Table 1 Summary of PIMS sessions
Session | Content | Session delivery | Type of SDs targeted | Techniques used |
|---|---|---|---|---|
1 | • Familiarisation with workbook • Understanding the problem – How does MS affect sex and intimacy? • Identifying MS ‘roadblocks’ • Mapping sexual/intimacy challenges • Between session task: Your personal ‘snowball’ | Self-directed | Primary; Secondary; Tertiary | Education |
2 | • Anatomy and physiology of sexual response • Introduction to sexual aids and treatments for sexual difficulties • Identifying your values and goals around sex and intimacy • Between sessions task: Mirror exercise | Self-directed | Primary; Secondary | Education; ACT |
3 | • Reviewing sex and intimacy issues from session 1 • Reviewing values from session 2 • Identifying and planning goals (connected to values) • Discussing treatment options • Between session task: 3-min breathing exercise | With facilitator | Primary; Secondary | ACT |
4 | • The stigma of sex and disability • Identifying sexual beliefs • Shifting the focus on sex and intimacy • Facing challenges with self-compassion • Between session task: Self-observation mindfulness exercise | Self-directed | Tertiary | ACT; Psychosexual therapy |
5 | • Identifying and accepting unwanted thoughts • Introduction to cognitive defusion • Body image and sexuality • Becoming more aware: Staying in the present moment • Between session tasks: mindfulness during a regular activity | Self-directed | Tertiary | ACT |
6 | • An introduction to sensate focus practices with self and others • Connecting intimately with others • Enhancing communication about sex and intimacy • Defining and maintaining boundaries • Between session exercise: Mindfulness of sound | Self-directed | Tertiary | Psychosexual therapy |
7 | • Discussing treatment progress/ check in • Identifying areas of difficulty • Adapting and committing to goals • Between session exercises: Body scan | With facilitator | Primary; Secondary; Tertiary | ACT |
8 | • Personal summary of sessions • Integrating mindfulness into daily life • Establishing a toolkit for success • Adapting to changes in MS, relationships, and body image • Keeping communication open | Self-directed | Primary; Secondary; Tertiary | Education; ACT; Psychosexual therapy |