Evaluation of a self-help intervention for improving well-being and reducing depression in a sample of people with MS

Emma Britneff

Research output: ThesisDoctoral Thesis

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Well-being is an essential aspect of mental health and treatment outcome. ‘GAP’ is an intervention that teaches goal-setting and planning skills, and in a self-help format has been shown to increase well-being and reduce depression in community and depressed samples. People with MS have lowered well-being and face challenges concerning adjusting important life goals due to unpredictable disease progression and exacerbation. The current study aimed to evaluate the effectiveness of GAP in a pure self-help (SHI) format for increasing well-being and reducing depression for a sample of people with MS.

A Randomised controlled trial was employed. 58 participants with MS were randomly allocated to receive GAP (n=29) or to wait-list control (n=29). Measures of well-being (I-PANAS-SF; Flourishing Scale; FAMS) and depression (PHQ9) were taken at baseline, post-intervention, and eight weeks follow-up. A 2 (treatment vs control) x 3 (Time 1, Time 2, Time 3) repeated measures ANOVA was employed to look at differences between the groups.

The intention to treat (ITT) primary analysis yielded a non-significant result for group x time interactions on all outcomes measures. There was a significant decrease in depression (F(2,112) = 0.97, p = .005, ηp2 = 0.02) and negative affect (F(2,112) = 4.34, p = .018, ηp2= 0.07) for the whole sample over time. A modified ITT analysis revealed a significant group x time interaction effect for the Family and Social well-being FAMS subscale only, with a large effect size (F(2, 40) = 4.65, p = .012, ηp2 = .12).

Potential explanations for the results are discussed, including methodological issues and MS-related factors resulting in GAP being ineffective. People with MS may require therapist guidance due to the increased challenges posed by MS requiring more adapting of goals. Further research is needed before recommendations could be made to use GAP in a MS population. Directions for future research are discussed.
Original languageEnglish
Awarding Institution
  • Royal Holloway, University of London
  • MacLeod, Andrew, Supervisor
Award date18 Oct 2019
Publication statusUnpublished - 2019

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