Trial By Error: Merck Manual Still Disseminates GET/CBT Advice

David Tuller


By David Tuller, DrPH

The graded exercise therapy/cognitive behavior therapy treatment paradigm for chronic fatigue syndrome—also imposed on those diagnosed with myalgic encephalomyelitis, CFS/ME, ME/CFS, and other variants–is like the undead. This concept keeps reemerging from the fetid intellectual swamplands that spawned it, no matter how many times it is revealed as nonsense.

Although the US Centers for Disease Control and Prevention removed the recommendations for these treatments almost three years ago, some medical organizations, like the Mayo Clinic, have continued to endorse such rehabilitative approaches. A few weeks ago, the Oxford Health NHS Foundation Trust posted—and quickly unposted—a coronavirus-and-fatigue pamphlet littered with debunked arguments on GET and CBT. And the Merck Manual [known in the UK as the MSD Manual] has posted a recently reviewed version of its online CFS information.


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