M ultiple sclerosis (MS) is a chronic neurologi- cal disorder of the central nervous system that affects approximately 1 in 3000 people in Australia. 1 Despite advances in the medical treatment of MS, it remains a serious chronic illness that is associ- ated with progressive disability and poorer quality of life for most patients. 2-7 An Australian cross-sectional study of the service and social needs of 1145 people with MS living in New South Wales indicated that the needs asso- ciated with physical disabilities were more often met than the emotional needs of people with MS, with near- ly 30% of participants identifying support from other people with MS as an unmet need. 8 Social support has been recognized as playing an important role in assisting people with MS to adjust to their illness. Depressive symptoms and psychosocial adjustment improve in MS patients as perceived social support increases. 9,10 Peer support groups are increasingly recognized as an effective forum for this psychosocial support, 11 offering emotional, educational, and instru- mental benefits for attendees. 12 A support group is a gathering of people who share similar life experiences and meet together under the guidance of a facilitator to receive and give support. Such groups have rules and norms that are designed to create a nonjudgmental cohe- sive environment conducive to expressing thoughts and feelings. 13-15 Having the opportunity to recreate events through narratives and extract meaning from negative experiences is thought to provide catharsis for group members, 16 whereas being able to identify with others in the same situation leads to a sense of belonging. 11,17 Recent research has suggested that the group facilita- tor is crucial in determining the success of support groups. 18 Although the degree of directivity and respon- sibility of the group facilitator differs among groups, facilitators are the key people responsible for maintain- ing the group’s viability. 19 The group facilitator, either unwittingly or purposefully, sets the tone for the group and encourages supportive group behaviors. 14,20 Further- more, the facilitator is responsible for many practical tasks and provision of empathy and genuine care. 21 Not surprisingly, burnout in group facilitators is common Challenges, Needs, Rewards, and Psychological Well-Being of Multiple Sclerosis Support-Group Facilitators Ilona Juraskova, PhD; Julie Chapman, BSc; Phyllis N. Butow, PhD; Afsaneh Jolan, BSc; Rachel Zordan, BSc; Laura T. Kirsten, PhD; Christine Sedgwick, BSc Support groups are an important resource for people living with multiple sclerosis (MS). However, lit- tle is known about the effect of leadership on support-group facilitators, despite their importance in producing positive group-member outcomes. The current study assessed the needs, challenges, rewards, and psychological well-being of 61 MS support-group facilitators (56% response rate), with purpose- designed and standardized measures. On the whole, participants did not display significant difficulty with group leadership, had good psychological well-being, and found their work highly rewarding. However, one third of leaders reported a lower level of personal accomplishment, which is suggestive of burnout. Leadership training, resources, and support were identified as the main areas of concern. Significant predictors of a higher number of challenges among MS facilitators included being male, not receiving formal supervision, and spending more time running MS group meetings per week. Fur- ther investigation of MS support-group facilitators who display lower levels of personal accomplish- ment and those who have decided not to continue in their role is required to elucidate the predictors of group dissipation and support/training needs of group facilitators. Int J MS Care. 2008;10:85–93. From the Medical Psychology Research Unit, School of Psychology, University of Sydney, NSW, Australia. International Journal of MS Care 85