cognitive behaviour therapy

Posted on Fibromyalgia

2 types of cognitive behavioural therapy (CBT) are equally effective for treating fibromyalgia.

Maria Hedman-Lagerlöf

Maria Hedman-Lagerlöf CREDIT Andreas Beronius

A recent study led by researchers at Karolinska Institutet found that there are no significant differences between exposure-based CBT and traditional CBT when it comes to treating fibromyalgia. Both forms of treatment resulted in a noticeable reduction in symptoms for people affected by the disease. This study, published in the journal PAIN, is one of the largest to date to compare different treatment options for fibromyalgia.



Approximately 200,000 people in Sweden are currently living with fibromyalgia, a long-term pain syndrome that causes widespread pain, fatigue, and stiffness in the body, resulting in significant suffering for patients. There is currently no cure for fibromyalgia, and existing drugs often provide inadequate relief, highlighting the need for more effective treatment methods. While cognitive behavioural therapy (CBT) has shown some effectiveness, there is a shortage of trained CBT practitioners and a lack of knowledge about which CBT methods are most effective.


The study compared two different forms of internet-delivered cognitive behavioural therapy in terms of how effectively they reduce the symptoms and functional impact of fibromyalgia.

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

In traditional CBT, participants are presented with various strategies to work on during treatment, such as relaxation techniques, activity planning, physical exercise, and methods for managing negative thoughts and improving sleep.

The study showed that traditional CBT was, in general, equivalent to the newer treatment form of exposure-based CBT. 

“Despite our hypothesis, our study shows that the traditional form can be equally effective,” says Maria Hedman-Lagerlöf, psychologist and researcher at Karolinska Institutet.

The randomized study involved 274 people with fibromyalgia, who were randomly assigned to be treated with traditional or exposure-based CBT. The treatments were delivered online, and all participants had regular contact with their therapist. 

Participants were asked to answer questions about their mood and symptoms before, during, and after treatment. Following the 10-week treatment, 60 percent of those who received exposure-based CBT and 59 percent of those who received traditional CBT reported that the 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,” says Maria Hedman-Lagerlöf. “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,” says Maria Hedman-Lagerlöf.

Posted on Fibromyalgia

Can cognitive-behavioral therapy reduce fibromyalgia pain?

Pain - what works best?
Pain – what works best?

In a recent randomized clinical trial of patients with fibromyalgia, cognitive-behavioral therapy (CBT), which uses structured techniques to alter distorted thoughts and negative moods, was found to be more effective than a matched education treatment in reducing the impact of pain and other aspects of fibromyalgia on daily living.

In the study published in Arthritis & Rheumatology, it was found that the group that received Cognitive Behavioral Therapy (CBT) experienced improvements. These improvements were partly due to reduced catastrophizing, which includes cognitive and emotional processes such as feelings of helplessness, rumination, and exaggeration of pain complaints.

Neuroimaging tests have shown that cognitive behavioral therapy (CBT) works by changing the connections between specific regions of the brain. This suggests that alterations in the brain circuitry associated with pain catastrophizing could be the reason why CBT is beneficial for fibromyalgia patients. Fibromyalgia is a condition marked by debilitating symptoms like widespread pain, fatigue, cognitive challenges, and psychosocial distress.

“According to corresponding author Jeungchan Lee, PhD, from Spaulding Rehabilitation Hospital and Harvard Medical School, these findings add to the growing body of research that emphasizes the benefits of non-pharmacologic treatments, such as CBT, for chronic pain conditions like fibromyalgia. Understanding the various biopsychosocial mechanisms through which these treatments reduce pain could help advance the practice of precision pain medicine and enhance treatment outcomes for the numerous patients affected by chronic pain.”

Posted on Pain Management

Cognitive Behavioral Therapy for Chronic Pain

Dr. David Talavera presented his talk, “Cognitive Behavioral Therapy for Chronic Pain,” for our Pain Science Lecture Series, March 2023 edition. The presentation provided an overview of Cognitive Behavioral Therapy (CBT) for Chronic Pain and outlined the importance of coping with emotions, thoughts, and behaviors often impacted by chronic pain.

Posted on Pain Management

Cognitive behavior therapy significantly reduced depression and anxiety in chronic pain patients

MS and depression


The results of a study presented today at the Annual European Congress of Rheumatology (EULAR) has shown that Acceptance and Commitment Therapy, a form of cognitive behavioural therapy (CBT) that focuses on psychological flexibility and behaviour change, provided a significant reduction in self-reported depression and anxiety among patients participating in a pain rehabilitation programme.

