CBT For Chronic Fatigue Syndrome (CFS)
The Science Media Centre states that “CFS/ME is highly controversial with longstanding disagreements between the mainstream medical community and campaigners about its cause and treatment” (Science Media Centre, 2018). Treatments currently recognized by the UK’s National Institute for Health and Care Excellence (NICE) include cognitive behavioral therapy (CBT), pacing and graded activity, and graded exercise therapy. Read more
Signs and Symptoms of CFS/ME
CFS/ME is characterized by disabling tiredness (fatigue) that lasts a long time and cannot be explained by other causes. CFS/ME should be considered if the fatigue prevents the individual from doing things that they used to be able to, if the fatigue gets worse after activity or gentle exercise, or if the following symptoms are present:
- sleep problems
- pain in the muscles or joints
- sore throat or sore glands that aren’t swollen
- problems thinking, remembering, concentrating, or planning
- flu-like symptoms
- feeling dizzy or sick or having palpitations
- exercising or concentrating on something makes your symptoms worse
Psychological Model and Theory of CFS/ME
Understanding of the causes and maintenance of CFS/ME is incomplete. Biomedical factors likely play a role. Like any physical illness it is normal to have thoughts and feelings about symptoms and what they mean, and so psychological approaches also have potential clinical value. Models of CFS/ME including psychological factors include:
- Browne and Chalder (2006)
- Burgess and Chalder (2004)
- Vercoulen et al. (1998)
- Harvey and Wessely (2009)
- Roche, Dawson, Moghaddam, Abey, and Gresswell (2017)
- Wiborg, Knoop, Frank, and Bleijenberg (2012)
Browne, T., & Chalder, T. (2006). Chronic fatigue syndrome. Psychiatry, 5(2), 48–51.
Burgess, M., & Chalder, T. (2004). Cognitive behaviourtherapy for CFS/ME: PACE manual for participants. MREC v. 2. Retrieved from: https://me-pedia.org/images/7/7a/PACE-cbt-participant-manual.pdf
Harvey, S. B., & Wessely, S. (2009). Chronic fatigue syndrome: Identifying zebras amongst the horses. BMC Medicine, 7(1), 58. https://doi.org/10.1186/1741-7015-7-58
Roche, L., Dawson, D. L., Moghaddam, N. G., Abey, A., & Gresswell, D. M. (2017). An Acceptance and Commitment Therapy (ACT) intervention for Chronic Fatigue Syndrome (CFS): A case series approach. Journal of Contextual Behavioral Science, 6(2), 178–186.
Science Media Centre (2018). Science Media Centre Factsheet: CFS/ME—The illness and the controversy. Retrieved from: http://www.sciencemediacentre.org/wp-content/uploads/2018/03/Science-Media-Centre-Factsheet-CFS-ME.pdf
Vercoulen, J. H. M. M., Swanink, C. M. A., Galama, J. M. D., Fennis, J. F. M., Jongen, P. J. H., Hommes, O. R., van der Meer, J. W., & Bleijenberg, G. (1998). The persistence of fatigue in chronic fatigue syndrome and multiple sclerosis: Development of a model. Journal of Psychosomatic Research, 45(6), 507–517.
Wiborg, J. F., Knoop, H., Frank, L. E., & Bleijenberg, G. (2012). Towards an evidence-based treatment model for cognitive behavioral interventions focusing on chronic fatigue syndrome. Journal of Psychosomatic Research, 72(5), 399–404.
The PACE trial was a large-scale study comparing CBT, graded exercise therapy (GET), and standard medical care for CFS. It found that CBT and GET were more effective for CFS than standard care alone.
- CBT for CFS therapist manual
- CBT for CFS participant manual
- Graded Exercise Therapy for CFS therapist manual
- Graded Exercise Therapy for CFS participant manual
- Pacing for people with M.E. – Action For M.E. download archive copy
- Self-help guide to recovery for chronic fatigue syndrome and fibromyalgia download archived copy
- Understanding chronic fatigue syndrome download archived copy
- CFS self-help information – Cambridgeshire and Peterborough NHS download archived copy
- Larun, L., Brurberg, K. G., Odgaard‐Jensen, J., & Price, J. R. (2016). Exercise therapy for chronic fatigue syndrome. Cochrane Database of Systematic Reviews, (2). download archived copy
- Marques, M. M., De Gucht, V., Gouveia, M. J., Leal, I., & Maes, S. (2015). Differential effects of behavioral interventions with a graded physical activity component in patients suffering from Chronic Fatigue (Syndrome): An updated systematic review and meta-analysis. Clinical psychology review, 40, 123-137.
- White, P. D., Goldsmith, K., Johnson, A. L., Chalder, T., & Sharpe, M. (2013). Recovery from chronic fatigue syndrome after treatments given in the PACE trial. Psychological medicine, 43(10), 2227-2235. download archived copy