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Complex Chronic Diseases Program (CCDP)

We treat and manage Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Fibromyalgia, and symptoms attributed to Chronic Lyme Disease.
At the Complex Chronic Diseases Program our goal for the program is to provide patient and symptom-centered care with the support of our interprofessional team of health care providers. 

We emphasize that treatment choice takes patient preferences into account, and that self-care is supported as well as treatment. Central to this is the development of partnership in care, and facilitation of patient involvement in assessment and in treatment decisions.

In the interest of ensuring the safety of our patients and staff, CCDP has postponed our in-person elective groups. We are currently connecting via zoom and phone. We will update the website when we resume in-person elective groups.

The Complex Chronic Diseases Program provides care for adults of all genders who are living with the following complex chronic diseases:

The Complex Chronic Diseases Program implemented a new model of care in early 2019 to better support our clients. Our program focuses on offering group-based education and self-management support, while continuing to offer 1:1 medical visits. This group education format is supported by client feedback and research. 

We have changed our model to increase client accessibility through telehealth and virtual health. Our model of care broadens our ability to support clients after they participate in our program and provide resources while they are on the waitlist.

The CCDP has an inter-professional team who bring different perspectives and expertise to your care and treatment plans.  All of the team members work together to collaborate with you around your care.

Our clerical team is responsible for scheduling your appointments. They will be your first point of contact with our clinic. 

Our medical team includes physicians, naturopath and pharmacist.

Our inter-professional team includes nurses, physiotherapist, occupational therapist, dietitian, social work and counseling. 

To participate in this program, you must have a completed referral form from your primary health care professional (such as a family doctor, nurse practitioner, naturopathic doctor) or specialist who will support your daily chronic disease management and follow your ongoing health. 

We will work directly with your primary health care professional to ensure that they receive information to provide you with the best available standards of care.

Referrals to the Complex Chronic Disease Program

New patients during COVID-19

In keeping with the BC provincial health officer's advice to meet the requirements of social distancing, all our in person appointments and elective groups will be offered via telephone or postponed.

For new patients that will be contacted during this time, you may receive a phone call from our booking team to schedule a telephone self-management assessment with a clinician followed by a telephone medical consult with a physician. Please complete lab work (if requested) prior to your telephone physician assessment.

The physician will determine your eligibility for the CCDP. If you are accepted into the program, our booking team will contact you by phone to schedule your case-coordination appointments and provide a follow up email with medical visit handouts and a link to our introduction videos. The case-coordination phone calls with our team will assist you in selecting the elective groups you would like to take at CCDP.


Cancelled/Rescheduled/Missed Appointments

We require at least two full business days’ notice to cancel or to reschedule an appointment. This allows us to accommodate other clients who are waiting.

Due to the very high need for our service, if you miss three
appointments you will be discharged from our program. If there are barriers to your participation in the program, please let us know as soon as possible. You can contact our us at: (604) 875-2061

What is a CCD?

Complex chronic diseases, such as Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Fibromyalgia (FM), and symptoms attributed to Chronic Lyme Disease, are long in duration and there is no specific treatment.  In many cases, the causes of these diseases are unknown.

Complex Chronic Diseases we support

The Complex Chronic Diseases Program provides care for patients who are living with the following complex chronic diseases:

Complex Chronic Diseases are called complex because:
  • The factors involved in causing these conditions are not well understood.
  • The symptoms and effects of any CCD can vary greatly among people with the same condition.
  • The longer duration of a CCD can lead to other health complications. These can include physical problems such as weakness, fatigue, and difficulty with daily activities (functionality). 
  • Any long-term illness can impair relationships, education and career goals, and affect a person’s mental health.

With all of these conditions, there are no blood or other laboratory tests to confirm a diagnosis. They are diagnosed based on symptoms described by the patient and medical assessment.

Each person with a CCD will experience their disease in a unique way, with symptoms that may or may not exactly match the most common descriptions. The most helpful approach to treatment will identify patients’ needs according to their symptoms and day to day functionality.

Even if you have had a CCD for a long time, there are steps you can take to feel better and gradually improve your condition. Having your CCD diagnosed as early as possible will help with a better and more rapid recovery.

