Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system that leads to a wide range of physical and psychological challenges, including depression and anxiety, which can significantly impair quality of life and treatment adherence. Providing psychological support is crucial for improving patient well-being. Telepsychotherapy and other telematic interventions have emerged as effective solutions for managing MS-related mental health issues, offering increased accessibility while reducing barriers related to mobility, cost, and time. Specific psychological needs should be considered when delivering psychological interventions to individuals with MS. However, challenges remain, including difficulties in establishing and maintaining a therapeutic alliance, low adherence, technological issues, and privacy concerns. For a more comprehensive and effective approach to mental health needs and to improve long-term care for people with MS, the design of telematic therapies, including proactive psychological interventions, should address these limitations and concerns.