Do you believe you have the power and skills to complete tasks and accomplish specific goals? If so, you have a high level of self-efficacy. People with high self-efficacy may be said to have a “can do” spirit.
Self-efficacy can be influenced by past experience, peer pressure, and physiological factors. Self-efficacy can also influence behavioral choices (e.g., avoiding tasks when belief in our ability is low, or choosing to undertake tasks when self-efficacy is high), affect motivation (e.g., people with high self-efficacy are more likely to persist in order to accomplish a task, whereas people with low self-efficacy might be discouraged and give up sooner), and affect thought patterns and responses (e.g., low self-efficacy can make you think a task is more difficult than it actually is, which leads to poor planning and increased stress).
Multiple sclerosis is a disease that can erode one’s independence and lead to lower self-efficacy. MS is often associated with significant reduction in physical activity, which also correlates with lower self-efficacy. Conversely, higher self-efficacy has a positive effect on physical activity and correlates with higher health-related quality of life (HRQoL) and lower rates of depression.
It’s important to develop effective ways to improve self-efficacy in people with MS. In multiple studies, researchers in the Netherlands have tested the short- and long-term effects of an intensive three-day, multidisciplinary, social cognitive “Can Do” treatment program in people with MS with the participation of their support partners.
What is the ‘Can Do’ program?
Rooted in sociology, the Can Do treatment program encourages participants to identify stressors that confine them to their physical, psychological, or social roles. Then the program aims to help them uncover their potential and use their existing capabilities to reduce the stressors. The Can Do treatment pushes participants to explore and exceed their own boundaries and create new boundaries. The treatment is centered on patients with their support partners, offers group sessions, and focuses on self-reliance, autonomy, and acceptance.
Crucial to the Can Do treatment is that patients and their support partners are continuously encouraged to make choices and to take action, and are thus stimulated to make optimal use of their self-efficacy. To provide a realistic framework for the capabilities of each individual, the central mottos are I Can, I Will, and I Choose. The treatment’s message is that by exploring their boundaries, people with MS become more aware of their faculties and improve their self-management, leading to a higher awareness of their potential and better communication with health care professionals.
Who does the Can Do program help?
Researchers conducted a 12-month study of the Can Do treatment program in 60 people with relapsing and progressive forms of MS, but only 36 participants submitted all questionnaires at 12 months and provided analyzable data. Twenty-two of those participants had RRMS and 14 had progressive MS.
Twelve months after the Can Do treatment, participants in the RRMS group demonstrated a 20 percent increase in self-efficacy control and 15 percent increase in physical HRQoL; depression and anxiety decreased by approximately 30 and 26 percent, respectively. However, in the progressive group, there were no changes that suggested improvements, except for a 26 percent decrease in depression.
In a previous study, the researchers observed a 25 percent increase in self-efficacy control and 22 and 18 percent increases in mental and physical HRQoL, respectively, in participants with RRMS six months after participating in the Can Do treatment program. Again, in the six-month study, there were no statistically significant improvements in the progressive MS group.
Researchers could not explain the absence of improvements in progressive patients, but note that the 12-month changes may have been clinically relevant in patients with RRMS. Authors suggest that benefits arose from participants having more confidence with managing symptoms and coping with the demands of their disease, having a better overall well-being, a better mood, and being less anxious and less fatigued.
It is interesting to note that the multidisciplinary team working with the patients during the Can Do treatment program observed no differences between the RRMS and progressive MS patients in terms of benefiting from the program in the short-term. Authors suggest that it might be that progressive patients need long-term, low-intensity aftercare to extend the benefits of the program as these patients are faced with continuous increases in disabilities and limitations.
How can I find a Can Do program near me?
The Can Do Multiple Sclerosis non-profit organization based in Colorado offers a four-day CAN DO program for people with MS and their support partners, as well as a two-day TAKE CHARGE program and a one-day JUMPSTART program. These are scheduled throughout the country. They also offer short online webinars covering single topics.
Lisa Emrich is a patient advocate, accomplished speaker, author of the award-winning blog Brass and Ivory: Life with MS and RA, and founder of the Carnival of MS Bloggers. Lisa uses her experience to educate patients, raise disease awareness, encourage self-advocacy, and support patient-centered research. Lisa frequently works with non-profit organizations and has brought the patient voice to health care conferences and meetings worldwide. Follow Lisa on Facebook, Twitter, and Pinterest.