CBT for Chronic Fatigue Syndrome (CFS) - Psychology tools.com

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Downloads include:

Behavioral Experiment Worksheet
"Behavioral experiments allow individuals to test the validity of their beliefs and assumptions. They are a core experiential technique for therapeutic change in cognitive behavioral therapy (CBT). This CBT worksheet helps you to plan and carry out effective behavioral experiments."

Unhelpful Thinking Styles & Errors Worksheet (Cognitive Distortions)
"Human beings are prone to thinking in biased ways, particularly at times when we are under stress or feeling strong emotions. Aaron Beck, the founder of cognitive behavioral therapy (CBT) identified a set of what he called ‘cognitive distortions’ – common ways in which our thinking can become biased or inaccurate. This list was later clarified by David Burns and described using the more approachable label of Unhelpful Thinking Styles. This CBT worksheet describes ten common unhelpful thinking styles which clients may find helpful as part of cognitive restructuring exercises in CBT."

Health Anxiety Thought Record
"Individuals with health anxiety experience clinically significant distress associated with health concerns. This thought-challenging record enables clients to address negative automatic thoughts, worries, and predictions associated with their health."

Safety Behaviors
"Safety behaviors are actions carried out with the intention of preventing a feared catastrophe. In the short-term they often give a sense of relief, but in the long-term they prove unhelpful because they act as a barrier to new learning. This CBT worksheet provides a clear and comprehensive explanation of safety behaviors and enables clients to have a strong understanding of the causes and consequences of safety behaviors so that they can be experimented with and relinquished."

https://www.psychologytools.com/professional/problems/chronic-fatigue-syndrome/


the cbt brigade are really upping the ante

 

They are describing graded exercise therapy.

They also don't distinguish between pacing for chronic pain and pacing for ME/CFS. The references listed are all for chronic pain, but the description refers to GET.

Unfortunately the evidence shows a lack of effect on activity levels and fitness. I don't remember seeing any evidence that it prevents boom and bust patterns of activity either.

 

I sent a quick email asking for a podcast interview about medical errors and their ethical responsibility. I cited their ME/CFS entry as a discussion starting point.

I'm not holding my breath waiting for a response.

 

Is this even legal? When you look at the "Treatment Guides" section, the "archived copy" links take you straight Wayback Machine copies of ... the PACE manuals!!! (The other links are broken QMUL ones). What's more I'm not certain these were the final versions of the manuals, being Nov 2004.

Surely any manuals produced for use in the context of a clinical trial should not legally/ethically be presumed valid for normal clinical usage, especially if potentially being used as self-help aids? I don't think the wriggly disclaimer on the web page can exempt them from that. Even if the trial had been perfect, that limitation would still have to apply surely? The differences between a clinical trial and normal clinical practice must surely be so different in terms of the manuals.

Feels to my like a valid complaint could be made to whoever oversees such organisations.

 

The formal NHS training for GPs is based on the failed FINE trial (the one that says "there is no disease" and concluded no useful benefit). It is highly unethical and immoral but that hasn't stopped anyone yet. If the NHS can do that, no reason why others wouldn't. After all they can even point to the NHS and say it's been validated.

Ideology makes ethics very malleable.

 

That is not the point I'm making. The PACE manuals, be they participants or therapists ones, were written for the purpose of running the trial - they were NOT written for use in normal clinical practice. I know I'm not an expert here, but I would be amazed if manuals written for this purpose are also valid for use as in normal clinical practice. Akin to test pilots' manuals for commercial aircraft type xyz, being also provided for commercial airline pilots to use when flying aircraft xyz. The requirements are enormously different, and I would sincerely hope some law, code, guideline, whatever would be broken if attempting to do so. It's grievously wrong surely. It would be wrong even if the manuals were written for the best ever run trial in the world.

@Jonathan Edwards ?

 

This is a complicated issue. Conditions in trials are different and in principle I agree with what you are saying. However, clinical guidelines can only be based on what the protocol was for the trial that shows the treatment was effective. So doses of drugs in guidelines must be those used in a trial etc.

I think if it is assumed that PACE showed these treatments to be effective then guidelines would need to quote the trial protocols.

 

could it be possible, to get from psychology / psychiatry statistics regarding their successes and treatments

psychiatric hospitalization per decade, e.g. 1950 -1960, 1960 - 1970 ....

- how many ppl went into psychiatric facilities
- how many ppl were released as "healed" / functional ...
- otherwise - outcome and improvement reached
- stay per patient in days until release / death
- average cost per patient / day

- what were the 10 most diagnosed diseases
- what were the 10 most prescribed pills
- average number of pills per patient per day
- how many patients showed serious side effects in %
- medication (top 10) with serious adverse effects

- how many patients additionally treated for diseases in hospital, during stay


- %age of patients that during or 24 months after treatment
----- commited suicide
----- a crime
----- died

or do those statistics exist... ?
yeah can be faked ... but nevertheless...

 

He says he is a clinical psychologist, not a psychotherapist. These are very different professions.

 

I wondered what FIL was. According to Dr Google it's Functional Imaging Laboratory. Just to save all of you like me who were wondering having to search!

 

I have a wonderful time saving device for such things.

I don't give them any thought, or even notice them.

A bit like Zaphods panic prevention sunglasses

 

Not surprisingly, when I make the invitation about their ethical responsibility, they don't reply. This is the first time I've not done it on twitter, so it is not as effective in terms of developing the narrative.

 

didn't spot this the first time I looked at this site

https://www.psychologytools.com/professional/problems/chronic-fatigue-syndrome/

ironic that the second reference is from ME-pedia.