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Overdraagbaarheid van het protocol ‘cognitieve-gedragstherapie bij het chronisch vermoeidheidssyndroom’

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Onlangs is het protocol ‘cognitieve-gedragstherapie bij het chronisch vermoeidheidssyndroom’ (cvs) verschenen. Met een eerdere versie van dit protocol is door dertien psychotherapeuten ervaring opgedaan in het kader van wetenschappelijk onderzoek. Deze psychotherapeuten behandelden met dit protocol 82 patiënten met cvs. Uit de resultaten van dit onderzoek is gebleken dat de behandeling effectief is. Daarom is het belangrijk ook zicht te krijgen op de mogelijkheden de uitvoering van de behandeling over te dragen aan perifere behandelaars. De psychotherapeuten in dit onderzoek waren uitgebreid getraind en gesuperviseerd. Maar hebben zij ook gedaan wat zij verondersteld werden te doen? En wat vonden zij van de uitvoerbaarheid van deze protocollaire vorm van cognitieve-gedragstherapie voor cvs? Om hier antwoord op te krijgen, is aan het eind van eerdergenoemd onderzoek aan de dertien psychotherapeuten die de behandelingen uitvoerden, een vragenlijst voorgelegd. Door analyse van audio-opnamen van de sessies is nagegaan in hoeverre de therapeuten de verschillende aspecten van de behandeling ook volgens protocol hebben uitgevoerd. In 89 procent van de sessies bleek dat in voldoende mate te zijn gebeurd. Uit de vragenlijst bleek dat de psychotherapeuten vonden dat cvs-patiënten moeilijker te behandelen zijn dan patiënten met psychische klachten en patiënten met andere lichamelijke klachten. Het moeilijkste vond men het integreren van individuele problemen in de behandeling, het gebrek aan vertrouwen in de behandeling van de patiënt en het omgaan met onvoldoende motivatie. Met name voor deze aspecten lijkt, naast het ter beschikking stellen van het protocol, extra training noodzakelijk. Het protocol zal zo geschreven moeten zijn dat de therapeut het protocol kan individualiseren en handreikingen krijgt met betrekking tot het motiveren van de patiënten.

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Referenties

  • Addis, M.E. (1997). Evaluating the treatment manual as a means of disseminating empirically validated psychotherapies. Clinical Psychology: Science and Practice, 4, 1-11.

    Google Scholar 

  • Addis, M.E., & Krasnow, A.D. (2000). A national survey of practicing psychologists' attitudes toward psychotherapy treatment manuals. Journal of Consulting and Clinical Psychology, 68, 331-339.

    Article  CAS  PubMed  Google Scholar 

  • Addis, M.E., Wade, W.A., & Hatgis, C. (1999). Barriers to dissemination of evidence-based practices: Addressing practitioners' concerns about manual-based psychotherapies. Clinical Psychology: Science and Practice, 6, 430-441.

    Article  Google Scholar 

  • Barlow, D.H. (1996). The effectiveness of psychotherapy: Science and policy. Clinical Psychology: Science and Practice, 3, 236-240.

    Article  Google Scholar 

  • Bazelmans, E., & Bleijenberg, G. (2000). Protocol cognitieve gedragstherapie bij het chronisch vermoeidheidssyndroom. Nijmegen: umc St. Radboud, afdeling Medische Psychologie.

    Google Scholar 

  • Bleijenberg, G., Vercoulen, J., & Bazelmans, E. (1996). Chronische vermoeidheid. In W.T.A.M. Everaerds e.a. (red.), Handboek Klinische Psychologie (C2000). Houten: Bohn Stafleu Van Loghum.

    Google Scholar 

  • Castonguay, L.G., Schut, A.J., Constantino, M.J., & Halperin, G.S. (1999). Assessing the role of treatment manuals: Have they become necessary but nonsufficient ingredients of change? Clinical Psychology: Science and Practice, 6, 449-455.

