Fibromyalgia is a prevalent chronic pain syndrome characterized by significant subjective distress and functional disability. While multidisciplinary approaches to clinical management are recommended, behavioral methods which increase patient management skills and reduce sick role behaviors by incorporating the active involvement of a family member in the treatment program merit exploration. In the proposed study, we will evaluate a comprehensive behavior therapy intervention integrating cognitive-behavioral and operant conditioning methods in the treatment of patients with primary fibromyalgia. Seventy-two patients recruited from Scripps Clinic and Research Foundation, the Department of Rheumatology of the University of California, San Diego, and from private practitioners in the San Diego area will be randomly assigned to one of two groups receiving (1)behavior therapy with family support or (20 education control. Treatments will be administered in groups of six patient participants over a 10-week treatment period. Six family members of the fibromyalgia patients also will participate in each of the therapy groups for those receiving the behavior therapy intervention. The functions of the family member will be to reinforce active coping efforts in fibromyalgia patients and to facilitate generalization of pain management skills to home and other social environments. The effects of the interventions will be evaluated on indices of pain, pain behaviors, tender point scores, quality-of-well-being, and depression across baseline, posttreatment and six-month follow-up periods. It is hypothesized that the behavior therapy intervention will be significantly superior to education-control on outcome measures since patients receiving such behavioral training will acquire skills, reinforced by family members, that will lead to better pain control and reduced pain behaviors.
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