Telephone-administered versus live group cognitive behavioral stress management for adults with CFS

Daniel L. Hall*, Emily G. Lattie, Sara F. Milrad, Sara Czaja, Mary Ann Fletcher, Nancy Klimas, Dolores Perdomo, Michael H. Antoni

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Objective Chronic fatigue syndrome (CFS) symptoms have been shown to be exacerbated by stress and ameliorated by group-based psychosocial interventions such as cognitive behavioral stress management (CBSM). Still, patients may have difficulty attending face-to-face groups. This study compared the effects of a telephone-delivered (T-CBSM) vs a live (L-CBSM) group on perceived stress and symptomology in adults with CFS. Methods Intervention data from 100 patients with CFS (mean age 50 years; 90% female) participating in T-CBSM (N = 56) or L-CBSM (N = 44) in previously conducted randomized clinical trials were obtained. Perceived Stress Scale (PSS) and the Centers for Disease Control and Prevention symptom checklist scores were compared with repeated measures analyses of variance in adjusted and unadjusted analyses. Results Participants across groups showed no differences in most demographic and illness variables at study entry and had similar session attendance. Both conditions showed significant reductions in PSS scores, with L-CBSM showing a large effect (partial ε2 = 0.16) and T-CBSM a medium effect (partial ε2 = 0.095). For CFS symptom frequency and severity scores, L-CBSM reported large effect size improvements (partial ε2 = 0.19–0.23), while T-CBSM showed no significant changes over time. Conclusions Two different formats for delivering group-based CBSM—live and telephone—showed reductions in perceived stress among patients with CFS. However, only the live format was associated with physical symptom improvements, with specific effects on post-exertional malaise, chills, fever, and restful sleep. The added value of the live group format is discussed, along with implications for future technology-facilitated group interventions in this population.

Original languageEnglish (US)
Pages (from-to)41-47
Number of pages7
JournalJournal of Psychosomatic Research
StatePublished - Feb 1 2017


  • CFS
  • Cognitive behavioral stress management
  • Perceived stress
  • Post-exertional malaise
  • Symptoms
  • Telehealth

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology


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