Research projects

Development and pilot of ePACT: a psychological treatment of depression in people with spinal cord injury

Principal researchers

Dr. Christine Migliorini1
Professor Bruce Tonge1
Dr. Andrew Sinclair2


1 Monash University
2 Independence Australia



Award type

Beyond Blue Victorian Centre of Excellence

Project completion year


Project brief

The availability of an online intervention may make it easier for people with spinal cord injury (SCI) to overcome problems of accessibility and stigma related to receiving psychological treatment for depression. The aim of this study was to develop and pilot a flexible online psychological treatment using Cognitive Behavioural Therapy (CBT) and positive psychology-based techniques, for individuals with SCI who are living with untreated depression and/or anxiety. A multiple case study approach provided, in principle, evidence of the acceptability of the Electronic Personal Administration of Cognitive Therapy: ePACT

Key findings

This project achieved its aim of developing a modified CBT program – the online treatment of depression, anxiety and stress in people with spinal cord injury who were not able to seek or access face-to-face therapy. Manual and online materials were prepared and tested. The results of this feasibility study indicated that the online program was acceptable and all participants showed some improvement in symptoms. In general, they were all able to follow the program instructions satisfactorily. Both male participants preferred to also interact via telephone rather than just emailing their homework tasks. This might indicate that therapist contact remains a motivating factor and thus may need to be a component of any online psychological treatment for this population. Highlighting the need for online delivery, all three participants who completed the program indicated that they would not have sought face-to-face therapy for reasons of access and stigma. They all had a strong sense of independence and felt this would have been questioned if they had sought therapy. 

Implications for policy and practice

Given the success in reducing psychopathology in an isolated and vulnerable population, this study justifies a full-scale, randomised, controlled trial of the efficacy of ePACT as a treatment for anxiety and depression in people with SCI who are unable or reluctant to access face-to-face therapy.

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