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
Janse,A. van Dam,A. Pijpers,C. Wiborg,J. Bleijenberg,G. Tummers,M. Twisk,J. Nikolaus,S. Knoop,H.
Janse,A.
van Dam,A.
Pijpers,C.
Wiborg,J.
Bleijenberg,G.
Tummers,M.
Twisk,J.
Nikolaus,S.
Knoop,H.
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.
Description
Date
2019
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Volume Title
Publisher
Research Projects
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Keywords
ACCESS, COGNITIVE-BEHAVIOR THERAPY, DISORDERS, PAIN, RECOVERY, SF-36, chronic fatigue syndrome, cognitive behavioural therapy, implementation, minimal intervention, stepped care
Citation
Janse, A, van Dam, A, Pijpers, C, Wiborg, J, Bleijenberg, G, Tummers, M, Twisk, J, Nikolaus, S & Knoop, H 2019, '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', Behavioural and Cognitive Psychotherapy, vol. 47, no. 5, pp. 548-558. https://doi.org/10.1017/S1352465819000110