Skip to main content

Advertisement

SpringerLink
Log in

Dating and Relationship Psychoeducational Group for Veterans with Spinal Cord Injury/Dysfunction: A Historical Account of an Initial Clinical Course

  • Original Paper
  • Published:
Sexuality and Disability Aims and scope Submit manuscript

Abstract

Numerous studies have examined sexual functioning among persons with paraplegia and quadriplegia. None have detailed a group skill model teaching social skills in the areas of dating and intimate relationships and little in the literature has focused on this important aspect of sexuality. A psychoeducational group for individuals with spinal cord injury/dysfunction (SCI/D) was developed to address social, dating, and relationship skills, as well as improve self-efficacy, confidence and quality of life. Seven male veterans with SCI/D, age 32–51, participated in a 12-week psychoeducational social skills training group that met weekly for 60 min. Sessions were structured to focus on one theme or set of skills, and homework was given at the end of each session. Participants answered pre and post questionnaires about their general well-being, self-esteem, depression, anxiety, and social skills in general and specific to dating and relationships. A 12-week follow-up session reviewed the constructs. All participants reported positive experiences in the group and improvement in targeted areas. A detailed outline of session topics, exercises and handouts are presented as well as pre and post feedback on functioning, knowledge and attitudes among group participants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Anderson, K.D.: Targeting recovery: priorities of the spinal cord injured population. J. Neurotrauma 21, 1371–1383 (2004)

    Article  PubMed  Google Scholar 

  2. Anderson, C., Krajci, K., Vogel, L.: Life satisfaction in adults with pediatric-onset spinal cord injuries. J. Spinal Cord Med. 25, 184–190 (2002)

    PubMed  Google Scholar 

  3. Anderson, C., Vogel, L.: Domain-specific satisfaction in adults with pediatric-onset spinal cord injuries. Spinal Cord 41, 684–691 (2003)

    Article  PubMed  Google Scholar 

  4. Anderson, C., Vogel, L., Willis, K., Randal, B.: Stability of transition to adulthood among individuals with pediatric-onset spinal cord injuries. J. Spinal Cord Med. 29, 46–56 (2006)

    PubMed  Google Scholar 

  5. Bandura, A.: Principles of Behavior Modification. Holt, Rinehart & Winston, New York (1969)

    Google Scholar 

  6. Bandura, A.: Social Learning Theory. General Learning Press, New York (1971)

    Google Scholar 

  7. Bandura, A.: Self-efficacy: toward a unifying theory of behavioral change. Psychol. Rev. 84, 191–215 (1977)

    Article  PubMed  Google Scholar 

  8. Berkman, A.H., Weissman, R., Friclich, M.H.: Sexual adjustment of spinal cord injured veterans living in the community. Arch. Phys. Med. Rehabil. 59, 29–33 (1978)

    PubMed  Google Scholar 

  9. Booth, S., Kendall, M., Fronek, P., Miller, D., Geraghty, T.: Training the interdisciplinary team in sexual rehabilitation following spinal cord injury: a needs assessment. Sex. Disabil. 21, 249–261 (2003)

    Article  Google Scholar 

  10. Brickman, P., Coates, D., Janoff-Bulman, R.: Lottery winners and accident victims—is happiness relative? J. Pers. Soc. Psychol. 36, 917–927 (1978)

    Article  PubMed  Google Scholar 

  11. Browne, J.: Dating for Dummies. Wiley Publishing Inc., New Jersey (2006)

    Google Scholar 

  12. Buse, D.C., Hough, S.: Dating and relationship issues for individuals with spinal cord injuries: a psycho-educational group program. Findings presented at symposium. In: Proceedings of the 16th Annual Conference of the American Association of Spinal Cord Injury Psychologists and Social Workers (September 3–6, 2002), Las Vegas, NV

  13. Chang, F.H., Wang, Y.H., Jang, Y., Wang, C.W.: Factors associated with quality of life among people with spinal cord injury: application of the international classification of functioning, disability and health model. Arch. Phys. Med. Rehabil. 93, 2260–2270 (2012)

    Google Scholar 

  14. Chen, Y., Anderson, C., Vogel, L., Chlan, K., Betz, R., McDonald, C.: Change in life satisfaction of adults with pediatric-onset spinal cord injury. Arch. Phys. Med. Rehabil. 89, 2285–2292 (2008)

    Article  PubMed  Google Scholar 

  15. Craig, A.R., Hancock, K., Chang, E., Dickson, H.: Immunizing against depression and anxiety after spinal cord injury. Arch. Phys. Med. Rehabil. 79, 375–377 (1998)

