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Objective-To assess and compare the benefits of three psychosocial treatments for rheumatoid arthritis.Methods-Rheumatoid arthritis (RA) patients were randomized to cognitive-behavior therapy (CBT), relaxation response training (RR), or arthritis education (AE). All treatment was conducted in groups. Follow-up occurred immediately after treatment and 6 and 12 months later. Pain, other RA symptoms, role impairment, and psychological distress were assessed with standardized selfreport questionnaires. Arthritis severity and activity were assessed with a joint examination, erythrocyte sedimentation rate, grip strength, and walking time. An intent-to-treat analytic strategy was employed. Linear regression was used to establish treatment effect on pain and other RA symptoms, while adjusting for sociodemographic and clinical variables.Results-168 patients were randomized. Pain improved significantly at 12 months in the RR and AE groups and showed a non-significant positive trend with CBT. Other RA symptoms improved significantly with CBT and AE, and showed a non-significant trend with RR. There were no significant differences in the outcomes across the 3 treatment groups. When the results for all 3 groups were aggregated, significant benefits were found for pain, other RA symptoms, self-care activities and social activities. Effect sizes ranged between 0.26 and 0.35.Conclusions-These three psychosocial treatments were beneficial, with treatment effect sizes in the small to moderate range. The effects appeared immediately after treatment and were generally sustained at long-term follow-up. These benefits were achieved over and above those

This article describes the Seattle Homeless Adolescent Research Project (SHARP), a research demonstration program with a goal of implementing and evaluating an intensive mental health case management program for homeless adolescents. This new program, Project Passage, is based on nine primary components: (a) assessment, (b) planning, (c) linkage, (d) monitoring or tracking, (e) advocacy, (f) counseling or the therapeutic relationship, (g) treatment teams, (h) crisis service, and (i) flexible funds. Case load was limited to no more than 12 cases, so that adolescent-centered, individualized services could be delivered. Youths were randomly assigned to Project Passage or a “regular” case management program. A 3-month follow-up found that both groups demonstrated significant improvements in mental health outcomes and social adjustment; however, youths in Project Passage evidenced lower levels of aggression and greater satisfaction with their quality of life.