Cella, Matteo, Stahl, Daniel, Reme, Silje Endresen et al. · Psychotherapy research : journal of the Society for Psychotherapy Research · 2011 · DOI
This study looked at whether it matters which therapist treats patients with ME/CFS when they receive cognitive behavioral therapy (CBT). Researchers tracked 374 ME/CFS patients treated by 12 different therapists in a specialized clinic and measured changes in fatigue and disability. They found that while patients improved overall, the individual therapist made almost no difference in outcomes—the patients' improvements were similar regardless of which qualified therapist treated them.
Understanding therapist effects is crucial for designing effective ME/CFS treatment services and allocating clinical resources. This finding suggests that for CBT in ME/CFS, the quality of the clinical setting, standardized training, and consistent therapeutic approach may matter more than individual therapist differences, which has important implications for service organization and accessibility.
This study does not prove that therapist skill and quality are unimportant in CBT for ME/CFS—the homogeneous, highly trained therapist sample may have been uniformly effective, leaving genuine differences masked. The findings are specific to this specialized setting and cannot be generalized to less structured or community-based therapy. The study does not establish whether individual therapist characteristics would show greater effects in different treatment contexts.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Cella, Matteo, Stahl, Daniel, Reme, Silje Endresen, & Chalder, Trudie (2011). Therapist effects in routine psychotherapy practice: an account from chronic fatigue syndrome.. Psychotherapy research : journal of the Society for Psychotherapy Research. https://doi.org/10.1080/10503307.2010.535571
BibTeX
@article{mecfsatlas-cella-2011-therapist-effects,
author = {Cella, Matteo and Stahl, Daniel and Reme, Silje Endresen and Chalder, Trudie},
title = {Therapist effects in routine psychotherapy practice: an account from chronic fatigue syndrome.},
journal = {Psychotherapy research : journal of the Society for Psychotherapy Research},
year = {2011},
doi = {10.1080/10503307.2010.535571},
note = {PubMed: 21271461},
url = {https://www.mecfsatlas.com/evidence/cella-2011-therapist-effects},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/cella-2011-therapist-effects
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