The Cognitive Behavioral Treatment of Depression and Low Self‐Esteem in the Context of Pediatric Chronic Fatigue Syndrome (CFS/ME): A Case Study

Abstract

Therapy was effective in remediating the young person's mood difficulties, but appeared to exacerbate their CFS/ME symptoms. Therefore, it is crucial that CFS/ME and mood treatments are designed and trialed to ensure a complementary approach. Good communication and joint working between involved professionals is also important, and ideally, treatments for mood and for CFS/ME would be provided by the same team to facilitate this.

Review: How has cognitive behaviour therapy been adapted for adolescents with comorbid depression and chronic illness? A scoping review

“…Problem‐solving skills to help manage the chronic illness generally were a key feature across the interventions (Cumba‐Avilés, 2017; Hickman et al., 2015; McGrady & Hood, 2013; Rofey et al., 2009; Szigethy et al., 2014; Szigethy et al., 2004). However, problem‐solving skills were also used to address barriers to medication adherence (Hilliard et al., 2011) or to tackle realistic negative thoughts (Loades, 2015a).…”

“…Some interventions taught relaxation skills including guided imagery, progressive muscle relaxation or calm breathing (Correa et al., 2015; Loades, 2015b; McGrady & Hood, 2013), and these were sometimes used more specifically to address symptoms of pain (Hilliard et al., 2011; Szigethy et al., 2014; Szigethy et al., 2007; Szigethy et al., 2004). Other specific skills that were covered included time management (Rosselló & Jiménez‐Chafey, 2006), sleep management (Loades, 2015a; Rofey et al., 2009) and general self‐care (Cumba‐Avilés, 2017; Rosselló & Jiménez‐Chafey, 2006).…”

“…blood glucose levels) and mood (Cumba-Avil es, 2017; Rofey et al, 2009;Szigethy et al, 2007;Szigethy et al, 2004). Some interventions included psychoeducation about thoughts, feelings and behaviours associated with the physical illness formulated within a CBT framework (Correa, Sperry, & Darkes, 2015;Hickman, Jacobson, & Melnyk, 2015;Hilliard, Ramey, Rohan, Drotar, & Cortina, 2011;Loades, 2015aLoades, , 2015bRossell o & Jim enez-Chafey, 2006) or an idiosyncratic formulation conceptualising the impact of chronic illness symptoms on depressive thinking (Loades, 2015b). • Participants must be assessed for depression using a reliable and valid measure…”

“…Problemsolving skills to help manage the chronic illness generally were a key feature across the interventions (Cumba-Avil es, 2017; Hickman et al, 2015;McGrady & Hood, 2013;Rofey et al, 2009;Szigethy et al, 2014;Szigethy et al, 2004). However, problem-solving skills were also used to address barriers to medication adherence (Hilliard et al, 2011) or to tackle realistic negative thoughts (Loades, 2015a). Some interventions taught relaxation skills including guided imagery, progressive muscle relaxation or calm breathing (Correa et al, 2015;Loades, 2015b;McGrady & Hood, 2013), and these were sometimes used more specifically to address symptoms of pain (Hilliard et al, 2011;Szigethy et al, 2014;Szigethy et al, 2007;Szigethy et al, 2004).…”

Same, Same But Different? Cognitive Behavioural Treatment Approaches for Paediatric CFS/ME and Depression

“…The current evidence does not allow robust conclusions to be drawn about whether tackling CFS/ME might alleviate depression, or whether a more integrated treatment approach is preferable. No studies have rigorously tested CBT for co-morbid depression in paediatric CFS/ME (Loades et al, 2016), although there are initial indications from a case study (Loades, 2015) that good outcomes can be achieved using a formulation-driven approach. Pragmatically, if a young person is low in mood but feels motivated, able to engage in, and hopeful about the outcome of CBT-CFS, then treatment could start with this focus.…”