Cognitive Behavioral Therapy and Chronic Fatigue and Immune
Dysfunction Syndrome (CFIDS)

Fact Sheet for CFIDS Patients
Cognitive behavioral therapy (CBT) is an individualized form of psychological therapy that is based on a person’s perception of his or her illness and the impact that is has on the person’s life. Working with a CBT therapist, the person can examine beliefs, concerns and coping behaviors and modify these as necessary, to develop constructive coping strategies. Unlike traditional (and stereotypical) psychological therapy, a person does not recline on a couch and discuss the intimate details of his or her life. 

• Research has shown that CBT can improve function and symptom management for people with CFIDS. It appears to have limited effect on pain and fatigue. Cognitive behavioral therapy will not cure CFIDS, nor will it alleviate all symptoms for many people with CFIDS. CBT does not address the controversy of the origin of CFS, but is simply intended to assist people in better managing the illness.
  
• Average length of this treatment course is 16 weeks; attending a session one-to-two times weekly.
  
• Psychological factors are relevant to any disease process. CBT has been shown to help people deal with these factors and better cope with the life-altering issues of chronic illness. In addition, stress can play a role in increasing illness symptoms and CBT may help people to recognize and manage stressors in their lives.
  
• CBT often involves the introduction of very slowly-increased physical activity. The activity is individualized for the person with CFS and based on their current activity tolerance. Even people with extremely limited tolerance can be helped to gradually achieve increased strength and conditioning. People accustomed to “boom or bust” cycles in which they engage in a great deal of activity when feeling able, then followed by exhaustion, may need to curtail activity and more evenly pace exertion from day to day.
  
• You, or any person, must believe in the potential benefits of CBT, which means that participating with an open mind is essential to a good outcome and correlates with the positive philosophy of the therapy.
  
• Successful CBT results depend on adhering to treatment components. Research studies show that people with CFIDS have a higher drop-out rate for CBT compared to other types of therapy.  An increase in symptoms or symptom severity is the main reason cited for discontinuing CBT. This may be avoided if a paced, personalized plan is followed.
  
• CBT requires that you take personal responsibility for change. Ask yourself if you are able to do this at this time in your life.
  
• Before automatically deciding that CBT is not for you, learn all that you can about this treatment method. Speak with a CBT therapist, read articles or search the Internet to get accurate facts – then make an informed decision.
  
• Special training is necessary for health care professionals who conduct CBT. The CBT therapist needs to be familiar with CFIDS, be aware of the evidence for CFS as a biologically-based disorder and validate your experience of living with a complex and misunderstood illness. Psychologists are not the only health care providers that can successfully guide CBT.  Nurses, physical and occupational therapist are examples of multi-disciplinary providers who are trained in CBT. The National Association of Cognitive Behavioral Therapists, available by phone at 1-800-853-1135 or www.nacbt.org , or theAssociation for the Advancement of Behavioral Therapy, telephone 212-647-1890 or online at www.aabt.org  may be able to assist in finding a trained provider in your area.
  
• CBT may be expensive and not always covered by insurance.