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• The family approach is key to recovery from chronic fatigue syndrome
  Carol Wine
  Published on: 22 March 2016

• Published on: 22 March 2016

  The family approach is key to recovery from chronic fatigue syndrome

  • Carol Wine, Social Worker
  • Other Contributors:
    • Anna Gregorowski, David Fisher, Russell Viner

  Dear Editor

  We welcomed the study of family-based cognitive behaviour therapy (CBT) for young people with Chronic Fatigue syndrome (CFS) by Chalder et al., as we too have found that the family approach to rehabilitation beneficial in this condition.

  Although there has been little research into the effectiveness of family therapy with patients with CFS, there is evidence that support by family...

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  Dear Editor

  We welcomed the study of family-based cognitive behaviour therapy (CBT) for young people with Chronic Fatigue syndrome (CFS) by Chalder et al., as we too have found that the family approach to rehabilitation beneficial in this condition.

  Although there has been little research into the effectiveness of family therapy with patients with CFS, there is evidence that support by family members for individuals with a range of other chronic conditions is of major importance to good outcomes [1,2,3] and, conversely, that in some instances the family can inadvertently reinforce illness behaviour.[4]

  In our outpatient program for adolescents with CFS, we added family sessions to other elements including activity scheduling, school reintegration and establishing appropriate sleep routines. Our aims were:
  (i) to establish whether this form of treatment was beneficial, and
  (ii) to identify whether there were family factors/arrangements that might be more or less helpful in promoting recovery from CFS.
  We varied the frequency and number of family sessions with the wants and needs of the family, and dovetailed family meetings with medical and/or physiotherapy appointments. Family sessions for each subject were an hour in duration and were not limited in number or duration over time.

  We used a structural family therapy approach informed by a biopsychosocial systems perspective.[5] The goal of the family work is a return to full-time education with the ancillary aim, particularly for socially isolated young people, of increased social and leisure activities.

  To date, we have offered family work to 36 young people with CFS and their families, of whom 30 engaged with the work. Of these, over 80 % have shown significant improvement.

  Although there are clear similarilites in terms of the family focus between our program and that described by Chalder et al., our program has not included CBT. This raises the question as to whether it is a particular therapeutic technique or the family approach that is important for recovery in CFS?

  References

  (1) Kinsella G. Psychosocial issues in recovery following severe head injury. Proceedings of the 13th Annual Brain Impairment Conference, Besthesda Hospital, 1989,248-67.

  (2) Shepherd G. Psychiatric Rehabilitation in the 1990s. In: Theory and Practice of Psychiatric Rehabilitation Watts F, Bennet D, Shepherd G, (Eds).1990. Chicester: John Wiley.

  (3) Brooks DN. The head injured family. J Clin Exper Neuro-Psychol 1991;13:155-88.

  (4) Brace MJ, Scott Smith M, McCauley E, Sherry DD. Family reinforcement of illness behavior: a comparison of adolescents with chronic fatigue syndrome, juvenile arthritis, and healthy controls. J Dev Behav Pediatr 2000 Oct;21(5):332-9.

  (5) Doherty W, McDaniel S, Hepworth J. Medical family therapy: an emerging arena for family work. J Fam Therapy 1994;16(1).

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  Conflict of Interest:
  None declared.

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