Skip to main content

Main menu

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • AV Rheum
    • Forum
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Author Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Accessibility
  • Contact Us
  • JRheum Supplements
  • Publisher Services

User menu

  • My Cart
  • Log In

Search

  • Advanced search
The Journal of Rheumatology
  • JRheum Supplements
  • Publisher Services
  • My Cart
  • Log In
The Journal of Rheumatology

Advanced Search

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • AV Rheum
    • Forum
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Author Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Accessibility
  • Contact Us
  • Follow jrheum on Twitter
  • Visit jrheum on Facebook
  • Follow jrheum on LinkedIn
  • Follow jrheum on RSS
Research ArticleArticle
Open Access

A Randomized Controlled Trial of an Internal Family Systems-based Psychotherapeutic Intervention on Outcomes in Rheumatoid Arthritis: A Proof-of-Concept Study

Nancy A. Shadick, Nancy F. Sowell, Michelle L. Frits, Suzanne M. Hoffman, Shelley A. Hartz, Fran D. Booth, Martha Sweezy, Patricia R. Rogers, Rina L. Dubin, Joan C. Atkinson, Amy L. Friedman, Fernando Augusto, Christine K. Iannaccone, Anne H. Fossel, Gillian Quinn, Jing Cui, Elena Losina and Richard C. Schwartz
The Journal of Rheumatology August 2013, jrheum.121465; DOI: https://doi.org/10.3899/jrheum.121465
Nancy A. Shadick
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nancy F. Sowell
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Michelle L. Frits
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Suzanne M. Hoffman
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Shelley A. Hartz
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Fran D. Booth
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Martha Sweezy
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Patricia R. Rogers
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Rina L. Dubin
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joan C. Atkinson
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Amy L. Friedman
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Fernando Augusto
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christine K. Iannaccone
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anne H. Fossel
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gillian Quinn
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jing Cui
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Elena Losina
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard C. Schwartz
From the Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; Department of Psychiatry, Cambridge Health Alliance, Boston, Massachusetts; Center for Self Leadership, Oak Park, Illinois; and Department of Psychology, Massachusetts School of Professional Psychology, Boston, Massachusetts, USA. Supported by the Bristol Myers Squibb Foundation, ABBVIE, and Genentech. N.A. Shadick, MD, MPH, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; N.F. Sowell, MSW, Department of Psychiatry, Cambridge Health Alliance; M.L. Frits, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; S.M. Hoffman, PhD; S.A. Hartz, RN, MSN, CS; F.D. Booth, MSW, Center for Self Leadership; M. Sweezy, PhD, Department of Psychiatry, Cambridge Health Alliance; P.R. Rogers, MSW; R.L. Dubin, Ed.D; J.C. Atkinson, MSW; A.L. Friedman, MSW; F. Augusto, PhD, Center for Self Leadership; C.K. Iannaccone, MPH; A.H. Fossel, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; G. Quinn, Department of Psychology, Massachusetts School of Professional Psychology; J. Cui, PhD; E. Losina, PhD, Department of Medicine, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Harvard Medical School; R.C. Schwartz, PhD, Center for Self Leadership. Address correspondence to Dr. N.A. Shadick, Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, USA. E-mail: nshadick@partners.org. Full Release Article. For details see Reprints/Permissions at jrheum.org. Accepted for publication June 25, 2013.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • References
  • Info & Metrics
  • PDF
  • eLetters
Next
Loading

Abstract

Objective To conduct a proof-of-concept randomized trial of an Internal Family Systems (IFS) psychotherapeutic intervention on rheumatoid arthritis (RA) disease activity and psychological status.

Methods Patients with RA were randomized to either an IFS group for 9 months (n = 39) or an education (control) group (n = 40) that received mailed materials on RA symptoms and management. The groups were evaluated every 3 months until intervention end and 1 year later. Self-assessed joint pain (RA Disease Activity Index joint score), Short Form-12 physical function score, visual analog scale for overall pain and mental health status (Beck Depression Inventory, and State Trait Anxiety Inventory) were assessed. The 28-joint Disease Activity Score-C-reactive Protein 4 was determined by rheumatologists blinded to group assignment. Treatment effects were estimated by between-group differences, and mixed model repeated measures compared trends between study arms at 9 months and 1 year after intervention end.

