A Tale of Two Treatments: A Randomised Controlled Trial of Mindfulness or Cognitive Behaviour Therapy Delivered Online for People with Rheumatoid Arthritis.
Louise Sharpe, Madelyne A Bisby, Rachel E. Menzies, Jack Benjamin Boyse, Bethany Richmond, Jemma Todd, Amy-Lee Sesel, Blake F Dear
Psychotherapy and Psychosomatics 2025 DOI: 10.1159/000542489 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 269 |
| Population | People with rheumatoid arthritis |
| Interventions | Mindfulness-based stress reduction Cognitive behaviour therapy |
| Duration | 6-month follow-up |
| Topics | Meditation |
| Keywords | Chronic pain Cognitive behaviour therapy Pain management Rheumatoid arthritis |
| Citations | 7 |
| Key findings | MBSR and CBT were equally efficacious in reducing pain interference compared to a waitlist control, with MBSR showing superior outcomes for fear of progression and functional ability and CBT showing superiority for pain severity. |
Abstract
This study aimed to determine the relative efficacy of mindfulness-based stress reduction (MBSR) or cognitive behaviour therapy (CBT) in comparison to a waitlist control (WLC) for people with rheumatoid arthritis (RA). Participants completed assessments before and after treatment and at 6-month follow-up. Two hundred and sixty-nine participants with RA were recruited and randomised in a 2:2:1 ratio to MBSR:CBT:WLC. Participants completed a semi-structured clinical interview for depression and were stratified for history of recurrent depression. We measured the primary outcome of pain interference, as well as pain severity, depression, anxiety, functional ability, and fear of progression. We predicted that MBSR and CBT would result in improvements compared to WLC. We also predicted that those with a history of recurrent depression would benefit more from MBSR than CBT for depression. MBSR and CBT were equally efficacious in reducing pain interference compared to WLC. Similar results were found for depression. MBSR demonstrated superior outcomes to CBT for fear of progression at post-treatment and functional ability at 6-month follow-up. CBT only was better than WLC for pain severity at 6-month follow-up. Depressive status did not moderate the efficacy of treatment. MBSR and CBT resulted in statistically and clinically significant changes in pain interference compared to WLC. MBSR was more efficacious than CBT for functional ability and fear of progression, while CBT showed superiority for pain severity. The effect sizes were comparable to those achieved with face-to-face interventions, confirming both online treatments are effective for people with RA.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 2
- Online mindfulness-based vs. cognitive-behavioural stress reduction for medical students: A randomized controlled trial. Psychiatry Research July 11, 2025
- The effectiveness of mindfulness-based interventions in reducing anxiety and depression among students: a systematic review and meta-analysis Clinical Psychologist February 9, 2026
Cites 7
- Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse JAMA Psychiatry April 28, 2016
- Feasibility and acceptability of using a meditation app in adults with rheumatic disease. Explore November 9, 2021
- A synthesis of meta-analyses of mindfulness-based interventions in pain. Pain August 14, 2023
- Development of a Web-Based Mindfulness Program for People With Multiple Sclerosis: Qualitative Co-Design Study. Journal of Medical Internet Research March 2, 2021
- Mindfulness-based stress reduction and cognitive behavioral therapy for chronic low back pain: similar effects on mindfulness, catastrophizing, self-efficacy, and acceptance in a randomized controlled trial. Pain November 2016
and 2 more in the library