This treatment also resulted in significant increases in self-efficacy, activity engagement and pain acceptance.

To assess the potential benefits of an 8-week programme of group Acceptance and Commitment Therapy (ACT) in people with persistent pain, measures of pain acceptance and activity engagement were taken using the Chronic Pain Acceptance Questionnaire. Measures of psychological distress using the Hospital Anxiety and Depression Scale and self-efficacy were also taken at assessment, on the final day of the programme, and at the follow up six-month review.

For those chronic pain patients with scores at all three time points, there were statistically significant improvements in all parameters between baseline and at six-months follow-up, including the change in mean score of depression, anxiety, self-efficacy, activity engagement and pain willingness (p<0.001).

“To further validate the role of ACT in the treatment of chronic pain, specifically in a rheumatology context, a randomised controlled clinical trial that includes measures of physical and social functioning within a Rheumatology service would be desirable,” said lead author Dr. Noirin Nealon Lennox from Ulster University in Northern Ireland.

ACT is a form of CBT that includes a specific therapeutic process referred to as “psychological flexibility”. ACT focuses on behaviour change consistent with patients’ core values rather than targeting symptom reduction alone. Evidence for this approach to the treatment of chronic pain has been mounting since the mid 2000’s. A previous systematic review had concluded that ACT is efficacious for enhancing physical function and decreasing distress among adults with chronic pain attending a pain rehabilitation programme.

In this study, patients were referred into the ACT programme by three consultant rheumatologists over a five-year period. Over one hundred patients’ outcome measures were available for a retrospective analysis.

Posted on Autism

The Effects of Cognitive Behaviour Therapy on Parents of Children With Autism




 

Image result for York U Research Identifies Effects of Cognitive Behaviour Therapy on Parents of Children With Autism

 




 

Parents of children with autism experience a greater impact from their child’s therapy than once thought, according to new research out of York University’s Faculty of Health.

Jonathan Weiss, Associate Professor in the Department of Psychology, Faculty of Health and CIHR Chair in Autism Spectrum Disorders (ASD) Treatment and Care Research, discovered that parents who participate in cognitive therapy with their children with autism also experience a real benefit that improves the family experience.

Approximately 70 per cent of children with autism struggle with emotional or behavioural problems, and may benefit from cognitive behaviour therapy to improve their ability to manage their emotions.

 




“Most of the time when parents bring in their kids for cognitive behaviour therapy, they are in a separate room learning what their children are doing, and are not being co-therapists,” said Weiss. “What’s unique about what we studied is what happens when parents are partners in the process from start to finish. Increasingly we know that it’s helpful for kids with autism, specifically, and now we have proven that it’s helpful for their parents too.”

Jessica Jannarone, a parent involved in the York U Faculty of Health study, Parental Outcomes Following Participation in Cognitive Behavior Therapy for Children with Autism Spectrum Disorder, led by Professor Jonathan Weiss shares her experience of the impact of cognitive behaviour therapy with her son.

Parents who took part in the study were involved in a randomized controlled trial. They were asked to complete surveys before and after the treatment and were compared to parents who had not begun therapy.

Weiss and Ph.D student Andrea Maughan, examined changes in parent mental health, mindfulness, and perceptions of their children, during a trial of cognitive behaviour therapy for 57 children with ASD aged 8-12 who did not have an intellectual disability. The study, published in the Journal of Autism and Developmental Disorders, showed that parents who participated in cognitive therapy with their children, experienced improvements in their own depression, emotion regulation, and mindful parenting.

“The research showed that parents improved their abilities to handle their own emotions and to see themselves in a more positive light,” said Weiss. “It helped them to become more aware of their parenting and all of the good they do as parents.”

In the study, parents were co-therapists with their child’s therapist and were tasked with employing the same strategies alongside their children. This allowed the parents to learn to help themselves in the process. Parents were required to write down their children’s thoughts during activities.

“As a parent participating in the SAS:OR Program, I have grown as much as my son did. I used to use a “one size fits all” strategy with my son – now he and I have many tools to manage through difficult moments,” said Jessica Jannarone, a parent involved in study. “The ability to talk about our feelings, identify triggers, and think proactively about approaches has brought both positivity and comfort to our lives. Watching my son develop in this program and find a way to start handling his feelings has been the greatest gift of all.”

Weiss added the findings also speak to the importance for health care providers to involve parents in the process of delivering care to children with autism.

“We know parents of children with autism, in addition to all the positive experiences they have, also experience high levels of distress. So if we can do something to reduce that, we have a responsibility to try to do so.”