Results Of 79 participants randomized, 68 completed the study assessments and 82% of the IFS group completed the protocol. Posttreatment improvements favoring the IFS group occurred in overall pain [mean treatment effects –14.9 (29.1 SD); p = 0.04], and physical function [14.6 (25.3); p = 0.04]. Posttreatment improvements were sustained 1 year later in self-assessed joint pain [–0.6 (1.1); p = 0.04], self-compassion [1.8 (2.8); p = 0.01], and depressive symptoms [–3.2 (5.0); p = 0.01]. There were no sustained improvements in anxiety, self-efficacy, or disease activity.

Conclusion An IFS-based intervention is feasible and acceptable to patients with RA and may complement medical management of the disease. Future efficacy trials are warranted. Clinical Trials.gov identifier: NCT00869349.

Next
Back to top

In this issue

The Journal of Rheumatology
Vol. 46, Issue 2
1 Feb 2019
  • Table of Contents
  • Table of Contents (PDF)
  • Index by Author
  • Editorial Board (PDF)
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about The Journal of Rheumatology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
A Randomized Controlled Trial of an Internal Family Systems-based Psychotherapeutic Intervention on Outcomes in Rheumatoid Arthritis: A Proof-of-Concept Study
(Your Name) has forwarded a page to you from The Journal of Rheumatology
(Your Name) thought you would like to see this page from the The Journal of Rheumatology web site.
Citation Tools
A Randomized Controlled Trial of an Internal Family Systems-based Psychotherapeutic Intervention on Outcomes in Rheumatoid Arthritis: A Proof-of-Concept Study
Nancy A. Shadick, Nancy F. Sowell, Michelle L. Frits, Suzanne M. Hoffman, Shelley A. Hartz, Fran D. Booth, Martha Sweezy, Patricia R. Rogers, Rina L. Dubin, Joan C. Atkinson, Amy L. Friedman, Fernando Augusto, Christine K. Iannaccone, Anne H. Fossel, Gillian Quinn, Jing Cui, Elena Losina, Richard C. Schwartz
The Journal of Rheumatology Aug 2013, jrheum.121465; DOI: 10.3899/jrheum.121465

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

 Request Permissions

Share
A Randomized Controlled Trial of an Internal Family Systems-based Psychotherapeutic Intervention on Outcomes in Rheumatoid Arthritis: A Proof-of-Concept Study
Nancy A. Shadick, Nancy F. Sowell, Michelle L. Frits, Suzanne M. Hoffman, Shelley A. Hartz, Fran D. Booth, Martha Sweezy, Patricia R. Rogers, Rina L. Dubin, Joan C. Atkinson, Amy L. Friedman, Fernando Augusto, Christine K. Iannaccone, Anne H. Fossel, Gillian Quinn, Jing Cui, Elena Losina, Richard C. Schwartz
The Journal of Rheumatology Aug 2013, jrheum.121465; DOI: 10.3899/jrheum.121465
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Save to my folders

Jump to section

  • Article
  • References
  • Info & Metrics
  • PDF
  • eLetters

Related Articles

Cited By...

More in this TOC Section

  • Radiographic Progression Inhibition with Intravenous Golimumab in Psoriatic Arthritis: Week 24 Results of a Phase III, Randomized, Double-blind, Placebo-controlled Trial
  • OMERACT Development of a Core Domain Set of Outcomes for Shared Decision-making Interventions
  • Cyclophosphamide for Systemic Sclerosis-related Interstitial Lung Disease: A Comparison of Scleroderma Lung Study I and II
Show more Articles

Similar Articles

Content

  • First Release
  • Current
  • Archives
  • Collections
  • AV Rheum
  • Forum

Resources

  • Guide for Authors
  • Submit Manuscript
  • Author Payment
  • Reviewers
  • Advertisers
  • Classified Ads
  • Reprints and Translations
  • Permissions
  • Meetings
  • FAQ
  • Policies

Subscribers

  • Subscription Information
  • Purchase Subscription
  • Your Account
  • Terms and Conditions

More

  • About Us
  • Contact Us
  • My Alerts
  • My Folders
  • RSS Feeds
The Journal of Rheumatology
The content of this site is intended for health care professionals.
Copyright © 2016 by The Journal of Rheumatology Publishing Company Limited
Print ISSN: 0315-162X; Online ISSN: 1499-2752
Powered by HighWire