Chronic fatigue syndrome

Our Chronic Fatigue Service (CFS), based at Sutton Hospital, with clinics at St Helier Hospital, provides management and support for people with CFS.

The service was opened in early 2005 under the leadership of Dr Amolak Bansal, consultant immunologist at St Helier Hospital, as part of the Department of Health’s chronic fatigue clinical network collaborative to introduce services for individuals with chronic fatigue syndrome where none existed.

General information

As there is currently no cure for chronic fatigue syndrome, treatment is presently based on the management of symptoms to improve function and quality of life. 

Management of symptoms will not necessarily take the symptoms away; however, there is evidence which supports a significant reduction in symptoms with improved quality of life through the implementation of lifestyle management strategies. We use a combined bio-psycho-social and cognitive behavioural therapy models in teaching you to manage your symptoms.

We provide one-to-one consultations, lifestyle management and education groups.

Please be advised that due to limited resources we can only provide advice and information regarding the management of chronic fatigue syndrome to patients currently in the service. If you have any queries of a general nature we advise you to contact your local support group or other voluntary CFS/ME organisations.

We do encourage local support services to contact us for information on management of CFS/ME in general and to liaise with us in the management of patients who are being seen in their services and ours.

Referrers

Referral forms can be found in the referring to our services in the for GPs and clinicians section of our website.

Contact us

Tel: 020 8296 3940

Taking Strides Group Programme

This is a six week group workshop focusing on strategies for improving physical function, sleep, cognition and engagement in valued activities for people who have CFS/ME.

Aims of the group

  • To increase understanding of CFS/ME
  • To review and increase activity levels and work towards physical goals
  • To improve balance between activity and rest/relaxation
  • To learn to deal with potential barriers to making progress utilising cognitive behavioural therapy (CBT) skills
  • To learn to manage a CFS/ME setback
  • To re-connect with a life that is important to you using value based goal setting.

Before the group 

After discussing with one of the clinicians whether you feel as though the group programme is right for you, you will be asked to complete and return questionnaires to secure your place.

Details of group

The course consists of six initial sessions – weekly for three weeks and then bi-weekly for a further 3 weeks. Thereafter, there are three follow-up sessions at one month, six month and 12 month intervals.  

The group is held on either:

  • Wednesday morning (9.45am – 12.15pm) or
  • Thursday afternoon (1.00pm – 3.30pm).

Each weekly group session lasts two and a half hours with two relaxation sessions (a brief relaxation and a longer 15 minute relaxation session). There is also a 15 minute tea break.

Each group is run with a maximum of 15 participants, all of whom will have a diagnosis of CFS/ME.

Content of the group 

The group content includes a variety of topics including:

  1. How we understand CFS/ME
  2. Activity management
  3. Sleep
  4. Setting Goals linked to values
  5. Thoughts and feelings
  6. Central sensitisation
  7. Communication
  8. Setback management
  9. Maintaining changes and moving forward.

What is expected of me? 

We ask you to commit to attending all the group sessions. If you know in advance that you are unable to attend one or more sessions due to prior commitments, it is advisable that you defer to the next group programme. If you are attending any other treatment intervention it is advisable that you complete this treatment before commencing the group.

Please bear in mind that you need sufficient energy to sustain two and a half hours of activity plus energy for your journey to and from the hospital. There is a tea break in the middle of the session.

The group sessions use different teaching methods including group work, discussion and active participation. You will only be expected to participate at a level you are comfortable with. You will be asked to carry out some preparatory work (e.g. collect some information) between sessions.

This is not a support group and no-one will be asked to share information of a personal or sensitive nature.

Follow up group programme 

When you successfully complete the programme (attending a minimum of five group sessions), you will be invited to the follow-up group meetings at one month, six months and 12 months.

Confidentiality

Confidentiality is agreed within the group. At the end of the group you will receive a confirmation of your attendance and summary of what has been covered. A copy which will also go to your GP and into your medical notes. If you have any questions or concerns about confidentiality please discuss these with the CFS team.

Patient information

Patient information

You will find a wide range of leaflets, worksheets and other documents about Chronic Fatigue Syndrome below. 

The following leaflet has been designed to help you understand the condition and advise you on how best to manage it:  Understand Chronic Fatigue Syndrome and Getting Started - Managing your CFS/ME [pdf] 552KB

You can also listen to the following short guided relaxation (11 minutes), helpful to use in rest breaks. Please make sure you are either seated or laying down comfortably whilst listening to it and do not use whilst driving.

 
Relaxation imagery - sailing (no music)
Show / hide transcript

Narrator:

Sit or lie down comfortably. Uncross your legs, and have your arms at your side. Take a couple of deep breaths in…and out…And on the out breath notice a sense of comfortable heaviness. It’s beginning in one hand and arm. Repeat to yourself: ‘My hand and arm are comfortably heavy. My hand and arm are comfortably heavy’.

