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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