The application of cognitive-behaviour therapy in altering illness representations of systemic lupus erythematosus

There is evidence to suggest that illness representations are associated with chronic illness outcomes. Accordingly, several authors have recommended that interventions aimed at improving illness outcomes should include an illness-representations component. While a few researchers have attempted to develop such interventions for chronic illness and chronic pain, no such intervention has been developed for individuals with systemic lupus erythematosus (SLE), a chronic auto-immune illness which results in a variety of negative physical and psychological symptoms. This article reports on a pilot program that investigated the feasibility of a cognitive and behavioural-based intervention for treating SLE which included an illness-representations-change component. The effectiveness of the intervention compared to usual treatment for SLE was evaluated. Also investigated was whether changed illness representations had a beneficial effect on physical health and psychological wellbeing. It was found that the intervention did change participants' treatment control and emotional representations, and that perceived stress was reduced following the intervention. The importance of these findings is discussed, two rival hypotheses for the findings obtained are explored and directions for future research are suggested.