Chronic Fatigue Syndrome: a Cognitive Behavioural Approach

Introduction:
Chronic Fatigue Syndrome (CFS), or Myalgic Encephalomyelitis, is characterised by severe physical and mental fatigue of at least six months duration and is associated with significant disability. It is a controversial condition which has been associated with polarised debates about whether the condition is physical or psychological in nature.

Content:
In order to transcend this dualistic bio-medical approach a cognitive behavioural model is used to understand the condition, which makes a distinction between precipitating and perpetuating factors. During treatment, a range of techniques such as a graded approach to activity and cognitive restructuring are used with the aim of improving disability and reducing symptoms. If appropriate, once the client has broadened their view of health and illness, more sophisticated cognitive techniques are introduced to address perfectionism, beliefs about showing emotions publically and/or shame. There are several randomized controlled trials providing evidence for CBT and recent studies suggest that fear avoidance beliefs mediate change in social adjustment and fatigue. Participants are expected to roleplay and techniques to facilitate acceptance of feelings and symptoms will be discussed.

Learning objectives:
At the end of the workshop participants will be able to:-
• formulate problems of fatigue in adults with CFS
• plan a graded rehabilitation programme
• address emotional difficulties without alienating the patient

Training modalities:
The workshop will be interactive and include didactic teaching, group work, discussion, roleplay and feedback.

About the presenter:
Trudie Chalder is Professor of Cognitive Behavioural Psychotherapy at King’s College London. She has worked as a clinician and a researcher in the area of medically unexplained symptoms such as chronic fatigue syndrome and irritable bowel syndrome for about 25 years. She develops models for understanding and treating these conditions and evaluates the approaches within the context of randomised controlled trials in primary, secondary and tertiary care. Her more recent research interests involve developing cognitive and behavioural models and treatment of symptoms and disability associated with chronic diseases such as Cancer.