Hospital Practices and Research

Improving Emotion Regulation and Reducing Stress in Patients with Rheumatoid Arthritis through Emotion-Focused Therapy

Articles in Press

Document Type : Original Article

Authors

Farideh Zeinali 1
Cyrus Momenzadeh 1, 2
Haydeh Saberi 3

1 Department of Psychology, SR.C., Islamic Azad University, Tehran, Iran

2 Pain Fellowship, Shahid Beheshti University of Medical Science, Tehran, Iran

3 Department of Psychology, Ro.C., Islamic Azad University, Roudehen, Iran

10.30491/hpr.2026.580886.1536
Abstract
Background: Patients with rheumatoid arthritis (RA) often experience significant psychological distress, including difficulties with emotion regulation and high levels of stress, which can exacerbate disease symptoms.
Objectives: This study aimed to investigate the effectiveness of Emotion-Focused Therapy (EFT) in improving cognitive emotion regulation strategies and reducing perceived stress in patients with RA.
Methods: This was a quasi-experimental study with a pretest-posttest control group design. The study population consisted of patients with RA referred to Shariati Hospital in Tehran, Iran, in 2022. A sample of 40 patients who met the inclusion criteria was selected and randomly assigned to an experimental group (n = 20) and a control group (n = 20). The experimental group participated in eight weekly 90-minute sessions of group EFT. Data were collected using the Cognitive Emotion Regulation Questionnaire (CERQ) and the stress subscale of the Depression Anxiety Stress Scales (DASS-21). The collected data were analyzed using analysis of covariance (ANCOVA).
Results: The results indicated that after the intervention, the experimental group showed a statistically significant increase in the use of adaptive cognitive emotion regulation strategies and a significant decrease in the use of maladaptive strategies compared to the control group (F = 38.72–45.83, P < 0.001, η² = 0.68–0.73). Furthermore, the participants in the EFT group reported a significant reduction in their perceived stress scores compared to the control group.
Conclusion: The findings suggest that EFT is an effective psychological intervention for improving emotion regulation skills and reducing stress levels in patients with RA. Therefore, EFT may serve as a useful adjunct to standard medical care in supporting the psychological well-being of this patient population.

Keywords

Rheumatoid Arthritis
Emotion-Focused Therapy
Emotion Regulation
Stress
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Hospital Practices and Research

Articles in Press, Accepted Manuscript
Available Online from 30 September 2026

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