2021 CMSC Annual Meeting

Occupational Therapy Delivered Emotional Regulation Interventions: A Case-Series of Female Patients with Multiple Sclerosis


Background: Emotional health disorders are common in the Multiple Sclerosis (MS) population and can cause significant deficits in quality of life and occupational performance. Individuals with MS experience emotional health disorders at higher rates than the general population. Lifetime prevalence rates show depression can affect up to 54% and anxiety disorders can affect up to 35.7% of people living with MS. Adjustment disorders occur in 22% of individuals within 2 months of being diagnosed with MS. Despite these statistics, emotional health disorders and related needs often go underdiagnosed and undertreated. Occupational therapy practitioners (OTPs) can address emotional regulation in clinical treatment as a component of the occupational performance area of health management and maintenance instrumental activities of daily living. This includes developing, managing, and maintaining health-promoting habits and routines to improve occupational performance, health, and quality of life. Specific interventions include education, trigger identification, technique training, self-monitoring, and symptom response planning. Objectives: Describe the delivery of emotional regulation interventions in patients with MS and provide a descriptive case series with clinical outcomes to demonstrate how these interventions can be integrated into an OT plan of care for females living with MS. Methods: The subjects (n=4) included in this case series participated in an average of 15 OT sessions over the course of their individual plans of care. All subjects were female, diagnosed with an emotional health disorder, and were between the ages of 30 and 53 at time of treatment. The Canadian Occupational Performance Measure (COPM), Multiple Sclerosis Quality of Life Inventory (MSQLI), and Health Related Quality of Life Short Form-36 (SF-36) were administered at pre- and post-intervention. Results: Overall, subjects demonstrated significant improvements throughout the course of their respective plans of care. Clinically significant improvements occurred in the COPM aggregate performance and satisfaction scores, with patients demonstrating an average 3.6-point increase on performance and 5.4-point increase on satisfaction. On average, SF-36 scores improved in 6.75 subscales including emotional well-being and vitality/energy, and MSQLI scores improved in 4.25 subscales including the Perceived Deficits Questionnaire. Conclusions: This case series supports the delivery of emotional regulation interventions by OTPs over the course of a plan of care to address emotional health needs in females living with MS. Additionally, these findings contribute to the broader evidence for the benefits of addressing emotional health needs in the MS population.