Module 5: Pain Management

This chapter describes an optional treatment module on pain management. It explores sources of pain, types of MS pain (acute pain, chronic pain), self-monitoring using a pain diary, relaxation and pain, tools for coping with pain.

Challenging Unhelpful Thoughts

Chapter 5 explores methods of challenging unhelpful thoughts. It describes how to cope with diminishing enthusiasm for treatment, challenging and changing negative thoughts and perceptions (examining the evidence, language, considering alternatives, crediting the positives, and positive statements).

Identifying and Evaluating your Unhelpful Thoughts

Chapter 4 discusses the identification and evaluation of unhelpful thoughts. It describes automatic thoughts, the importance of awareness, the use of an unhelpful thought diary (UTD), the strength of emotions and physical symptoms, as well as negative thought patterns and how to identify them.

Module 8: Ending Treatment and Maintaining Gains

This chapter describes an optional treatment module on ending treatment and maintaining gains. This includes a review of the strategies and techniques that have been learned, common reactions to ending the weekly meetings and therapy overall, developing a stress management plan, and useful resources.

Module 7: Self-Injection Anxiety Counseling (SIAC)

This chapter describes an optional treatment module on self-injection anxiety counselling (SIAC). This module is designed for patients who have needle anxiety and who rely on self-injection for the management of their illness. It presents basic information about self-injection anxiety, cognitive impairment, the anxiety response, subjective units of distress (SUDS) rating, the use of hierarchies, systematic desensitization, unhelpful thoughts, the actual injection process, and relapse prevention.

Module 3: Reducing Anxiety and Worry

This chapter describes an optional treatment module on reducing anxiety and worry. It explores signs of excessive worry, the risk/resource ratio, real alarms versus false alarms, and techniques to manage anxiety and worry (determining the real risk, evaluate coping resources, estimate probability, reduce physical tension, postponing worry and scheduling worry time).

Social Support

Chapter 6 discusses social support, including its benefits, types of support (emotional, information, practical, belonging), identifying a social support network, things to consider in developing and using support, and problems that may occur when support needs are met (decreasing isolation, asking for support, your ability to provide care and support to others).

Module 6: Planning and Organization

This chapter describes an optional treatment module on planning and organization. It discusses why planning and organization are important, cognitive problems in MS, using an organizer, to-do lists, realistic daily goals and planning for bigger jobs, obstacles that interfere with planning and organization (attention and concentration problems, negative emotional reactions) and other organizational tips.

Module 1: Communication and Assertiveness

This chapter describes an optional treatment module on communication and assertiveness. It explores improving communication skills, styles of communication (passive, aggressive, passive-aggressive, and assertive), components of communication (active listening, styles of expression), obstacles to self-assertion, and how to overcome them.

Positive Activities

Chapter 3 discusses positive activities, the importance of including positive activities in plans, the relationship between activities and mood, activity diaries, scheduling positive activities, and noticing positive events.