Effectiveness of exposure-based cognitive behaviour therapy for fibromyalgia

Internet-based exposure-cognitive behaviour therapy (CBT) is not superior to traditional CBT for fibromyalgia, but both significantly reduce symptoms, highlighting the clinical utility of online treatments and affirming traditional CBT as a reliable standard.

To evaluate whether exposure-based cognitive behaviour therapy (Exp-CBT) could outperform traditional CBT in improving symptoms of fibromyalgia, a debilitating chronic pain condition with limited treatment options.

A total of 274 individuals having fibromyalgia were randomized with a 1:1 ratio to either Exp-CBT or traditional CBT over 10 weeks. Online CBT sessions focused on managing fibromyalgia symptoms were performed. These individuals were evaluated at the start of the therapy, weekly during therapy, after the therapy, and at 6- and 12-month follow-up using the Fibromyalgia Impact Questionnaire (FIQ).

There were no significant differences between Exp-CBT and traditional CBT in reducing fibromyalgia severity from pre- to post-treatment. A minimal clinically important improvement was observed in 60% of cases with Exp-CBT compared to 59% with traditional CBT. Both therapies maintained efficacy up to 12 months’ post-treatment.

As Exp-CBT did not demonstrate superiority over traditional therapy, traditional CBT remains a viable and clinically relevant treatment option compared to newer approaches.