Study finds how two forms of CBT are useful in fibromyalgia treatment

According to a study, there do not appear to be any substantial differences in the treatment of fibromyalgia between so-called exposure-based CBT and standard CBT.

Both methods of therapy reduced symptoms significantly in people suffering from the illness.
The findings of the Karolinska Institutet study, published in the journal PAIN, are one of the largest to date evaluating different treatment regimens for fibromyalgia.

Fibromyalgia, a long-term pain illness that causes widespread pain, exhaustion, and stiffness in the body, affects around 200,000 people in Sweden today.

Fibromyalgia has no known cure. Existing medications frequently have insufficient efficacy, necessitating the development of new, effective therapeutic options.

Although cognitive behavioural therapy (CBT) has demonstrated some promise, there is a scarcity of certified CBT practitioners.

There is also a lack of understanding about which type of CBT is the most beneficial.

The study examined two types of internet-delivered cognitive behavioural therapy in terms of how well they lessen fibromyalgia symptoms and functional impact.

In summary, exposure-based CBT entails the participant systematically and repeatedly confronting situations, activities, and stimuli that the patient has previously avoided due to pain, psychological discomfort, or symptoms such as exhaustion and cognitive impairments.

In traditional CBT, the participant is presented with several different strategies to work on during treatment, such as relaxation, activity planning, physical exercise, or strategies for managing negative thoughts and improving sleep.

The study showed that traditional CBT was by and large equivalent to the newer treatment form of exposure-based CBT.

“This result was surprising because our hypothesis, based on previous research, was that the new exposure-based form would be more effective. Our study shows that the traditional form can provide an equally good result and thus contributes to the discussion in the field,” said Maria Hedman-Lagerlof, licenced psychologist and researcher at the Centre for Psychiatry Research at the Department of Clinical Neuroscience, Karolinska Institutet.

The randomised study involved 274 people with fibromyalgia, who were randomly assigned to be treated with traditional or exposure-based CBT.

The treatments were delivered entirely online and all participants had regular contact with their therapist.
Participants answered questions about their mood and symptoms before, during, and after treatment.
After the 10-week treatment, 60 percent of those who received exposure-based CBT and 59 percent of those who received traditional CBT reported that their treatment had helped them.

“The fact that both treatments were associated with a significant reduction in the participants’ symptoms and functional impairment and that the effects were sustained for 12 months after completion of the treatment indicates that the internet as a treatment format can be of great clinical benefit for people with fibromyalgia,” said Maria Hedman-Lagerlof. “This is good news because it enables more people to access treatment.”

The study is the second largest to compare different psychological treatment options for fibromyalgia, according to the researchers.

“Our study is also one of the first to compare with another active, established psychological treatment,” said Maria Hedman-Lagerlof.