A qualitative study exploring psychosocial professionals' perceptions of the acceptability and effectiveness of psychosocial interventions in multiple sclerosis care

Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system, affecting more than 2.3 million people worldwide, with over 100,000 people in the UK diagnosed with the condition (NHS, 2021). The symptoms of MS appear in different forms, resulting in physical and psychosocial impacts. Previous research has stressed the need to consider the perspectives of both patients and healthcare professionals (HCPs) in supporting people with MS. Despite this, the perceptions of HCPs in MS psychosocial support are under researched. This study aimed to explore the perceptions of psychosocial HCPs of the acceptability and effectiveness of psychosocial interventions in MS care. In this qualitative study, 32 HCPs currently delivering psychosocial interventions in MS, completed open-ended questions in an online survey. Five themes were identified using thematic analysis; ; 1) “CBT can be helpful, but thought challenging can have limited use”: CBT and the complexity of MS, 2) “Change isn’t possible” vs Ready to change, 3) “Not trying to be the expert”: Working collaboratively and respectfully, 4) “It helps to know they are not on their own”: The value of support networks, 5) “There is not enough focus or funding for this kind of input”: Systematic barriers. Findings brought into question the effectiveness and acceptability of existing psychosocial interventions in MS care. The main findings showed that despite its common use, CBT was said to be limited due to the cognitive decline in people with MS, resulting in difficulties understanding CBT principles. With the breadth of MS symptoms, a flexible approach should be taken for interventions to be effective, however not all HCPs felt they had the knowledge of how to achieve this. A lack of understanding of psychosocial interventions in MS care was said to be held by both people with MS and other HCPs. Support networks made up of HCPs and family/friends are needed alongside psychosocial interventions to increase the acceptability and effectiveness of these. Psychosocial interventions in MS care were also said to be inadequately resourced and undervalued making it challenging to deliver these effectively. This study has provided valuable insight and knowledge of the perceptions of HCPs of psychosocial interventions in MS care. Findings have implications for health psychology in the design and delivery of psychosocial interventions for people with MS. This includes training and educating HCPs to develop the confidence to deliver effective and acceptable interventions which meet the diverse needs of patients. Organisations are encouraged to review how service capacity is used in order to be more effective and to meet the recommended guidelines set out by NICE (2019, 2016)