The aim of our study was to explore whether community-based mental health care centres (MHCs) are able to implement and sustain cognitive behavior therapy (CBT) for chronic fatigue syndrome (CFS) with the help of an implementation manual.
We monitored the implementation process and treatment outcome data of three Dutch MHCs that implemented or sustained CBT for CFS, one in the context of a stepped care program.
We compared these data with findings of other treatment studies conducted in the context of CBT for CFS. All three MHCs included at least 40 patients with dropout rates between 15% and 35% from intention-to-treat to second assessment.
Effect sizes ranged between 0.88 and 1.76 for changes in fatigue severity and 0.43 and 1.23 for changes in physical functioning. With one exception, these outcomes were within the range of our benchmark.
Contrary to original expectations, we provided additional implementation support to the two MHCs new with CBT for CFS. We concluded that our implementation manual does not seem to substitute external support for team leaders and associated professions during initial implementation of CBT for CFS but may have the potential to make this assistance more efficient.
Particular attention should be paid to challenges of implementing stepped care for CFS.
Source: Clinical Psychology & Psychotherapy, Dec 11, 2012 . PMID:23229956, by Wiborg JF, Wensing M, Tummers M, Knoop H, Bleijenberg G. Expert Centre for Chronic Fatigue, Radboud University Nijmegen Medical Centre, The Netherlands; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf & Schön Klinik Hamburg-Eilbek, Hamburg, Germany. [Email: email@example.com]