Table 4 Summary of findings from cognitive and behavioral therapies, education, and complementary and alternative medicine

1.

Cognitive skills training in general has not shown more benefit than group education or social support in improving fibromyalgia.

2.

CBT that is targeted to specific outcomes such as function, sleep, or coping may be beneficial for fibromyalgia.

3.

Group education with social support can reduce pain behaviors and feelings of helplessness.

4.

Combining education with exercise can improve a sense of control over symptoms and reduce the impact of fibromyalgia.

5.

As in exercise studies, adherence to psychological and education programs is problematic, emphasizing the need to identify subgroups of patients who might benefit from these programs. For example, patients with severe depression may not be candidates for this approach until the depression is treated.

6.

Traditional acupuncture did not reduce pain associated with fibromyalgia more than sham interventions.

7.

Convincing evidence does not exist for complementary and alternative medicine in the treatment of fibromyalgia.