What behavioral therapies help in the treatment of fibromyalgia?

The most effective psychological treatments for fibromyalgia are cognitive behavioral therapy and conditioning behavioral therapy (also called operant behavioral therapy). Cognitive behavioral therapy changes the way you think about fibromyalgia. It helps you reduce negative thoughts that can make your symptoms worse. Conditioning behavioral therapy can change how you react to pain by helping you reduce behaviors that may increase your pain.

Cognitive behavioral and conditioning behavioral therapies are among the most effective fibromyalgia treatments. For example, in one well-designed study, 125 people with fibromyalgia were randomly assigned to treatment with cognitive behavioral therapy, conditioning behavioral therapy, or to a control group that received no skills training. Skills were taught in groups of five patients, seen for two-hour sessions once a week for 15 weeks. The control group received general education without any specific training. One year after treatment, people getting either treatment improved more than the control group. In addition:

• Pain levels dropped by at least half in 45% of those treated with cognitive behavioral therapy and 54% of those who received conditioning behavioral therapy, but in only 5% of the control group.
• Disability decreased by at least half for 38% treated with cognitive behavioral therapy and for 58% with conditioning behavioral therapy, but for only 8% of the control group.
• The number of physician visits dropped by 17% after cognitive behavioral therapy and by 56% with conditioning behavioral therapy. In contrast, visits increased by 39% in the control group.