A Mixed Method Evaluation of Cognitive Behavioral Group Psychotherapy Based Relaxation in Patients Diagnosed with Fibromiyalga Syndrome

Abstract

Objectives: Due to the clinical features of Fibromyalgia Syndrome (FMS), the emphasis on multidisciplinary treatments is increasing day by day. The main purpose of this study is to examine the effectiveness of relaxation-oriented cognitive behavioral group psychotherapy in FMS patients. It is aimed to improve the pain management, functional coping strategies, self-efficacy and psychological well-being of the patients at the end of the intervention. Also, relaxation exercise was used as a motivational and complementary technique. The study was conducted with 25 women who were diagnosed with FMS and had the characteristics to carry out the group psychotherapy process. However, since 17 people attended the eighth session in which the last tests of the study were taken, the analyzes were made with the data of these people. Mixed method including both quantitative and qualitative research methods was used in the data collection and analysis process of the study. Qualitative data were obtained through written records kept by the observers in the sessions and the observations of the therapists. In collecting quantitative data, Sociodemographic and Clinical Information Form, Visual Analogue Scale (VAS), Patient Health Questionnaire-Somatic Anxiety and Depression Symptoms (PHQ-SAD), Pain Self-Efficacy Questionaire-2 (PSQ-2) and Pain Coping Inventory (PCI) were used. Thematic Analysis methods were used in the qualitative analysis of the interview contents. The analysis of the data obtained from the scales was carried out with the Wilcoxon Signed Ranks Test. Quantitative analysis findings show that although improvement was observed in the majority of outcome variables after the intervention, this development was not statistically significant. According to the qualitative analysis results, the group therapy process was considered three themes as “pain related problems”, “emotional and social problems” and “adherence with the group therapy process”. It was seen that the participants made improvements in the subcodes of the themes. Results indicates the importance of using quantitative and qualitative patterns together in demonstrating the effectiveness of the intervention. It is thought that it will be useful to test the intervention in a larger sample in future studies. Keywords: Pain management; cognitive behavioral therapy; fibromyalgia syndrome; relaxation exercise; group psychotherapy; mixed method.