Randomised control trial of ePACT: a flexible treatment of depression and anxiety in adults living with chronic spinal cord injury

Investigators: Dr Christine Migliorini, Dr Andrew Sinclair, Dr Peter New, Assoc Prof Doug Brown, Emeritus Prof Bruce Tonge.

Previous Australian research has shown that many people living with spinal cord injury (SCI) demonstrate great resiliency and lead happy, productive lives while others are living with co-morbid emotional difficulties such as depression and/or anxiety.  What is more, this research found the majority were not receiving any psychological treatment or support.  The Electronic Personal Administration of Cognitive Therapy program – ePACT - was developed as a direct consequence of this finding.

ePACT is 10-module skills and psycho-educational program founded on sound mental health principles of cognitive behaviour therapy.  It can be used on its own as a self-help program, however it is recommended to also have clinician support by phone and/or email. 

The successful pilot of ePACT provided promising results with each participant experiencing an increase in well-being and decrease in symptoms of mood disturbance.  Building on these positive results, the researchers tried ePACT with a larger group of adults with chronic SCI and co-morbid depression, anxiety and/or clinically-significant stress.  This time the trial used a randomised waitlist control design and again the results were positive.  Univariate analyses (simple statistical tests) revealed large improvements in mental health and well-being in those who did the program.  Multivariate analyses (complex statistical test) were also positive though not as statistically significant. 

Overall, the project suggests that the internet-based program will not replace face-to-face care but it will be a useful adjunct treatment that is especially helpful for individuals who, for varying reasons, cannot attend mental health clinics.  Currently the researchers are directing their efforts to enabling the program to become more widely available. 


For more information about the ePACT study please contact:

Austin Health, Janette Alexander – janette.alexander@austin.org.au - 03 9496 5218

Austin Health, Melinda Millard – melinda.millard@austin.org.au - 03 9496 5906

Our Mission

Spinal Research Institute (SRI) is a not-for-profit spinal cord research charity. Our mission is to support world class clinical research and clinical trials. We provide means for Australian and international spinal cord injury (SCI) researchers to build much needed collaboration and to translate research outcomes into life changing health solutions for people living with SCI.

Support Us

Vital investment is needed to support research into new and better treatments that will improve the quality of life of people living with spinal cord injury... Be part of it!

Tweet Feed

Be our Partner

Here at The SRI we encourage businesses and organisations of all sizes to recognise the importance of Corporate Social Responsibility and to strive to be great corporate citizens by aligning our brands for bigger and better outcomes. With us you can make an impact – now!