The utility of group narrative therapy to facilitate psychological adjustment in multiple sclerosis

Doctoral thesis English OPEN
van den Heuvel, Ananda
  • Subject: BF76.5 | RC0377 | RC0475

Section A reviews and critically evaluates the empirical literature on psychosocial interventions for multiple sclerosis (MS), the determinants of adjustment to MS, and the theoretical frameworks to account for these. Further, a conceptual and empirical review of the literature on narrative therapy is provided and an argument advanced for the utility of narrative therapy in facilitating adjustment to MS. Possible areas for further research are outlined.\ud Section B describes a feasibility study which aimed to begin to test a theoretical argument for the application of group narrative therapy to facilitate psychosocial adjustment to MS, and to ascertain the feasibility of a larger scale randomised controlled trial. Fourteen MS patients received 8 weekly sessions of group narrative therapy delivered at two sites in England. Quality of life, coping processes, and illness representations were assessed at two time points prior to the intervention and immediately after the intervention, and analysed using Wilcoxon Matched-Pairs tests. Additional qualitative measures were taken and analysed using content analysis. The feasibility of a larger scale study was, in part, assessed by means of semi-structured interviews with health professionals involved in the study, and analysed using thematic analysis. Although none of the findings reached statistical significance upon correcting for multiple comparisons, positive trends were revealed for the mental health component of quality of life, confrontive coping, and the consequences component of illness representations. With respect to the feasibility of this study, several issues pertaining to recruitment and data collection emerged from the data that can inform future research. Taken together, the results of this pilot study are promising and warrant further investigation using a sufficiently large sample.\ud Section C provides a reflection on the skills and abilities developed and learning needs identified whilst undertaking the research. It further offers a critical reflection on the study‟s methodology and the potential implications for clinical practice. Further potential lines of enquiry are outlined.
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