Job Vacancy No. 1:

Employer: Royal Liverpool & Broadgreen University Hospitals NHS Trust

Job title: Trainee Clinical Fatigue Therapist

Chronic Fatigue Treatment Service
Ref: 2570

For informal enquiries please contact Pauline Powell or Fran Morgan, Senior Therapists

Closing date: 31st January 2005

"The service has a multi-disciplinary team (MDT) that provides a unique treatment which involves explanation of symptoms, self-managed graded exercise, psychological support and motivation to patients with chronic fatigue syndrome. Improvements in health are achieved and results are monitored."


1. Psychological treatment involves delivering a highly complex understanding of the psychological, physiological and social factors of CFS to everely disabled, fatigued patients and relatives, in order to change perpetuating illness behaviour and motivate patients to perform a self-managed activity programme, regulate disturbed sleep patterns and modify predisposing personality style.

2. Clients with CFS, because of their chronically fatigued state, experience barriers to understanding. For some clients there can be significant barriers to accepting the changes needed in behaviour, which have to be overcome in therapy in order to facilitate a successful outcome.

3. The post holder can be required to work frequently in an emotive and demanding environment with exposure to distressing problems and must maintain a high degree of professionalism at all times.

4. Requires intense concentration and prolonged periods of sitting whilst assessing and providing psychological therapy for clients with CFS. Individual treatment sessions are up to 2 hours long, twice weekly group sessions are 3 hours in length, and frequent counselling phone call sessions are up to one hour long.

5. As some clients with CFS may be resistant to working in a psychological framework there may be exposure to verbal aggression.

6. Clients are frequently seen on a one to one basis without other staff immediately nearby."

Job Vacancy No. 2:

Employer: Epsom and St Helier NHS Trust

Job title: Highly Specialist Clinical Psychologist in Chronic Fatigue Syndrome Management

Chronic Fatigue Syndrome Service, Sutton Hospital Ref: HJUK/ZP/238

Managerially accountable to: Dr Amolak Bansal (Consultant Immunologist) Service Manager for Chronic Fatigue Syndrome Service

Professionally accountable to: Dr Angela Tomkins Principal Clinical Psychologist, Chronic Fatigue Syndrome Service

Closing date: 18 March 2005

For further details / informal visits contact: Dr Angela Tomkins, Clinical Psychologist - Chronic Fatigue Service on 0208 2936 4152 or, Dr Hilary Rankin, Trust Professional Lead for Clinical Health Psychology on 0208 296 4317

"As a result of a successful bid for government funding, an exciting opportunity now exists for a newly or recently qualified Clinical Psychologist to join an innovative new service for people with Chronic Fatigue Syndrome. The successful applicant will contribute to the provision of assessment, and individual and group therapies for patients across the full age range in the local area."

"In addition to direct clinical work, the service has a remit to contribute to the development and provision of education, training and support to
health professionals working with people with CFS in the local PCTs. The service has links to a nationwide Network for CFS services to support its service development initiatives."

"The multi-disciplinary team will comprise of a Consultant Immunologist, Clinical Psychologists, Occupational Therapist, Physiotherapist and Clinical Nurse Specialist amongst others. A Clinical Psychologist with considerable experience of working with patients with chronic conditions is already in post."


The CFS Service provides an expert multidisciplinary assessment and management service for people with persistent fatigue for whom medical intervention is no longer appropriate. Patients referred to the service often present with complex medical and psychological problems, are highly distressed and may have difficulty accepting and be hostile to the rationale for adopting a cognitive-behavioural approach to the management of their fatigue.

Engaging these patients in the service requires sensitive discussion and skilled multi-disciplinary management. The CFS Service aims to help people with chronic fatigue to improve their quality of life, reduce distress and health care usage and where possible, return to work through a multidisciplinary cognitive-behavioural programme.

The CFS Service aims to develop both group and individual multi-disciplinary programmes to extend services to those individual patients who have challenging presentations including high levels of distress and disability, interpersonal difficulties and co-morbid physical and mental health problems that mean that a group management programme is not suitable.

In addition, patients using this service may have problems of an intimate nature eg sexual difficulties, history of trauma or abuse, which are not
suitable for treatment in a group setting.

Key result Areas


1. Working with the principal clinical psychologist, to provide a comprehensive, specialist psychological assessment for patients referred to
the CFS Service. This input will be based on the appropriate use, interpretation and integration of complex data from a variety of sources
including psychological tests, self-report measures, rating scales and semi-structured interviews with clients, family members and others involved
in the client's care.

2. To work closely with the multidisciplinary team to evaluate and make decisions about treatment options, taking into account a range of both
theoretical and therapeutic psychological models and highly complex factors concerning historical and developmental processes that have shaped the individual or family.

3. To be responsible for helping to develop and for providing clinical psychology input on a group management programme. This involves utilising a
range of skills including

· Delivering complex concepts and ideas to groups of patients

· Managing challenging group dynamics

· Managing and containing individual patients and group needs in ahighly sensitive manner

4. To provide appropriate advice on chronic fatigue management to, often highly distressed, patients while at all times maintaining awareness
of professional boundaries.

5. For patients referred to individual psychological therapy programme for chronic fatigue, to exercise responsibility for -

· Comprehensive highly specialist assessment and formulation of patient's presenting problems

· Implementing a range of psychological interventions with individuals, couples and families, continually adjusting and refining psychological formulations drawing on different explanatory models and maintaining a number of provisional hypotheses

· Employing methods based upon evidence of treatment efficacy.

· Discharge or referral on from the service

6. To communicate in a skilled and sensitive manner, information concerning the assessment, formulation and treatment plans to patients and other health professionals and to monitor progress during the course of uni- and multi- disciplinary care.

7. Where patients present with multiple needs e.g. patients with severe mental health problems and persistent pain, to liaise with other local
specialist services eg mental health services to enable effective case management.

8. To undertake risk assessment with distressed clients and to provide advice to team members and other health professionals on psychological
aspects of risk assessment and risk management

9. To take an active role in the development of information and educational materials for people with chronic fatigue.

10. To work with other members of the team to raise awareness of CFS services and the efficacy of a self management approach to chronic fatigue amongst Trust staff and other local services including GPs."