Research on refractory coeliac disease (RCD) has predominantly focused on medical treatments to manage symptoms and reduce the risk of serious health complications. Consequently, the psychological impact of RCD remains poorly understood despite the chronicity and severity of the condition. Individuals with RCD may experience persistent symptoms alongside uncertainty regarding their health, potentially contributing to anxiety and psychological distress.
This feasibility study co-produced a cognitive behavioural therapy (CBT) intervention tailored to individuals with RCD, with the aim of addressing anxiety. As the first study to evaluate a psychological intervention specifically for RCD, it sought to establish whether a brief online CBT intervention was feasible and acceptable to this population.
Participants completed measures of anxiety, quality of life, and psychological inflexibility before the intervention, after two sessions, and one month following completion of all three sessions. Findings indicated small effect sizes, including a modest reduction in anxiety (d = 0.24, 95% CI [-0.48, 0.96]), alongside improvements in quality of life and psychological flexibility over time. Reliable change analyses identified both improvement and deterioration across individual participants.
As the primary aim was to assess feasibility and acceptability rather than intervention effectiveness, participant feedback was also collected using questionnaires and free-text responses. Content analysis highlighted positive experiences of the intervention, with participants describing feeling validated and valuing the opportunity to learn techniques for managing anxiety and distress.
These preliminary findings suggest that psychological support for individuals with RCD is both needed and acceptable. They support the feasibility of further research evaluating tailored psychological interventions for this underserved clinical population.