[Six years' experience with outpatient group treatment of fibrositis patients.]

Since 1982, a total of 88 patients with refractory fibrositis have received treatment as part of an integrated group program within a psychiatric outpatient clinic working closely with the department of rheumatology. The best arrangement proved to be a series of 15 weekly two-hour sessions with groups of 8 patients. The program has three main elements: information, instruction in pain control strategies, and group discussion. The pain control strategies taught are cognitive behavioral techniques, relaxation, and exercises. A controlled study with 27 patients demonstrated that a comprehensive program of this kind was superior to instruction in autogenic training alone. Patient feedback confirmed the importance of the information given and of the group discussions; it is helpful to offer patients a wide range of pain control strategies that they can apply themselves. Our program makes it possible for a greater proportion of patients to learn one or more techniques affording some measure of pain relief. It is important for the therapists to adopt a positive and convincing attitude while restricting themselves to helping the patients to help themselves and avoiding power struggles. They should also be ready to accept the patients and their view of the illness, and not attempt to interpret the illness as the expression of something else.