Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and early maladaptive schemas: A single case study

Abstract

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex illness, one that is devastating and life changing for many people. Early maladaptive schemas (EMS), as described by Young et al., (2003), have been observed in some patients with ME/CFS; seemingly adversely impacting on psychological and physical wellbeing. This study explores the experience of working at schema level with a woman with ME/CFS and endorsed EMS. It provides an overview of the therapeutic treatment, with the aim of adding to the limited research in this area.The instrumental single case study takes place within a clinical context. The client received 20 sessions of therapy. Standard cognitive behavioural therapy (CBT) was initially utilised to work with the client’s depression; once reduced, schema work commenced. Beck’s Depression Inventory (BDI-II) was used to measure mood, and Young’s Schema Questionnaire (YSQ-S3) was employed to measure schemas.By the end of therapy only two schemas from the nine schemas that the client had endorsed at the start of therapy remained at a level of ‘therapeutic significance’; three schemas diminished once the depression had been treated. The client reported that her quality of life had improved and that she had taken up part-time paid employment.The results appear to offer some support for working at schema level with people that have ME/CFS and also endorse EMS. However, treating existing depression first is recommended.