Chronic Fatigue Syndrome: Using Cognitive-Behavioural Therapy


Cognitive-behavioural therapy teaches you how to change your thinking and fears. It can help you learn to think accurately about your situation instead of letting fear guide your feelings and your behaviour. This type of therapy is good news for people who have chronic fatigue syndrome (CFS). Studies show that this type of therapy can help you feel better.footnote 1

How does the therapy work?

For most people, therapy usually consists of weekly 1-hour visits over the course of just a few weeks or months. Longer-term and/or more frequent therapy is available for those who need it. A cognitive-behavioural therapist may teach you to:

  • Keep an energy diary. This can serve as a guide for what limits you should set on your activities and how to plan your day according to how your energy level changes throughout the day.
  • Confront discouraging thoughts. This will help you move from the idea that "I'm not strong enough" to the idea that "I will find evidence to show that I can control this disease."
  • Learn to be flexible. This can help you adapt when your energy levels vary from their usual pattern.
  • Set limits. Many people who have CFS need to learn how to pace themselves to avoid over-exercising and bringing back their fatigue.
  • Prioritize and delegate tasks. You can identify jobs or activities that are more important for you to perform. Then you can assign family and friends to perform others.
  • Accept relapses. It's easy to do too much too soon. And it's important to accept what happens when you do that—and then move on.

Therapy can be expensive and may not be covered by insurance. But the fact that it is usually short-term helps keep the cost down.



  1. Reid S, et al. (2011). Chronic fatigue syndrome, search date March 2010. BMJ Clinical Evidence. Available online:

Other Works Consulted

  • White PD, et al. (2011). Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): A randomised trial. Lancet, 377(9768): 823–826.


ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
Brian D. O'Brien, MD - Internal Medicine
Specialist Medical ReviewerNancy Greenwald, MD - Physical Medicine and Rehabilitation

Current as ofFebruary 20, 2015