In reviewing the possible role of psychology in treating long Covid (Long Covid is very far from ‘all in the mind’ – but psychology can still help us treat it, 27 April), Dr Carmine Pariante misrepresents why many ME/chronic fatigue syndrome patients remain sceptical about psychological interventions such as cognitive behavioural therapy (CBT). It is not because we deny the important overlap between mental and physical illness, but rather because these interventions are offered as treatments based on poor-quality evidence of short-term marginal improvements in some patients.
No cancer patient is offered psychotherapeutic interventions as treatment; rather, these therapies play a supportive role for patients who require them. In contrast, CBT has been recommended as a first-line treatment for ME/CFS for more than a decade. Indeed, the dominance of the biopsychosocial model of ME/CFS – with its emphasis on the roles of thoughts and behaviour, rather than pathology – is one of the reasons why long Covid patients are now facing such limited options in clinics.
Dr Dominic Salisbury
Lytham St Annes, Lancashire
