A Pilot Randomised Control Trial of an Online Acceptance and Commitment Therapy (ACT) Resilience Training Program for People with Multiple Sclerosis

Background: This pilot study explored the effectiveness and feasibility of an online version of a group acceptance and commitment therapy (ACT) resilience training intervention for people with multiple sclerosis (PwMS), called e-READY for Multiple Sclerosis (MS). Methods: Fifty-six PwMS were randomized to intervention (n = 31) or waitlist control (WLC) (n = 25). The primary outcome, resilience, and secondary outcomes (quality of life (QoL), distress, psychological flexibility) were assessed at pre- and post-intervention and 12-week follow-up. Results: Intervention participants reported greater pre- to post-intervention improvements in anxiety (d = 0.56) and stress (d = 0.62) than WLC. Gains were maintained at follow-up. Confidence intervals revealed a trend for the intervention group to report greater improvements than WLC across all outcomes. Reliable Change Index data showed that, compared to WLC, there were trends for more intervention participants to evidence clinically significant improvements in physical health QoL. Recruitment response was weak, intervention retention was good, adherence to program progression guidelines was satisfactory, program usability satisfaction was high, and study protocol attrition at post-intervention and follow-up was low and high, respectively. Most participants viewed the intervention as enjoyable, helpful, and resilience-building, and would recommend it to other PwMS. Qualitative feedback validated the usefulness of intervention tools and digital delivery mode and bolstered resilience through improved ACT-related skills. Conclusions: Effectiveness and feasibility results from this proof-of-concept study provide preliminary support for the e-READY for MS program.