    Article  PubMed  Google Scholar 

  16. Craig, A.R., Hancock, K., Chang, E., Dickson, H.: The effectiveness of group psychological intervention in enhancing perceptions of control following spinal cord injury. Aust. N. Z. J. Psychiatry 32, 112–118 (1998)

    Article  PubMed  Google Scholar 

  17. Craig, A., Hancock, K., Dickson, H.: Improving the long-term adjustment of spinal cord injured persons. Spinal Cord 37, 345–350 (1999)

    Article  PubMed  Google Scholar 

  18. Dijkers, M.: Correlates of life satisfaction among persons with spinal cord injury. Arch. Phys. Med. Rehabil. 80, 867–876 (1999)

    Article  PubMed  Google Scholar 

  19. Dobson, K.S.: Handbook of Cognitive-Behavioral Therapies, 2nd edn. The Guilford Press, New York (2001)

    Google Scholar 

  20. Ducharme, S., Gill, K.: Sexuality after Spinal Cord Injury: Answers to Your Questions. Paul H. Brookes Publishing Co., Baltimore (1997)

    Google Scholar 

  21. Forchheimer, M., Tate, D.G.: Enhancing community re-integration following spinal cord injury. Neurorehabilitation 19, 103–113 (2004)

    PubMed  Google Scholar 

  22. Fronek, P., Kendall, M., Booth, S., Eugarde, E., Geraghty, T.: A longitudinal study of sexuality training for the interdisciplinary rehabilitation team. Sex. Disabil. 29, 87–1000 (2011)

    Article  Google Scholar 

  23. Gill, K., Hough, S.: Sexuality training, education and therapy in the healthcare environment: taboo, avoidance, discomfort or ignorance? Sex. Disabil. 25, 73–76 (2007)

    Article  Google Scholar 

  24. Hart, K., Rintala, D., Fuhrer, M.: Educational interests of individuals with spinal cord injury living in the community: medical, sexuality and wellness topics. Rehabil. Nurs. 21, 82–90 (1996)

    Article  PubMed  Google Scholar 

  25. Hess, M.J., Hough, S.: Impact of spinal cord injury on sexuality: broad based clinical practice intervention and practical application. J. Spinal Cord Med. 35, 211–218 (2012)

    Article  PubMed  Google Scholar 

  26. Hough, S., Hess, M.J. Buse, D.C.: Re-establishing one’s sexuality following a spinal cord injury: mind and body integration. In: Workshop Proceedings at the Society for the Scientific Study of Sexuality 44th Annual Meeting (November 7–10, 2002), Montreal, Canada

  27. Hough, S., Hess, M.J., Tammaro, E., Buse, D.C.: An interdisciplinary approach to address sexuality concerns of individuals with spinal cord injury: mind and body integration. In: Proceedings of the 79th Annual Meeting of the American Congress of Rehabilitation Medicine and 9th Annual Meeting of the American Society of Neurorehabilitation (October 3–6, 2002), Philadelphia, PA

  28. Kennedy, P., Duff, J., Evans, M., Beedie, A.: Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries. Br. J. Clin. Psychol. 42, 41–52 (2003)

    Article  PubMed  Google Scholar 

  29. Kreuter, M.: Spinal cord injury and partner relationships. Spinal Cord 38, 2–6 (2000)

    Article  PubMed  Google Scholar 

  30. Kreuter, M., Taft, C., Siosteen, A., Biering-Sorensen, F.: Women’s sexual functioning and sex life after spinal cord injury. Spinal Cord 49, 154–160 (2011)

    Article  PubMed  Google Scholar 

  31. Kurianks, J.: Complete Idiot’s Guide to Dating. Penguin Group, New York (2003)

    Google Scholar 

  32. Lund, M., Norlund, A., Bernspang, B., Lexell, J.: Perceived participation and problems in participation are determinants of life satisfaction in people with spinal cord injury. Disabil. Rehabil. 29, 1417–1422 (2007)

    Article  PubMed  Google Scholar 

  33. Maslow, A.: A theory of human motivation. Psychol. Rev. 50, 370–396 (1943)

    Article  Google Scholar 

  34. McAlonan, S.: Improving sexual rehabilitation services: the patient’s perspective. Am. J. Occup. Ther. 50, 826–834 (1996)

    Article  PubMed  Google Scholar 

  35. McColl, M., Stirling, P., Walker, J., Corey, P., Wilkins, R.: Expectations of independence and life satisfaction among ageing spinal for injured adults. Disabil. Rehabil. 21, 231–240 (1999)

