Patricia A. Fennell, MSW, LCSW-R, is the Founder and President of Albany Health Management Associates, Inc., a multidisciplinary organization focusing on the global health care effects of chronic illness and trauma. She created the Four-Phase Model (FFPM)™ for understanding and treating chronic conditions. She, also, co-created the Fennell Scale or Fennell Phase Inventory used with patients who have myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and other chronic illnesses.
- 2011, Chronic Illness and the Fennell Four Phase Treatment™ Approach: Working with People Who Don't Get Better
Abstract - "Chronic mental and physical illnesses can be traumatizing, life-changing experiences. The empirically validated Fennell Four Phase Treatment (FFPT™) model recognizes the influences of cultural, psychosocial, and physical factors in assessment and treatment. The multi-phased approach provides a narrative framework and cognitive map for understanding and integrating chronic illness. Phase 1, Crisis: Individuals move from illness onset, which may be specifically detectable or may happen gradually, to an emergency period when it's obvious that something is seriously wrong. The task of the individual, caregivers and clinicians during this phase is to cope with urgency and trauma. Phase 2, Stabilization: Individuals discover that they fail to return to “normal” regardless of interventions or behavior. The task in this phase is to initiate stabilization and life restructuring. Phase 3, Resolution: Individuals recognize deeply that their old life will never return. Early in this phase, most people experience profound existential despair. The task of this phase is to begin establishing an authentic new self and start developing a supportive, meaningful philosophy. Phase 4, Integration: Individuals define a new self in which illness may be an important, but not primary life factor. The goal is integration of the illness into a meaningful life. Within each phase, the Fennell Four-Phase Model addresses three domains: physical/behavioral, psychological, and social/interactive. The experience of chronic illness does not remain the same over time; needs in the early phases of illness may differ from those several years later. Also, life changes that may be unrelated to illness may cause the individual to move backward or forward within the Phases over the course of a lifetime. FFPT helps clinicians treat patients more effectively and can greatly reduce practitioner frustration. It offers a step-by-step, research-based approach, grounded in clinical practice, to help people with chronic illnesses solve problems and create positive change.
- 2005, A team approach to treating CFS: Matching best medical practices to phases of illness.
- 2000, Chronic fatigue syndrome: An examination of the phases.
Abstract - "The present study examined the Fennell Phase Inventory, an instrument designed to measure the phases typically experienced by individuals with chronic fatigue syndrome (CFS). This inventory yields three factor scores of Crisis, Stabilization, and Integration. These factor scores have been employed in a cluster analysis, yielding four clusters that matched the four phases predicted by Fennell: Crisis, Stabilization, Resolution, and Integration. The present study represents a partial replication study of a prior investigation of the Fennell Phase Inventory by Jason et al. (in press), but that earlier study did not have an independent physician examination to diagnose patients with CFS. In the present study, 65 patients diagnosed with chronic fatigue syndrome by a physician were recruited and administered the Fennell Phase Inventory and other measures assessing CFS-related symptoms, disability, and coping. Each of the 65 patients was classified into one of four predefined clusters measuring a Crisis phase, a Stabilization phase, a Resolution phase, and an Integration phase. Relationships were explored between three of these cluster groupings and measures of symptoms, disability, and coping. Results confirmed Fennell's model, revealing significant differences between the three clusters in terms of levels of disability and modes of coping. Results suggest that the Fennell Phase Inventory accurately differentiates phases of adaptation to illness experienced by individuals with CFS."
- 2000, An empirical verification of the Fennell phases of the CFS illness
Abstract - "The Fennell Phase Inventory is an instrument designed to measure the phases typically experienced by individuals with chronic fatigue syndrome. In a previous study, a three-factor solution emerged. A cluster analysis was then conducted using the three mean scores for each individual, and four clusters emerged. These clusters matched the four phases predicted by Fennell. The Fennell Phase Inventory appears to be a promising way of differentiating the phases that are experienced by individuals with CFS."
- 1999, Measuring phases of recovery in patients with CFS.
- 1999, An investigation of the different phases of the CFS illness
Summary - "The present study examined the factor structure of the Fennell Phase Inventory, an instrument designed to measure the phases of the illness known as chronic fatigue syndrome. Four hundred participants were recruited and randomly assigned to two equally sized groups. A similar three-factor solution emerged for both samples, suggesting that three phases characterize this illness: a Crisis phase, a Stabilization phase, and an Integration phase. Factor scores on the Crisis Factor were significantly related to levels of fatigue and disability. The Fennell Phase Inventory appears to be a promising way of differentiating the different phases that are experienced by patients with CFS. The implications of these findings are discussed."
