This paper, 3 years in the writing is a contribution towards improving the notoriously problematic therapeutic relationships between patients with ME/CFS and health care practitioners. My patients continually tell me of problems they encounter with other practitioners (and I’m sure sometimes with myself). Eva Stormorken a nurse and PhD candidate who runs groups for ME/CFS and myself have listened to our patients and colleagues and have highlighted the most common challenges that arise. We then formulated solutions to those challenges. Dr. Bengt Karlsson, a nursing academic, helped us find language to describe our patient centered, collaborative approach. Like the Psychiatric Guidelines paper I wrote in 2005, we submitted this paper to several journals and it was declined by all. Likely this is in part due to it being a theoretical paper and not research based. We feel having a strong therapeutic relationship is an essential prerequisite for good clinical care. We hope the paper will be widely read and the hypotheses tested by others. Click here to read the paper.