    Article  PubMed  Google Scholar 

  36. Miller, N.E., Dollard, J.: Social Learning and Imitation. Yale University Press, New Haven (1941)

    Google Scholar 

  37. National Spinal Cord Injury Statistical Center (NSCISC): Spinal Cord Injury Facts and Figures at a Glance, 2009. Foundation for Spinal Cord Injury Prevention, Care and Cure. http://www.fscip.org/facts.htm (2009). Accessed 25 July 2012

  38. Newman, S.: Evidence-based advocacy: using Photovoke to identify barriers and facilitators to community participation after spinal cord injury. Rehabil. Nurs. 35, 47–59 (2010)

    Article  PubMed  Google Scholar 

  39. Ostrander, N.: Sexual pursuits of pleasure among men and women with spinal cord injuries. Sex. Disabil. 27, 11–19 (2009)

    Article  Google Scholar 

  40. Oswald, A., Podthavee, N.: Does happiness adapt? A longitudinal study of disability with implications for economists and judges. J. Public. Econ. 92, 1061–1077 (2008)

    Article  Google Scholar 

  41. Pershouse, K., Barker, R., Kendall, M., Buettner, P., Kuipers, P., Schuurs, S., Amsters, D.: Investigating changes in quality of life and function among the lifespan for people with spinal cord injury. Arch. Phys. Med. Rehabil. 93, 413–419 (2012)

    Article  PubMed  Google Scholar 

  42. Phelps, J., Michael, A., Dunn, K., Joseph, A.: Spinal cord injury and sexuality in married or partnered men: activities, function, needs, and predictors of sexual adjustment. Arch. Sex. Behav. 30, 591–602 (2001)

    Article  PubMed  Google Scholar 

  43. Quale, A., Schanke, A.: Resilience in the face of coping with a severe physical injury: a study of trajectories of adjustment in a rehabilitation setting. Rehabil. Psychol. 55, 12–22 (2010)

    Article  PubMed  Google Scholar 

  44. Sakellariou, D: If not the disability, then what? Barriers to reclaiming sexuality following spinal cord injury. Sex. Disabil. 24, 101–111 (2006)

    Google Scholar 

  45. Scherer, M., Banks, M., Blair, K., Bost, R., Hanson, S., Hough, S., Kurylo, M., Langer, K., Stiers, W., Wegener, S., Young, G.: Rehabilitation psychology. In: Weiner, I.B., Craighead, W.E. (eds.) The Concise Corsini Encyclopedia of Psychology and Behavioral Science, 4th edn, pp. 1444–1447. John Wiley & Sons, Hoboken (2010)

    Google Scholar 

  46. Tepper, M.: Providing comprehensive sexual health care in spinal cord injury rehabilitation: implementation and evaluation of a new curriculum for healthcare professionals. Sex. Disabil. 15, 131–165 (1997)

    Article  Google Scholar 

  47. Turk, D., Meichenbaum, D.: A cognitive-behavioral approach to pain management. In: Wall, P.D., Mezack, R., Bonica, J.J. (eds.) Textbook of Pain, 3rd edn, pp. 1337–1418. Churchill Livingstone, Edinburgh (1994)

    Google Scholar 

  48. Wessler, R., Wessler, R: The Principles and Practice of Rational—Emotive Therapy. Jossey-Bass Publishers, San Francisco (1980)

  49. Willmuth, M.E.: Sexuality after spinal cord injury: a critical review. Clin. Psychol. Rev. 7, 389–412 (1987)

    Article  Google Scholar 

  50. Wolf, S.: Guerilla Dating Tactics. Penguin Books, New York (1998)

    Google Scholar 

Download references

Acknowledgments

We wish to thank Marika J. Hess, M.D. for her participation, support and feedback.

Author information

Authors and Affiliations

  1. Psychology Service, VA Boston Healthcare System, Boston, MA, USA

    Sigmund Hough & Melissa T. Stone

  2. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Sigmund Hough

  3. Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA

    Sigmund Hough

  4. Massachusetts School of Professional Psychology, Boston, MA, USA

    Melissa T. Stone

  5. Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA

    Dawn C. Buse

  6. Montefiore Medical Center, Bronx, NY, USA

    Dawn C. Buse

  7. 396 Washington Street, Suite 211, Wellesley Hills, MA, 02181, USA

    Sigmund Hough

Authors
  1. Sigmund Hough
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Melissa T. Stone
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dawn C. Buse
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sigmund Hough.

Appendices

Appendix 1: Program Format

WeekOne

I. Group rules

II. Introductions

III. Homework

a. Confidentiality: What is shared in the group, stays in the group was the primary rule for confidentiality

a. Who are you?

 Where do you live?