News & Events
February 14, 2023
DABC Feb 14 23 attempt 2.jpgCommunity Event: 

Canada Pension Plan-Disability (CPP-D)  Zoom Webinar

What: Canada Pension Plan-Disability (CPP-D) Benefit- Zoom webinar
Who: Hosted by the CCDP and Disability Alliance BC. Anyone can attend
When: Feb 14th, 2023, from 1:30 – 3pm
Where: Zoom. Click on the link below to register

Info session will cover: 
Eligibility criteria
Application process
Q & A

 February 22, 2023
Alumni Event

Sex, Intimacy and Chronic Illness

Who: CCDP Alumni (discharged from the CCDP)
When: February 22, 2023 from 10-11:30am
Where: ZOOM. You will receive the meeting details after e-mail registration.
Why: To share ideas, wisdom, and foster connection.

Sex, Intimacy, and Chronic Illness: In this session we hope to create a space to explore how this might have changed with chronic illness. We hope to explore what intimacy means, what good enough sex is and how to adapt. 

To oin us for this session please register for this event by email to and indicate the date of the event.
DABC dec 13 2022.jpg
BC Persons with Disabilities Benefits
Who: This is a CCDP community event and is open to anyone
What: Info Session that will cover eligibility criteria for BC Persons with Disabilities (PWD)
When: December 13th, 2022 from 1:30 pm to 3 pm
Where: ZOOM. You will receive the meeting details after e-mail registration.
Register here: 
After registering, you will receive a confirmation email containing information about joining the webinar from CCDP staff.

This event is not able to be recorded.
Dr Ric Arseneau
Dr Arseneau is a pioneer in the treatment of Complex Chronic Diseases in British Columbia.  His vision and direction has helped refine the care we offer at the CCDP.  He is leaving the CCDP to focus on his private practice.  He will be missed by our patients and the team at the CCDP.  He will continue to provide care to individuals with CCDs, your primary care practitioner can help you access Dr Arseneau. 

Dr Arseneau is a pioneer in the treatment of CCDs in British Columbia. His vision and direction has helped refine the care we offer at the CCDP. He is leaving the CCDP to focus on his private practice. He will be missed by our patients and the team at the CCDP. He will continue to provide care to individuals with CCDs, your primary care practitioner can help you access Dr Arseneau. 

*The Friends and Family event is currently on hiatus. We are in the process of reviewing the format and hope to offer it again in the future. Once it is available we will update our website and also advise patients as part of our regular communications.

Previous CCDP updates

20Panel Title

November 23, 2021

Educational event on complex chronic diseases with UBC students and patients

On November 23, 2021, four patient representatives from the CCDP’s Community Advisory Committee participated in a workshop entitled, Unmet Health Care Needs: The Impacts of Poorly Understood Chronic Conditions in partnership with the Patient & Community Voices workshop series at UBC. The workshop was attended by 24 students from eight different disciplines including audiology, dietetics, nursing, occupational therapy, pharmacy, physical therapy, speech language pathology, and social work. Dr. Luis Nacul, Medical and Research Director of the CCDP also in attendance and addressed the students. This is the second time this workshop has been hosted; In both events, students provided strong, positive feedback.  

September 22, 2021

Medical Education Webinar: Myalgic Encephalomyelitis - Diagnosis, Management and Current Research (with Dr Teresa Clark and Dr Luis Nacul from CCDP)

On September 22, 2021, ME/FM Society of BC partnered with ICanCME's Working Group on Trainee Development and Medical Education to develop a webinar for the Federation of Medical Women in Canada (FMWC - FFMC). Topics covered included: diagnosis, management and current research.

Dr Teresa Clark (from CCDP and the FMWC) chaired the event, which included presentations from international experts, Dr. Nina Muirhead (ICanCME and Doctors with M.E) and Dr. Lucinda Bateman (Bateman Horne Center), BC’s CCDP Medical and Research Director, Dr. Luis Nacul (Women's Health Research Institute), and Patient Voice, Hilary Robertson (ME/FM Society of BC). 

Pre-recorded webinar runs for 1hr 12mins.  

(adapted from

August 21, 2020


The International Association for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (IACFS/ME) will be hosting their first virtual research conference on August 21, 2020.

The conference will focus on biomedical, public health, and behavioral aspects of ME/CFS and associated comorbidities.

CCDP Medical Director, Dr. Luis Nacul, will be presenting on "The impact of COVID-19 on the risk and prognosis of ME/CFS."

CCDP Internist, Dr. Jane McKay, will be speaking about "Low-dose naltrexone in ME/CFS and FM- the Vancouver experience."

Please click here to view the conference main page and registration information

August 19, 2020

CCDP is excited to announce that our Research and Medical Director, Dr. Luis Nacul, has two research projects that was recently awarded funding and support from the BC SUPPORT UNIT Fraser Centre.

