2010 Chalder - Family focussed CBT RCT

[Esther12]

I was just reading a literature review of evidence based psychology (you're only young once), and came across an entry for this study, where the review seems to spin the results even more than the researchers. Also - I thought this paper had been discussed here, but I cannot find it now, so have added the original abstract at the end too.

Family-focused cognitive behaviour therapy versus psycho-education for chronic
fatigue syndrome in 11- to 18-year-olds: A randomized controlled treatment trial
Chalder, T., Deary, V., Husain, K., & Walwyn, R. Psychological Medicine 2009.
DOI:10.1017/S003329170999153X.
RCT (2 groups) including 3-, 6- and 12-month follow up
63 adolescents with chronic fatigue syndrome
Psychoeducation
CBT
Participants were randomly assigned to either family-focused CBT or psychoeducation
over a 6-month period. The CBT intervention consisted of 13 hourly sessions, offered
every two weeks. Particular emphasis was placed on working collaboratively with
all family members. Psychoeducation consisted of 4 sessions over 6 months.
At the 6-month follow up, there were no statistical differences between the two groups
on the primary measure (school attendance) or any of the secondary measures (fatigue,
functioning); however those in the family-focused CBT group reported greater levels of
satisfaction. Those in the family-focused CBT group returned to school more quickly than
those in the psychoeducation group; however, the increased school attendance in the CBT
group at treatment completion had decreased significantly at the 12-month follow up.

Here's the abstract and one for a related study:

Family-focused cognitive behaviour therapy versus psycho-education for chronic fatigue syndrome in 11- to 18-year-olds: a randomized controlled treatment trial.

Chalder T, Deary V, Husain K, Walwyn R.
Source

Department of Psychological Medicine and Psychiatry, King's College London, Weston Education Centre, London, UK. trudie.chalder@kcl.ac.uk
Abstract

BACKGROUND:

Only one previous randomized controlled trial (RCT) has examined the efficacy of cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) in children. The aim of this study was to compare family-focused CBT with psycho-education for CFS in adolescents.
METHOD:

Sixty-three 11- to 18-year-olds (43 girls, 20 boys) with CFS were randomly assigned to either family-focused CBT or psycho-education delivered over 6 months. School attendance was the main outcome, which was assessed at the end of treatment and at 3, 6 and 12 months follow-up.
RESULTS:

At the main outcome point (the 6-month follow-up) both groups had improved similarly. However, although those who received family-focused CBT were attending school for longer than those who received psycho-education, at discharge from treatment and at 3 months follow-up, they improved less quickly across the follow-up period.
CONCLUSIONS:

Adolescents with CFS get back to school more quickly after family-focused CBT. This is important as they are at a crucial stage of their development. However, the finding that psycho-education was as effective as family-focused CBT at 6 and 12 months follow-up has important implications for health service delivery.

http://www.ncbi.nlm.nih.gov/pubmed/19891804

Br J Health Psychol. 2010 Feb;15(Pt 1):167-83. Epub 2009 May 6.

Cognitive behavioural therapy and psycho-education for chronic fatigue syndrome in young people: reflections from the families' perspective.
Dennison L, Stanbrook R, Moss-Morris R, Yardley L, Chalder T.

Centre for Clinical Applications of Health Psychology, University of Southampton, UK.

Abstract
OBJECTIVES: Recent trials have produced optimistic results for family-focussed cognitive behavioural therapy (CBT) for chronic fatigue syndrome (CFS) in young people. This study sought to examine the under-researched question of the views and experiences of patients and families who take part. DESIGN: Semi-structured interviews and qualitative analysis were chosen in order to address clients' perspectives in depth. METHODS: Sixteen young people and sixteen parents who participated in a trial of CBT versus psycho-education (PE) for CFS were interviewed. Key themes were discerned using inductive thematic analysis. RESULTS: Most families had low expectations of a cure but hope for improvement. Generally speaking, participants found both CBT and PE acceptable and helpful. Behavioural aspects of CBT (e.g. goal-setting, graded activity) were found helpful. The opportunity to gain support, recognition and validation was important. Cognitive elements of therapy were sometimes deemed inappropriate and some felt emotional aspects of CFS were not adequately addressed. Participants were ambivalent towards the extent of family involvement. Negative experiences related to the therapy setting and feeling inappropriately labeled. Most participants felt therapy was a stepping-stone towards normal life, although many felt recovery was incomplete. Very few differences were found between themes from CBT and PE participants. A notable exception was that every young person who experienced CBT described therapy as helpful, whereas the participants who strongly opposed the therapy approach had all experienced PE. CONCLUSIONS: The detailed insights regarding families' therapy experiences suggest areas of improvement for service delivery and topics for further investigation.

PMID: 19422732 [PubMed - indexed for MEDLINE]

-----------------

http://www.ncbi.nlm.nih.gov/pubmed/19422732

 

[wdb]

That sounds like a fair and unbiased trial giving one treatment arm 13 session and the other 4

 

[Dolphin]

Esther12 : at the top, you have copied the same abstract twice, which confused me anyway for a little while, trying to spot the differences. corrected

Regarding the changes, good spot. I think the change may be justified: the initial one:

Those in the family-focused CBT group returned to school more quickly than
those in the psychoeducation group; however, the increased school attendance in the CBT
group at treatment completion had decreased significantly at the 12-month follow up.

could be interpreted by some as a deterioration in the follow-up period, when that isn't what happened (going by the second paper).

 

[Dolphin]

Full text of the second paper:

Dennison L, Stanbrook R, Moss-Morris R, Yardley L, Chalder T. Cognitive behaviour therapy and psychoeducation for chronic fatigue syndrome in young people; reflections from the families' perspective. British Journal of Health Psychology 15, 167-183 (2010). DOI:10.1348/135910709X440034

free here: http://eprints.soton.ac.uk/146013/1/Dennison_et_al_CFS_qual_study_BJHP_2010.doc

 

[Esther12]

@ Dolphin - thanks - I think I had a total brain-fart, so have edited my first post. I didn't really take the time to look in to the study, but needed to close my windows, so thought I'd post it up... I think I got confused in the rush.