Efficacy of an emotion-focused treatment for prolonged fatigue.

Eleven adults with long-lasting fatigue joined a CBT program that focused on emotions.

Therapists used a multiple-baseline design: they staggered start dates so each person began treatment at a different time.

Sessions taught clients to notice, label, and shift emotional responses linked to tiredness.

Fatigue scores dropped below the illness cutoff for eight of the eleven adults.

Gains held steady three to four months later without extra coaching.

The drop happened only after treatment started, giving the design clear control.

Lappalainen et al. (2007) ran a small RCT and saw ACT beat CBT on mixed symptoms. Their ACT edge may come from teaching acceptance, while Bhaumik et al. (2008) added emotion work inside CBT—both tweaks improve outcomes over standard CBT.

Renne et al. (1976) and Sanberg et al. (2018) used the same staggered-start design for social skills and sleep issues. All three studies show the multiple baseline still works across very different adult and child problems.

Petkovski et al. (2026) will test deepfake ‘virtual rescripting’ for grief using the same design. If it helps, it will extend the idea that emotion-focused steps, delivered in a multiple baseline, can ease chronic adult distress.

You can copy the staggered-start plan to check if your emotion or acceptance module really cuts fatigue, pain, or worry in adult clients. Track daily fatigue with a 0–10 scale, start the module only when baseline is stable, and keep the measure at follow-up to show lasting change.