Attachment-based compassion therapy (ABCT) combined with regular fibromyalgia management treatment seems more effective in reducing symptoms than relaxation techniques and usual treatment, according to a small clinical trial.
The discovery was made by the Spain-based Primary Care Prevention and Health Promotion Research Network (redIAPP).
The study, “Efficacy of ‘Attachment-Based Compassion Therapy’ in the Treatment of Fibromyalgia: A Randomized Controlled Trial,” was published in the journal Frontiers in Psychiatry.
Due to the complex nature of fibromyalgia, successful treatment normally requires addressing the disease-related behavioral, cognitive, and affective processes, including pain, anxiety and depression.
ABCT is based on the attachment theory. It involves mindfulness training and exercising compassion by the practice of receiving and offering compassion to friends, “problematic” people, unknown people, and oneself.
“Several intervention protocols based on compassion have been described and used to treat psychological disorders such as anxiety and depression, with promising benefits. However, to date, such approaches have not been used to treat [fibromyalgia],” scientists said.
Researchers assessed the efficacy of attachment-based compassion therapy on the general function of fibromyalgia patients. As a secondary aim, they also evaluated the effect of this non-pharmacological therapy on the psychological (pain, depression, anxiety) features of the disease.
The study (NCT02454244) included 42 fibromyalgia patients ages 18-65 who were randomly allocated to receive either the compassion therapy or relaxation techniques — breathing and mental exercises, progressive muscle relaxation, and imagery — during eight weekly two-hour sessions followed by three monthly reminder sessions.
Both groups combined ABCT or relaxation techniques with regular (depending on the patients’ complaints) fibromyalgia pain and depression management therapies — what the team called treatment as usual, or TAU.
Researchers found that attachment-based compassion therapy plus TAU led to better outcomes in terms of general health status, as measured by the FIQ (Fibromyalgia Impact Questionnaire), compared to patients who received TAU and relaxation therapies. The improvement in symptoms was found to be still significant after three months.
Regarding the disease-associated psychological features, researchers also saw improvements in clinical severity, anxiety, depression, and quality of life. Still, patients continued to have extremely negative thoughts about pain (called pain catastrophizing).
“In general, the [effect sizes] obtained in the present study were larger than those achieved when treating [fibromyalgia] using [cognitive-behavioral therapy] or mindfulness alone,” researchers concluded.