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STUDY: Brief group interventions good for reducing psychological distress in MS

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  • STUDY: Brief group interventions good for reducing psychological distress in MS

    Heck, the way this reads, ActiveMSers could almost count as a form of therapy in the ACT arm (acceptance and commitment therapy). Except it's better IMHO, ha. Either way, if you have anxiety or depression (both very common in MS), therapy helps. - Dave

    Brief cognitive behavioural therapy in outpatient groups with multiple sclerosis. A randomised controlled pilot study on acceptance and commitment therapy and relaxation training

    L. Nordin, I. Rorsman (Lund, SE)

    Background: Psychological distress is common in multiple sclerosis (MS) and interfere with social function, adherence to treatment, and functional status. In a Cochrane review it was concluded that the scope for using psychological interventions in MS is broad while the evidence base still is relatively small (Thomas et al., 2006).

    Acceptance and commitment therapy (ACT) is a modern cognitive behavioural therapy approach, designed to improve functioning and quality of life by increasing acceptance and a personís ability to stay active. The evidence for this treatment has been promising although further studies are needed in which ACT is compared with empirically supported treatments. So far there has been no published research using ACT on MS patients. Relaxation Training (RT) is a behavioural intervention that previously has been successfully applied on patients with MS. Given the extensive data in support of its efficacy, RT is often compared to other psychological methods in clinical trials.

    Objective: The aim of this pilot study was to evaluate the effectiveness of ACT as a group-intervention for MS patients with symptoms of psychological distress.

    Methods: Twentyone MS outpatients with elevated symptoms of anxiety and/or depression were randomly assigned to ACT (n=11) or RT (n=10). Both treatments consisted of five sessions over 15 weeks containing didactic sessions, group discussions, and exercises. Outcome was assessed by self-rated symptoms of anxiety, depression (Hospital Anxiety and Depression Scale - HADS) and a measure of activity and acceptance (Acceptance and Action Questionnaire, AAQ-II) at pretreatment, end of treatment, and at three month follow-up.

    Results: Compared to ACT, the RT group showed a larger decline in HADS-depressive symptoms at end of treatment (p <= .05). Also, the RT group had a significant decline in symptoms of anxiety on HADS from pretreatment to follow-up (p <= .05). The ACT group showed an improvement in rated acceptance and activity on AAQ-II at end of treatment (p <= .05) and this effect was maintained 3-month follow up (p <= .05).

    Conclusion: The results reflect the different emphases of the therapies. ACT is aimed at living an active, valued life and increasing acceptance, while RT focuses directly on coping strategies to handle symptoms of depression and anxiety. The results are preliminary but supportive of further study of brief group interventions for reducing psychological distress in MS patients.
    Dave Bexfield
    ActiveMSers
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