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Patient Educ Couns. 2013 Jun;91(3):357-63. doi: 10.1016/j.pec.2013.01.018. Epub 2013 Feb 18.

An acceptance-oriented cognitive-behavioral therapy in multimodal rehabilitation: a pre-post test evaluation in highly distressed patients with rheumatic diseases.

Author information

1
Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. j.vriezekolk@maartenskliniek.nl

Abstract

OBJECTIVE:

To examine the potential effectiveness of a multimodal rehabilitation program including an acceptance-oriented cognitive-behavioral therapy for highly distressed patients with rheumatic diseases.

METHODS:

An observational study employing a one-group pre-post test design (N=25). The primary outcome was psychological distress. Secondary outcomes were quality of life, illness acceptance, and coping flexibility. Group pre-to-post and pre-to-12 months follow-up treatment changes were evaluated by paired-samples t-tests and Cohen's effect sizes (d). Individual changes were evaluated by the reliable change index (RCI) and clinically significant change (CSC) parameters.

RESULTS:

Significant effects were found post-treatment and maintained at 12 months in psychological distress (d>0.80), illness acceptance (d=1.48) and the SF-36 subscales role physical, vitality, and mental health (d ≥ 0.65). No significant effects were found for coping flexibility and the SF-36 subscales physical functioning, bodily pain, social functioning, and role emotional. Both a reliable (RCI) and clinically significant (CSC) improvement was observed for almost half of the highly distressed patients.

CONCLUSION:

The patients enrolled in the multimodal rehabilitation program showed improved psychological health status from pre to post-treatment.

PRACTICE IMPLICATIONS:

A randomized clinical trial is needed to confirm or refute the added value of an acceptance-oriented cognitive-behavioral therapy for highly distressed patients in rehabilitation.

PMID:
23428511
DOI:
10.1016/j.pec.2013.01.018
[Indexed for MEDLINE]

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