title: Behavior change, acceptance, and coping flexibility in highly distressed patients with rheumatic diseases: feasibility of a cognitive-behavioral therapy in multimodal rehabilitation.
abstract: OBJECTIVE
  To describe the development and feasibility of the integration of a cognitive-behavioral therapy (CBT) within a multimodal rehabilitation program for highly distressed patients with rheumatic diseases.
  
  
  METHODS
  Development included the detailed specification of the theoretical and empirical-based underpinnings of the CBT and the comprehensive description of its design and content. Feasibility was assessed by percentage of eligible patients, attrition and attendance rates, and patient satisfaction.
  
  
  RESULTS
  The developed CBT component seeks to decrease psychological distress and improve activities and participation across multiple life domains by accomplishing behavior change, acceptance, and coping flexibility. Motivational interviewing was applied to endorse patients' own reasons to change. Forty percent (35/87) of the eligible patients were admitted to the program. Attendance rate (>95%) was high. Patient satisfaction ranged from 6.8 to 8.0 (10-point scale).
  
  
  CONCLUSIONS
  Integrating CBT within a multimodal rehabilitation program is feasible. An acceptable proportion of the intended patient sample is eligible and patient's attendance and satisfaction is high.
  
  
  CONCLUSIONS
  Patients with impaired physical and psychosocial functioning despite adequate medical treatment pose a great challenge. Their treatment outcome may be improved by screening and selecting highly distressed patients and offering them a CBT embedded in multimodal rehabilitation program.
authors: Sint Maartenskliniek, Department of Rheumatology, Nijmegen, The Netherlands. j.vriezekolk@maartenskliniek.nl
authors: Johanna E
authors: JE
authors: Vriezekolk
authors: Rinie
authors: R
authors: Geenen
authors: Cornelia H M
authors: CH
authors: van den Ende
authors: Helma
authors: H
authors: Slot
authors: Wim G J M
authors: WG
authors: van Lankveld
authors: Toon
authors: T
authors: van Helmond
mesh_terms: D000223:Adaptation, Psychological; D001521:Behavior Therapy; D015928:Cognitive Behavioral Therapy; D003376:Counseling; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D009788:Occupational Therapy; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011788:Quality of Life; D012216:Rheumatic Diseases / Q000523:psychology* / Q000534:rehabilitation*; D013315:Stress, Psychological; D016896:Treatment Outcome