The two projects aim to apply brain imaging and neurophysiological tools to help patients living with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

To learn more about these projects, please visit the ME/FM Society of BC website.

August 2019

Government of Canada invests $1.4M in biomedical research to improve the quality of life of people living with myalgic encephalomyelitis 

This $1.4M, five-year investment aims to improve the quality of life of people living with ME through:

  • investigating the causes of ME, including possible links to viruses and genes;
  • linking cohorts of patients and researchers in Canada and the US, enabling investigators to share research samples, clinical data, and analysis methods;
  • supporting graduate students working on ME to build Canadian capacity to research this condition; and
  • benefiting from the wisdom of people with ME who are active research partners.  


Find out more about the role of the Complex Chronic Diseases Program in this research.

Read the full News Release from the Canadian Institutes of Health Research.

April 2019

BC Women’s welcomes Dr. Luis Nacul as the new Medical Director for the CCDP

We are thrilled to welcome Dr. Luis Nacul as the new medical director and research director of the Complex Chronic Diseases Program (CCDP). 

“We are very lucky to have Dr. Nacul join our team and lead CCDP,” says Dr. Stephanie Rhone, senior medical director, specialized programs, at BC Women’s. “Dr. Nacul will have dedicated research time in addition to his clinical and administration work, which is a huge asset to the program. His research expertise will inform the way we treat patients and open the door to new discoveries.”

Dr. Nacul is an internationally renowned leading clinician and researcher in his field with a broad understanding of complex chronic diseases treated at CCDP from medical, health services and research perspectives.

“It is a privilege for me to join such a dedicated team at one of a few centres in the world that specifically treats complex chronic diseases,” says Dr. Nacul. “I look forward to starting my new role and the opportunity to work in a collaborative environment that involves patient and community groups that are most affected.”

One of the challenges in treating complex chronic diseases is that their causes are unclear. In his capacity as CCDP research director, Dr. Nacul will leverage an established clinical program to expand research into complex chronic diseases. This is an important gain for the program, as CCDP patients with myalgic encephalomyelitis /chronic fatigue syndrome (ME/CFS), fibromyalgia syndrome and symptoms attributed to chronic Lyme-like disease will be able to benefit directly from research discoveries.

Dr. Nacul will also have an appointment as a researcher with the Women’s Health Research Institute. His research time is funded by the BC Centre for Disease Control (BCCDC) Foundation through its BCCDC Foundation Research Scholar Award.

New Model of Care Development

November 2018

The Complex Chronic Diseases Program is excited to announce that we are developing a new model of care to better support our clients. We are changing our current model to increase client accessibility through telehealth, build connections amongst clients, and reduce wait times between appointments. The new model of care will broaden our ability to support clients after they participate in our program and provide resources while they are on the waitlist.

‎Our new program will focus on offering group based education and self-management support, while continuing to offer 1:1 medical visits. This group education format is supported by client feedback and research. The new model of care will roll out in early 2019. As we develop this new model we will continue to see clients, and will communicate with our current clients about how this change may impact their journey with us. Please check back to the website for updates on our progress.

Complex Chronic Disease Program Awards
The Complex Chronic Disease Program team wins two significant awards!

  • Award of Excellence for Interprofessional Collaboration: This award honours exemplary interprofessional collaborative practices, leadership and excellence from individuals and teams throughout BC Women's Hospital, BC Women's Hospital & Health Centre, and Sunny Hill Health Centre for Children. 

  • PHSA+ Awards: We share this award with BC Cancer and the Office of Virtual Health. This award celebrates the people and projects who exemplify PHSA's value of leadership in providing excellent care for vulnerable populations. 

International Awareness Day
May 12 is International Awareness Day for Chronic Immunological and Neurological Diseases. This day recognizes a host of diseases that include Fibromyalgia, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Multiple Chemical Sensitivity and Gulf War Syndrome. Click here to find out more.
  • In May 2017, The CCDP, in partnership with our Community Advisory Committee, held a World Cafe style engagement event. Read the CCDP World Cafe report from this event.
  • We have received several questions around the role of Cognitive Behavioural Therapy (CBT) in the Program.  Please click here to learn more about CBT in the program and the patient experience. 

    We are excited to share that we are embarking on a project to make more information available to the community through the use of patient and public education videos. 
  • For an update on The Complex Chronic Diseases Study, led by Dr. Patrick, click here.
  • To watch an interview Dr. Patrick gave on Lyme Disease, click here.

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