Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-22T16:17:25.121Z Has data issue: false hasContentIssue false
  • English
  • Français

Implementation of stepped care for patients with chronic fatigue syndrome in community-based mental health care: outcomes at post-treatment and long-term follow-up

Published online by Cambridge University Press:  12 March 2019

Anthonie Janse Open the ORCID record for Anthonie Janse [Opens in a new window] ,
Arno van Dam ,
Coby Pijpers ,
Jan F. Wiborg ,
Gijs Bleijenberg ,
Marcia Tummers ,
Jos Twisk ,
Stephanie Nikolaus  and
Hans Knoop
Anthonie Janse
Affiliation:
Expert Centre for Chronic Fatigue, Department of Medical Psychology, Amsterdam Public Health Research Institute, VU Medical Centre, Amsterdam, The Netherlands Academic Medical Centre (AMC), University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health Research Institute, The Netherlands
Arno van Dam
Affiliation:
GGZ Westelijk Noord-Brabant, Institute for Mental Health Care, Roosendaal, The Netherlands
Coby Pijpers
Affiliation:
GGZ Westelijk Noord-Brabant, Institute for Mental Health Care, Roosendaal, The Netherlands
Jan F. Wiborg
Affiliation:
Expert Centre for Chronic Fatigue, Department of Medical Psychology, Amsterdam Public Health Research Institute, VU Medical Centre, Amsterdam, The Netherlands
Gijs Bleijenberg
Affiliation:
Radboud University Medical Centre, Nijmegen, The Netherlands
Marcia Tummers
Affiliation:
Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
Jos Twisk
Affiliation:
Department of Methodology and Applied Biostatistics, Vrije Universiteit, Amsterdam, The Netherlands
Stephanie Nikolaus
Affiliation:
Expert Centre for Chronic Fatigue, Department of Medical Psychology, Amsterdam Public Health Research Institute, VU Medical Centre, Amsterdam, The Netherlands
Hans Knoop*
Affiliation:
Expert Centre for Chronic Fatigue, Department of Medical Psychology, Amsterdam Public Health Research Institute, VU Medical Centre, Amsterdam, The Netherlands Academic Medical Centre (AMC), University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health Research Institute, The Netherlands
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Cognitive behavioural therapy (CBT) is an evidence-based treatment for chronic fatigue syndrome (CFS). Stepped care for CFS, consisting of a minimal intervention followed by face-to-face CBT, was found efficacious when tested in a CFS specialist centre. Stepped care implemented in a community-based mental health centre (MHC) has not yet been evaluated.

Aims:

(1) To test the effectiveness of stepped care for CFS implemented in a MHC at post-treatment and at long-term follow-up; and (2) compare post-treatment outcomes of implemented stepped care with treatment outcomes of a CFS specialist centre.

Method:

An uncontrolled study was used to test effectiveness of stepped care implemented in a MHC (n = 123). The outcomes of implemented care were compared with the outcomes of specialist care reported in previous studies (n = 583). Data on outcomes from implemented stepped care were gathered at post-treatment and at long-term follow-up. Mixed models were used as method of analysis.

Results:

Fatigue decreased and physical functioning increased significantly following implemented stepped care (both p < .001). The follow-up was completed by 94 patients (78%) within 1–6 years after treatment. Treatment effects were sustained to follow-up. Patients in the MHC showed less improvement directly following stepped care compared with patients in a CFS specialist centre (p < .01).

Conclusion:

Implemented stepped care for CFS is effective with sustained treatment gains at long-term follow-up. There is room for improvement when compared with outcomes of a CFS specialist centre. Some suggestions are made on how to improve stepped care.