And now allow your attention to pass to the other hand and arm, and repeat: ‘My hand and arm are comfortably heavy. Both my hands and arms are comfortably heavy’.

Again, taking more deep breaths now turn your attention to one of your lower limbs. Repeating to yourself: ‘My leg and foot are comfortably heavy. My leg and foot are comfortably heavy’. And now turn your attention to your other leg. Repeating to yourself: ‘My leg and foot are feeling comfortably heavy, my leg and foot are feeling comfortably heavy’.

‘My arms, legs, hands, and feet are comfortably heavy…and I am feeling quiet inside’. And now just spend a few moments mentally scanning the whole of your body for any signs of stress or tension, and should you find any just allow it to float up and away, to leave you with a sense of peacefulness and calm.

As you go deeper now…each easy breath relaxing you…calming you…you can be aware of how comfortable and peaceful you are becoming…as your body relaxes and your mind relaxes with it…all tension…all anxiety and fear just draining away now and calm filling your completely. I would like you to imagine that you are in a sailing boat, all alone, floating on a lake…all around are mountains, their steep sides covered with forests of pine trees…their peaks snow-capped. You have sailed to the very centre of the lake, enjoying the fresh crispness of the air and the scent of the pine forests carried on the breeze that drives the boat…filling the sails at a gentle but exhilarating pace…the splash and gurgle of the water as the boat cuts through the gentle swell…the creaking of the rigging and the crack of the sails as they fill with each gentle gust of air.

You can be aware of how good you feel…alone with your own thoughts…alone with the sounds of nature all around…a calm natural peace that knows no concerns or troubles…nothing disturbs that peace…nothing bothers you at all.

Now the wind drops to almost nothing…the sails flap limply as they empty of the wind that drives the boat forward…the surface of the water becomes calm…still…flat as a mill pond.

You feel the sun warming your skin…comfortably warm…soothing and relaxing you…the quiet surrounds you now, broken only by the gurgle of water beneath the hull…the faint sounds of bird-song…the occasional splash as a fish rises to take an insect…calm…peaceful tranquillity surrounds you and envelops you.

You lie down on a soft cushion on the bottom of the boat, unconcerned at the lack of wind…knowing that the engine is there in perfect working order when and if required. You look up at the crystal clarity of the blue sky…small clouds perfect and white hang above and around the tops of the mountains visible where you are so relaxed and comfortable.

 The boat drifts…rising and falling with the almost non-existent swell…you are looking now at the very tip of the mast as it sways gently…it appears to touch the clear blue sky above…the air is so clean here…you can taste it and you feel the calm tranquillity…absorb that gentle peace…and you drift too with thoughts that are pleasant and calming…you breathe in peace and calm with every gentle breath…breathing out anxiety and stress.

Here you have time to reflect on those things that have caused you stress…you have time now to assess carefully and with a clarity never before available to you…the importance and the relevance of so many different things. You realise that you have fallen into a habit of reacting in a manner which has proved stressful for you. You resolve now to ignore the red flags and to calmly reflect and decide on the most peaceful and effective way to live your life…calmly…confidently…in control…knowing that you are in control of you and of your life.

Things that are stressful are so because we allow them so to be…and you are now that person who is aware that you do have the choice…you choose to be calm and unaffected by the rush and hurry…to make unhurried and calculated decisions that are the right ones for you and those who are important to you.

You can be aware now of the peace…the calm…the confidence that fills you…expanding within you…and you enjoy the stillness…the warmth of the sun…the subtle sounds of nature all around…the sights and the scents that can allow you to be aware of the larger world…the depth of water beneath you…the natural world at peace with itself…as all troubles and cares fade into unimportance…insignificance. You feel so much stronger now…aware that the strength comes from deep within you…it was there all the time…hidden for a time beneath turmoil and stress, but now no longer shrouded within a veil of negativity and lack of confidence, it shines through…and you recognise the strength that is yours and resolve now to use that which is yours to your highest benefit.

As the boat drifts you know that it can be so easy to allow the prevailing winds to take you wherever they will…but in your vessel you have the power when winds blow, to tack and to steer, using the winds as you choose to guide which is the right way for you…and you can have in reserve, too, that engine…that power which can mean to you that you have complete choice in the way you go…but it can be pleasant to drift…knowing that you can choose freedom…calm…confidence and you will, will you not?

If ever you feel burdened and stressed…you can choose to get into your boat and drift whenever you need to, whenever you want to…using the strength that is yours, and so growing stronger and stronger with every day.

Enjoy this wonderful sense of calm and peacefulness and then when you are ready, open your eyes slowly.  Become aware of your surroundings and then slowly when you are ready sit up or stand….slowly move on with the rest of your day. Aware of the wonderful sense of calm within. 

 
Relaxation imagery - sailing (with music)
Show / hide transcript

Narrator:

Sit or lie down comfortably. Uncross your legs, and have your arms at your side. Take a couple of deep breaths in…and out…And on the out breath notice a sense of comfortable heaviness. It’s beginning in one hand and arm. Repeat to yourself: ‘My hand and arm are comfortably heavy. My hand and arm are comfortably heavy’.

