Client-centred therapy in multiple sclerosis: more intensive diagnostic evaluation and less intensive treatment

Area of Science:

• Rehabilitation Medicine
• Clinical Psychology

Background:

• Client-centred practice offers benefits in communication and process measures.
• However, client-centred practice has been linked to suboptimal functional outcomes.

Purpose of the Study:

• To investigate if client-centred therapy allocates more time to diagnostic consultation than to treatment.
• To compare this allocation against usual care in rehabilitation.

Main Methods:

• A multicentre cluster randomised controlled trial involving 269 outpatients with multiple sclerosis.
• Data collected on diagnostic and treatment goals, session numbers, therapy duration, and intensity.

Main Results:

• Client-centred therapy showed increased sessions for diagnostic consultation (10.9% difference, p=0.030).
• Longer time to formulate initial treatment goals (11.4 days difference, p=0.041) and a tendency towards more diagnostic goals were observed.
• Increased hours on indirect issues (1.16 h difference, p=0.051) and a longer total therapy period (1.56 months difference, p=0.058) were noted.

Conclusions:

• Client-centred therapy involves a more intensive diagnostic evaluation phase.
• This leads to less intensive treatment, potentially impacting functional outcomes.
• Recommendations suggest adjusting the time distribution between diagnostics and treatment in client-centred therapy.