A Trial of Home-Based Cognitive-Behavioral Therapy for Arthritis in a Regional Center

Residents of rural and regional areas often have limited access to health care professionals. This study investigated the ability of a modification of the Arthritis Basics for Change program developed by the American Arthritis Foundation to improve psychosocial functioning in a group of individuals with osteoarthritis and rheumatoid arthritis who lived in northern Queensland. The program comprised five, home-based sessions spaced over three weeks incorporating an audio CD and two 10-minute telephone consultations. A total of 34 individuals (7 males, mean age 59 years) were randomly assigned to either an intervention group or a wait list control group. Measures were administered before, after and at three-months follow up and included the Arthritis Helplessness Index, Hospital Anxiety and Depression Scale, Health Assessment Questionnaire, and the Coping Strategies Questionnaire. Improvements in both groups were noted in helplessness, anxiety, and depression following the program and at a three-month follow up. No changes were observed for pain, disability, or coping skills across time and between groups. A higher proportion of individuals in the intervention group than in the control group attained clinically significant improvement on the HADS Depression scale. Despite the small sample size, results showed that some significant gains can be made through short, specifically tailored interventions.