Mindful or mind-full? An eight-week program on mental health and quality of life in people with multiple sclerosis

Arm 1: Mindfulness-based cognitive therapy (face to face, 8x2hour sessions, once/week for 8 weeks, at MSWA office, delivered by trained MBCT clinical psychologist, plus a daily 20 minute home practice) Arm 2: Mindfulness-based cognitive therapy (online, 8x2hour sessions, once/week for 8 weeks, at participants' home or their preferred place, delivered by trained MBCT clinical psychologist, plus a daily 20 minute home practice) Arm 3: yoga (face to face, 8x2hours sessions, once/week for 8 weeks, at Yoga Space studio, delivered by trained yoga teacher trainee, plus a daily 20 minute home practice) Arm 4: wait-list control group (receive yoga after 8 weeks, face to face, 8x2hours sessions, once/week for 8 weeks, at Yoga Space studio, delivered by trained yoga teacher trainee, plus a daily 20 minute home practice) The MBCT intervention includes cognitive therapy and mindfulness practice. Each of the weekly session involves learning to disengage and detach from habitual ruminative thoughts and action, being aware of the warning signs, choosing an action (instead of the habitual destructive thoughts and actions) when encountering potential stressors and maintaining mindful practices in daily routines. Participants will also have a handbook. Depending on the level of commitment the participants could commit to at the screening phase, a brief MBCT (maximum 75-90 minutes per session) might be provided instead of the full MBCT program to allow people with MS but are time-poor to participate. The brief MBCT program is based on the same model and content, but shortened and valid. It also allows people without formal diagnosis of depression to participate, which is likely to be more inclusive of most people with MS. The yoga will be similar to a stretching yoga (Hatha yoga) adaptable for wheelchair-bound participants (if any). The trained MBCT clinical psychologist will record attendance at each session. Adherence to home practice will be recorded at each four-week interval for the six-month follow-up by asking intervention participants to note in their diaries “On average, how many minutes per day and days per week did you practise active mindfulness every week, such as in the form of body scan, mindful movement or breath meditation?”, “Which practice did you use?”, “What obstacles have you experienced while trying to practise?,”, “What insights did you gain while practising (if any)?”, “Comment on overall benefit of practice since the last time".