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NCT Number: NCT07507149

Evaluating the Feasibility and Effectiveness of an Online Psychological Intervention Targeting Problem-Solving and Coping Strategies in People With Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic autoimmune disease that affects the brain and spinal cord, often leading to unpredictable symptoms and significant emotional distress. Many people with MS experience anxiety, depression, and difficulties in coping with the challenges of the disease. Research has shown that effective coping-especially problem-focused coping-can reduce psychological distress and improve quality of life. However, access to psychological care can be limited, particularly in low-resource or mobility-restricted settings.This study, conducted at the Nehme and Therese Tohme Multiple Sclerosis Center at the American University of Beirut Medical Center (AUBMC), evaluated the feasibility and preliminary effectiveness of an eight-week, online psychological intervention designed to enhance problem-solving and coping strategies in adults with MS living in Lebanon.The primary objective was to determine whether an online problem-solving coping strategies (PCS) intervention is feasible, acceptable, and well-tolerated for people with MS. The secondary objective was to assess the intervention's preliminary effects on problem-focused coping, depression, and anxiety.

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Key information

Conditions

Multiple Sclerosis Anxiety Anxiety Disorders Autoimmune Diseases Autoimmune Diseases of the Nervous System Behavior Behavioral Symptoms Coping Demyelinating Autoimmune Diseases, CNS Demyelinating Diseases Depression Depression Anxiety Disorder Immune System Diseases Mental Disorders Nervous System Diseases Problem Solving

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

American University of Beirut

Beirut, 1107 2020, Lebanon

About this study

Design and Methods:This was a pilot randomized controlled trial (RCT) including 30 adults diagnosed with MS for at least one year. Participants were randomly assigned in equal numbers (1:1 ratio) to one of two groups:1. PCS Intervention group: 15 participants received eight weekly, 60-minute individual online sessions with a licensed clinical psychologist using WhatsApp video calls.2. Treatment-as-Usual (TAU) group: 15 participants continued their regular neurological and nursing care without additional psychological intervention.All participants completed questionnaires at baseline and at the end of the 8-week study to measure coping strategies, anxiety, and depression using validated Arabic versions of the Brief-COPE Scale and the Hopkins Symptom Checklist (HSCL-25). The PCS group also completed a self-developed Feasibility Questionnaire to assess the acceptability and practicality of the online sessions.Intervention Details:The PCS program was developed in Arabic by a multidisciplinary team including psychologists, nurses, and physicians. It was based on Lazarus and Folkman's Transactional Model of Stress and Coping (1984) and Problem-Solving Therapy principles. Each session included psychoeducation about healthy versus maladaptive coping, guided problem-solving exercises, and real-life applications through weekly homework. The sessions emphasized identifying challenges, generating solutions, weighing pros and cons, and implementing action plans

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adults aged 18 years or older
  • Diagnosis of Multiple Sclerosis ≥ 1 year (McDonald criteria 2017)
  • Access to a stable internet connection and smartphone/laptop
  • Able to provide informed consent

Exclusion criteria

  • Active suicidal ideation at screening
  • Cognitive impairment or psychiatric instability precluding participation

Treatment and study plan

Problem-Solving Coping Strategies (PCS) Intervention

Behavioral

This intervention is unique in that it delivers a structured, psychologist-guided problem-solving and coping program entirely via WhatsApp video calls, a widely accessible and low-cost platform in Lebanon and the MENA region. Unlike most telehealth or cognitive-behavioral interventions that rely on specialized software, this program was developed in Arabic and culturally adapted for adults with multiple sclerosis (MS) to address psychosocial stress, depression, and anxiety within local contexts.

The content integrates Lazarus and Folkman's Transactional Model of Stress and Coping with Problem-Solving Therapy (PST) principles, emphasizing practical, real-life coping skills rather than symptom education alone. Delivered individually by a licensed clinical psychologist trained in MS-specific behavioral care, the program also includes weekly skill practice, personalized feedback, and a coping diary, making it a tailored, behaviorally focused, and patient-centered telepsychology model disti

Treatment as usual (TAU)

Other

Standard neurological and nursing care, including regular medical follow-up, medication management, and rehabilitation or physical therapy as clinically indicated. No structured psychotherapy provided.

Primary outcomes

  1. Feasibility and Acceptability of the Online Problem-Solving Coping Strategies (PCS) Intervention

    Time frame: • Recruitment rate (% of eligible patients enrolled) - 4 months • Retention and session adherence (completion of ≥6/8 sessions) - 8 weeks • Participant satisfaction using the Feasibility Questionnaire (score range: 13-65; 8weeks)

    Feasibility and acceptability were evaluated using a self-developed Feasibility Questionnaire (score range: 13-65; higher scores indicate greater satisfaction and tolerance).

Secondary outcomes

  1. Preliminary Effectiveness of the Online Problem-Solving Coping Strategies (PCS) Intervention

    Time frame: Assessments were completed at baseline and at 8 weeks following the intervention. • Change in Problem-Focused Coping (Brief-COPE subscale) baseline to 8 weeks

    Preliminary Effectiveness of the Online Problem-Solving Coping Strategies (PCS) Intervention Effectiveness was assessed by comparing pre- and post-intervention coping changes between PCS and Treatment-as-Usual (TAU) groups. Problem-focused coping was measured using the Brief COPE Scale (scores 8-32; higher scores indicate greater use of problem-focused strategies).

Sponsors and collaborators

Lead sponsor

American University of Beirut Medical Center

Other

Collaborators

  • University of Michigan

Registry information

Important dates

Study start
2023
Primary completion
2023
Study completion
2024
First posted
Apr 2, 2026
Registry last updated
Apr 2, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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