Article

Two-thirds of the people with multiple sclerosis (pwMS) experience pain.
Medications provide minimal relief, and current non-pharmacological interventions
lack a clear conceptualization of MS pain.
This study explored the potential
efficacy of a telephone-supported hybrid cognitive behavior therapy and
acceptance and commitment therapy self-management intervention for pwMS based on
an empirically supported model of MS pain using a replicated single-case series
design. METHODS: Seven pwMS with varied demographic and disease characteristics
completed the 8-week home-based program alongside 3 hours of telephone support.
Online questionnaires were completed every four days for 16 weeks (4-weeks
baseline, 8-weeks treatment, 4-weeks follow-up). The primary outcomes were pain
severity and pain interference. Psychological process variables drawn from the MS
pain model were also completed, and post-treatment qualitative interviews
conducted. RESULTS: Simulation modeling analysis (SMA) showed three patients had
large improvements in pain outcomes, two showed no change and two worsened. Five
participants showed significant change on various psychological process
variables. Change in pain catastrophizing was the most consistent finding.
CONCLUSIONS: The findings suggest a self-management program for MS pain with
minimal therapy support may be effective for some pwMS, but not those with more
complex comorbidities. The participants suggested web-based delivery may simplify
the approach, and therapist telephone contact was highly valued. Implications for
Rehabilitation This case series suggests a hybrid CBT/ACT self-management
workbook program for MS pain improves severity and impact of pain in some pwMS.
Pain-related catastrophizing reduced in most pwMS, whilst change in other ACT and
CBT process variables varied across the individuals. PwMS feedback suggests a
tailored web-based delivery of the program with therapist telephone support may
be optimal. PwMS with serious co-morbid depression and very advanced disease may
not respond well to this self-management approach.

Langue : ANGLAIS