Acceptance and commitment therapy for Chronic Fatigue Syndrome (PhD thesis)

[Dolphin]

Free full text

Source: University of Lincoln
Date: July 4, 2016 and september 2, 2016
URL: http://eprints.lincoln.ac.uk/24006/

http://eprints.lincoln.ac.uk/24006/... Portfolio Volume 1 - FINAL - with poster.pdf

Acceptance and commitment therapy for Chronic Fatigue Syndrome: A case series approach
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Lauren Roche
- School of Psychology, Faculty of Health and Social Sciences,
University of Lincoln, Brayford Campus, Lincoln, LN6 7DL, UK

Abstract

Background

Acceptance is understood to be an important element in coping with chronic illnesses, linked to positive outcomes such as reduced symptoms and greater quality of life. Chronic Fatigue Syndrome (CFS) is a disabling syndrome that is associated with a poor reported quality of life even in comparison to other chronic conditions. Given that Acceptance and Commitment Therapy (ACT) is a psychotherapeutic model aimed at increasing psychological flexibility, with an emphasis on experiential acceptance and the pursuit of values, this approach holds potential for living and coping with CFS.

Methods

This study used a mixed method multiple single case design to explore the effects of a six week self-help ACT intervention with six participants with CFS.

Results

Significant increases in 'engaged response style' was replicated in four out of six participants and maintained at follow up, with the qualitative data adding further validity to the importance of the values component of the intervention. Low initial acceptance scores improved in four participants but were not maintained. Overall measures of psychological flexibility indicated improvements maintained at follow up for three participants. All participants wearing the activity monitor showed increased physical activity post-intervention, three of which maintained this at follow up. Five participants reported less symptoms and disability, which was maintained for three participants. The implicit measure indicated that underlying beliefs remained stable.

Conclusion

This study was largely exploratory but it seems that this intervention might be of benefit to some individuals with CFS, particularly in the promotion and pursuit of individual values. This study adds support to the role of acceptance in CFS however in this format at least it seems that any benefits from the intervention are difficult to maintain. Although improvements in overall psychological flexibility were replicated in three out of six participants, this prompts discussion about the ineffectiveness of the intervention for other participants.

-------- (c) 2016 University of Lincoln

 

[Denise]

Under the heading of "What will happen to me if I take part?"

Does this mean the intervention was 6 weeks, with a follow up at 8 weeks (2 weeks after the end of the intervention)? And results were maintained for those 2 weeks?
Not sure I am enthusiastic about being able to maintain for 2 weeks. This disease has so many ups and downs at unforeseen intervals that I am not sure maintaining for 2 weeks means a lot.
The 3 month followup was not required (I haven't yet seen what the results were at that mark).

 

[trishrhymes]

I've skimmed through this and am at least reassured that the researcher is aware of the criticisms of CBT and GET, and is trying a different approach that seems to be more about helping people live with CFS and improve quality of life.

Not sure about the lack of definition of diagnostic criteria used, self selected sample, lack of control group... And one person seemed to be nearly 100 on the physical SF questionnaire all 3 times, making me wonder if they had ME.

At a glance there seems to be very little correlation between Fitbit scores and questionnaire scores, making me wonder what use most questionnaires are in measuring anything objective, bringing me full circle to the PACE trial data, and how useless it is.

And wild week by week fluctuations in Chalder fatigue scores and SF physical functioning scores demonstrates both the fluctuating nature of CFS and ME, and the unreliability of using a single measure of these as before and after measures in other studies such as PACE.

In fact I'd say the greatest, though unintended, value of this study is this evidence of fluctuation in these 2measures, adding to the evidence of the unreliability if the PACE trial!

The author does acknowledge that this is a pilot study to test feasibility of such interventions. Which makes any conclusions from this tiny sample completely unreliable.

 

[Dolphin]

A paper has now been published on this:

http://www.sciencedirect.com/science/article/pii/S2212144717300315


Journal of Contextual Behavioral Science
Available online 8 April 2017

In Press, Accepted Manuscript — Note to users



An Acceptance and Commitment Therapy (ACT) intervention for Chronic Fatigue Syndrome (CFS): A case series approach

• Lauren Rochea,
• David L Dawsona, , ,
• Nima G Moghaddama,
• Anne Abeyb

https://doi.org/10.1016/j.jcbs.2017.04.007

Separate thread on the paper:
http://forums.phoenixrising.me/inde...ntion-for-chronic-fatigue-syndrome-cfs.51201/