There are key moments in the lives of people with MS that they find more stressful thanThere are key moments in the lives of people with MS that they find more stressful thanothers. However, we also know that many people with MS experience longer-termproblems with anxiety and depression. These have a knock-on effect on their MS andother aspects of their lives. Our portfolio of studies explores how best to support peopleat the points of diagnosis and transition to secondary progressive MS, and people withlow mood. We also examine how people manage their invisible symptoms and how tobest support people with MS to remain in work.

1. Providing Emotional support around thepoint of Multiple Sclerosis diagnosis(PrEliMS):

A feasibility randomised controlledtrialDiagnosing MS can be a lengthy and stressfulprocess. Difficulties during this challengingperiod may influence people’s perceptionof MS, their relationships with the healthcareteam, and can contribute to ongoing MSadjustment. Therefore, providing support topeople with MS around diagnosis is important,but does not routinely happen in NHS MSclinics.

In this feasibility trial, we are testingstandard care with two new psychosocialinterventions, which were developed followingstakeholder consultations: (i) delivered by MSnurse specialists and (ii) delivered by MS nursespecialists and MS Society volunteers.

Funder: MS Society

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2. Behavioural Activation for Low mood in2. Behavioural Activation for Low mood inMultiple Sclerosis (BALMS)

People with MS a lifetime prevalence ofdepression of around 50%, and people withadvanced MS are more likely to experienceclinically significant depression than those withminimal disease symptoms. BehaviouralActivation aims to reduce behaviours thataintain or exacerbate depression by promotingcounteracting behaviours, using strategies suchas activity monitoring and scheduling. In thismixed-methods study, Lloyd will (i) adapt anexisting behavioural activation protocol forpeople with secondary progressive MS, and (ii)evaluate the new adapted intervention usingmultiple single-case experimental design and afollow-up change interview. The HospitalAnxiety and Depression Scale will be used toinvestigate changes in depression.

Funder: Health Education England (as part ofthe DClinPsy degree)

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3.  Acceptance Based Telephone Support wellbeingaround the time of Transition to Secondary Progressive Multiple Sclerosis:

A FeasibilityRandomised Controlled TrialThere is good evidence that those transitioningto secondary progressive MS (SPMS) feel anincreasing sense of loss, frustration and worry.We also know that people with SPMS are morelikely to have depression compared to thosewith other MS subtypes. Acceptance andCommitment Therapy (ACT) is now a wellestablishedpsychological intervention, but isstill resource intensive, so is not routinely offeredin NHS MS clinics. In this mixed-methodsfeasibility trial, Chris is evaluating the feasibilityof providing a low-resource acceptance-basedtelephone support intervention around the timeof transition to SPMS, and assessing the efficacyof this intervention compared to usual care.Furthermore, with the support ofthe UK MS Register, he is examining theassociation between psychologicalflexibility and distress in those with SPMS.

Funder: Health Education England (as part ofthe DClinPsy degree)

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4. Seeing the invisible: An exploration of livingwith, and how people manage, invisible symptoms of MS:

Many of the symptoms people with MS face areconsidered ‘invisible symptoms’ because theyare not visible to others, and indeed,sometimes to the people with MS themselves. Inthis project Le-Sharn uses photo-voice as aninterview technique and research practice toexplore the experience of living with theseinvisible symptoms and how people managethese invisible symptoms in daily life.Participants take photos on their mobile phonesof these two aspects and send them to theresearchers, who use the photographs asa starting point for wide-ranging discussionsaround invisible symptoms.

Funder: Health Education England (as part ofthe DClinPsy degree)

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5. Preventing job loss in people with MS:

The average age of onset of MS is around 30years of age, when people are at the beginningof their professional career and seeking to liveindependently. Work is an important partof most people’s lives. After 10 years with MS,fewer than 50% remain at work and this figuredecreases to 20% after 15 years.Blanca’s PhD research aims to develop and testa job retention vocational rehabilitationintervention for people with MS. As part ofher PhD, Blanca has reviewed various vocationalrehabilitation programmes offered for peoplewith MS across the world, and is adapting thesefor use in the UK context. She is currentlyevaluating this newly developed intervention asa series of case studies.

Funder: Joan Browne Legacy Funding

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