Individuals with spinal cord injury (SCI) experience several physical and psychosocial difficulties after injury. Research shows that about 17% to 24% of individuals may experience major depressive episode and 13% to 40% of individuals may experience anxiety and related disorders. For such individuals, access to cognitive behavioral therapy (CBT) is crucial.
CBT helps to identify and manage thoughts and feelings related to anxiety and depression. Despite its benefits, there are many barriers preventing CBT access such as stigma, lack of transportation, financial barriers such as lack of funding.
To address these barriers, internet-delivered CBT (iCBT) offers a promising solution. By providing therapy through online platforms, iCBT allows individuals to receive treatment from home, overcoming many traditional obstacles. In this blog post, we will explore the impact of iCBT on individuals with SCI, highlighting its benefits, challenges, and the potential it holds for improving mental health outcomes in this population.
What is internet delivered cognitive behavioral therapy (iCBT)?
iCBT is a form of psychological treatment in which an internet operated device such as a computer or smartphone is used to deliver CBT to individuals without face-to-face access. Utilizing the core principles of CBT, iCBT provides online educational materials and interactive exercises, such as recording maladaptive thoughts or practicing relaxation techniques, for individuals to complete in their own time. Individuals also can check in with a therapist in person.
Why use iCBT?
Research shows that iCBT enables patients to better understand their illness, leading to improved patient functioning and knowledge about their condition. It helps to manage stress levels and improve cognition, resulting in a better quality of life.
Drawbacks of traditional therapy include high costs, transportation barriers, and lack of follow up, especially in a younger or low socioeconomic population. In the context of SCI, individuals who already deal with significant physical limitations, often compounded by pain or negative mood, may lack the energy to commit to in-person CBT appointments. In such cases, iCBT is invaluable.
Additionally, iCBT has been used to treat various psychological disorders, including depression, anxiety, and PTSD, in a diverse range of patients, such as those with spinal cord injuries, stroke, diabetes, and chronic pain.
iCBT and SCI
iCBT for individuals with spinal cord injury has a plethora of benefits. Such benefits include, but are not limited to:
Accessibility: SCI can limit mobility and access to transportation hindering individual ability to attend in-person sessions. iCBT allows individuals the independence to access high-quality psychosocial support from home.
Flexibility: The flexible nature of the treatment accommodates for varying pain levels, fatigue, and other challenges common among individuals with SCI. This way, participants can efficiently access therapy materials at a convenient time.
Guided support: iCBT programs consist of regular contact with therapist via email or phone, providing a sense of support and accountability, and helping to alleviate feelings of isolation.
Tailored approach: iCBT programs can be tailored to the unique needs of the individual with SCI, providing specific resources that tailor to their emotional and psychological needs.
Some challenges related to iCBT
Technical issues: technical challenges such as connectivity issues, website glitches or software problems may interrupt the therapy session.
Self-motivation and engagement: iCBT is primarily self-directed and relies on self-motivated individuals to complete assignments and progress through the program without the accountability of in-person sessions. If participants do not feel motivated or connected to the program, it may lead to dropouts.
Limited accessibility: Though iCBT is designed with the purpose of therapy equity and accessibility, individuals who are not comfortable with technology may continue to fall though the gap.
Scope: iCBT may not be suitable for individuals with complex psychiatric conditions that require close monitoring and in-person interventions.
With the advent of widespread internet access over the past ten years, ICBT is a relatively new therapy. Yet already, the research looks promising. In a time where healthcare access is a nation-wide crisis, iCBT with its far-reaching net can address a wide range of psychological conditions.
References
Kumar, V., Sattar, Y., Bseiso, A., Khan, S., & Rutkofsky, I. H. (2017). The effectiveness of internet-based cognitive behavioral therapy in treatment of psychiatric disorders. Cureus. https://doi.org/10.7759/cureus.1626
Mehta, S., Hadjistavropoulos, H. D., Earis, D., Titov, N., & Dear, B. F. (2019). Patient perspectives of internet-delivered cognitive behavior therapy for psychosocial issues post spinal cord injury. Rehabilitation Psychology, 64(3), 351–359. https://doi.org/10.1037/rep0000276
Image by Freepik