Effectiveness of an emotion-focused behavioral treatment program for adults with multiple sclerosis

INTERVENTION: Immediately after randomization using a random digits table, participants in the experimental group will receive the Unified Protocol for Adolescents (UP‐A) for 12‐14 weeks. The control group will receive treatment as usual, which involves no behavioural treatment. The UP‐A sessions are delivered in a flexible manner. Several of the UPs treatment elements are fixed and received by all participants (psychoeducation about emotions and emotional behavior, awareness and mindfulness skills, antecedent cognitive reappraisal/problem‐solving skills, emotion exposure strategies, and relapse prevention skills), although applied for varying numbers of sessions depending on clinical need. Other strategies (motivational enhancement, parenting strategies and crisis management strategies) are applied on an as‐needed basis based on client needs. CONDITION: Emotional regulation difficulties in people with multiple sclerosis and associated depression or anxiety disorder ; Mental and Behavioural Disorders PRIMARY OUTCOME: ; 1. Depression assessed using the Hospital Anxiety and Depression Scale (HADS) at baseline, after the end of the intervention and 3 months after the end of the intervention; 2. Anxiety assessed using the Hospital Anxiety and Depression Scale (HADS) at baseline, after the end of the intervention and 3 months after the end of the intervention; 3. Emotion regulation difficulties assessed using the Difficulties in Emotion Regulation Scale (DERS) at at baseline, after the end of the intervention and 3 months after the end of the intervention; SECONDARY OUTCOME: ; 1. Extent of emotion regulation difficulty assessed using the Difficulties in Emotion Regulation Scale (DERS) at baseline, after the end of the intervention and 3 months after the end of the intervention; 2. Positive and negative affect assessed using the Positive and Negative Affect Schedule (PANAS) at baseline, after the end of the intervention and 3 months after the end of the intervention; 3. Mindful awareness of distressing thoughts and images assessed using the Southampton Mindfulness Questionnaire (SMQ) at baseline, after the end of the intervention and 3 months after the end of the intervention; 4. Use of emotional regulation strategies assessed using the Emotion Regulation Questionnaire (ERQ‐R) at baseline, after the end of the intervention and 3 months after the end of the intervention; INCLUSION CRITERIA: 1. Diagnosis of MS for 3 years or more 2. Fluent in Persian 3. Aged at least 18 years 4. Received at least one current diagnostic of a valid depression disorder and an anxiety disorder on Structural Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition Axis I Disorders. 4. Received at least one self‐report score outside the cut‐off range specified for screening measures for anxiety (using the HADS‐A scale) and depression (using the HADS‐S scale 5. Willing to participate in the research 6. Completed and signed consent form 7. Medical MS agreement for participation