No abstract

(Objective. This paper critically reviews research studies examining the long-term effects of cognitivebehavioral therupy interventions for managing pain in rheumatoid arthritis patients. Methods and Results. The first section of the paper evaluates long-term results obtained in studies of cognitive-behavioral therapy, arthritis education inter vent ions, and combined cognitive-behavioral therapy-arthritis education interventions. These studies :jhor/v that although some rheumatoid arthritis patients lire able to maintain initial improvements in pain and cllisability, other rheumatoid arthritis patients do not. In the second section of this review, a cognitive-behavioral model of maintenance of pain coping skills ,is presented. This model may be useful in increasing our understanding of the relapse process and in plan-.iling interventions to enhance and prolong cognitivebehtrvioral therapy treatment gains. The final section of this paper addresses important future directions jor research. The need for empirical studies of relapse m d maintenance processes is underscored. Conclusions. Controlled studies are needed to test i he utility of new cognitive-behavioral interventions designed to enhance the long-term maintenance of irealment gains in RA patients. We suggest that a focus on issues of relapse and maintenance may be just as important for medical and surgical interventions for rheumatoid arthritis pain, as it is for cognitive-behavioral therapy interventions.