Schreurs, K M G, Veehof, M M, Passade, L et al. · Behaviour research and therapy · 2011 · DOI
This study tested whether combining cognitive behavioural therapy (a type of talking therapy that addresses thought patterns and behaviours) with graded exercise therapy (gradually increasing physical activity) helps people with ME/CFS. About one-third of patients experienced meaningful improvement in fatigue and physical function. The study found that patients who were more physically active before treatment, felt more in control of their symptoms, and had been unwell for a shorter time tended to do better.
This study provides evidence that structured combined psychological and exercise interventions may benefit some ME/CFS patients, and identifies which patient characteristics predict better outcomes. Understanding predictors could help clinicians identify who may benefit most from this type of treatment and inform future trial design.
This study does not prove that CBT+GET is universally effective for ME/CFS, as it was uncontrolled with no comparison group—improvements could be due to natural recovery, placebo effects, or regression to the mean. It cannot determine whether cognitive factors cause fatigue perpetuation or simply correlate with treatment response. The findings may not generalise to outpatient settings or less disabled patients.
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
Schreurs, K M G, Veehof, M M, Passade, L, & Vollenbroek-Hutten, M M R (2011). Cognitive behavioural treatment for chronic fatigue syndrome in a rehabilitation setting: effectiveness and predictors of outcome.. Behaviour research and therapy. https://doi.org/10.1016/j.brat.2011.09.004
BibTeX
@article{mecfsatlas-schreurs-2011-cognitive-behavioural,
author = {Schreurs, K M G and Veehof, M M and Passade, L and Vollenbroek-Hutten, M M R},
title = {Cognitive behavioural treatment for chronic fatigue syndrome in a rehabilitation setting: effectiveness and predictors of outcome.},
journal = {Behaviour research and therapy},
year = {2011},
doi = {10.1016/j.brat.2011.09.004},
note = {PubMed: 21982345},
url = {https://www.mecfsatlas.com/evidence/schreurs-2011-cognitive-behavioural},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/schreurs-2011-cognitive-behavioural
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