Social Security judges often call psychologists to testify as expert witnesses in fibromyalgia disability cases because there is medical literature that characterizes fibromyalgia as a mental health condition that produces physical symptoms.
However, if you mention cognitive behavioral therapy to fibromyalgia advocates and you’re sure to get a passionate response.
Cognitive behavioral therapy or CBT is a term that covers a wide variety of psychological treatment approaches in which focus is placed on the role of the patient’s thoughts in controlling and impacting behavior and choices.
Some advocates and patients assert that focusing on CBT merely perpetuates unproven myths that the patient’s pain is “all in the head” – i.e., purely a mental issue. Others assert that CBT has been proven to lessen symptoms of fibromyalgia and should be a central part of treatment.
A recent multi-site clinical trial, the results of which are being reported in Arthritis & Rheumatism, seems to back up the latter group. This study found that CBT lessened depression in teenagers with fibromyalgia and helped them cope with the disease’s symptoms more effectively.
The study looked at 114 teenagers who had been diagnosed with juvenile fibromyalgia. The subjects were divided into groups which received either CBT or fibromyalgia education. Those in the CBT group experienced a reported 37% improvement in disability and depression compared to 12% of the education-only group.
While CBT and other forms of therapy might be useful in fibromyalgia treatment, and patients should consider any treatment that might be effective in managing the debilitating pain associated with fibromyalgia, care should be taken not to infer a reverse correlation. The mere fact that psychiatric treatment models may help a patient develop better coping skills does not mean that the disease is a psychiatric disorder.
On the other hand, if you are applying for Social Security disability, your goal is to win. If the judge wants to consider your fibromyalgia as a mental condition there is no practical reason to object if if he finds in your favor.