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We are currently developing and evaluating this course ...

Rheumatoid Arthritis Trial



Researchers at the University of Sydney and Macquarie University are conducting a trial looking at the effectiveness of two evidence-based online interventions for people with Rheumatoid Arthritis (RA).


Our aim is to explore and compare different evidence-based online interventions as a way of increasing access to psychologically-based interventions for RA. We know these interventions can really help people to manage the impacts of RA on their day-to-day lives and their emotional wellbeing. However, we know many people with RA struggle to access these kinds of interventions in their traditional face-to-face form.


You can learn more about RA and this trial below ...


About Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is a progressive and chronic autoimmune disorder, which affects approximately 1% of the population. Because RA is an autoimmune disorder, it causes the body to attack healthy cells, resulting in inflammation and damage to the tissue and joints. As such, RA can be incredibly painful and debilitating – especially if left untreated.

Although effective drugs have been developed to help manage RA, there is no cure. This means that it is something which people must learn to manage. However, the physical limitations and the uncontrolled pain associated with RA can trigger negative thoughts and feelings, resulting in the development of anxiety or depression in some people. For this reason, psychological treatments have become an important strategy in the management of RA.

RA can impact almost all areas of our lives. Some common impacts include:

  • Physical impact: pain, inflammation, joint swelling and tenderness, morning stiffness, fatigue, loss of appetite, weight loss, fever, weakness.

  • Behavioural impact: reduced activities, irritability, avoidance, doing fewer pleasurable activities, getting into underdoing-overdoing activity cycles.

  • Mental impact: negative thoughts about your RA or your ability to cope, self-criticism, self-doubt and worry are also common.


Because the primary symptoms of RA are pain and reduced mobility, this can affect people’s ability to participate in many aspects of life. For instance, people with RA may find it difficult to work or may be forced to take time off from work when their symptoms flare up. Individuals with RA may also find themselves limited or unable to participate in activities which they previously enjoyed, which can result in feeling isolated from friends and family.

It is understandable that people with RA often experience a decline in their mental health and quality of life. In fact, approximately 16% of people with RA report clinically significant depressive symptoms, a figure substantially higher than that found in the general population. The good news is that there are practical strategies that can be used to manage pain, anxiety and depression, which can limit the impact that RA has on your life.

Treatment of Rheumatoid Arthritis

It is important to work with your doctor to ensure that you are receiving the appropriate medical treatment for your RA. Fortunately, effective medications, such as disease-modifying anti-rheumatic drugs (DMARDs), are available which can prevent joint damage and improve physical functioning.

However, pain is a persistent symptom of RA, which many find difficult to manage. As such, there has been a long history of implementing psychological treatments alongside medical interventions. In fact, the European League Against Rheumatism (EULAR) guidelines recommend that programs which help people better cope with the pain and disability associated with RA, should be used as an adjunct to medical treatment.

Psychological treatments typically focus on teaching people multiple coping strategies to deal with their physical symptoms, as well as their negative thoughts and feelings. Importantly, research also supports the use of these treatments, as they have been found to produce improvements in pain, disability and psychological wellbeing in those with RA.

For further information about treatment options and assistance you can:

(a) Talk to your General Practitioner
(b) See another health professional to learn pain management strategies.
(b) Or, you can continue reading to find out more about a clinical trial for RA that we are running.

What have we found so far?

We have now had a lot of people complete this course. Participants are reporting improvements in:


  • PTSD and other trauma-related symptoms

  • Stress and generalised anxiety

  • Low mood and depression


Although the Course is hard work, more than 90% of participants are also reporting the course is worth their time and that they'd recommend it to others. 

Some of the key papers we have published on this course are:

  • Spence J, Titov N, Johnston L, Jones MP, Dear BF, Solley K. (2014). Internet-based trauma-focussed cognitive behavioural therapy for PTSD with and without exposure components: A randomised controlled trial. Journal of Affective Disorders, 162, 73-80. 

  • Spence J, Titov N, Dear BF, Johnston L, Solley K, Lorian C, Wootton B, Zou J, Schwencke G. (2011). A Randomized Controlled Trial of Internet-based Cognitive Behaviour Therapy for Posttraumatic Stress Disorder. Depression and Anxiety, 28, 541-550. 

What is the current trial or study looking at?

Every time we offer a course we offer it as a part of a trial or study. This means that participants are helping us to answer an important research question while they participate in our courses.

The current trial seeks to better understand why some interventions are more effective for specific individuals than others. By developing and evaluating online versions of these interventions, we also hope to increase accessibility to these interventions.

As part of this study, you will be randomly assigned to either one of two different treatments or to a waitlist control condition. Both treatment groups will complete an 8-week online course. During the course you will be guided by a registered clinical psychologist who will offer telephone and email support. If you are allocated to the waitlist control, you will not be given access to either program during the trial. However, at the conclusion of the trial (after approximately 6 months), you will be given access to the program of your choice.

Who is the trial suitable for?

To be eligible for inclusion in this study, you must be an adult (aged over 18) who is currently living in Australia and has a confirmed diagnosis of RA. In addition to this, you must also have regular access to the internet and have functional written and spoken English.

If you are receiving treatment for RA, you must have been on a consistent treatment regime for more than one month to participate in this study. If you are taking anti-depressant medication, you must have been on a stable dose for more than 8 weeks to take part in this study.

You will not be eligible for this study, if you have:

  • Suicidal intent requiring emergency care

  • Substance abuse or dependence

  • A psychotic illness

  • Received consistent psychotherapy within the last 6 months


If you have any further queries, you are welcome to contact the University of Sydney Research Team via email:

To learn more about the study and see if you are eligible, please click the button below ...

Interested in this trial?
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