The research has shown that counselling was helpful to some respondents with M.E. but not helpful for others, and has explored some possible reasons for this. Important issues that have affected some respondents with M.E. have been identified and explored. Every item relating to a possible area of exploration for clients had some positive responses, even those items such as ‘suicide’ which fewer explored and only a few found helpful in counselling. This clearly indicates the need to acknowledge the unique and individual needs and wishes of clients and to keep an open mind about what each client might find helpful.

For respondents who rated efficacy items high it often appears important that they should have learned something they can recognise and value in counselling. This might include learning to explore thoughts or feelings.   It also seems important that respondents can recognise and value work they have done in counselling; for some this meant addressing issues such as fears about coping, relationships, adapting to life with M.E., anger and grief at how M.E. has affected their life, and feeling hurt by people’s misunderstanding of M.E. Some respondents valued exploring concepts such as the ‘inner critic’, power, fear, anger, isolation, choice and responsibility, and the meaning or meaninglessness of life. This learning and work was more likely to be highly rated if the respondent also highly rated their counsellor’s qualities, and in particular felt able to place trust in the counsellor. In addition it was a moderately positive influence if counselling was not considered a ‘treatment’ for M.E.

Some respondents who rated efficacy items low found their counsellor did not know about or understand their illness or appreciate the significance of problems the illness causes them.   Some experienced ‘psychologizing’ of their illness, dismissal of their suffering and a lack of work or learning they could perceive as useful. They sometimes, but not always rated their counsellor’s qualities lower.   These respondents do not appear to have been helped by counselling and some have felt hurt by the experience.

This research has found what other research has already shown; that people with M.E. have sometimes had bad experiences of relationships they might have expected to be helpful.   People with M.E. are sometimes hurt by stigma, disbelief and ‘delegitamization’ of their illness and suffering.   These experiences or fear of them discourages some people with M.E. from choosing counselling. Sadly, some who received counselling appear to have experienced these things in counselling. Those who were helped by counselling often valued the experience highly.

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