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Dissertation defense Maaike Ferwerda

Thesis abstract: In this thesis the development and effectiveness of a tailored guided internet-based cognitive behavioural therapy is described for patients with rheumatoid arthrtis. Patients with a chronic condition such as rheumatoid arthritis, generally adapt well to living with their condition after the initial processing of having a chronic disease. However, about a third of patients suffer from anxiety or a depressive mood. Cognitive behavioural therapy has been shown to be effective in improving outcomes for these patients. In order to improve the implementation and efficiency of the intervention, the internet offers possibilities to reduce both patient and therapist time and improve the convenience of the intervention as patients can choose when and where to spend time on the therapy.

The development of the intervention was done in close collaboration with patients and several aspects such as the therapeutic relationship were explored. The internet-based treatment has been shown to be effective to improve psychological outcomes and quality of life. Therefore, implementation of the internet-based tailored therapist guided cognitive behavioural therapy is recommended.

Future research could be aimed at improvement of the intervention by a further exploration of therapist guidance online and tailoring treatments to patients needs.