Implementing cognitive behavioral therapy for chronic fatigue syndrome in a mental health center: a benchmarking evaluation

J Consult Clin Psychol. 2008 Feb;76(1):163-71. doi: 10.1037/0022-006X.76.1.163.

Abstract

Objective: This study evaluated the success of implementing cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) in a representative clinical practice setting and compared the patient outcomes with those of previously published randomized controlled trials (RCTs) of CBT for CFS.

Method: The implementation interventions were the following: spreading information about the new treatment setting to general practitioners and CFS patients; training mental health center (MHC) therapists in CBT for CFS; and organizing changes in the MHC patient workflow. Patient outcomes were documented with validated self-report measures of fatigue and physical functioning before and after treatment. The comparison of the treatment results with RCT results was done following the benchmark strategy.

Results: One-hundred forty-three CFS patients were referred to the MHC, of whom 112 started treatment. The implementation was largely successful, but a weak point was the fact that 32% of all referred patients dropped out shortly after or even before starting treatment. Treatment effect sizes were in the range of those found in the benchmark studies.

Conclusions: CBT for CFS can successfully be implemented in an MHC. Treatment results were acceptable, but the relatively large early dropout of patients needs attention.

Publication types

  • Comparative Study

MeSH terms

  • Activities of Daily Living / psychology
  • Adult
  • Benchmarking*
  • Cognitive Behavioral Therapy / standards*
  • Community Mental Health Centers*
  • Fatigue Syndrome, Chronic / psychology
  • Fatigue Syndrome, Chronic / rehabilitation*
  • Female
  • Health Plan Implementation
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / standards
  • Patient Dropouts
  • Randomized Controlled Trials as Topic
  • Rehabilitation, Vocational