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Graded activity therapy
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==Theory == Graded activity therapy uses a '''graded''' approach, meaning continual goals involving increases in physical or cognitive activities regardless of the degree of symptoms or illness caused.<ref name="srft" /> The aim it to continue increase until full health is achieved, with CFS/ME assumed to be "curable" [[medically unexplained symptoms]] despite the known [[List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis|abnormal findings]] in ME/CFS patients. Under this graded approach there is no consideration for patients with a deteriorating course of ME/CFS, or of patients who do not improve. Patients are told to "push through" and ignore their symptoms. In [[cognitive behavioral therapy]] (CBT) patients are told their symptoms are not a sign of illness and to avoid "symptom focusing" but not to avoid "exercise and activity". Patients assumed to have abnormal [[illness beliefs]] in both CBT and GAT/GET, despite significant evidence disputing this.<ref name="Geraghty2019" /> This approach is known as the [[biopsychosocial model]] for ME/CFS, and is the justification for the use of both [[cognitive behavioral therapy]] and [[graded exercise therapy|graded activity/exercise therapy]] in [[ME/CFS]], which assumes no disease process is present and that symptoms are the result of inactivity, patient behaviors such as resting too much, and other factors claimed to [[The 3Ps model|"perpetuate"]] the illness.<ref name="Geraghty2019">{{Cite journal | last = Geraghty | first = Keith | authorlink = Keith Geraghty | last2 = Jason | first2 = Leonard | authorlink2 = Leonard Jason | last3 = Sunnquist | first3 = Madison | authorlink3 = Madison Sunnquist | last4 = Tuller | first4 = David | authorlink4 = David Tuller | last5 = Blease | first5 = Charlotte | authorlink5 = Charlotte Blease | last6 = Adeniji | first6 = Charles | authorlink6 = Charles Adeniji | date = Jan 1, 2019 | title = The ‘cognitive behavioural model’ of chronic fatigue syndrome: Critique of a flawed model| url = https://doi.org/10.1177/2055102919838907|journal=Health Psychology Open|language=en|volume=6|issue=1 | pages = 2055102919838907|doi=10.1177/2055102919838907|issn=2055-1029|quote=|via=}}</ref><ref name="Geraghty2018">{{Cite journal | last = Geraghty | first = Keith J. | authorlink =Keith Geraghty | authorlink2 =Charlotte Blease | last2 = Blease | first2 = Charlotte | date = 2018-06-21 | title = Myalgic encephalomyelitis/chronic fatigue syndrome and the biopsychosocial model: a review of patient harm and distress in the medical encounter |url =https://www.tandfonline.com/doi/abs/10.1080/09638288.2018.1481149?scroll=top&needAccess=true&journalCode=idre20&|journal=Disability and Rehabilitation|language=en | pages = 1–10|doi=10.1080/09638288.2018.1481149|issn=0963-8288}}</ref><ref name="Geraghty2016">{{Cite journal | last = Geraghty | first = Keith J. | last2 = Esmail | first2 = Aneez | authorlink2 = Esmail Aneez | authorlink =Keith Geraghty | date = 2016-08-01 | title = Chronic fatigue syndrome: is the biopsychosocial model responsible for patient dissatisfaction and harm?| url = https://bjgp.org/content/66/649/437|journal=Br J Gen Pract|language=en|volume=66|issue=649 | pages = 437–438|doi=10.3399/bjgp16X686473|issn=0960-1643|pmid=27481982}}</ref><ref name="Parliament">{{Cite web | url = https://hansard.parliament.uk/commons/2018-02-20/debates/990746C7-9010-4566-940D-249F5026FF73/PACETrialPeopleWithME | title = PACE Trial: People with ME - Hansard | last = | first = | date = Feb 20, 2018 | website = hansard.parliament.uk|language=en|archive-url=|archive-date=|url-status=|access-date=2018-10-29|edition=Volume 636}}</ref><ref name="IIMER">{{Cite web | url = http://www.investinme.org/Documents/Fact%20Sheets/Invest%20in%20ME%20Research%20-%20Flaws%20in%20BPS%20Theory%20for%20ME%20Fact%20Sheet.pdf | title=Notes on the Ineffectiveness of the Biopsychosocial Model for Treating Myalgic Encephalomyelitis | last = Invest in ME Research | authorlink = Invest in ME Research | first = | date = |website=|archive-url=|archive-date=|url-status=|access-date= October 30, 2018}}</ref><ref name="GET-harms">{{Cite web | url = http://iacfsme.org/PDFS/Reporting-of-Harms-Associated-with-GET-and-CBT-in.aspx | title = Bulletin of the IACFS/ME 59 Reporting of Harms Associated with Graded Exercise Therapy and Cognitive Behavioural Therapy in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome | last = Kindlon | first = Tom | authorlink = Tom Kindlon | date = |website=IACFSME|archive-url=|archive-date=|access-date=}}</ref>
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