By David F Marks.
Despite evidence of physiological and cellular abnormalities in myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS), the dominant therapeutic approach has been cognitive behaviour therapy (CBT) and graded exercise therapy (GET). Patients report distress and dissatisfaction following healthcare encounters based on GET and CBT. A significant body of research suggests that CBT and GET are harmful for many patients with ME/CFS. These findings raise ethical concerns and suggest that more collaborative working between scientists, therapists and patients would be helpful in making scientific progress in this difficult field.
CBT and GET follow the discredited biopsychosocial approach of influential psychiatrists and psychologists of the Wessely school (Wessely, David, Butler & Chalder, 1989; White et al., 2011). Multiple patient reports and studies indicate stigmatization, distress and dissatisfaction following GET and CBT. A significant body of research suggests what patients have known for a very long while that CBT and GET are not only ineffective, but harmful for many patients with ME/CFS.
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