Recovery from chronic fatigue syndrome: a reflexive thematic analysis of experiences of people before, during and after treatment, 2025, Chalder+

[SNT Gatchaman]

Recovery from chronic fatigue syndrome: a reflexive thematic analysis of experiences of people before, during and after treatment

Spoiler: Authors

Tom Ingman; Trudie Chalder; Vanessa Lawrence

INTRODUCTION
Chronic fatigue syndrome (CFS) is a chronic illness marked by severe, medically unexplained fatigue. Cognitive behavioural therapy (CBT) moderately improves fatigue and functioning. However, there is debate about recovery and how this should be operationalised. The impact of treatment on how recovery is viewed is also unclear. This study explored how people with CFS receiving CBT viewed recovery and whether these views differed at various stages of treatment.

METHODS
A total of 19 people with CFS receiving CBT were recruited from a specialist service in the UK. Purposive sampling was used to ensure a mix of age, gender, ethnicity and treatment stage. Semi-structured interviews were used to gather data and a reflexive thematic analysis was conducted.

RESULTS
The sample included 11 (57.9%) females and 8 (42.1%) males, with a mean age of 40 years old (range: 20−63) The mean duration of illness prior to treatment was 60 months (range: 12−142). The following four themes were identified in relation to recovery: (1) a personal process; (2) a reduction in symptoms; (3) a process of rebuilding, regaining, and retaining; (4) disrupting old ways of living. Theme Four was expressed mostly by those at later-treatment stages, suggesting that these emerged during treatment.

DISCUSSION
Recovery is a blend of ‘clinical recovery, ‘personal recovery and ‘illness management models applied to other chronic conditions. Data suggests that concepts can change, and treatment may result in patients adopting views more in line with ‘personal recovery and ‘illness management models. These more flexible definitions, particularly those comprising changes to pre-illness beliefs and behaviours, new roles, acceptance and strategies to manage symptoms, corresponded with greater hope. Findings may help to inform realistic treatment expectations and contribute to more meaningful outcome measures.

Web | DOI | PDF | International Journal of Qualitative Studies on Health and Well-being | Open Access

 

[SNT Gatchaman]

Taken together, findings from the current study indicate that CBT treatment may elicit more flexible views of recovery that share similarities with the ‘illness management’ and ‘personal recovery’ models. These definitions of recovery include a rejection of previously unhelpful ways of living, adopting new roles and identities, acceptance and tools to manage symptoms. Flexible views of recovery and illness such as these may give rise to increased hope and better outcomes.

Conversely, those participants who held predominantly ‘clinical’ definitions of recovery, involving total symptom remission and restoring what is lost without change, generally had lower hope for recovery. The ‘clinical’ model of recovery was held by participants at various stages of treatment, including one participant at the end of treatment who did not feel treatment had been long enough or had provided her with enough home-based support. This latter participant expressed less hope for recovery and may represent the significant minority of people who feel they do not improve following current forms of CBT.

So CBT leads to redefinition of recovery away from actual recovery to Recovery™.

 

[Jonathan Edwards]

International Journal of Qualitative Studies on Health and Well-being

It reminds me of the option of domestic science instead of chemistry at school. Suitable for dimbos.

Someone should tell Tom that we judge a man by the company he keeps.

Data suggests that concepts can change, and treatment may result in patients adopting views more in line with ‘personal recovery and ‘illness management models.

And yes, the intellectual underwear may be showing a bit here.

 

[Eleanor]

the significant minority of people who feel they do not improve following current forms of CBT.

"You see, it's not that CBT isn't helpful, it's just that the poor dears don't realise they've been helped."

 

[ScoutB]

One of the funniest clues that BPS treatments don’t work is that the people with the best view of its results, its proponents, keep writing papers redefining recovery to be not recovering at all.

 

[NelliePledge]

No surprise the emperor is still parading the corridor of Kings College Psychology in the altogether with people still pronouncing their admiration of his “recovery” new clothes

 

[Sean]

Chronic fatigue syndrome (CFS) is a chronic illness marked by severe, medically unexplained fatigue. Cognitive behavioural therapy (CBT) moderately improves fatigue and functioning.​

Starts badly and quickly degenerates from there in an entirely predictable manner.

That it has Chalder's name on it is entirely unsurprising. She really is a one-trick pony.

 

[SNT Gatchaman]

Inclusion criteria were: (1) a diagnosis of CFS according to Centre for Disease Control and Prevention criteria (Fukuda et al., 1994) or Oxford criteria (Sharpe et al., 1991) following a biopsychosocial assessment conducted by psychiatrists with expertise in CFS; (2) aged 18 or over; (3) those referred to, receiving or having recently completed CBT. Exclusion criteria were: (1) unable to speak English (2); a co-morbid diagnosis (e.g., bipolar disorder); (3) expression of suicidal intent.

 

[forestglip]

They also used a 19 year old study for prevalence. I assume because prevalence studies have moved on to newer criteria since then.

The prevalence of CFS in the UK population is estimated to be between 0.4% and 2.5% (Prins
et al., 2006).

I don't see any mentions of post-exertional malaise.

I mean if they want to study a disease defined by those criteria, I guess CFS is the name of it. But it doesn't help patients fulfilling any definitions when papers keep coming out about two different conditions called the same thing.

Maybe it's time we get on with migrating to SEID. Or meckfuss. Or something.