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Learning to cope with chronic illness. Efficacy of a multi-component treatment for people with chronic fatigue syndrome
Patient Education and Counselling, 07/20/09

Goudsmit EM et al. – At six months, there were significant differences between the groups for fatigue, self–efficacy and anxiety. Overall, 82% of the treated patients reported feeling better and 23% had improved to such a degree that they were discharged from the clinic. The gains were maintained at twelve months. This programme was found to be both helpful and acceptable and may provide a useful first–line intervention for many patients with CFS.

Exclusive Author Commentary
Ellen M. Goudsmit, 07/20/09

The findings are consistent with those of cognitive therapy, studied in the USA. It offers the flexibility which the more rigid CBT-based programmes do not. Although it includes many elements found in CBT, e.g. use of a diary for guided discovery, advice re diet, activity, sleep, reducing stress etc, it is not based on the contentious CBT model, which assumes that the symptoms are largely due to inactivity and stress. It's versatile, helpful, and based on effect size etc, as effective as approaches such as CBT/GET. However, it's more acceptable (lower attrition rate) and cheaper. It worked in a busy NHS hospital, and has external validity. We propose that it could form the basis for physician-led, multi-component programme, individualized to meet the patients needs and preferences. Admittedly, the sample was small, but we hope it provides food for thought.

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