Enhancing Self-Efficacy for Caregivers of Family Members With Spinal Cord Injury
| Status: | Recruiting |
|---|---|
| Conditions: | Hospital, Orthopedic |
| Therapuetic Areas: | Orthopedics / Podiatry, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 7/20/2018 |
| Start Date: | November 2015 |
| End Date: | April 2019 |
| Contact: | Susan Charlifue |
| Email: | susie@craighospital.org |
| Phone: | 3037898306 |
Spinal cord injury (SCI) may result in physical deficits that require assistance from others
in order to stay healthy and live independently in a community. The assistance provided by
caregivers to a family member with SCI often involves a wide range of activities from helping
with basic activities, like toileting and bathing, to managing more complex tasks, such as
keeping up with household finances, shopping, and transportation. Caregiving puts demands on
an individual's ability to cope and deal with day-to-day stresses, and may be influenced by
personal beliefs about one's ability to cope with stress. Beliefs about our ability to
perform tasks that affect our lives have been termed "self-efficacy". A strong sense of
self-efficacy has been shown to positively impact life choices, motivation, quality of
functioning, resilience to adversity, and vulnerability to stress and depression. People with
low self-efficacy tend to avoid challenges, discontinue tasks that are difficult, and be at
risk for more depression and stress, resulting in less satisfaction with life.
This study uses a psychological strategy, called cognitive behavioral therapy (CBT), to
enhance self-efficacy skills for caregivers of family members with SCI, with a focus on
changing thinking styles to help people make emotional and behavioral changes. The
investigators hypothesize that by providing family caregivers with a six week group
educational intervention, their self-efficacy skills as well as general life satisfaction can
be improved, and minimize depression, stress and anxiety that often accompany the caregiving
role. The innovation of the proposed intervention is its integration of positive
psychotherapy concepts into structured group CBT to develop optimistic self-efficacy beliefs,
strengthen the caregiver's ability to deal with day-to-day stress, and enhance a sense of
well-being in the caregiver which, in turn, may benefit the family member with SCI.
in order to stay healthy and live independently in a community. The assistance provided by
caregivers to a family member with SCI often involves a wide range of activities from helping
with basic activities, like toileting and bathing, to managing more complex tasks, such as
keeping up with household finances, shopping, and transportation. Caregiving puts demands on
an individual's ability to cope and deal with day-to-day stresses, and may be influenced by
personal beliefs about one's ability to cope with stress. Beliefs about our ability to
perform tasks that affect our lives have been termed "self-efficacy". A strong sense of
self-efficacy has been shown to positively impact life choices, motivation, quality of
functioning, resilience to adversity, and vulnerability to stress and depression. People with
low self-efficacy tend to avoid challenges, discontinue tasks that are difficult, and be at
risk for more depression and stress, resulting in less satisfaction with life.
This study uses a psychological strategy, called cognitive behavioral therapy (CBT), to
enhance self-efficacy skills for caregivers of family members with SCI, with a focus on
changing thinking styles to help people make emotional and behavioral changes. The
investigators hypothesize that by providing family caregivers with a six week group
educational intervention, their self-efficacy skills as well as general life satisfaction can
be improved, and minimize depression, stress and anxiety that often accompany the caregiving
role. The innovation of the proposed intervention is its integration of positive
psychotherapy concepts into structured group CBT to develop optimistic self-efficacy beliefs,
strengthen the caregiver's ability to deal with day-to-day stress, and enhance a sense of
well-being in the caregiver which, in turn, may benefit the family member with SCI.
Spinal cord injury (SCI) may result in physical limitations such that receiving assistance
from others is critical to maintaining health and facilitating full social integration. The
assistance ranges from helping with basic daily activities such as bowel and bladder
management, hygiene and dressing, to instrumental activities of daily living, including
managing household finances, shopping, or transportation. The challenges that accompany a
caregiving role may result in a caregiver's inability to balance responsibilities at home and
in the workplace. In addition, there is a tendency for caregivers to neglect their own
health, which may jeopardize the ability of the person with SCI to obtain the necessary care
and support required for optimal independent functioning. Vulnerability and resilience to the
ongoing stresses associated with caregiving for a loved one with SCI may be influenced by
personal beliefs about the caregiver's capabilities for coping with them. People's belief
about their capabilities for successfully performing tasks that affect their lives has been
termed "self-efficacy".
