New treatment method should help treat fatigue

Treatment for fatigue syndrome focuses heavily on recovery. This is the view of researcher and psychologist Jacob Clason van de Leur, who works with a therapeutic model where meaning in work is at the center.

The diagnosis of fatigue syndrome is unique in Sweden. At the same time, there is a lack of evidence-based models for treatment. Jacob Clason van de Leur has been working with patients with fatigue syndrome for ten years and recently completed a thesis on the topic at the Department of Psychology at Uppsala University. He believes that there has been too much focus on recovery in the treatment of fatigue syndrome.

“The concepts of recovery and stress are so widely accepted that it’s hard to examine them critically. It’s easy to get stuck in a stress mindset where treatment consists of limiting your impressions, not doing too many challenging tasks, and taking regular breaks. But a one-sided focus on recovery can lead to inaction, which can be harmful over time, he says.

Treatment varies across the country.

At the moment, the treatment of burnout looks very different. In some areas, the patient only gets a visit to the health center, while in others it is much more comprehensive. In his thesis, Jacob Clason van de Leur followed 915 patients in Stockholm who took part in a very ambitious rehabilitation process based on cognitive behavioral therapy, where the patient interacts with a doctor, a psychologist and a physiotherapist. Even if the results are positive, this is a rather inefficient health care effort, and it is difficult to know what is in the treatment that works best, says Jacob Clason van de Leur.

– We shoot everything and hope we hit something, but we don't know what actually helped. When I started, the treatment was for a year. Then we cut it down to six months. Now we cut it down to twelve weeks.

The shorter program is based on a therapeutic model where burnout syndrome is viewed as an existential crisis resulting from a lack of connection to meaning.

– Instead of focusing on recovery, the patient should think about things like; What keeps me busy at work, what is my role and is it clear what I should be doing?

So the most efficient model can help the patient.

The new model was tested in a pilot study where 26 burnout patients underwent a 12-week online treatment programme. The main part consisted of digital cognitive behavioural therapy followed by chat with a psychologist and video visits. It also included support in returning to work.

“We see the same effect in twelve weeks as in a year,” says Jacob Claesson van de Leur.

The fact that treatment time can be shortened makes it less resource intensive, meaning more people can receive treatment.

“Since so many people feel bad, I think we need better models to understand why people feel stressed. Our results show that with a different focus, treatment can be more effective,” says Jacob Clausen van de Leur.