Geraghty, Keith J, Blease, Charlotte · Journal of health psychology · 2018 · DOI
This review looked at whether cognitive behavioural therapy (CBT)—a type of talk therapy focused on thoughts and behaviors—actually helps ME/CFS patients. The researchers found that CBT may help some people feel less tired in the short term, but there's little proof it works long-term or improves physical abilities. Importantly, CBT can sometimes make people feel worse if it's not done carefully, and much of any improvement might come from the therapist's skill or placebo effect rather than the therapy itself.
This study is crucial because CBT is widely promoted for ME/CFS despite limited evidence of long-term benefit. It highlights the importance of informed consent—patients need to understand both potential benefits and harms before choosing treatment. The findings raise ethical concerns about whether patients are given complete, honest information about CBT's actual effectiveness and risks.
This review does not prove CBT is ineffective for all ME/CFS patients, only that evidence for long-term benefit and physical improvement is lacking. It cannot establish causation regarding harm from CBT or determine which patients might benefit from it. The study does not identify which specific CBT approaches (if any) might be most appropriate for ME/CFS.
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
Geraghty, Keith J & Blease, Charlotte (2018). Cognitive behavioural therapy in the treatment of chronic fatigue syndrome: A narrative review on efficacy and informed consent.. Journal of health psychology. https://doi.org/10.1177/1359105316667798
BibTeX
@article{mecfsatlas-geraghty-2018-cognitive-behavioural,
author = {Geraghty, Keith J and Blease, Charlotte},
title = {Cognitive behavioural therapy in the treatment of chronic fatigue syndrome: A narrative review on efficacy and informed consent.},
journal = {Journal of health psychology},
year = {2018},
doi = {10.1177/1359105316667798},
note = {PubMed: 27634687},
url = {https://www.mecfsatlas.com/evidence/geraghty-2018-cognitive-behavioural},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/geraghty-2018-cognitive-behavioural
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