Pasini Ilenia, Donisi Valeria, Veneziani Elisa, Perlini Cinzia, Nizzero Marta, Lippolis Irma, Polati Enrico, Schweiger Vittorio, Del Piccolo Lidia
Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
Pain Therapy Centre, Department of Surgery, Dentistry, Maternal and Infant Sciences, Verona University Hospital, Verona, Italy.
Front Med (Lausanne). 2024 Oct 24;11:1408693. doi: 10.3389/fmed.2024.1408693. eCollection 2024.
To present an innovative integrated manualized psychotherapeutic intervention for fibromyalgia (FM) based on cognitive and behavioral therapy, acceptance and commitment therapy, and somatic experiential techniques (namely the INTEGRated Psychotherapeutic InterventiOn, INTEGRO) and illustrate its application on two case studies.
INTEGRO is composed of 12 individual sessions. The main objectives of the intervention were psychoeducation of chronic pain mechanisms, understanding the role of cognitive and emotional variables in one's pain perception, teaching patient-tailored skills to increase pain awareness and its management, and learning how to live with pain experience. A 57-year-old woman (patient A) and a 26-year-old woman (patient B) with FM have been selected to describe their care pathways connected to the INTEGRO protocol. Data related to assessment variables and clinical processes have been reported, focusing on the mechanisms that contribute to the maintenance (i.e., avoidance or overcompensation) of chronic pain in FM, on the role of patients' naïf theories, and on the implications that all these aspects may have on the burden related to pain management.
Both patients showed a reduction in FM burden and an increase in self-efficacy in pain management: patient A reported an improvement in emotional regulation ability; patient B showed a decrease in pain interference in work activities and on emotional dimension.
Examining each phase of the clinical protocol through the lens of its clinical application, the paper provides insights into the relationship among crucial psychosocial mechanisms, pain perception, management in FM treatment, and how all these aspects have been dealt with during psychotherapeutic treatment.
介绍一种基于认知行为疗法、接纳与承诺疗法以及躯体体验技术的针对纤维肌痛（FM）的创新性综合手动心理治疗干预方法（即综合心理治疗干预，INTEGRO），并举例说明其在两个案例研究中的应用。
INTEGRO由12次个体治疗组成。干预的主要目标是对慢性疼痛机制进行心理教育，理解认知和情绪变量在个体疼痛感知中的作用，教授针对患者的技能以提高疼痛意识及其管理能力，以及学习如何与疼痛体验共处。选取了一名57岁女性（患者A）和一名26岁女性（患者B）患有FM的患者来描述她们与INTEGRO方案相关的护理路径。报告了与评估变量和临床过程相关的数据，重点关注导致FM慢性疼痛维持（即回避或过度补偿）的机制、患者朴素理论的作用，以及所有这些方面可能对疼痛管理负担产生的影响。
两名患者的FM负担均减轻，疼痛管理方面的自我效能感均增强：患者A报告情绪调节能力有所改善；患者B在工作活动和情绪维度上的疼痛干扰有所减少。
通过临床应用的视角审视临床方案的每个阶段，本文深入探讨了关键心理社会机制、疼痛感知、FM治疗中的管理之间的关系，以及在心理治疗过程中如何处理所有这些方面。
