Therapeutic Intervention Addresses Key Psychosocial Challenges
NEW YORK (January 2, 2014) – Veterans living with spinal cord injury/dysfunction (SCI/D) experienced improvements in self-esteem and attitudes toward dating following a 12-week pilot program focused on dating skills, social skills and finding a mate. Clinicians from Montefiore Medical Center and the VA Boston Healthcare System designed the program to address a gap in psychoeducation around sexual and intimate relationship skills for individuals with SCI/D. The results of this first-of-its-kind program recently were published in the journal Sexuality and Disability.
It is estimated that between 236,000 and 337,000 people are living with SCI/D in the U.S. Past research suggests that of the factors that influence quality of life, intimate relationships are the most strongly impacted in these individuals. While a number of studies have examined areas such as sexual functioning and fertility among persons with paraplegia and quadriplegia, none have previously addressed the question of how individuals without a partner can find a mate or detailed a model to successfully teach social skills in the areas of dating and intimate relationships, all important aspects of sexuality.
“The dating and relationship group program taught skills for initiating and sustaining romantic relationships to individuals who are extremely vulnerable to marked declines in happiness, well-being, and self-confidence,” said Dawn C. Buse, Ph.D., director of behavioral medicine, Montefiore Headache Center and associate professor of clinical neurology, Albert Einstein College of Medicine of Yeshiva University. “After the program, our participants reported improved confidence in several areas, including the ability to meet new people and ask someone out on a date. Based on these findings, we are hopeful that psychosocial support groups focusing on intimate relationships will be made available to men and women with spinal cord injuries and disability in more locations.”
The pilot clinical program involved seven male veteran patients between 32 and 51 years old who participated in group psychoeducational social skills training sessions and pre- and post-surveying over a 12-week period. Participants were asked to identify short- and long-term relationship goals in six weekly sessions focused on the unique social, psychological and physical challenges of dating for men with SCI/D.
Topics discussed during the weekly sessions included medical and relationship history, self-esteem, readiness for an intimate relationship, making connections, effective communication and nurturing and sustaining relationships. Sessions were led by psychologists with additional instruction from nurses, social workers, and physical and occupational therapists. Sessions were interactive and included voluntary participation and homework assignments.
Materials created specifically for the program were based on dating guides for general audiences and grounded in well-researched cognitive behavioral therapy techniques including awareness of self-identity, body language and presentation and correction of irrational or self-defeating thoughts and behaviors.
“Given their importance to adjustment and quality of life outcomes, knowledge and confidence in intimate relationship building and maintenance should be a part of all comprehensive spinal cord injury rehabilitation programs and ongoing care,” said Sigmund Hough, Ph.D., ABPP/rp, clinical rehabilitation neuropsychologist, VA Boston Healthcare System, adjunct assistant professor of psychiatry, Boston University School of Medicine and assistant professor in the Department of Psychiatry, Harvard Medical School. “This effective group model offers a roadmap for other clinicians to integrate these topics into patient healthcare.