And now allow your attention to pass to the other hand and arm, and repeat: ‘My hand and arm are comfortably heavy. Both my hands and arms are comfortably heavy’.

Again, taking more deep breaths now turn your attention to one of your lower limbs. Repeating to yourself: ‘My leg and foot are comfortably heavy. My leg and foot are comfortably heavy’. And now turn your attention to your other leg. Repeating to yourself: ‘My leg and foot are feeling comfortably heavy, my leg and foot are feeling comfortably heavy’.

‘My arms, legs, hands, and feet are comfortably heavy…and I am feeling quiet inside’. And now just spend a few moments mentally scanning the whole of your body for any signs of stress or tension, and should you find any just allow it to float up and away, to leave you with a sense of peacefulness and calm.

As you go deeper now…each easy breath relaxing you…calming you…you can be aware of how comfortable and peaceful you are becoming…as your body relaxes and your mind relaxes with it…all tension…all anxiety and fear just draining away now and calm filling your completely. I would like you to imagine that you are in a sailing boat, all alone, floating on a lake…all around are mountains, their steep sides covered with forests of pine trees…their peaks snow-capped. You have sailed to the very centre of the lake, enjoying the fresh crispness of the air and the scent of the pine forests carried on the breeze that drives the boat…filling the sails at a gentle but exhilarating pace…the splash and gurgle of the water as the boat cuts through the gentle swell…the creaking of the rigging and the crack of the sails as they fill with each gentle gust of air.

You can be aware of how good you feel…alone with your own thoughts…alone with the sounds of nature all around…a calm natural peace that knows no concerns or troubles…nothing disturbs that peace…nothing bothers you at all.

Now the wind drops to almost nothing…the sails flap limply as they empty of the wind that drives the boat forward…the surface of the water becomes calm…still…flat as a mill pond.

You feel the sun warming your skin…comfortably warm…soothing and relaxing you…the quiet surrounds you now, broken only by the gurgle of water beneath the hull…the faint sounds of bird-song…the occasional splash as a fish rises to take an insect…calm…peaceful tranquillity surrounds you and envelops you.

You lie down on a soft cushion on the bottom of the boat, unconcerned at the lack of wind…knowing that the engine is there in perfect working order when and if required. You look up at the crystal clarity of the blue sky…small clouds perfect and white hang above and around the tops of the mountains visible where you are so relaxed and comfortable.

 The boat drifts…rising and falling with the almost non-existent swell…you are looking now at the very tip of the mast as it sways gently…it appears to touch the clear blue sky above…the air is so clean here…you can taste it and you feel the calm tranquillity…absorb that gentle peace…and you drift too with thoughts that are pleasant and calming…you breathe in peace and calm with every gentle breath…breathing out anxiety and stress.

Here you have time to reflect on those things that have caused you stress…you have time now to assess carefully and with a clarity never before available to you…the importance and the relevance of so many different things. You realise that you have fallen into a habit of reacting in a manner which has proved stressful for you. You resolve now to ignore the red flags and to calmly reflect and decide on the most peaceful and effective way to live your life…calmly…confidently…in control…knowing that you are in control of you and of your life.

Things that are stressful are so because we allow them so to be…and you are now that person who is aware that you do have the choice…you choose to be calm and unaffected by the rush and hurry…to make unhurried and calculated decisions that are the right ones for you and those who are important to you.

You can be aware now of the peace…the calm…the confidence that fills you…expanding within you…and you enjoy the stillness…the warmth of the sun…the subtle sounds of nature all around…the sights and the scents that can allow you to be aware of the larger world…the depth of water beneath you…the natural world at peace with itself…as all troubles and cares fade into unimportance…insignificance. You feel so much stronger now…aware that the strength comes from deep within you…it was there all the time…hidden for a time beneath turmoil and stress, but now no longer shrouded within a veil of negativity and lack of confidence, it shines through…and you recognise the strength that is yours and resolve now to use that which is yours to your highest benefit.

As the boat drifts you know that it can be so easy to allow the prevailing winds to take you wherever they will…but in your vessel you have the power when winds blow, to tack and to steer, using the winds as you choose to guide which is the right way for you…and you can have in reserve, too, that engine…that power which can mean to you that you have complete choice in the way you go…but it can be pleasant to drift…knowing that you can choose freedom…calm…confidence and you will, will you not?

If ever you feel burdened and stressed…you can choose to get into your boat and drift whenever you need to, whenever you want to…using the strength that is yours, and so growing stronger and stronger with every day.

Enjoy this wonderful sense of calm and peacefulness and then when you are ready, open your eyes slowly. Become aware of your surroundings and then slowly when you are ready sit up or stand….slowly move on with the rest of your day. Aware of the wonderful sense of calm within. 

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Healthy Workplace Achievement Award 2016 NHS Choices