Keywords

chronic fatigue syndromecognitive behavioural therapyimplementationminimal interventionstepped care
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 47 , Issue 5 , September 2019 , pp. 548 - 558
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aaronson, N. K., Muller, M., Cohen, P. D., Essink-Bot, M. L., Fekkes, M., Sanderman, R., et al. (1998). Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. Journal of Clinical Epidemiology, 51, 1055–1068.10.1016/S0895-4356(98)00097-3CrossRefGoogle ScholarPubMed
Ali, S., Goldsmith, K., Burgess, M. and Chalder, T. (2017). Guided self-help for patients with chronic fatigue syndrome prior to starting cognitive behavioural therapy: a cohort study. Behavioural and Cognitive Psychotherapy, 45, 448–466. doi: 10.1017/S135246581700025X CrossRefGoogle ScholarPubMed
Beck, A. T., Guth, D., Steer, R. A. and Ball, R. (1997). Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care. Behaviour Research and Therapy, 35, 785–791.10.1016/S0005-7967(97)00025-9CrossRefGoogle ScholarPubMed
Bloot, L., Heins, M. J., Donders, R., Bleijenberg, G. and Knoop, H. (2015). The process of change in pain during cognitive-behavior therapy for chronic fatigue syndrome. Clinical Journal of Pain, 31, 914–921. doi: 10.1097/AJP.0000000000000191 CrossRefGoogle ScholarPubMed
Bower, P. and Gilbody, S. (2005). Stepped care in psychological therapies: access, effectiveness and efficiency. Narrative literature review. British Journal of Psychiatry, 186, 11–17. doi: 10.1192/bjp.186.1.11 CrossRefGoogle ScholarPubMed
Brown, C. A. and Lilford, R. J. (2006). The stepped wedge trial design: a systematic review. BMC Medical Research Methodology, 6, 54. doi: 10.1186/1471-2288-6-54 CrossRefGoogle ScholarPubMed
Fukuda, K., Straus, S. E., Hickie, I., Sharpe, M. C., Dobbins, J. G. and Komaroff, A. (1994). The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Annals of Internal Medicine, 121, 953–959.10.7326/0003-4819-121-12-199412150-00009CrossRefGoogle ScholarPubMed
Harvey, A. G. and Gumport, N. B. (2015). Evidence-based psychological treatments for mental disorders: modifiable barriers to access and possible solutions. Behaviour Research and Therapy, 68, 1–12. doi: 10.1016/j.brat.2015.02.004 CrossRefGoogle ScholarPubMed
Heins, M. J., Knoop, H., Burk, W. J. and Bleijenberg, G. (2013). The process of cognitive behaviour therapy for chronic fatigue syndrome: which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue? Journal of Psychosomatic Research, 75, 235–241. doi: 10.1016/j.jpsychores.2013.06.034 CrossRefGoogle ScholarPubMed
Hempel, S., Chambers, D., Bagnall, A. M. and Forbes, C. (2008). Risk factors for chronic fatigue syndrome/myalgic encephalomyelitis: a systematic scoping review of multiple predictor studies. Psychological Medicine, 38, 915–926. doi: 10.1017/S0033291707001602 CrossRefGoogle ScholarPubMed
Janse, A., Nikolaus, S., Wiborg, J. F., Heins, M., van der Meer, J. W., Bleijenberg, G., et al. (2017). Long-term follow-up after cognitive behaviour therapy for chronic fatigue syndrome. Journal of Psychosomatic Research, 97, 45–51. doi: 10.1016/j.jpsychores.2017.03.016 CrossRefGoogle ScholarPubMed
Janse, A., Wiborg, J. F., Bleijenberg, G., Tummers, M. and Knoop, H. (2016). The efficacy of guided self-instruction for patients with idiopathic chronic fatigue: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 84, 377–388. doi: 10.1037/ccp0000085 CrossRefGoogle ScholarPubMed
Knoop, H. and Bleijenberg, G. (2010). Het chronisch vermoeidheidssyndroom. Behandelprotocol cognitieve gedragstherapie voor CVS. [Chronic fatigue syndrome. Treatment protocol for cognitive behavioural therapy with CFS-patients]. Bohn Stafleu Van Loghum, Houten.Google Scholar
Knoop, H., Bleijenberg, G., Gielissen, M. F., van der Meer, J. W. and White, P. D. (2007a). Is a full recovery possible after cognitive behavioural therapy for chronic fatigue syndrome? Psychotherapy and Psychosomatics, 76, 171–176. doi: 10.1159/000099844 CrossRefGoogle ScholarPubMed
Knoop, H., Stulemeijer, M., Prins, J. B., van der Meer, J. W. and Bleijenberg, G. (2007b). Is cognitive behaviour therapy for chronic fatigue syndrome also effective for pain symptoms? Behaviour and Research Therapy, 45, 2034–2043. doi: 10.1016/j.brat.2007.03.002 CrossRefGoogle ScholarPubMed
