title: An evidence-based review of the effectiveness of cognitive behavioral therapy for psychosocial issues post-spinal cord injury.
abstract: METHODS
  Systematic review.
  
  
  OBJECTIVE
  To examine the evidence supporting the effectiveness of cognitive behavioral therapy (CBT) for improving psychosocial outcomes in individuals with spinal cord injury (SCI).
  
  
  METHODS
  Electronic databases (MEDLINE, CINAHL, EMBASE, and PsycINFO) were searched for studies published between 1990 and October 2010. Randomized control trials (RCTs) and nonrandomized control trials (non-RCTs) utilizing a CBT intervention to improve psychosocial outcomes (depressive symptomatology, anxiety, coping, and adjustment to disability) in outpatient persons with SCI were included for review. Levels of evidence were assigned to each study using a modified Sackett scale. Effect size calculations for the interventions were provided where possible.
  
  
  RESULTS
  Nine studies met the inclusion criteria. The studies reviewed included two RCTs, six prospective controlled trials (PCTs) and one cohort study. All studies examined at least two groups. There is Level 1 and Level 2 evidence supporting the use of specialized CBT protocols in persons with SCI for improving outcomes related to depression, anxiety, adjustment, and coping.
  
  
  CONCLUSIONS
  CBT holds promise as an effective approach for persons with SCI experiencing depression, anxiety, adjustment, and coping problems. As CBT may involve many different components, it is important in the future to determine which of these elements alone or in combination is most effective in treating the emotional consequences of SCI.
authors.affiliation: Aging, Rehabilitation and Geriatric Care Program, Lawson Health Research Institute and St. Joseph’s Health Care, Parkwood Hospital, London, Ontario, Canada.
authors.forename: Swati
authors.initials: S
authors.lastname: Mehta
authors.forename: Steven
authors.initials: S
authors.lastname: Orenczuk
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Hansen
authors.forename: Jo-Anne L
authors.initials: JA
authors.lastname: Aubut
authors.forename: Sander L
authors.initials: SL
authors.lastname: Hitzig
authors.forename: Matthew
authors.initials: M
authors.lastname: Legassic
authors.forename: Robert W
authors.initials: RW
authors.lastname: Teasell
mesh_terms: D000223:Adaptation, Psychological; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D018849:Controlled Clinical Trials as Topic; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D019317:Evidence-Based Medicine; D006801:Humans; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D013119:Spinal Cord Injuries / Q000523:psychology* / Q000534:rehabilitation*; D016896:Treatment Outcome