Knowledge Bank

Cognitive behavioural therapy helps teenagers with ME

While it is heartening to hear that ME (Myalgic Encephalomyelitis) or CFS (Chronic Fatigue Syndrome) has at last been recognised as a health condition by the medical profession, today’s figures about the number of teenagers affected by it are quite shocking. Why are around one in a 100 of our teenagers here in the UK unable to get out of bed in the mornings to go to school, or barely able to keep awake during lessons? And what help is available to them?

One in 100 secondary school pupils could be missing classes because of chronic fatigue syndrome, also known as Myalgic Encephalomyelitis (ME), say researchers. A study following 2,855 pupils at three schools, published in the online journal BMJ Open, found 28 missed school with chronic fatigue syndrome. The researchers said the effect was "potentially devastating".

Questions must be asked about why teenagers today are suffering from such a debilitating illness that could affect the outcome of their whole lives, in terms of missed lessons and exams. What is it in the environment in the last decade that wasn’t there before?

'Potentially devastating'

Overall, ME is affecting more than 6% of pupils who were missing large amounts of school. Dr Ester Crawley, researcher at the University of Bristol, told the BBC: "The impact of missing school is potentially devastating." However, the figure may be even higher.

The chief executive of the Association of Young People with ME, Mary-Jane Willows, said that "1% is a phenomenal number. It proves the problem we're up against."

But she added: "I would say that it is on the lean side, it is at least 1%, there is a hidden population out there."

Of the newly diagnosed pupils, 19 chose to have treatment. They were given either cognitive behavioural therapy, which alters the way people think and cope with their symptoms, or graded exercise therapy, a gradual and supervised increase in activity levels.

Cognitive therapy is a psychotherapy developed by Aaron Beck, a psychiatrist, in the 1960s.

Psychotherapy had previously focused on trying to determine what the patient was unconsciously feeling and being driven by (known as ‘behaviourism’). But Beck believed that it was what the patient actually thought and how they interpreted things that were the key – a term scientifically called ‘cognition’ – to therapy.

Beck focused initially on depression and came to several conclusions about the driving force behind depression, which included the fact that the patient will have selective abstraction, over-generalisation, magnification of negative factors and minimisation of positive factors in their lives. Cognitive therapy therefore attempts to identify and change these ways of thinking and hence to influence the patient’s emotions and behaviour.

Cognitive therapy is sometimes treated in addition to using elements of behavioural therapy, and this form of therapy is hence called ‘cognitive behavioural therapy’.

Cognitive therapy works usually on a one-to-one basis between therapist and client and begins with determining the client’s thoughts and beliefs and evaluating the validity of them. For example, if the client makes a statement, there will be a discussion to evaluate whether there is any truth to the statement.

Next the therapist will assess what the client expects and/or predicts, followed by assessing what the client acknowledges as the cause for certain events. In this way, the therapist can help the client to understand why they are feeling the way they are, sometimes by making an association with an event in their past, such as loss, rejection or criticism.

To learn more about cognitive behavioural and other therapies which may help with ME, go to The Therapy Book.

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