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Qualitative study of the acceptability and feasibility of acceptance and commitment therapy for adolescents with chronic fatigue syndrome


Senior Member
Authors: Philippa Clery, Jennifer Starbuck, Amanda Laffan, Roxanne Morin Parslow, Catherine Linney, Jamie Leveret, Esther Crawley
Published: October 1, 2021
doi: 10.1136/bmjpo-2021-001139

Original preprint title: Is it time to ACT? A qualitative study of the acceptability and feasibility of Acceptance and Commitment Therapy for adolescents with Chronic Fatigue Syndrome
Preprint doi: 10.1101/2021.04.20.21255804

Clery et al. said:
Background Paediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is disabling and relatively common. Although evidenced-based treatments are available, at least 15% of children remain symptomatic after one year of treatment. Acceptance and commitment therapy (ACT) is an alternative therapy option; however, little is known about whether it is an acceptable treatment approach. Our aim was to find out if adolescents who remain symptomatic with CFS/ME after 12 months of treatment would find ACT acceptable, to inform a randomised controlled trial (RCT) of ACT.
Methods We recruited adolescents (diagnosed with CFS/ME; not recovered after one year of treatment; aged 11–17 years), their parent/carer and healthcare professionals (HCPs) from one specialist UK paediatric CFS/ME service. We conducted semi-structured interviews to explore barriers to recovery; views on current treatments; acceptability of ACT; and feasibility of an effectiveness RCT. Thematic analysis was used to identify patterns in data.
Results Twelve adolescents, eleven parents and seven HCPs were interviewed. All participants thought ACT was acceptable. Participants identified reasons why ACT might be efficacious: pragmatism, acceptance and compassion are valued in chronic illness; values-focussed treatment provides motivation and direction; psychological and physical needs are addressed; normalising difficulties is a useful life-skill. Some adolescents preferred ACT to cognitive behavioural therapy as it encouraged accepting (rather than challenging) thoughts. Most adolescents would consent to an RCT of ACT but a barrier to recruitment was reluctance to randomisation. All HCPs deemed ACT feasible to deliver. Some were concerned patients might confuse ‘acceptance’ with ‘giving up’ and called for clear explanations. All participants thought the timing of ACT should be individualised.
Conclusions All adolescents with CFS/ME, parents and HCPs thought ACT was acceptable, and most adolescents were willing to try ACT. An RCT needs to solve issues around randomisation and timing of the intervention.


Senior Member
I like how this thread has already been tagged with "confirmation bias" and "pseudo-study". :p:lol:

Just a more accurate description of asking potential participants of an RCT and healthcare providers in a hypothetical manner about the subjectively predicted effectiveness of a therapy and using this as if it meant anything.

A "qualitative study" is kind of contradicting in itself. A scientific study needs to be empirical, methodical, systematic, measurable. In my opinion, this doesn't apply to a method that thematically analyses the opinions from half-random patients (since a substantial amount didn't even respond), from their parents (sometimes even separated) in a semi-structured manner that allows putting words (and thereby topics) into their mouths.

They ask them if they prefer this over CBT because they consider CBT as the "treatment-as-usual". I only know the term "Standard of Care". But they do what they want to do, and they call this "treatment-as-usual".

If I come up with a hypothesis and ask twelve forum members if they agree with me and if they were willing to participate in a study, et voila, we have a qualitative study. :rolleyes:

Art Vandelay

Senior Member
Acceptance and Commitment Therapy (ACT) appears to be the back-up plan for many of the UK-based BPS quacks if the new NICE guidelines finally outlaw GET and CBT.

I imagine Crawley etc will simply change the name of their existing treatments to 'ACT' and continue on as they have before.