Videoconference-delivered acceptance and commitment therapy for depressed individuals with spinal cord injury sustained within the past 5 years: A pilot randomized controlled trial.

OBJECTIVE

This pilot study examined the effects of videoconference-delivered acceptance and commitment therapy (ACT), supplemented with psychoeducation materials, compared to psychoeducation materials alone, on depressive symptoms and other mental health outcomes in individuals with spinal cord injury (SCI) sustained within the past 5 years.

METHOD: A parallel-group, two-arm randomized controlled trial was conducted in the United States with 34 adults who had sustained an SCI within 5 years and reported at least mild depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] scores ≥5). Participants were randomly assigned to either the ACT group (n = 15) or the control group (n = 19). The ACT group received eight weekly 1-hr individual ACT sessions via videoconferencing, along with a 1-hr booster session. The control group received only psychoeducation materials. The primary outcome was depressive symptoms measured by the PHQ-9.

RESULTS

From pretest to posttest, the ACT group demonstrated significantly greater improvements in PHQ-9 scores (Z = 2.1, p = .04, d = 0.75) and all other mental health outcomes compared to the control group, with medium-to-large effect sizes. These improvements were maintained at the 2-month follow-up for PHQ-9 scores (Z = 2.78, p = .005, d = 0.97) and all other measures, except cognitive fusion.

CONCLUSION

This pilot randomized controlled trial is the first to demonstrate the potential efficacy of videoconference-delivered ACT in improving mental health outcomes among individuals with SCI experiencing depressive symptoms. Larger, more diverse samples and longer follow-up periods are needed to confirm and extend these findings. (PsycInfo Database Record (c) 2026 APA, all rights reserved).