title: Understanding why cognitive-behavioral therapy is an effective treatment for adolescents with juvenile fibromyalgia.
abstract: Recent studies have demonstrated that cognitive-behavioral therapy (CBT) is an effective treatment for children and adolescents with juvenile fibromyalgia. Unfortunately, the specific psychological changes that occur during treatment that explain why CBT works are not well understood. Historically, the increased use of specific coping strategies learned during CBT was thought to be the primary reason for why CBT was effective. However, evidence to support the notion that increases in adaptive coping directly lead to patient improvement is minimal. Instead, a growing number of studies in adults suggest that CBT results in more global changes of psychological perceptions of the pain itself (cognitive appraisals) and one's ability to manage the pain. This report discusses the role of coping and aspects of cognitive appraisal as potential psychological changes that explain CBT-related improvements for youths with juvenile fibromyalgia.
authors.affiliation: Division of Behavioral Medicine & Clinical Psychology, Cincinnat Children's Hospital Medical Center, Cincinnat, OH 45229, USA.
authors.forename: Soumitri
authors.initials: S
authors.lastname: Sil
authors.affiliation: Division of Behavioral Medicine & Clinical Psychology, Cincinnat Children's Hospital Medical Center, Cincinnat, OH 45229, USA ; Department of Pediatrics, University of Cincinnat College of Medicine, Cincinnat, OH, USA.
authors.forename: Susmita
authors.initials: S
authors.lastname: Kashikar-Zuck
keywords: adaptive coping; catastrophic thinking; chronic pain; cognitive appraisal; cognitive–behavioral therapy; coping self-efficacy; juvenile fibromyalgia