For family caregivers of individuals with SCI, self-efficacy beliefs are essential for coping
with the stressors that are experienced in the caregiving role. Anxiety, depression, and a
sense of "losing" one's own identity are frequently reported by family caregivers. However,
there has been relatively little research regarding caregiving in SCI and even fewer
treatment options to enhance self-efficacy for these caregivers. The proposed study involves
a randomized clinical trial to examine the effect of an intervention specifically designed by
and for family caregivers to help improve self-efficacy and reduce emotional distress
associated with it. The goal of this project is to test a six-week manualized,
cognitive-behaviorally based group educational intervention to improve family caregivers'
self-efficacy beliefs and skills, improve their resilience to the ongoing stresses associated
with caregiving, and enhance their overall quality of life with the potential added benefit
of improving the quality of life for their family members with SCI. Investigators hypothesize
that by providing family caregivers with this educational intervention, the intervention can
improve their self-efficacy skills as well as general life satisfaction, and minimize
depression, stress and anxiety associated with caregiving. The proposed intervention consists
of weekly facilitator-led sessions for a total of 6 weeks and includes didactic presentations
of 8 key principles, discussion topics and experiential exercises such as goal setting and
problem solving with extensive group discussion. At the end of each session, tasks are
assigned to participants to be completed outside the group prior to the next meeting. Session
content is organized around concepts of identifying and building character strengths,
cultivating positive emotion through focusing on gratitude and on the good in one's life,
experientially engaging in pleasurable activities, and accomplishing personal goals. The
innovation of the proposed intervention lies in its integration of positive psychotherapy
concepts into structured group CBT to develop optimistic self-efficacy beliefs, thereby
strengthening the caregiver's resilience to emotional distress, enhancing a sense of
well-being in the caregiver which, in turn, may benefit the family member with SCI.
from others is critical to maintaining health and facilitating full social integration. The
assistance ranges from helping with basic daily activities such as bowel and bladder
management, hygiene and dressing, to instrumental activities of daily living, including
managing household finances, shopping, or transportation. The challenges that accompany a
caregiving role may result in a caregiver's inability to balance responsibilities at home and
in the workplace. In addition, there is a tendency for caregivers to neglect their own
health, which may jeopardize the ability of the person with SCI to obtain the necessary care
and support required for optimal independent functioning. Vulnerability and resilience to the
ongoing stresses associated with caregiving for a loved one with SCI may be influenced by
personal beliefs about the caregiver's capabilities for coping with them. People's belief
about their capabilities for successfully performing tasks that affect their lives has been
termed "self-efficacy".
For family caregivers of individuals with SCI, self-efficacy beliefs are essential for coping
with the stressors that are experienced in the caregiving role. Anxiety, depression, and a
sense of "losing" one's own identity are frequently reported by family caregivers. However,
there has been relatively little research regarding caregiving in SCI and even fewer
treatment options to enhance self-efficacy for these caregivers. The proposed study involves
a randomized clinical trial to examine the effect of an intervention specifically designed by
and for family caregivers to help improve self-efficacy and reduce emotional distress
associated with it. The goal of this project is to test a six-week manualized,
cognitive-behaviorally based group educational intervention to improve family caregivers'
self-efficacy beliefs and skills, improve their resilience to the ongoing stresses associated
with caregiving, and enhance their overall quality of life with the potential added benefit
of improving the quality of life for their family members with SCI. Investigators hypothesize
that by providing family caregivers with this educational intervention, the intervention can
improve their self-efficacy skills as well as general life satisfaction, and minimize
depression, stress and anxiety associated with caregiving. The proposed intervention consists
of weekly facilitator-led sessions for a total of 6 weeks and includes didactic presentations
of 8 key principles, discussion topics and experiential exercises such as goal setting and
problem solving with extensive group discussion. At the end of each session, tasks are
assigned to participants to be completed outside the group prior to the next meeting. Session
content is organized around concepts of identifying and building character strengths,
cultivating positive emotion through focusing on gratitude and on the good in one's life,
experientially engaging in pleasurable activities, and accomplishing personal goals. The
innovation of the proposed intervention lies in its integration of positive psychotherapy
concepts into structured group CBT to develop optimistic self-efficacy beliefs, thereby
strengthening the caregiver's resilience to emotional distress, enhancing a sense of
well-being in the caregiver which, in turn, may benefit the family member with SCI.
Inclusion Criteria:
1. Living with a family member with SCI at any level for whom they are the primary
caregiver;
2. 18 years of age or older at the time of study enrollment;
3. English speaking in order to complete study measures and participate in group
interactions;
4. score of 30 or lower on the GSES; and
5. able to provide informed consent to participate.
Exclusion Criteria:
1. Not providing any amount of assistance to a family member with SCI;
2. not related through marriage or blood to the person with SCI;
3. lives beyond a reasonable commuting distance from Craig Hospital;
4. unable to verbally communicate;
5. unable to attend group sessions;
6. active participation in another formal clinical group or psychological therapy; or
7. have any condition that, in the judgment of the investigators, precludes successful
participation in the study.
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