- 1998, Capturing the different phases of the CFS illness
- 1995, The four progressive stages of the CFS experience: A coping tool for patients
Summary - The CFS experience may be construed as a series of adaptations and adjustments that begin at the onset of symptoms. The ability of the CFS-affected individual to cope with symptoms and disabilities is strongly influenced by sociocultural factors. The purpose of this paper is to present a comprehensive multistage model of the CFS experience that recognizes the influences of cultural, psychosocial and medical factors in CFS assessment and treatment. The patient's awareness of these stages of adjustment can be an important coping tool in reconstructing the illness experience.
- 1995, CFS sociocultural influences and trauma: Clinical considerations
Summary - "An integrated model of the assessment and treatment of the CFS population needs to include the sociocultural influences that affect CFS patients as well as their treating clinicians. These sociocultural factors include: (1) the pre-existing cultural climate toward disease, (2) cultural intolerance of ambiguity, (3) cultural intolerance of chronic vs. acute illness, (4) the ongoing psyche-soma duality among health care providers, and (5) initial disease illegitimacy and subsequent enculturation. These specific influences, as well as the patient's medical status, need to be carefully considered in the assessment and treatment of CFS patients and their families. The traumatogenic effects of these sociocultural influences on CFS patients will be discussed and specific treatment strategies will be suggested."
- 1993, A systematic, four-stage progressive model for mapping the CFIDS experience.
- 2003, The Handbook of Chronic Fatigue Syndrome by Leonard Jason, Patricia A. Fennell and Renée R. Taylor (2003) Chapter: "A four-phase approach to understanding chronic fatigue syndrome," pp.155-175, Chapter: "Chronic fatigue syndrome in adolescence," pp. 693-712. Handbook of Chronic Fatigue Syndrome ISBN-10: 047141512X ISBN-13: 978-0471415121
- 2003, Managing Chronic Illness Using the Four-phase Treatment Approach: A Mental Health Professional's Guide to Helping Chronically Ill People
- 2003, Managing chronic illness: The four phase approach
- 2012, "The Four Phases Of Chronic Illness" by Patricia Fennell for Solve ME/CFS Initiative newsletter
- 2012, "Coping With CFS: Five Capacities of Improvisation" by Patricia Fennell for Solve ME/CFS Initiative newsletter
- 2000, "The Healing Journey: Benefits of Retreats"
- Fennell, P. A. (2011). Chronic Illness and the Fennell Four Phase Treatment™ Approach: Working with People Who Don’t Get Better. In 10th global conference, Making Sense Of: Health, Illness, and Disease. Oxford, UK September (pp. 6-8).
- Fennell, P. A., & Bateman, L. (2005). "A team approach to treating CFS: Matching best medical practices to phases of illness." CFS Research Review, Summer.
- Leonard A Jason, Guy Fricano, Renee R Taylor, Jane Halpert, Patricia A Fennell, Susan Klein, Susan Levine (2000) Chronic fatigue syndrome: An examination of the phases. Journal of Clinical Psychology, 56 12:1497-1508
- LA Jason, PA Fennell, RR Taylor, G Fricano, JA Halpert (2000) An empirical verification of the Fennell phases of the CFS illness. Journal of Chronic Fatigue Syndrome, 6 1:47-56. http://dx.doi.org/10.1300/J092v06n01_05
- Fennell, Patricia A., Leonard A. Jason, and S. M. Klein. (1999) Measuring phases of recovery in patients with CFS. Journal of Chronic Fatigue Syndrome, 5 88-88.
- Leonard A Jason, Patricia A Fennell, Susan Klein, Guy Fricano, Jane Halpert. (1999) An investigation of the different phases of the CFS illness. Journal of chronic fatigue syndrome, 5 3-4:35-54. http://dx.doi.org/10.1300/J092v05n03_03
- Fennell, P., Jason, L., & Klein, S. (1998). Capturing the different phases of the CFS illness. CFIDS Chronicle, 11, 13-16.
- Fennell, PA (1995), "The four progressive stages of the CFS experience: A coping tool for patients", Journal of Chronic Fatigue Syndrome, 1 (3-4): 69-79, doi:10.1300/J092v01n03_11
- Fennell, PA (1995), "CFS sociocultural influences and trauma: Clinical considerations", Journal of Chronic Fatigue Syndrome, 1 (3-4): 159-173, doi:10.1300/J092v01n03_25
- Fennell, P. A. (1993). A systematic, four-stage progressive model for mapping the CFIDS experience. The CFIDS Chronicle, Summer, 40-46.
- Fennell, P. (2003). Managing Chronic Illness Using the Four-phase Treatment Approach: A Mental Health Professional's Guide to Helping Chronically Ill People. John Wiley & Sons Incorporated, New York, NY.
- Fennell, P. A. (2003). Managing chronic illness: The four phase approach. John Wiley and Sons Inc., New York, NY.
- Fennell, P., Graham, E., Jason, L., & Taylor, R. (2000). The Healing Journey: Benefits of Retreats. CFIDS CHRONICLE, 13, 14-15.