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).


METHODS
Randomized controlled trial.


METHODS
Spinal injuries unit of a rehabilitation center.


METHODS
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.


METHODS
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.


METHODS
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.
South Australian Spinal Cord Injury Service, Hampstead Rehabilitation Centre, Northfield, South Australia, Australia. diana.dorstyn@adelaide.edu.au
Diana
D
Dorstyn
Jane
J
Mathias
Linley
L
Denson
Marie
M
Robertson
D000223:Adaptation, Psychological; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control*; D003376:Counseling / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology*; D013689:Telephone