 Current or past work

 Hobbies

 Sports

 Education and life experiences

 Personal facts they want the group to know

#1: “Who am I and who am I looking for?” (See Appendix 2)

b. Attendance: to all sessions is expected unless there is a conflict with a more urgent healthcare appointment. For planned absence: call/contact either clinician and inform them of absence

b. Relationship history: marriage, divorce, engagement, other significant relationships

 

c. Feel comfortable to participate as little or as much as they choose. All participants should be respected

c. Group goals: what would you like to get out of this group?

 

d. Complete homework exercises, as a supplement to the group

d. Relationship goals: short term, long term

 

Week Ttwo

I. Group rules and homework review

II. Making sure you are ready

III. Self esteem

a. Should be reviewed briefly: confidentiality, attendance, and participation

a. Not on the “rebound”—rule of thumb: at least 1 year approximately after divorce or serious relationship

a. Learning to like and accept yourself

b. Homework Review: Three questions in particular can be asked:

 Qualities I admire in myself (was this difficult, did you ask anyone for help, did the things they said surprise you?)

 Qualities I would like to change

 Qualities I am looking for in a partner: (does this picture match the people you have had relationships with in the past? Any surprises or changes?)

b. No current crises: medical, financial, emotional

 Solve those first

b. Ways to project confidence

internally:

 Remember the good qualities and skills you have

Week Two

IV. Homework

a. Conduct cost-benefit analysis, an asset listing assignment.

c. No “anger” towards past relationships

 Get therapy and help first

c. Ways to project confidence externally:

 Sit up straight.

 Make eye contact

 Smile

 Introduce yourself

 

d. Life is content: feel secure with friends, during activities, and within one’s general mood

d. Preparation:

 Grooming and cleanliness: deodorant, cologne

 For example, seek fashion conscious females, friends, and family members for opinions on what looks nice

 Take them shopping with you and develop a personal style

  

e. Always look good when you leave the house. You never know when you will meet someone

Week Three

I. Group rules

II. Dating tactics

III. Meeting people

a. Should be reviewed briefly: confidentiality and participation

“The Complete Idiot’s Guide to Dating” (24)

If you are interested in meeting people then … who, what, where, how

b. Attendance and Participation

a. Be proactive

b. Get out!

c. Go places and do things you enjoy

d. Meet as many people as you can

Sports: Can both participate and watch various sporting events including Professional, Paralyzed Veterans Association activities and Wheelchair Olympics

Spiritual: Church, Synagogue, place of worship and spiritual healing, bible study, yoga, holistic health groups, meditation, relaxation groups

Social: parties, social events, weddings, wine tastings

Art: Museums, classes (extension, enrolled, adult courses), art supply shops

 

Psychosocial:

a. Know but be flexible about your “love criteria”

b. Boost your self-esteem

c. Don’t be afraid of rejection

d. Let people know who you are

e. Let people know that you are available

Music: Classes, concerts, music stores

Health: Health club/gym, community centers, health food stores

Other: Volunteer work (hospital, peer mentoring, animal shelter, big brother), restaurants, Laundromat, shopping, main streets, political campaigns, waiting rooms, video arcades, comedy clubs, marketplaces, singles events, airports, tourist attractions

Other options: Blind dates through friends, family coworkers, neighbors, online dating, singles events, dating services, and professional matchmakers

.

Week Four

I. Group rules

II. Making connections

III. Compatibility test

Review briefly:

a. Confidentiality

a. How to approach someone

a. Do the two of you have similar values?

b. Attendance and Participation

b. Breaking the ice

b. Can you resolve your differences?

 

c. Topics for conversations

c. Do you have similar needs for closeness and independence?

 

d. Accepting Rejection: reframe and rebound

d. Do you have similar sex drives?

 

e. Accessibility for dates (planning ahead)

e. Do you have similar life styles?

 

f. Polishing your look and approach

f. Do you have similar goals?

 

g. Exiting gracefully

 
 

h. The follow-up

 

Week Five

I. Group rules

II. Effective communication

III. Overcoming sexual insecurity

Should be reviewed briefly:

a. Confidentiality

b. Attendance and Participation

On-going review of importance

b. Impotency and other technical issues

.

Week Six

I. Group rules

II. Keeping your relationship alive

Should be reviewed briefly:

a. Confidentiality

b. Attendance and Participation

1. Review of accomplishments and feedback

2. Future goals for growth

3. Closure

Appendix 2: Session Themes

  1. a.

    Who I am

    1. 1.

      Confidence.

    2. 2.

      Polishing your Social Being.

      1. 1.

        What makes you “YOU.”

      2. 2.

        Being Ready.

