Tag: psychotherapy

Re-visiting professional ethics in psychotherapy: Reflections on the use of talking therapies as a supportive adjunct for myalgic encephalomyelitis / chronic fatigue syndrome and ‘medically unexplained symptoms’

Abstract:

Following years of debate over the effectiveness of cognitive behavioural therapy for myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS), public health bodies in the UK and beyond have determined that no psychotherapy is clinically proven for this patient group.

In the field of ME/CFS and the wider arena of ‘medically unexplained symptoms’ (MUS), patient survey data and qualitative research capturing patient experiences and psychotherapist attitudes suggest that therapeutic practice may sometimes fall short of required ethical standards. This raises questions about how psychotherapists can safely support, as opposed to treat, people with these debilitating conditions.

We consider four ethical principles that feature throughout psychotherapists’ codes of practice, those of respect, competence, responsibility, and integrity, and discuss examples of good and poor practice in this arena as evinced by recent empirical literature.

Following this, we offer a variety of suggestions to help strengthen ethical psychotherapy practice among patients with ME/CFS and other MUS. In terms of practitioner education, we recommend greater emphasis on humility and reflexive practice, exploration of personal as well professional ethics, and integration of patient expertise-by-experience, accompanied with latest evidence, into foundational and on-going training.

In terms of practice, we suggest consideration of formalized patient-focused feedback systems and greater transparency visà-vis patient access to clinical notes. Finally, we underline the importance of elevating patients from mere subjects to co-producers of psychotherapy research.

Source: Joanne Hunt, Charlotte Blease. Re-visiting professional ethics in psychotherapy: Reflections on the use of talking therapies as a supportive adjunct for myalgic encephalomyelitis / chronic fatigue syndrome and ‘medically unexplained symptoms.’ OSF preprints. https://osf.io/2m9eb/ (Full text)

The Role of Psychotherapy in the Care of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Abstract:

Myalgic encephalomyelitis/chronic fatigue (ME/CFS) is a post-infectious, chronic disease that can lead to severe impairment and, even, total disability. Although the disease has been known for a long time, and has been coded in the ICD since 1969 (G93.3), medical research has not yet been able to reach a consensus regarding its physiological basis and how best to treat it. Against the background of these shortcomings, psychosomatic disease models have been developed and psychotherapeutic treatments have been derived from them, but their empirical testing has led to sobering results.
According to the current state of research, psychotherapy and psychosomatic rehabilitation have no curative effect in the treatment of ME/CFS. Nevertheless, we see numerous patients in practices and outpatient clinics who suffer severely as a result of their illness and whose mental well-being and coping strategies would benefit from psychotherapeutic help.
In this article, we outline a psychotherapeutic approach that serves this need, taking into account two basic characteristics of ME/CFS: firstly, the fact that ME/CFS is a physical illness and that curative treatment must therefore be physical; and secondly, the fact that post exertional malaise (PEM) is a cardinal symptom of ME/CFS and thus warrants tailored psychotherapeutic attention.
Source: Grande T, Grande B, Gerner P, Hammer S, Stingl M, Vink M, Hughes BM. The Role of Psychotherapy in the Care of Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Medicina. 2023; 59(4):719. https://doi.org/10.3390/medicina59040719 (Full text)

Chronic fatigue syndrome and women: can therapy help?

Abstract:

This article presents current research on chronic fatigue syndrome, which currently afflicts mostly females between the ages of 25 and 55. Because depression is a common symptom of chronic fatigue syndrome, mental health practitioners are often involved with the victims and must formulate an appropriate treatment strategy that considers the physiological, intrapsychic, interpersonal, and environmental aspects of the client. This article includes case material focusing on a woman who was medically diagnosed with the Epstein-Barr virus and was in psychotherapy with the author. The difficulty of managing the interplay of the real health problems and the emotional issues presented by the client is highlighted.

Comment in:

“Chronic fatigue syndrome and women: can therapy help?”. [Soc Work. 1992]

“Chronic fatigue syndrome and women: can therapy help?”. [Soc Work. 1992]

“Chronic fatigue syndrome and women: can therapy help?”. [Soc Work. 1992]

Source: Burke SG. Chronic fatigue syndrome and women: can therapy help? Soc Work. 1992 Jan;37(1):35-9.  http://www.ncbi.nlm.nih.gov/pubmed/1542805