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Table 2 Details of the two week classroom training program for the nurse-therapists

From: Protocol for the saMS trial (supportive adjustment for multiple sclerosis): a randomized controlled trial comparing cognitive behavioral therapy to supportive listening for adjustment to multiple sclerosis

Pragmatics of the trial and house keeping (6 hours) • Line management and orientation to the units
  • Record keeping for the trial, general paperwork, keeping patient notes and writing GP letters
Understanding MS: (6.5 hours) • Introduction to MS including the pathogenesis of the disease, types of MS, symptoms and medical treatment
  • Understanding adjustment to MS and introduction to the CBT model and manual
  • The role of partners and family members
Cognitive Behavioral Therapy (32.5 hours) • Introduction to Beck's systems model of CBT
  • Introduction to CBT, psychological therapies, and psychiatric diagnosis
  • Process of treatment and how change takes place over time
  • Assessment, conceptualization and formulation in CBT
  • Supervision and how to use it
  • Exploring the nurse-therapists' personal beliefs and assumptions
  • Motivational Interviewing Skills
  • Setting homework
  • Overview of anxiety and depression, including prevalence and diagnostic criteria.
  • Emotional processing and how to facilitate it.
  • Psychiatric emergencies and risk assessment
  • Identifying MS specific cognitions
  • How to use thought records to link, thoughts, behaviors and emotions
  • Challenging unhelpful thoughts
  • How to deal with patients "realistic" negative thoughts
  • Behavioral Activation and behavioral experiments
  • Problem solving
  • Dealing with resistance
  • Dealing with hopelessness
Supportive Listening (13 hours) • Introduction to therapist and patient manuals
  • Issues around housekeeping
  • Introduction to concepts of unconditional regard, warmth and empathy
  • Describing the active listening techniques
  • Facilitator demonstration of techniques
  • Nurse role play using MS case studies
  • Nurse role play using a personally relevant difficult or painful situation
  • Practice and feedback using the variety of techniques