  2. b.

    Who am I looking for in a person?

    1. 1.

      Finding a date and relationship.

    2. 2.

      Being Cool and Remaining Cool.

  3. c.

    The Actual Date

    1. 1.

      Asking.

    2. 2.

      Getting contact information.

    3. 3.

      Finding the right place.

  4. d.

    Date Day Preparation

    1. 1.

      Getting my Outside Arranged.

    2. 2.

      Getting my Inside Organized.

    3. 3.

      Polishing the presentation so the person can see ME.

  5. e.

    The Date

    1. 1.

      Having a “Way Cool Time.”

    2. 2.

      The Date goes wrong from different perspectives.

  6. f.

    The Day After and the Future

    1. 1.

      Next day.

    2. 2.

      Second and third date.

    3. 3.

      Learning about each other, mutual sharing.

    4. 4.

      Speed Bumps on Life’s Highway.”

    5. 3.

      Casual dating, serious dating and heavy dating.

    6. 4.

      Breaking-Up and ending.

    7. 5.

      Rebound effect and status.

  7. g.

    Playing it Safe and Careful

    1. 1.

      Safety is important and primary.

    2. 2.

      Dating “sight unseen.”

    3. 3.

      Dangerous Dates.

  8. h.

    Techniques

    1. 1.

      Ways to know you are in love.

    2. 2.

      Ways to not date.

    3. 3.

      Ways to date happy.

    4. 5.

      Ways to date miserably.

    5. 6.

      Ways to have Valentine’s Day all the time.

Appendix 3: Sample Worksheet #1

Appendix 4: Sample Worksheet #2

Appendix 5: Sample Worksheet #3

Dating and Relationship Group: Worksheet #3

Name: — Date: —

“Qualities you want in a partner”

Instructions: “Circle the most important 10 qualities you want in a romantic partner. Put an “X” next to the 10 qualities you could not stand in a partner (“deal breakers”).

  • Active

  • Athletic

  • Exercises regularly/Works Out

  • Likes playing sports

  • Likes watching sports

  • Nice smile

  • Eye color

  • Nice eyes

  • Hair color

  • Overweight

  • Physical appearance

  • Sexy

  • Pretty

  • Strong

  • Weight

  • Height

  • Wears a lot of make-up

  • Well-groomed

  • Stylish dresser

  • Shop-a-holic

  • Frugal

  • Does not offer to pay

  • Feminine

  • Tom-boy

  • Dislikes sports

  • Able-bodied

  • Disabled

  • Was/is in military

  • Afraid

  • Anxious

  • Aggressive

  • Hostile

  • Irritable

  • Jealous

  • Angry

  • Gloomy

  • Calm

  • Carefree

  • Reckless

  • Casual

  • Flexible

  • Close-minded

  • Open-minded

  • Tolerant

  • Generous

  • Fun

  • Happy

  • Unhappy

  • Sad/Depressed

  • Loving

  • Warm

  • Open

  • Optimistic

  • Pleasant

  • Forgetful

  • Dependable

  • Unpredictable

  • Trustworthy

  • Honest

  • Thoughtful

  • Thoughtless

  • Good sense of humor

  • Good natured

  • Crude

  • Homebody

  • Lonely

  • Quiet

  • Shy

  • Loud

  • Talkative

  • Outgoing

  • Polite

  • Patient

  • Short-tempered

  • Quarrelsome

  • Stubborn

  • Temperamental

  • Prejudiced

  • Mean

  • Rude/bad manners

  • Good cook

  • Lives close by

  • Infidelity

  • Smart

  • Intelligent

  • A certain level of education

  • Has a good job

  • Poor

  • Rich

  • Good with animals

  • Good with children

  • Does not want children

  • Has children

  • Wants to have children

  • Wants to stay home with the children

  • Has been married before

  • Is divorced

  • Age

  • Young

  • Much older

  • Much younger

  • Geographical

  • Lives far away

  • Has lived overseas

  • Likes to travel

  • Shared hobbies

  • Shared interests

  • Speaks another language

  • Believes in God

  • Atheist

  • Attends church regularly

  • Same religion

  • Different religion

  • Interested in current events

  • Interested in politics

  • Republican political party

  • Democratic political party

  • Independent political party

  • Other:

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hough, S., Stone, M.T. & Buse, D.C. Dating and Relationship Psychoeducational Group for Veterans with Spinal Cord Injury/Dysfunction: A Historical Account of an Initial Clinical Course. Sex Disabil 31, 337–359 (2013). https://doi.org/10.1007/s11195-013-9330-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11195-013-9330-8

Keywords

Search

Navigation