Picariello, Federica, Ali, Sheila, Foubister, Caroline et al. · British journal of health psychology · 2017 · DOI
This study looked at what 13 ME/CFS patients thought about cognitive behavioural therapy (CBT), a talking therapy that helps people change unhelpful thinking patterns and behaviors. Most patients were satisfied with CBT and felt better, though not completely recovered. The study found that the personal support from a therapist and accepting that ME/CFS involves both physical and mental factors were important for success.
Understanding why some ME/CFS patients benefit more from CBT than others can help clinicians optimize treatment and set realistic expectations. Patient perspectives on therapy barriers—particularly around beliefs about illness causation—may inform future interventions designed to improve engagement and outcomes.
This study does not prove that CBT is universally effective for ME/CFS, as outcomes were mixed and recovery incomplete. It cannot establish causation regarding which factors directly cause better outcomes, only that patients perceive certain elements as helpful. The small, self-selected sample limits generalizability to all ME/CFS populations.
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
Picariello, Federica, Ali, Sheila, Foubister, Caroline, & Chalder, Trudie (2017). 'It feels sometimes like my house has burnt down, but I can see the sky': A qualitative study exploring patients' views of cognitive behavioural therapy for chronic fatigue syndrome.. British journal of health psychology. https://doi.org/10.1111/bjhp.12235
BibTeX
@article{mecfsatlas-picariello-2017-feels-sometimes,
author = {Picariello, Federica and Ali, Sheila and Foubister, Caroline and Chalder, Trudie},
title = {'It feels sometimes like my house has burnt down, but I can see the sky': A qualitative study exploring patients' views of cognitive behavioural therapy for chronic fatigue syndrome.},
journal = {British journal of health psychology},
year = {2017},
doi = {10.1111/bjhp.12235},
note = {PubMed: 28349621},
url = {https://www.mecfsatlas.com/evidence/picariello-2017-feels-sometimes},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/picariello-2017-feels-sometimes
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