Counselling interventions can include an emphasis on identifying the right balanced lifestyle and structure with care to direct available energy towards what is most important to the patient. This involves identifying priorities and goals in life. At the same time it is important to increase energy levels through a carefully graduated set of physical activities to improve cardiovascular fitness while also seeking to identify and re-engage in “passions” and activities that are stimulating and absorbing to the patient. Some benefit can also be gained at times through teaching different ways of breathing to improve energy available through respiration. However, progress is often slow and can involve a number of setbacks which means that additional emphasis needs to be given to encouragement and focusing on affirming whatever gains are made.