    Article  Google Scholar 

  • Clarke, G.N. (1995). Improving the transition from basic efficacy research to effectiveness studies: Methodological issues and procedures. Journal of Consulting and Clinical Psychology, 63, 718-725.

    Article  CAS  PubMed  Google Scholar 

  • Davison, G.C. (1998). Being bolder with the Boulder model: The challenge of education and training in empirically supported treatments. Journal of Consulting and Clinical Psychology, 66, 163-167.

    Article  CAS  PubMed  Google Scholar 

  • Eifert, G.H., Schulte, D., Zvolensky, M.J., Lejuez, C.W., & Lau, A.W. (1997). Manualized behavior therapy: Merits and challenges. Behavior Therapy, 28, 499-509.

    Article  Google Scholar 

  • Gaston, L., & Gagnon, R. (1996). The role of process research in manual development. Clinical Psychology: Science and Practice, 3, 13-24.

    Article  Google Scholar 

  • Heimberg, R.G. (1998). Manual-based treatment: An essential ingredient of clinical practice in the 21st century. Clinical Psychology: Science and Practice, 5, 387-390.

    Article  Google Scholar 

  • Hunsley, J., & Rumstein-McKean, O. (1999). Improving psychotherapeutic services via randomized clinical trials, treatment manuals, and component analysis designs. Journal of Clinical Psychology, 55, 1507-1517.

    Article  CAS  PubMed  Google Scholar 

  • Iwamasa, G.Y., & Orsillo, S.M. (1997). Individualizing treatment manuals as a challenge for the next generation: Commentary on ‘Manualized behavior therapy: Merits and challenges’. Behavior Therapy, 28, 511-515.

    Article  Google Scholar 

  • Kendall, P.C. (1998). Directing misperceptions: Researching the issues facing manual-based treatments. Clinical Psychology: Science and Practice, 5, 396-399.

    Article  Google Scholar 

  • Kendall, P.C., Chu, B., Gifford, A., Hayes, C., & Nauta, M. (1998). Breathing life into a manual: Flexibility and creativity with manual-based treatments. Cognitive and Behavioral Practice, 5, 177-198.

    Article  Google Scholar 

  • Luborsky, L., & DeRubeis, R.J. (1984). The use of psychotherapy treatment manuals: A small revolution in psychotherapy research style. Clinical Psychology Review, 4, 5-14.

    Article  Google Scholar 

  • Marques, C. (1998). Manual-based treatment and clinical practice. Clinical Psychology: Science and Practice, 5, 400-402.

    Article  Google Scholar 

  • Prins, J., Bleijenberg, G., Bazelmans, E., Elving, L., Boo, T. de, Severens, H., Wilt, G. van der, Spinhoven, P., & Meer, J.van der (2001). Cognitive behaviour therapy for chronic fatigue syndrome: a multicenter randomised controlled trial. Lancet, 357, 841-847.

    Article  CAS  PubMed  Google Scholar 

  • Prins, J.B., & Bleijenberg, G. (1998). Cognitieve gedragstherapie bij een patiënte met het chronische-vermoeidheidssyndroom. Gedragstherapie, 31,117-139.

    Google Scholar 

  • Prins, J.B., & Bleijenberg, G. (1999). Cognitive behavior therapy for chronic fatigue syndrome: A case study. Journal of Behavior Therapy and Experimental Psychiatry, 30, 325-339.

    Article  CAS  PubMed  Google Scholar 

  • Schulte, D. (1996). Tailor-made and standardized therapy: Complementary tasks in behavior therapy: A contrarian view. Journal of Behavior Therapy and Experimental Psychiatry, 27, 119-126.

    Article  CAS  PubMed  Google Scholar 

  • Task Force on Promotion and Dissemination of Psychological Procedures. (1995). Training in and dissemination of empirically-validated psychological treatments. Clinical Psychologist, 48, 3-23.

    Google Scholar 

  • Vakoch, D.A., & Strupp, H.H. (2000). The evolution of psychotherapy training: Reflections on manual-based learning and future alternatives. Journal of Clinical Psychology, 56, 309-318.

