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The main purpose of this clinical discussion is to illustrate and describe some of the barriers that arise when attempting to implement group cognitive-behaviour therapy (CBT) in a spinal cord injury (SCI) hospital-ward context. Difficulties encountered included patient characteristics, denial, avoidance, schedule conflicts, difficulties in group formation, and erratic attendance due to patient illness. Despite the pragmatic and motivational problems experienced in implementing group CBT for newly injured SCI persons, on completion of the program, the majority of SCI persons were very positive about the program and recommended it be introduced as a routine component of hospital rehabilitation. However, it is important that health professionals such as psychologists be aware of the difficulties involved in implementing group therapy in such a population. Suggestions are made on how to overcome some of the difficulties encountered.
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Craig et al. (1994) studied this question.
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