sessions of psychoeducation in individuals with SCI. The eligibility criteria included at least mild symptoms of psychological distress (Depression, Anxiety and Stress Scale-21). Data using questionnaires and individual interviews was collected at pretest and posttest and analyzing using Wilcoxon signed-rank tests and interpretative phenomenological analysis. Ten people participated in the study. Implementing videoconferencing ACT was feasible and acceptable for distressed individuals with SCI. Statistically significant improvements were found in depression, anxiety, stress, grief, participation in meaningful activities, and self-compassion with medium to large effect sizes. Participants gained a new way of thinking by: being aware of thoughts and emotions; exploring perceptions of others; and focusing on the present. Also, the program equipped participants to deal with challenges by: improving coping with SCI-related conditions; practicing self-compassion, acceptance, and meditation; and acquiring skills of value-based decision making and committed action. This was the first study that investigated ACT for this population in the USA. Future randomized controlled trials are needed for efficacy testing.

References

Hayes, S. C., Pistorello, J., & Levin, M. E. (2012). Acceptance and commitment therapy as a unified model of behavior change. The Counseling Psychologist, 40(7), 976–1002. https://doi.org/10.1177/0011000012460836

Kraft, R., & Dorstyn, D. (2015). Psychosocial correlates of depression following spinal injury: A systematic review. Journal of Spinal Cord Medicine, 38(5), 571–583. https://doi.org/10.1179/2045772314y.0000000295

Li, Y., Bressington, D., & Chien, W. T. (2017). Systematic review of psychosocial interventions for people with spinal cord injury during inpatient rehabilitation: implications for evidence‐based practice. Worldviews on Evidence-Based Nursing, 14(6), 499–506. https://doi.org/10.1111/wvn.12238