Phoenix Rising - Cort Johnson's Column
...Presenting complex chronic fatigue syndrome (ME/CFS) research in a way we can all understand.
Repeat After Me “CBT Is Not A Cure….CBT Is Not a Cure….CBT Is Not a Cure….”
Response to Treatment in Chronic Fatigue Syndrome: Evaluation of Combining Cognitive Behavioral Therapy and Exercise Therapy. G. Moorken, M. Weyns, C. Mertens and H. Wyant
(IACFS/ME Conference 2009)
by Cort Johnson
This ambitious and very large study (219 patients) combined the two big mainstream behavioral therapies in Europe; cognitive behavioral therapy (CBT) and graded exercise therapy (GET). One had the feeling that there were hopes that this was going to ace it for the behavioral therapists; the combination of these two hot therapies was going to knock this disease out once and for all and this large study would usher in a new era of treatment. That’s apparently what the Belgian government thought when they created a series of CFS treatment centers.
That didn’t quite happen. On the way, though, we learned some interesting things. The infectious onset cases have always got the lion’s share of attention in ME/CFS. Dr. Moorkens asked the patients in her study about triggers and, although infection was the single most common trigger, it was not deemed a trigger in most cases. Here are the triggers she identified.
- No trigger – 34%
- Infection – 23%
- Relational Problems – 15%
- Work Related Stress – 10%
- Pregnancy – 9%
- Trauma – 6%
- Surgery – 5%
This group, with their high rates of relational violence (28%!) and their ‘hyperactive lifestyle’ (?) (30%), appeared to have a fairly high level of psychological issues and would seem to be a good candidate group for cognitive behavioral therapy. But while the participants in general improved, they didn’t improve that much and the trial failed to produce ‘significant’ benefits – an apparently devastating outcome not just for the patients but for the Belgium government. Even though Dr. Moorkens told them CBT was not a cure before the trial started, they apparently didn’t take it to heart. They thought, since they thought the disease to be a psychological disorder, that the trial would succeed. They’re so upset in fact that they’re considering pulling the plug on the whole effort. (Talk about behavioral problems…..)
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