title: Implementing cognitive behavioral therapy for chronic fatigue syndrome in a mental health center: a benchmarking evaluation.
abstract: OBJECTIVE
  This study evaluated the success of implementing cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) in a representative clinical practice setting and compared the patient outcomes with those of previously published randomized controlled trials (RCTs) of CBT for CFS.
  
  
  METHODS
  The implementation interventions were the following: spreading information about the new treatment setting to general practitioners and CFS patients; training mental health center (MHC) therapists in CBT for CFS; and organizing changes in the MHC patient workflow. Patient outcomes were documented with validated self-report measures of fatigue and physical functioning before and after treatment. The comparison of the treatment results with RCT results was done following the benchmark strategy.
  
  
  RESULTS
  One-hundred forty-three CFS patients were referred to the MHC, of whom 112 started treatment. The implementation was largely successful, but a weak point was the fact that 32% of all referred patients dropped out shortly after or even before starting treatment. Treatment effect sizes were in the range of those found in the benchmark studies.
  
  
  CONCLUSIONS
  CBT for CFS can successfully be implemented in an MHC. Treatment results were acceptable, but the relatively large early dropout of patients needs attention.
authors.affiliation: Expert Centre Chronic Fatigue, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. k.scheeres@nkcv.umcn.cl
authors.forename: Korine
authors.initials: K
authors.lastname: Scheeres
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
authors.forename: Hans
authors.initials: H
authors.lastname: Knoop
authors.forename: Gijs
authors.initials: G
authors.lastname: Bleijenberg
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D019985:Benchmarking; D015928:Cognitive Behavioral Therapy / Q000592:standards*; D003155:Community Mental Health Centers; D015673:Fatigue Syndrome, Chronic / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006284:Health Plan Implementation; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000592:standards; D010352:Patient Dropouts; D016032:Randomized Controlled Trials as Topic; D012050:Rehabilitation, Vocational