Knoop, H., van der Meer, J. W. and Bleijenberg, G. (2008). Guided self-instructions for people with chronic fatigue syndrome: randomised controlled trial. British Journal of Psychiatry, 193, 340–341. doi: 10.1192/bjp.bp.108.051292 CrossRefGoogle ScholarPubMed
Menting, J., Tack, C. J. and Knoop, H. (2017). Prevalence and correlates of pain in fatigued patients with type 1 diabetes. Journal of Psychosomatic Research, 95, 68–73. doi: 10.1016/j.jpsychores.2017.02.010 CrossRefGoogle ScholarPubMed
Reeves, W. C., Lloyd, A., Vernon, S. D., Klimas, N., Jason, L. A., Bleijenberg, G., et al. International Chronic Fatigue Syndrome Study (2003). Identification of ambiguities in the 1994 chronic fatigue syndrome research case definition and recommendations for resolution. BMC Health Services Research, 3, 25. doi: 10.1186/1472-6963-3-25 CrossRefGoogle ScholarPubMed
Richards, D. A. (2012). Stepped care: a method to deliver increased access to psychological therapies. Canadian Journal of Psychiatry, 57, 210–215.10.1177/070674371205700403CrossRefGoogle ScholarPubMed
Scheeres, K., Wensing, M., Knoop, H. and Bleijenberg, G. (2008). Implementing cognitive behavioral therapy for chronic fatigue syndrome in a mental health center: a benchmarking evaluation. Journal of Consulting and Clinical Psychology, 76, 163–171. doi: 10.1037/0022-006X.76.1.163 CrossRefGoogle Scholar
Shafran, R., Clark, D. M., Fairburn, C. G., Arntz, A., Barlow, D. H., Ehlers, A., et al. (2009). Mind the gap: improving the dissemination of CBT. Behaviour and Research Therapy, 47, 902–909. doi: 10.1016/j.brat.2009.07.003 CrossRefGoogle ScholarPubMed
Stewart, A. L., Hays, R. D. and Ware, J. E. Jr (1988). The MOS short-form general health survey. Reliability and validity in a patient population. Medical Care, 26, 724–735.10.1097/00005650-198807000-00007CrossRefGoogle Scholar
Tummers, M., Knoop, H. and Bleijenberg, G. (2010). Effectiveness of stepped care for chronic fatigue syndrome: a randomized noninferiority trial. Journal of Consulting and Clinical Psychology, 78, 724–731. doi: 10.1037/a0020052 CrossRefGoogle ScholarPubMed
Tummers, M., Knoop, H., van Dam, A. and Bleijenberg, G. (2012). Implementing a minimal intervention for chronic fatigue syndrome in a mental health centre: a randomized controlled trial. Psychological Medicine, 42, 2205–2215. doi: 10.1017/S0033291712000232 CrossRefGoogle Scholar
Ware, J. E. Jr and Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473–483.10.1097/00005650-199206000-00002CrossRefGoogle ScholarPubMed
White, P. D., Goldsmith, K., Johnson, A. L., Chalder, T. and Sharpe, M. (2013). Recovery from chronic fatigue syndrome after treatments given in the PACE trial. Psycholical Medicine, 43, 2227–2235. doi: 10.1017/S0033291713000020 CrossRefGoogle ScholarPubMed
Wiborg, J. F., van Bussel, J., van Dijk, A., Bleijenberg, G. and Knoop, H. (2015). Randomised controlled trial of cognitive behaviour therapy delivered in groups of patients with chronic fatigue syndrome. Psychotherapy and Psychosomatics, 84, 368–376. doi: 10.1159/000438867 CrossRefGoogle ScholarPubMed
Wiborg, J. F., Wensing, M., Tummers, M., Knoop, H. and Bleijenberg, G. (2014). Implementing evidence-based practice for patients with chronic fatigue syndrome. Clinical Psychology and Psychotherapy, 21, 108–114. doi: 10.1002/cpp.1827 CrossRefGoogle ScholarPubMed
Worm-Smeitink, M., Gielissen, M., Bloot, L., van Laarhoven, H. W. M., van Engelen, B. G. M., van Riel, P., et al. (2017). The assessment of fatigue: psychometric qualities and norms for the Checklist Individual Strength. Journal of Psychosomatic Research, 98, 40–46. doi: 10.1016/j.jpsychores.2017.05.007 CrossRefGoogle ScholarPubMed
Supplementary material: File

Janse et al. supplementary material

Janse et al. supplementary material 1

Download Janse et al. supplementary material(File)
File 53.4 KB
Supplementary material: File

Janse et al. supplementary material

Janse et al. supplementary material 2

Download Janse et al. supplementary material(File)
File 53.5 KB
Supplementary material: File

Janse et al. supplementary material

Janse et al. supplementary material 3

Download Janse et al. supplementary material(File)
File 92.6 KB
Submit a response

Comments

No Comments have been published for this article.