Specialized Psychotherapy Shown to Help Those with Rheumatoid Arthritis

New research from Wayne State and Duke universities suggests a non-pharmaceutical approach can help individuals cope with rheumatoid arthritis (RA).

RA is a serious autoimmune disease that affects one to two percent of adults, a painful condition that can cause disability and joint disfigurement. The disease causes serious stress and can disrupt work, family life, and marital functioning.

While many pharmacological advances help some RA patients, residual pain and disability is common. And some patients avoid newer medications due to their high cost or side effects.

Because of this, researchers are looking at psychosocial interventions such as cognitive-behavioral and emotional processing approaches.

A new paper by a team of researchers from Wayne State University and collaborators from Duke University Medical Center discussed two psychological interventions separately and in combination to determine their effectiveness in offering relief to RA patients.

The paper is found in the Journal of Consulting and Clinical Psychology.

The study, led by Mark A. Lumley, Ph.D., revealed cognitive-behavioral coping skills training (CST) had positive effects on the pain and mood of patients that lasted for at least one year.

In contrast, written emotional closure (WED) — expressive writing about stress — had only temporary and inconsistent benefits on patients’ joints and functioning, and did not help with pain or mood.

The combination of CST and WED had had no unique benefits.

CST trains patients in various cognitive and behavioral techniques or skills to enhance their ability to cope with pain and improve their behavioral and psychological functioning.

A few studies have shown that WED can reduce stress and improve health by having patients write privately for 20 minutes each day for three or four days about stressful experiences and their deepest thoughts and feelings.

“Our study revealed that patients with RA receive positive benefits in both the short and long-term using cognitive behavioral techniques such as relaxation, increasing pleasant activities, changing negative thoughts, and problem-solving,” said Lumley.

“WED, however, was less effective, and an examination of patients’ expressive writings suggests that many patients either did not have much unresolved stress or more likely did not know how to effectively identify important stressors, label and express their negative emotions, and learn from or resolve these conflicts while writing by themselves.

“We probably need to identify and target those patients with unresolved stress or trauma, and then help them more effectively disclose and work with their unexpressed emotions.”

The research team noted that continued development and integration of therapies that target the full range of processes underlying pain and functioning, not just biological but also behavioral, cognitive, emotional, and interpersonal, are critical for helping more RA patients have better health status.

Source: Wayne State University

Woman with rheumatoid arthritis photo by shutterstock.