Mind-Body Reprogramming Therapy (MBRT): Development, Theoretical Foundation, and Clinical Application for Long COVID, 2026, Reme et al

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Mind-Body Reprogramming Therapy (MBRT): Development, Theoretical Foundation, and Clinical Application for Long COVID

Silje Endresen Reme, Henrik Børsting Jacobsen

Abstract
This paper presents the development and clinical rationale for Mind-Body Reprogramming Therapy (MBRT), a novel, theory-based intervention for patients with Long COVID experiencing persistent symptoms. Rooted in predictive processing, classical and operant conditioning, and Relational Frame Theory (RFT), MBRT targets maladaptive brain-based alarm responses believed to underlie symptoms such as fatigue, pain, and cognitive dysfunction.

We argue that the chronicity of these alarms in patients reflects not only inferential biases and conditioned responses, but verbal relational networks that bind symptoms to identity, anticipated futures, and rule-governed avoidance, which become primary targets of treatment. The intervention combines personalized education, stress regulation techniques, and experiential learning delivered by an interdisciplinary team over a 7–10-day hybrid format.

We describe the theoretical foundation of MBRT and outline its core components, including psychoeducation, values clarification, interoceptive exposure, and behavior change strategies. A detailed case study illustrates the therapeutic process and potential for recovery.

We argue that persistent symptoms in Long COVID may reflect learned brain patterns rather than ongoing physical injury, and that targeted interdisciplinary interventions can help patients reverse these patterns. MBRT is currently under evaluation in a randomized controlled trial.

Web | DOI | Frontiers in Psychology | Abstract only ahead of publication
 
Jonathan Edwards said:
And why on earth did they think it was ethical to submit people to this 'theory-based' nonsense without doing a proper trial?

If the best they can do is produce one case study they are in deep trouble.
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They have done multiple trials. SIPCOV (the Nerli trial) was a version of this, and MINIRICO (not yet published, but the results were in a grant application). Both resulted in a change in the primary outcome below the MCID, and both were passed of as successes.

From the application:
A recently completed randomised clinical trial (MINIRICO) of a brief cognitive-behavioural intervention (mind-body reprogramming therapy, MBRT) vs. care as usual in Long COVID showed a favourable effect on physical function as well as other measures of symptoms and capabilities. 37
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Likewise, another trial (SIPCOV) of a similar brief cognitive-behavioural intervention in Long COVID showed remarkable similar beneficial effects with persistence over time. 30
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Also, the intervention was associated with lower costs and higher quality adjusted life years as compared to the control group. Both trials had reassuring safety results, with lower incidence of negative effects in the intervention group than the control group
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IMG_0183.webp
MCID was predefined as 10 points for both trials. Notice the cropping of the scale. If you zoom in you can also see that there were no differences for the objective measurements.

Nina Steinkopf has covered these results on melivet.com.

The grant application for a third trial, REHAB-FATIGUE was approved, granting them 25M NOK (the same as the cost of ResetME). The funder, KLINBEFORSK, argued that the trial was of sufficient quality to be funded, despite this comment by the second peer reviewer:
Key weaknesses relate primarily to internal validity. The use of care as usual as the comparator is inherently heterogeneous across sites, introducing variability despite planned sensitivity analyses. Moreover, the lack of participant and therapist blinding, combined with reliance on patient-reported outcomes, increases the risk of expectation and performance bias, thereby potentially limiting the reliability of the findings.
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The first peer reviewer thought it was a great trial.

The trial will have 960 participants.

Peer review reports from an FOI request:
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Reviewer 1:
«REHAB-FATIGUE aims at determining the efficacy, safety and costs of Mind- Body Reprogramming Therapy (MBRT) in patients with fatigue due to different conditions. The study is controlled and randomized by means of comparing MBRT with care as usual and is nationwide. PF is a disabling symptom for the individual and has a high cost for society. There is up to now no effective rehabilitation programs available which makes the study of great interest.

The head of the project and the other members of the research group have a high competence within the field which makes the study feasible and there is also a representative for the patient organization.

Reviewer 2:
«Strengths include the high clinical relevance of the topic, a clearly defined and standardised intervention, and an experienced research team with a strong track record in the field. In addition, impact and implementation potential are high, as the intervention is scalable, low cost, and could be rapidly integrated into routine care if shown to be effective.

Key weaknesses relate primarily to internal validity. The use of care as usual as the comparator is inherently heterogeneous across sites, introducing variability despite planned sensitivity analyses. Moreover, the lack of participant and therapist blinding, combined with reliance on patient-reported outcomes, increases the risk of expectation and performance bias, thereby potentially limiting the reliability of the findings.»
Reme has been all over the media with this and Pain Reprocessing Therapy, and they claim to have trained over 200 HCPs in PRT already. They got a TV producer that was the sibling of one of the practitioners to make a TV series about PRT, and they are now working on another series about MBRT.
 
Utsikt said:
Both resulted in a change in the primary outcome below the MCID, and both were passed of as successes.
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A reminder of the SF-36 physical functioning questionnaire:

Here's how to calculate your score:
SF-36 Physical Functioning Questionnaire

The following items are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?

For each of the ten items, score as follows:

Yes, Limited a Lot Score 0

Yes, Limited a Little Score 5

No, Not limited at All Score 10

Add up your total score.
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a. Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports

b. Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf

c. Lifting or carrying groceries

d. Climbing several flights of stairs

e. Climbing one flight of stairs

f. Bending, kneeling, or stooping

g. Walking more than a mile

h. Walking several blocks

i. Walking one block

j. Bathing or dressing yourself
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When my ME/CFS would have been classed as mild and I was able to teach more than half time and care for a family, with just a cleaner to help, my score on this scale was around 40.
These people in this study were not severely affected and cound easily have been persuaded to upgrade a couple of scores from limited a lot to a little, or from a little to not limited.
We have a members poll to calculate your score and discuss it.
 
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