A Brief emotion-focused psychodynamic intervention for fatigue, pain, and health-related quality of life in women with relapsing–remitting multiple sclerosis: A randomized pilot trial

Aims: To examine the feasibility, acceptability, and preliminary clinical outcomes of an eight-session individual emotion-focused psychodynamic intervention for women with relapsing–remitting multiple sclerosis (RRMS). Methods: In this randomized pilot trial, 30 women with RRMS were allocated to either an eight-session individual emotion-focused psychodynamic intervention (n = 15) or treatment as usual (TAU; n = 15). Fatigue (Fatigue Severity Scale), pain (McGill Pain Questionnaire–Pain Rating Index), and health-related quality of life (HRQoL; MSQOL-54) were assessed at baseline, immediately after treatment, and at one-month follow-up. Feasibility outcomes included recruitment, retention, treatment attendance, and intervention delivery. Clinical outcomes were explored using repeated-measures analyses of variance to estimate patterns of change and preliminary effect sizes. Results: Recruitment and retention supported the feasibility of the intervention, with 93% of participants completing the post-treatment assessment and 90% completing the one-month follow-up. Mean attendance was 7.3 of 8 sessions, and no intervention-related adverse events occurred. Exploratory analyses showed significant Group × Time interactions for fatigue, pain, and HRQoL (all p < .001), with large effect sizes (partial η² = .59–.73). Participants receiving the intervention demonstrated substantial reductions in fatigue and pain and improvements in HRQoL, with these changes largely maintained at one-month follow-up. Conclusions: This pilot randomized trial demonstrated that a brief emotion-focused psychodynamic intervention was feasible and acceptable for women with RRMS. The observed improvements in fatigue, pain, and HRQoL provide preliminary estimates of potential clinical benefit and support further evaluation in a fully powered randomized controlled trial. © 2026 Elsevier B.V.