Cognitive-Behavioral Intervention in Chronic Fatigue Syndrome: Benefits, Limitations, and Open Questions – Source: Quarterly Bulletin of the IACFS/ME, Winter 08-09
By Fred Friedberg, PhD
Note: Dr. Fred Friedberg, President of the International Association of CFS/ME (IACFS/ME), specializes in studies of behavioral treatment of ME/CFS/FM and other chronic pain conditions at Stony Brook (NY) University. In this article, he provides a critical perspective on the assumptions shaping cognitive-behavioral therapy (CBT) use and trials for ME/CFS patients – suggesting that neither a complete rejection of this model’s value nor an uncritical endorsement is in the patients' best interest.
The cognitive-behavioral model of chronic fatigue syndrome (CFS) postulates fear-based avoidance behavior and physical deconditioning to explain symptoms and impairments.
This article examines these assumptions and provides a brief critical perspective of CBT trials in patients with CFS.
Although CBT is effective to varying degrees in reducing symptoms and improving functioning, published reports often do not address:
a. The influence of baseline functioning on intervention rationale;
b. Clinical vs. statistical significance of outcomes;
c. Patient non-response to CBT; and
d. The potential role of biological variables in predicting response to intervention.
A balanced assessment of the effectiveness of CBT in CFS is important in providing accurate information to both professionals and patients.
Source: Bulletin of the IACFS/ME – Vol 16 (4) pp 22-27. To read the full text of this article at the IACFS/ME website, CLICK HERE