Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.
Changes or goals might involve:
A way of acting: like smoking less or being more outgoing;
A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past.
They concentrate on a person’s views and beliefs about their life, not on personality traits.
Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families.
Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.
HOW TO GET HELP:
If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet.
You may, or may not, find a competent therapist in this manner.
It is wise to check on the credentials of a psychotherapist.
It is expected that competent therapists hold advanced academic degrees.
They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association.
Of course, they should be licensed to practice in your state.
You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations.
You may, of course, visit our website (www.abct.org) and click on "Find a CBT Therapist"
The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition.
These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.
Chronic fatigue syndrome (CFS) is an illness characterized by a combination of
symptoms and signs that have lasted six months or longer. Characteristics of
this syndrome include disabling fatigue, fever, sore throat, painful lymph
nodes, muscle weakness, muscle pain, after-exercise fatigue, headaches, joint
pain, sleep disturbance, and neuropsychological symptoms (such as forgetfulness,
confusion, irritability, depression, and trouble concentrating). The
strength of the illness can vary from severe to lesser symptoms.
What Causes CFS?
The cause of CFS is unknown. It is probably triggered by several factors,
including infection, surgery, stress, and others. These factors may act individually
or together to trigger CFS. However, no trigger or abnormality has been identified
that is shared by everyone with CFS. Long after the triggering factors have
occurred, the illness continues.
Chronic Fatigue Syndrome Is a “Diagnosis of Exclusion”
Because the cause of CFS is unknown, there is no laboratory test to prove or
disprove the presence of CFS. A number of other illnesses with symptoms like
those of CFS must be ruled out before CFS is diagnosed. Self-diagnosis with CFS
should be avoided; consideration of a CFS diagnosis requires comprehensive,
sophisticated medical and psychological evaluations.
Other illnesses to be ruled out include neuromuscular diseases (such as multiple
sclerosis), autoimmune diseases (such as systemic lupus erythematosus),
cancers, and diseases from parasitic infections (such as giardia), to name a few.
Because emotional problems such as depression have symptoms similar to
CFS, some professionals have thought that CFS was a “hidden” depression or
anxiety problem. However, emotional problems do not account for some CFS
signs and symptoms, such as fevers and swollen lymph glands, which makes it
hard to support emotional problems as a cause. On the other hand, when a person
has fewer or more symptoms than the list of CFS symptoms, other diagnoses,
including psychological ones, must be considered.
What Role Do Psychological Factors Play in CFS?
A person’s response to the illness is important in determining its course.
Similarly, family’s, friends’, physician’s, and co-workers’ responses affect how a
person copes with symptoms. For example, some people react to illness by denying
that it exists and underrespond to their symptoms. This may not be in their
best interest, as they are likely to overexert themselves and make their symptoms
worse or set unrealistically high goals that they cannot achieve, leading to
depression and/or anger.
On the other hand, other people may respond to symptoms with fear and
pessimism and unnecessarily limit their activities. Further problems can result
from this sort of response, such as a loss of muscle tone and therefore of strength. Behavior therapists can help a person learn to cope effectively and
flexibly with symptoms.
How Is CFS Treated?
Gather your treatment team. The treatment of CFS is symptomatic and
supportive. Because its cause is not known, treatments cannot be directed at
the underlying cause but are directed at its symptoms. Management and
treatment of CFS involves both medical and psychological professionals, and
may also include other professionals, such as physical therapists.
It is very important that one physician is designated as the doctor in
change. This physician acts as the overseer. Many people with CFS obtain
consultation with multiple professionals, and having one doctor in charge
helps to keep an eye on the “big picture” and to manage recommendations
from other consultants, which can be conflicting and confusing.
Symptomatic relief is sometimes obtained from medications. Antiinflammatory
drugs such as ibuprofen help relieve headaches and muscle
and joint aches and pains. Antidepressants are sometimes prescribed to help
with depressive symptoms and pain. These drugs have other effects useful
for people with CFS, such as anti-inflammatory effects or sedation to help
with sleep. Antiviral drugs have been tried without good results. Many other
drugs have been tried to treat CFS. No single drug helps all people with CFS.
Exercise and Physical Therapy
People with CFS often avoid exercise altogether as it can seem to make
symptoms worse. This can lead to a sense of mistrust of one’s body. For
these reasons, a gradual physical activity program can be helpful. It is important
to begin with activities that can be achieved. For example, if a person
suffers from dizziness and loss of balance, a program of stretching exercises
done from a seated or lying position would be more safe and comfortable
than those that involve standing or balancing.
For many people with CFS, programs of strenuous aerobic exercise may
make symptoms worse. If this is the case, daily, gentle exercise should be
directed toward goals of maintaining flexibility, mobility, and accomplishment,
and of gradually increasing strength and endurance (e.g., walking,
bicycle riding, swimming).
Behavior therapy is used to treat both direct symptoms of CFS and the
consequences of having a chronic illness (such as depression, anxiety, job
loss, or relationship conflict). When treating CFS symptoms, the therapist
will help the patient analyze what makes the symptoms worse or better. This
is usually done by asking the person with CFS to keep detailed records.
For example, if the symptom of fatigue is the target, the person might be
asked to rate the severity of fatigue on an hourly basis throughout the day
and keep track of what else is going on in his or her life; when he or she
sleeps, rests, lies down, takes a medication, eats, exercises, does a social
activity, works, and so forth. Over time, a pattern may emerge that will lead
to a specific treatment. For example, if symptom tracking reveals that
exhaustion begins in the late afternoon, a scheduled rest period before this
time of day may prevent symptoms from increasing. Record keeping also lets
the therapist and the person with CFS know if they are making progress or
How a person thinks about CFS affects his or her mood and ability to
cope. Tracking symptoms and identifying patterns increases the person’s
sense of control. Other ideas, like “activity causes illness,” may not be completely
correct, and may have negative effects, such as leading the person to
avoid all activity. Behavior therapy helps identify and modify detrimental
thoughts as well.
When treating the consequences of CFS, such as depression, anxiety, or
relationship conflict, behavior therapists use well-established techniques but
modify them to take into account the special circumstances of people with
For example, behavior therapy for depression often involves increasing a
person’s activity level. A person who was depressed about having CFS may be
depressed exactly because it is more difficult to be active. Prescribing more
activity would need to be done with creativity and flexibility to identify enjoyable,
but not physically strenuous, activities that the person could do without
making his or her symptoms worse.
Behavior therapy plays an important role in the overall treatment of CFS
by helping the person be as active and productive as possible.
Some people enjoy and benefit from attending support groups; other do
not. Support groups can be a forum for sharing information and ideas, and
participation can counteract the sense of isolation (“I’m the only one who’s
ever had to deal with this...”) that can occur with CFS.
CFS is a recently defined diagnosis, and both medical and psychological
scientists are working to understand and treat it. Recovery is impossible to
predict. However, multidisciplinary care that is overseen by one physician
can help the person with CFS learn to decrease symptoms and cope with
them more effectively.
For more information or to find a therapist:
Please feel free to photocopy or reproduce this fact sheet, noting that this fact sheet was writen and produced by ABCT. You may also link directly to our site and/or to the
from which you took this fact sheet