A Long Term Follow-up of a Multi-Disciplinary Approach to Chronic Fatigue Syndrome

Literature Review: A critical review of the literature investigated the question ‘what is the strength of the evidence base for Cognitive Behavioural Therapy (CBT) for Chronic Fatigue Syndrome (CFS) on fatigue and physical functioning?’ The studies reviewed included nine group based CBT studies, and six individually based CBT interventions. The evidence base was found to be weak, study designs complex making comparison difficult. There was some positive evidence for efficacy of CBT on fatigue and physical functioning in CFS sufferers, but it was found that some alternative interventions used as comparators such as Graded Exercise Therapy and Counselling showed similar results. There was no clear difference between the efficacy in individual or group based CBT approaches and long-term outcomes for both approaches were inconclusive. Research Report: The current study evaluated the long-term effectiveness of a multi-disciplinary approach to CFS and explored patients’ experience of service use through a longitudinal questionnaire based survey of patients who used a British multi-disciplinary secondary care specialist service. Measures were taken pre and post intervention, and at follow up (average 34 months post intervention). Telephone interviews with 10 participants based on a semi-structured interview schedule were used to explore in-depth information about experience of using the service. Gains made in outcome measures were mostly maintained and continued to improve at follow up. A thematic analysis of interviews found that patients felt positively about the service, and gained validation, education and management skills from the intervention. Areas highlighted to be developed were improving access, reducing gate-keeping by primary care medical services, and offering all patients both group and individual interventions. Critical Appraisal: A summary of the researcher’s reflections on the research process can be found in the critical appraisal.