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In small trials, people with chronic fatigue syndrome (CFS) have benefited from cognitive-behavioral therapy (CBT; focused on overcoming fear of activity) and graded exercise therapy (GET; focused on gradually improving exercise tolerance). Some patient organizations, however, have reported that CBT and GET can be harmful, and they favor adaptive pacing therapy (APT; focused on optimizing expenditure of limited energy).
U.K. researchers randomized 641 patients with CFS to receive specialist medical care (including education and symptomatic pharmacotherapy) alone or with added CBT, GET, or APT. During 1 year, all patients received at least three sessions of specialist care. Patients randomized to CBT, GET, or APT were offered as many as 14 th…