Support for a non-therapist assisted, internet-based cognitive-behavioral therapy (iCBT) intervention for mental health in rheumatoid arthritis patients
Open accessAbstract
Anxiety is common in patients with rheumatoid arthritis (RA) and associated with worse RA outcomes. This study assessed the feasibility and preliminary health impacts (mental and physical) of a non-therapist assisted, online mental health intervention targeting anxiety in this population. Participants with confirmed RA and elevated anxiety symptoms were enrolled into the Worry and Sadness program, an Internet-based cognitive-behavioral therapy (iCBT) intervention for anxiety and depression shown to be effective in the general population. Validated self-report measures of anxiety, depression, pain interference, fatigue, physical health-related quality of life, functional status, and patient-reported disease severity were collected at baseline, post-intervention, and at three-month follow-up. Emotional distress scores were tracked between lessons. Participants provided qualitative feedback in writing post-intervention. We analyzed the responses of 34 participants; the majority was female (86%) and the mean age was 57 (SD = 13). Of these, 80% (n = 28) completed the study in its entirety. Among these completers, 94.1% described the program as worthwhile. We found statistically significant improvements in anxiety, depression and fatigue from baseline to three-month follow-up, with small to large effect sizes (d = 0.39–0.81). Post-hoc analyses revealed that statistically significant change occurred between baseline and post-intervention for anxiety and depression and was maintained at three-month follow-up, whereas statistically significant change occurred between baseline and three-month follow-up for fatigue. Statistically significant reductions in emotional distress occurred across the program, with a large effect size (d = 1.16) between the first and last lesson. The Worry and Sadness program shows promise as a feasible resource for improving mental health in RA.
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Pain researchers also describe alternative development strategies, such as digitalizing a paper-based self-help book or treatment manual, adapting or testing a digital treatment originally targeting another condition, relying on clinical expertise and knowledge of the research team, and/or following theoretical frameworks.
“Pain researchers also describe alternative development strategies, such as digitalizing a paper-based self-help book or treatment manual (Bendelin et al., 2018; Ljótsson et al., 2014), adapting or testing a digital treatment originally targeting another condition such as depression or anxiety (Blaney et al., 2021; Dear et al., 2018), relying on clinical expertise and knowledge of the research team”
From Using Personas in the development of eHealth interventions for chronic pain: A scoping review and narrative synthesis (2023) · cites this paper as Blaney et al., 2021
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Digital Psychiatry for the Treatment of Comorbid Disorders
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Exploring psychological symptom associations among people living with HIV using an apriori algorithm
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- Authors
- Blaney, C., Hitchon, C. A., Marrie, R. A., Mackenzie, C., Holens, P., & El-Gabalawy, R.
- Affiliations
- University of Manitoba (CA)
- Corresponding author
- El-Gabalawy, Renée
- ORCID
- Venue
- Internet Interventions
- Publisher
- Elsevier BV
- Published
- 2021-04
- Volume
- 24
- Pages
- 100385
- ISSN
- 2214-7829 (ISSN-L)
- PMC
- PMC8056225
- OpenAlex
- W3149545080
- Cited by
- 14
- References
- 52
- Citations by year
- 2026: 2 · 2025: 3 · 2023: 3 · 2022: 4 · 2021: 2
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Internet Interventions (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Arthritis Society
- University of Manitoba
- Canadian Institutes of Health Research
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- rheumatoid arthritis, internet-based cognitive behavioral therapy, anxiety, depression, fatigue, mental health, emotional distress, feasibility, pain interference, health-related quality of life
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