The Importance of Hope in Coping with Severe Acquired Disability

Traditionally, adjustment to a serious injury such as spinal cord injury has been conceptualised as staged grieving process. Hope, in this tradition, is commonly defined as denial and considered counterproductive to positive adjustment. These concepts were challenged as the author observed the strength of clients' hope in the face of extremely confronting physical, social and environmental challenges following spinal cord injury. This paper presents qualitative data about the role of hope from the perspective of the person with spinal cord injury and considers the theoretical and clinical aspects of hope in the coping process. The data presented are a subset of data from a 10 year longitudinal study of a sample of 46 people with spinal cord injury. Semi-structured qualitative interviews were conducted at discharge from hospital, 6, 12, 24, and 36 months post-discharge and again at 10 years post discharge. Results showed that 73% of the participants identified hope as an essential factor that helped them cope following their injury. Three main foci of hope emerged from the data set: (a) hope for a complete recovery, (b) hope for a cure, and (c) hope for a satisfying quality of life. Hope emerged as a strong theme in the overall adjustment and coping process. Clinical implications for working with people who sustain spinal cord injury are discussed. It is recommended that interventions that support and facilitate hope need to be developed and tested.