SELF-HELP MANUAL-ASSISTED COGNITIVE BEHAVIOURAL THERAPY FOR SICKLE CELL DISEASE

The feasibility of using a self-help treatment manual to assist a cognitive behavioural therapy programme developed with the aim of improving pain coping ability and quality of life, and reducing psychological distress in sickle cell patients was evaluated. Adult patients attending a London hospital outpatient sickle cell clinic were invited to 12-week cognitive behavioural therapy. Outcome was assessed with measures of pain status, health service utilization, psychological coping (Coping Strategies Questionnaire - revised for Sickle Cell Disease), quality of life (Medical Outcomes Survey Short Form 36), and mood (Hospital Anxiety and Depression Scale). Baseline disease severity data were also collected. No significant differences in baseline data were observed between patients who completed cognitive behavioural therapy and "dropouts". Improvements over baseline at 12 weeks in patients who completed cognitive behavioural therapy were significant. Active coping and use of physician advised methods for pain increased. Emotional responses decreased, general health and vitality improved, while anxiety reduced. This demonstrates that a brief manual-assisted cognitive behavioural therapy programme is feasible in sickle cell disease, and may help to improve coping, quality of life and mood.