15 | Psychological Issues And SCI

Spinal cord injury (SCI) is an extreme and stressful life event that can leave individuals in a state of emotional instability. The person's overall psychological well-being can be influenced not only by the stress experienced during and after the trauma, but also by his or her personal resources and coping strategies.

Ingrid had been living an independent and successful life when a mountain bike tour changed her life completely.

To develop a profile of Ingrid’s functioning state at the start of the Rehab-Cycle^®, her rehabilitation team conducted a comprehensive assessment. This first assessment encompassed a battery of discipline-specific evaluations (health professional perspective) and involved interviewing Ingrid to capture her perspective about her functioning and health status (patient perspective).

As a guide for creating Ingrid's functioning profile, for setting goals and for determining intervention targets based on the first assessment of Ingrid's functioning, the rehabilitation team utilised the ICF Core Set for spinal cord injury (SCI) in the post-acute context.

In Ingrid's Rehab-Cycle^®, a psychologist was assigned to address her emotional and psychological needs, focusing primarily on Ingrid's cycle goal 4 ‘psychosocial well-being’.

After completing the intervention phase of the Rehab-Cycle^® Ingrid's functioning was re-evaluated to assess the extent to which the goals she and her rehabilitation team had set at the beginning of the Rehab-Cycle^® were achieved.

The major life changes and the stress that accompany a spinal cord injury (SCI) can contribute to increasing the risk of developing emotional and other psychosocial problems.

1. Lazarus RS, Folkman S. Stress, appraisal and coping. New York, USA: Springer Publishing; 1984.
2. Kennedy P, Evans M, Sandhu N. Psychological adjustment to spinal cord injury: The contribution of coping, hope and cognitive appraisals. Psych Health Med. 2009; 14(1): 17-33.
3. Peter C, Rauch A, Cieza A, Geyh S. Stress, internal resources and functioning in a person with spinal cord disease. NeuroRehabilitation. 2012; 30(2): 119-130.
4. Bickenbach J, Officer A, Shakespeare T, von Groote P. (eds.) International perspectives on spinal cord injury (IPSCI). Geneva, Switzerland: World Health Organization; 2013.
5. Fichtenbaum J, Kirshblum S. Psychological impact of spinal cord injury. In: Kirshblum S, Campagnolo DI. (eds.) Spinal cord medicine. Philadelphia, Pennsylvania (USA): Lippincott Williams & Wilkins; 2011. p. 382-397.
6. Galvin L, Godfrey H. The impact of coping on emotional adjustment to spinal cord injury (SCI): Review of the literature and application of a stress appraisal and coping formulation. Spinal Cord. 2001; 39: 615-627.
7. Livneh H, Martz E. Coping strategies and resources as predictors of psychosocial adaptation among people with spinal cord injury. Rehabil Psychol. 2014; 59(3): 329-339.
8. Mohta M, Sethi AK, Tyagi A, Mohta A. Psychological care in trauma patients. Injury, Int J Care Injured. 2003; 34: 17-25.
9. North NT. The psychological effects of spinal cord injury: A review. Spinal Cord. 1999; 37: 671-679.
10. Harper LA, Coleman JA, Perrin PB, Olivera SL, Perdomo JL, Arango JA, Arango-Lasprilla JC. Comparison of mental health between individuals with spinal cord injury and able-bodied controls in Neiva, Colombia. J Rehabil Res Dev. 2014; 51(1): 127-136.
11. Lequerica AH, Forschheimer M, Tate DG, Roller S, Toussaint L. Ways of coping and perceived stress in women with spinal cord injury. J Health Psych. 2008; 13(3): 348-354.
12. Folkman S. The case for positive emotions in the stress process. Anxiety, Stress, & Coping. 2008; 21(1): 3-14.
13. Pollard C, Kennedy P. A longitudinal analysis of emotional impact, coping strategies and post-traumatic psychological growth following spinal cord injury: A 10-year review. Br J Health Psychol. 2007, 12: 347-362.
14. Kennedy P, Kilvert A, Hasson L. A 21-year longitudinal analysis of impact, coping, and appraisal following spinal cord injury. Rehabil Psychol. 2016; 61(1): 92-101.
15. Elfström ML, Kennedy P, Lude P, Taylor N. Condition-related coping strategies in persons with spinal cord lesion: A cross-national validation of the Spinal Cord Lesion-related Coping Strategies Questionnaire in four community samples. Spinal Cord. 2007; 45: 420-428.
16. Elfström ML, Rydén A, Kreuter M, Persson LO, Sullivan M. Linkages between coping and psychological outcome in the spinal cord lesioned: Development of SCL-related measures. Spinal Cord. 2002; 40: 23-29.
17. Dryden DM, Saunders LD, Rowe BH, May LA, Yiannakoulias N, Svenson LW, Schopflocher DP, Voaklander DC. Depression following spinal cord injury. Neuroepid. 2005; 25(2): 55-61.
18. Orenczuk S, Mehta S, Slivinski J, Teasell RW. Depression following spinal cord injury. In Eng JJ, Teasell RW, Miller WC, Wolfe DL, Townson AF, Hsieh JTC, Connolly SJ, Noonan VK, Loh E, McIntyre A. Eds. Spinal Cord Injury Rehabilitation Evidence (SCIRE) Version 5.0. 2014. p. 1-33.
19. Post MWM, van Leeuwen CMC. Psychosocial issues in spinal cord injury: A review. Spinal Cord. 2012; 50: 382-389.
20. World Health Organization. International Classification of Functioning, Disability and Health (ICF). Geneva, Switzerland: World Health Organization; 2001.
21. Kirchberger I, Cieza A, Biering-Sørensen F, Baumberger M, Charlifue S, Post MW, Campbell R, Kovindha A, Ring H, Sinnott A, Kostanjsek N, Stucki G. ICF Core Sets for individuals with spinal cord injury in the early post-acute context. Spinal Cord. 2010; 48(4): 297-304.
22. Grazebook K, Garland A. What is CBT? (PDF on the British Association For Behavioural and Cognitive Psychotherapies (BABCP) website). [Internet] June 2005. Available from: http://www.babcp.com/Public/What-is-CBT.aspx. Accessed May 2016.
23. Hillier S and Worley A. The effectiveness of the Feldenkrais Method: A systematic review of the evidence. Evid Based Complement Alternat Med. 2015; 2015 (Article ID 752160): 1-12.
24. Elfström ML, Rydén A, Kreuter M, Taft C, Sullivan M. Relations between coping strategies and health-related quality of life in patients with spinal cord lesions. J Rehabil Med. 2005; 37: 9-16.