Group-based therapy targeting thoughts and emotions could be an effective strategy to improve fibromyalgia knowledge and ease the burden of patients, according to a nursing study.

The report, “Problems and Solutions for Patients with Fibromyalgia: Building New Helping Relationships,” was published in the Journal of Advanced Nursing.

A team of nursing professors at Rovira i Virgili University in Tortosa, Spain, aimed to solve the main biological, psychological, and sociological problems experienced by fibromyalgia patients using a method called Group Problem-Solving Therapy (GPST) .

“GPST is a technique for identifying and solving problems, increasing assertiveness [and] self-esteem, and eliminating negative thoughts,” the researchers wrote.

Forty-three women and one man who were diagnosed with fibromyalgia from six GPST sessions were included in the study. A total of 24 sessions were audio recorded and analyzed.

GPST consisted of four two-hour sessions. The first three sessions took place once a week, and the final session was held a month after the third session.

In the first session, participants were asked to identify the main problems they dealt with due to the disease at the physical, psychological, and social levels.

During the second session, the strategy was to find at least 10 possible solutions to the previously identified problems. The solutions could be pointed out by anyone in the group or leading the sessions.

The best way to put the solutions to work was drafted during the third session.

“The solutions provided often could not solve the problem completely,” the researchers stated. “The aim was to make participants aware that the difficulties that arise in people’s lives can be assessed differently and addressed more effectively, as can the negative feelings derived from these experiences, such as anger and frustration.”

In the fourth session a month later, the effectiveness of the GPST was evaluated, according to the potential of the proposed solutions to reduce the fibromyalgia patients’ negative experience.

“The main aim was not to solve all the patients’ problems, but for them to see that almost all problems may have a solution,” the researchers added.

The participants had a mean age of 61.1 years, and they had lived with a fibromyalgia diagnosis for a mean time of 11.6 years. About 46.5 percent were retired or were receiving a pension, with only 7.0 percent still actively working. The mean time between symptoms onset and diagnosis for these patients was 9.8 years.

During the therapy sessions five major themes were identified:

• Patients’ problems are often related to historic trauma;
• There are no one-size-fits-all solutions;
• Fibromyalgia is life-changing;
• Fibromyalgia is widely misunderstood;
• The disease has significant impacts on physical, psychological, and social aspects of life.

The majority of patients identified the onset of fibromyalgia as a traumatic event, or related to the accumulation of a series of events that is extremely stressful.

Regarding treatment, the study revealed that pain medications do not benefit all, and that each patient uses different medications. Some individuals mentioned that swimming and massages are often helpful.

“There is a before and after in your life when the disease appears,” the patients reported. In most cases the patients felt they weren’t the same person after the onset of fibromyalgia. While trying to adapt to the forced changes, many have to deal with physical incapacity and a lack of awareness about the disease.

The physical symptoms the patients reported the most were ongoing pain, fatigue or overload, difficulty with daily activities, memory problems, difficulty with mobility, and allergies.

Psychologically, the patients commonly reported symptoms of depression, anxiety, and rage. Socially, they reported feelings of loneliness, a lack of support from a partner, even abuse.

“What this paper brings to the debate are the solutions to the problems perceived by the group – the result of reflecting on their experience using GPST – and the importance of emotions in the management of symptoms and of asking for help and of not wanting to do it all alone,” the researchers said.

Many of the solutions proposed by the groups were focused on changing thoughts relating to fear, anxiety, and avoidance of activity, to lessen the experience of pain.

“A change in the focus of activities and beliefs about the disease could reduce symptoms and improve pain tolerance and functional status,” the researchers stated. “These findings can improve the self-management of fibromyalgia patients by helping to enhance adaptive behaviors and incorporating the female gender approach.”