period. There was also a trend for anxious partici-
pants at initial assessment to improve over time. This
improvement in symptoms of anxiety was greater
than that experienced by the control group. Although
a signi®cant contribution to the development of
eective psychological treatments for SCI, this study
has limitations. The fact that no signi®cant dierences
were found between the treatment and control groups
suggests the intervention is not addressing the
predictor variables for the majority of individuals.
Those with signi®cant distress were seen to improve
after treatment but this does not overcome the fact
that most individuals who may have been experien-
cing subclinical levels of distress were not helped by
this treatment. A further diculty with this study is
the lack of control for the actual intervention itself. It
is dicult to say the intervention is responsible for
decreases in actual depression scores when it has not
been compared to an intervention targeting depres-
sion speci®cally. In the future the comparison of
general CBT interventions with CBT speci®cally for
depression in this population may shed light on to the
actual eectiveness of this program. At this point all
that can be said is CBT may be having some non
speci®c eects on long term adjustment.