Cognitive behavioral therapy

Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that is used as a management technique for a wide range of life-altering events, including serious and/or chronic illness such as cancer and multiple sclerosis. In these contexts, it helps patients to adapt to their health condition.

CBT is often proposed as a treatment for ME/CFS. However, in this context, its goal is frequently to disabuse patients of purportedly false illness beliefs.

CBT is one of the therapies used in the controversial PACE trial.

United Kingdom

This video shows excerpts from a British training video. CBT is offered (free of charge) to patients by the British National Health Service (NHS).

Articles Explaining CBT Not Appropriate For ME/CFS

ProHealth: The Chokehold Behavioral Treatments Have on Chronic Fatigue Syndrome

ME Association: No decisions about ME without me:

ME/CFS Research UK Slams Lancet Psychiatry Report Advocating Exercise For Chronic Fatigue Syndrome Sufferers

Notable studies

• 2016, Group Cognitive Behaviour Therapy for Chronic Fatigue Syndrome
• 2009, A review on cognitive behavorial therapy (CBT) and graded exercise therapy (GET) in myalgic encephalomyelitis (ME) / chronic fatigue syndrome (CFS): CBT/GET is not only ineffective and not evidence-based, but also potentially harmful for many patients with ME/CFS (Frank Twisk)

Centers for Disease Control

July 2017, the CDC's Chronic Fatigue Syndrome page has been changed to Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and GET and CBT recomendations have been removed.

Learn more

• Cognitive Behavioral Therapy, Wikipedia
• 2013, Wiley - Chronic Fatigue Syndrome Part Two. Specific Disorders (Trudie Chalder)
• 2016, Editorial: Cognitive-behavior therapy: why is it so vilified in the chronic fatigue syndrome community? (written by Fred Friedberg)
• 2001, Cognitive behaviour therapy and chronic fatigue syndrome

cognitive behavioral therapy (CBT) - A type of psychotherapy geared toward modifying alleged unhealthy thinking, behaviors or illness beliefs. One of the treatment arms used in the controversial PACE trial.

cognitive behavioral therapy (CBT) - A type of psychotherapy geared toward modifying alleged unhealthy thinking, behaviors or illness beliefs. One of the treatment arms used in the controversial PACE trial.

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

graded exercise therapy (GET) - A gradual increase in exercise or activity, according to a pre-defined plan. Focuses on overcoming the patient's alleged unhelpful illness beliefs that exertion can exacerbate symptoms, rather than on reversing physical deconditioning. Considered controversial, and possibly harmful, in the treatment or management of ME. One of the treatment arms of the controversial PACE trial.

pacing The practice of staying within one's "energy envelope" or personal limit by combining periods of activity with periods of rest or avoiding exerting beyond a certain level. ME/CFS patients use pacing to avoid or reduce post-exertional malaise (PEM). Some patients use a heart rate monitor to help with pacing.

cognition Thought processes, including attention, reasoning, and memory.