A considerable literature has developed over the past two decades that has investigated the utility of cognitive behavioural treatments for a variety of medical disorders, including rheumatoid arthritis. Research has consistently found that psychological variables affect the course of the illness and that cognitive behavioural approaches can improve psychological and physical function. However, the literature has focused almost exclusively on chronic illness. There is little literature that has investigated the role of cognitive behavioural therapy in facilitating the adjustment early in the disease course to diagnosis and subsequent illness. The diagnosis of any potentially chronic illness has enormous ramifications for a person's life and it is well documented that many people become depressed even early in the disease course. Theoretical accounts have been put forward that allow a model for understanding the process of adaptation and offer a foundation for the use of cognitive and behavioural strategies with a recently diagnosed group of patients. The present paper reports the use of a cognitive and behavioural intervention to facilitate coping and adjustment to illness.