The effects of a group-based cognitive behavioral therapy on people with multiple sclerosis: a randomized controlled trial
Open accessAbstract
Objective: To evaluate the effectiveness of a cognitive behavioral group-based intervention aimed at reducing depression and fostering quality of life and psychological well-being of multiple sclerosis patients through the promotion of identity redefinition, sense of coherence, and self-efficacy. Design: A randomized controlled trial. Setting: Non-medical setting, external to the Multiple Sclerosis Clinic Centre. Subjects: Eighty-two patients: 64% women; mean age 40.5, SD = 9.4; 95% with relapsing-remitting multiple sclerosis; Expanded Disability Status Scale (EDSS) between 1 and 5.5 were included in the study. Interventions: Patients were randomly assigned to an intervention group (five cognitive behavioral group-based sessions, n = 41) or to a control group (three informative sessions, n = 41). Main measures: Depression (CES-D), Quality of life (MSQOL revised), Psychological well-being (PANAS), Identity Motives Scale, Sense of Coherence (SOC), and Self Efficacy in Multiple Sclerosis. Results: Quality of life increased in the intervention group compared with the control at 6-months follow-up (mean change 0.72 vs. −1.76, p < 0.05). Well-being in the intervention group increased for males and slightly decreased for females at 6-months follow-up (mean change 6.58 vs. −0.82, p < 0.05). Contrasts revealed an increase in self-efficacy in the intervention group at posttreatment compared with the control (mean change 2.95 vs. −0.11, p < 0.05). Depression tended to lower, while identity and coherence increased in the intervention group compared with the control, though the differences were not significant. Conclusions: Preliminary evidence suggests that intervention promotes patients’ quality of life and has an effect on psychological well-being and self-efficacy.
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Previous investigations found improvements in self-efficacy after wellness programs, cognitive behavioral interventions, and fatigue management programs.
“Previous investigations have found improvements in self- efficacy following involvement in wellness programs,73 cognitive behavioral interventions,74 and fatigue management programs75”
From Quality of life and psychological well-being in the early stages of multiple sclerosis (MS): importance of adopting a biopsychosocial model (2018) · cites this paper as [74]
At follow-up, the intervention groups in Calandri et al and Graziano et al had experienced an increase in quality of life.
“At follow-up, the intervention groups in both studies had experienced an increase in QoL.”
From Quality of life in adults with multiple sclerosis: A systematic review (2020) · cites this paper as [115]
Interventions designed to reinforce protective factors, including identity redefinition, sense of coherence, self-efficacy, resilience training and emotional regulation, were all successful in improving quality of life.
“Several of the interventions were designed to reinforce protective factors in patients with MS. Graziano et al115 focused on identity redefinition, sense of coherence and self-efficacy. Pakenham et al119 implemented a programme based on resilience training, and the programme by Blair et al113 focused on the improvement of emotional regulation. All of them were successful in improving QoL,”
From Quality of life in adults with multiple sclerosis: A systematic review (2020) · cites this paper as [115]
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- Authors
- Graziano, F., Calandri, E., Borghi, M., & Bonino, S.
- Affiliations
- Cosso Foundation, Pinerolo, Torino, Italy
- University of Turin (IT)
- Ospedale San Luigi Gonzaga (IT)
- Venue
- Clinical Rehabilitation
- Publisher
- SAGE Publications
- Published
- 2013-09-06
- Volume
- 28
- Issue
- 3
- Pages
- 264-274
- ISSN
- 0269-2155 (ISSN-L)
- 1477-0873
- OpenAlex
- W2165793645
- Cited by
- 87
- References
- 29
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 7 · 2023: 5 · 2022: 6 · 2021: 7 · 2020: 7 · 2019: 6 · 2018: 8 · 2017: 11 · 2016: 11 · 2015: 6 · 2014: 2
- FWCI
- 4.73
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Clinical Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- multiple sclerosis, cognitive behavioral therapy, group therapy, depression, quality of life, psychological well-being, self-efficacy, sense of coherence, identity redefinition, relapsing-remitting multiple sclerosis, psychological intervention
- MeSH terms
- Adult, Aged, Depression, Female, Humans, Italy, Male, Middle Aged, Multiple Sclerosis, Psychotherapy, Group, Quality of Life, Cognitive Behavioral Therapy, Outcome Assessment, Health Care, Self Efficacy, Young Adult
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