Patient Perspectives of Internet-Delivered Cognitive Behavior Therapy for Psychosocial Issues Post Spinal Cord Injury

Purpose: Many individuals with a spinal cord injury (SCI) report significant symptoms of depression and/or anxiety post-SCI; however, access to mental health services can be limited. The purpose of this study was to evaluate patient perspectives on the acceptability of an 8-week guided Internet-delivered cognitive behavior therapy (ICBT) course (Chronic Conditions Course) for people with SCI. In particular, we sought to understand patient perceptions of facilitators and barriers of engaging in ICBT and strengths and weaknesses of ICBT program content. Method: Semistructured interviews were conducted with 8 SCI patients after completion of the ICBT course. The interviews were audio-recorded, transcribed verbatim, and examined by means of thematic analysis by 2 coders. Results: Eight participants (mean age = 53.2 years; males = 50%; paraplegia = 67.5%) were interviewed. Four major themes emerged when examining facilitators to completing the program: accessibility, flexibility, motivation, and guided support. Barriers to completing the program included course timeframe and physical health. Strengths of the course included effective skill development and mental health prioritization. Suggested changes to the course included improved breadth of case stories, development of extra resources, adjusting the course timeframe to account for the SCI, and more support from the guide. Conclusions: ICBT was overall highlighted as an acceptable method of receiving care for people with SCI. The study provides direction for improving delivery of ICBT to ensure this method of treatment meets the needs of individuals with SCI.