    Article  CAS  PubMed  Google Scholar 

  • Vercoulen, J.H., Swanink, C.M., Fennis, J.F., Galama, J.M., Meer, J.W. vander, & Bleijenberg, G. (1996). Prognosis in chronic fatigue syndrome: a prospective study on the natural course. Journal of Neurology, Neurosurgery and Psychiatry, 60, 489-494.

    Article  CAS  Google Scholar 

  • Vercoulen, J.H., Swanink, C.M., Galama, J.M., Fennis, J.F., Jongen, P.J., Hommes, O.R., Meer, J.W. vander, & Bleijenberg, G. (1998). The persistence of fatigue in chronic fatigue syndrome and multiple sclerosis: development of a model. Journal of Psychosomatic Research, 45, 507-517.

    Article  CAS  PubMed  Google Scholar 

  • Visser, S. (1997). Behandelprotocollen: karikaturen en praktijk. Gedragstherapie, 29, 267-287.

    Google Scholar 

  • Werf, S.P. van der , Prins, J.B., Vercoulen, J.H.M.M., Meer, J.W.M. van der, & Bleijenberg, G. (2000). Identifying physical activity patterns in chronic fatigue syndrome using actigraphic assessment. Journal of Psychosomatic Research, 49, 347-379.

    Google Scholar 

  • Wilson, G.T. (1996). Manual-based treatments: The clinical application of research findings. Behaviour Research and Therapy, 34, 295-314.

    Article  CAS  PubMed  Google Scholar 

  • Wilson, G.T. (1998). Manual-based treatment and clinical practice. Clinical Psychology: Science and Practice, 5, 363-375.

    Article  Google Scholar 

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Authors and Affiliations

  1. afdeling Medische Psychologie, umc St Radboud, Postbus 9101, 6500 HB, Nijmegen, The Netherlands

    Ellen Bazelmans (gz-psycholoog en gedragstherapeut)

  2. www.dth.bsl.nl

    Ellen Bazelmans (gz-psycholoog en gedragstherapeut), Judith Prins (klinisch psychologe), Sigrid Hoogveld (Hoogveld is psychologe) & Gijs Bleijenberg (J. Prins is klinisch psycholoog)

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  1. Ellen Bazelmans
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  2. Judith Prins
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  3. Sigrid Hoogveld
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  4. Gijs Bleijenberg
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Correspondence to Ellen Bazelmans.

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Abstract

Recently, the ‘Standardised cognitive behavioural treatment for Chronic Fatigue Syndrome’ (cfs) was published. An earlier version of this standardised treatment was used by thirteen therapists in a treatment research program. They treated 82 cfs-patients and the results of this study showed that the treatment is effective. Hence it is important to look into the possibility of transferring this treatment to periferal therapists. The therapists in the research program were thoroughly trained and supervised. But did they actually do what they were supposed to do? And what did they think of the usability of the standardised treatment? In order to find some answers, the thirteen therapists were asked to complete a questionnaire. Also, analyses of audiotaped sessions were conducted to find out whether the therapists had stuck to the standardised treatment. In 89% of the sessions this appeared to be the case. The questionnaire revealed that the therapists found it more difficult to treat cfs-patients than patients with psychological or other physical problems. The most difficult task was integrating individual problems into the standardised treatment, patients' lack of confidence in the treatment and handling insufficient motivation. For these aspects, extra training seems necessary. The new standardised treatment will have to be written in such a way, that therapists can individualise the interventions and are supplied with interventions aimed at motivating their patients.

Zij is verbonden aan de afdeling Medische Psychologie van het Universitair Medisch Centrum St Radboud in Nijmegen.

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Bazelmans, E., Prins, J., Hoogveld, S. et al. Overdraagbaarheid van het protocol ‘cognitieve-gedragstherapie bij het chronisch vermoeidheidssyndroom’. DITH 21, 61–72 (2001). https://doi.org/10.1007/BF03060254

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