Evaluation of a program for training psychologists in an acceptance and commitment therapy resilience intervention for people with multiple sclerosis: a single-arm longitudinal design with a nested qualitative study

Abstract

Purpose

This single-arm longitudinal study evaluated the effectiveness of a program for training psychologists in delivering an acceptance and commitment therapy-based program (REsilience and Activities for every DaY; READY) for people with multiple sclerosis (PwMS).

Materials and methods

The training encompassed three phases: (1) training workshop; (2) READY participation; (3) READY delivery to PwMS. Self-report data were collected immediately before the workshop, before and after participation in READY, and at 3- and 15-month follow-ups.

Results

Forty psychologists successfully completed the training. The training was effective in fostering the acquisition of knowledge and skills for effective delivery of READY to PwMS. Participants improved over the course of training in resilience, positive affect, wellbeing, psychological flexibility, and associated processes. These improvements peaked during the participation in READY phase and continued to accrue at a slower rate three months later. Psychological flexibility mediated the improvements in resilience, positive affect, and wellbeing. Qualitative data confirmed the personal, professional, and multiple sclerosis (MS) psychologist community level positive training impacts.

Conclusions

The training fostered positive professional and personal development in trainees and consolidated the integration of READY into a frontline service for PwMS. To date, more than 50 READY groups for PwMS have been conducted in Italy.

Implications for rehabilitation

• Training psychologists in delivering an acceptance and commitment therapy (ACT)-based resilience intervention for people with multiple sclerosis (MS) is associated with positive personal and professional impacts for the trainees.

• The training program strengthened the sense of community among members of the professional network who attended as trainees.

• In ACT training, psychological flexibility plays a key role in improving resilience, positive affect, and wellbeing in trainees, and is therefore an important intervention target.

• ACT training for practitioners fosters the integration of ACT-based interventions into frontline services.

Keywords:

• Resilience training
• health practitioner
• multiple sclerosis
• acceptance and commitment therapy
• growth curve modeling
• mindfulness

Acknowledgements

We thank the “RETE PSICOLOGI AISM” for providing access to the AISM Psychologist Network and many other forms of support in conducting the project. We also thank the psychologists who willingly participated in the project and engaged personally with the training. Thank you for being open to new learnings. Most importantly, Ambra Mara Giovannetti wants to thank colleague Angela Tilli, who embodied her value of living a full and meaningful life while facing its end; for being a great life-teacher; and for the unforgettable contribution and the enthusiasm as a trainee participant, friend and outstanding therapist.

Authors contributions

AMG, AS, and KP conceived and developed the study protocol. AMG and KP conceived and developed The ACT and be READY for MS Training Program. AMG ran the training. AMG performed the data analysis. AMG, AS, and KP drafted the manuscript. All authors approved the final manuscript.

Disclosure statement

AMG received a research grant from Rehabilitation In Multiple Sclerosis (RIMS) European network for best practice and resource. AS received a research grant from Fondazione Italiana Sclerosi Multipla (FISM) during the study implementation and personal fees from Biogen Idec, Merck Serono, Novartis, Almirall, and Excemed. As a staff member of the University of Queensland and co-author of the READY program, KP receives royalties from UniQuest for commercial (not research) licensing arrangements entered into by third parties who want to deliver the program. During the elaboration of the study, data collection and manuscript preparation, MMU was an employee of the Italian Multiple Sclerosis Society Research Foundation. She is currently an employee of Biogen.

Data availability statement

Data are available upon request to the corresponding author.

Additional information

Funding

This work was supported by FISM – Fondazione Italiana Sclerosi Multipla – cod. 2016/B/3 and financed or co-financed with the “5 per mille” public funding. The funding source had no role in study design, data collection, data analysis, data interpretation or report writing.