Participant perspectives on a tailored CBT intervention for migraine and multiple sclerosis: A qualitative study

A tailored psychological intervention has the potential to prevent and manage migraines in relapsing-remitting multiple sclerosis (RRMS) and improve wellbeing and meaningful participation. Acceptability of this approach is yet to be established. We explored participant perspectives on the content and delivery of a five-week telehealth intervention, tailored to RRMS and migraine, combining CBT and cognitive strategies (CBT-MMS). Transcripts from qualitative interviews were analysed through reflexive and codebook thematic analyses. Participants were 27 adults aged 22-59 years old with a RRMS history of 5.96±5.57 years, migraine history of 16.30±13.69 years, and 8.26±6.44 days of migraine per month. Five themes were generated reflecting the perceived value of CBT-MMS, including: 1-Feeling lost within a health system that has not met their needs, 2-Understanding their struggles and strengths, 3-Supported through a new therapeutic endeavour, 4-Developing a toolkit for life's challenges, and 5-One size CBT does not fit all. The therapy content and delivery were considered acceptable and relevant, though more detailed migraine education and cognitive strategy implementation were recommended. Our findings highlight the benefits of tailoring interventions to the individual with RRMS and their specific needs, and building self-efficacy through guided and practical strategies delivered by a supportive therapist.