When the M.E. group data is sorted by age groups the trend is much the same in each group, a wide range of values from low to high is present with slightly fewer low values in the 18 to 29 year old age group with some criteria.
And when the data is sorted according to how long the respondents have been ill a similar range of low and high ratings can be seen, with fewer low ratings for the ‘below 3 years’ group. No data was collected relating to how long respondents had been ill at the time they received counselling.
When data is sorted according to whether respondents ticked the item ‘was counselling intended as a ‘treatment’ for M.E.?’, it can be seen that where the answer is ‘yes’ there are proportionally more low ratings.
Many possible issues arise with whether or not respondents considered that their counselling was a intended by themselves or others as a ‘treatment’ for their illness. Anxiety about the counsellor ‘psychologizing’ the client’s experiences, believing that the illness is treatable by psychological interventions and perhaps dismissing or diminishing the client’s suffering could all occur. Clients and counsellors may have unrealistic expectations of what counselling can achieve and disappointment could be a factor for both parties. Occasionally, clients may have felt obliged to accept counselling if they were referred by their doctor and felt unable to decline, and might therefore be reluctant participants. Respondents remarked:
>I think counselling can be useful to people with CFS/ME if they are willing or wanting to take it.
>The counsellor claimed to be a CBT counsellor but in fact had only taken a workshop in it. I had been referred to her for by the GP when having sleep problems, clearly something the CBT would not help since my problem wasn't going to sleep but remaining asleep. I felt I could not refuse the referal but sleep studies and treatment was what corrected the problem.
>I feel that, as with all counselling, the "voluntary" and pro-active aspects of participation are vital.
Aother respondent with M.E. commented:
If a person is open and accepting of counseling, chooses to do it of their own free will and most importantly - if the counselor truly understands ME/CFS then counseling can be very helpful. However, if the person is forced into counseling and/or the counselor is not familiar with ME/CFS counseling could prove worthless or even worse make the persons situation worse - such as by recommending exercise for a CFS person who crashes badly after exercise.
The implications of ‘treating’ illness with counselling could be a factor affecting the outcome, though as can be seen in the above graphs, for some clients the outcome was positive. The graphs show that whether respondents received counselling as a ‘treatment’ or not appears to have an influence but might not have determined the outcome. Both groups had a wide range of low and high ratings. Examination of the data shows that where respondents ticked ‘treatment’, is not an indication that they received counselling within any particular approach.
The sample of different approaches is too small to draw conclusions. It is nevertheless noticeable that with all the approaches there are a wide range of values, from low to high. This can be seen in individual items and the composite criteria in the graphs above. An omission in the design of the surveys was a failure to include ‘exploring behaviour’ and other items that might have shown the particular strengths of CBT and other cognitive approaches.
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