Cognitive behaviour therapy in adults with spinal cord injury: A scoping review

Aim The aim of this study is to report on the extent and range of the research evaluating cognitive behaviour therapy (CBT) in adults with spinal cord injury. Background Spinal cord injury is a devastating event that can lead to permanent neurologic deficit. Compared with the average person, spinal cord injury (SCI) patients are at twice the risk of developing mood disorders, highlighting vulnerability of SCI patients' mental states which can be easily hurt. CBT is the most commonly used psychosocial intervention. Design This was a scoping review. Review method Five electronic databases (MEDLINE, CINAHL, EMBASE, PsycINFO and Airiti Library) were searched for articles published between 1990 and 2021. Google Scholar was utilized to search additional articles listed in the reference lists of included articles. Results Overall, 16 articles met the inclusion criteria, with the majority reporting on CBT, that focused on psychological distress and neuropathic pain. The core concept of intervention included disease identification, cognitive distortion/modification and coping strategies. Conclusions There were significant knowledge gaps on the interventions' content and effectiveness for psychological distress of persons with SCI. Development of multifaceted cognitive behaviour interventions, especially to strengthen self‐identity and to inspire patients' hope, is needed. Further research is required to investigate the long‐term effectiveness of CBT. Summary statement What is already known about this topic? Persons with spinal cord injury experience clinically significant levels of psychological distress. Cognitive behavioural intervention is the most commonly used psychosocial intervention. Cognitive behaviour therapy (CBT) may be effective in improving symptoms of depression, coping and adjustment in adults following SCI. What this paper adds? Findings offer an understanding of CBT which may contribute to clinical practice. Multiple gaps in the literature were identified in relation to study design, description of interventions and coping strategies. The implications of this paper: The three domains (disease identification, cognitive distortion/modification, and coping strategies) of CBT play a key role in promoting positive adjustment for patients with SCI. Further qualitative research is needed to increase our understanding of the coping experience of people with spinal cord injury and to identity transformation and the rebuilding of self‐worth.