A couple-based psychological intervention for chronic fatigue syndrome [In progress, April 2018]

EzzieD said:
TBH, the knitwear lady would probably do just as well (especially if she wears one of her own blue cardigans while carrying out the therapy). In your link, it shows that Dr Cuddy is at Kings College London. It appears that despite PACE's failure at providing any objective evidence of CBT as curative for CFS, that lot are determined to carry on regardless...
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But it rather sounds as if for some reason they have run out of takers ordinaryCBT. Thebastards think it is a bit too active. So they are trying a new tack?

Seems the approach is 'we have no idea what will work but we will pretend we have invented a therapy and try it out to see if we can invent a therapy.
 
Jonathan Edwards said:
It also sounds as if they have switched to coping CBT rather than Chaldea CBT. I wonder if this lot have actually read the PACE trial?
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For the sake of the people involved, I hope that's true. But this section suggests otherwise, I think.
However, fatigue and other symptoms experienced by this patient group can make CBT, which is quite an ‘active’ therapy, quite difficult to engage in.

For these reasons, it is believed that involving partners in a constructive manner in a psychological intervention for patients affected by CFS could enhance the effectiveness of the intervention and prove beneficial to partners.
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The kind of CBT we have difficulty engaging in is the kind that tells us we are not ill, just scared to exercise, and we should change our beliefs and start exercising. Getting partners on board with that to 'help' their sick partner to engage is deeply worrying.
 
Trish said:
For the sake of the people involved, I hope that's true. But this section suggests otherwise, I think.
..
The kind of CBT we have difficulty engaging in is the kind that tells us we are not ill, just scared to exercise, and we should change our beliefs and start exercising. Getting partners on board with that to 'help' their sick partner to engage is deeply worrying.
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On a perusal of the link provided by @Andy, I noted that her last project - Bibliotherapy for Premature Ejaculation - an article published in 'Sexual and Relationship Therapy', May 2017 (also published earlier in November 2015, and May 2016). At least the abstract notes the following:

..Univariate analyses indicated slightly greater treatment effects in the guided self-treatment group, but multivariate tests failed to identify a significant effect of therapist support. These mixed findings raise questions regarding the amount and quality of therapist input used in this study, and also about a possible ceiling effect of cognitive-behaviour therapy for PE.
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So perhaps she is looking at a different form of "getting partners on board" and "engaged" to that which you originally envisaged Trish, though I suspect not? :rofl:

As Andy implies, it would seem she has fallen to the dark side; she worked on what looks like some interesting stuff, particularly in the 1990's. I also note that she has not updated her profile? She left Kings College London in September 2003.

For anyone further interested ..

Link to ISRCTN 16045700, which suggests that they are looking to recruit 10 couples for this pilot study. I am confused as to why the 'Funder Type' is listed as Government, given that the 'Funder' is the British Association for Cognitive Behavioural & Cognitive Psychotherapies (BABCP), who are a Registered Charity?

Link to BABCP, who are funding this study. It does appear that the BABCP are already well embedded in the IAPT programme. I could only stomach 10 mins or so, regards their podcast on the page linked, and not a recommendation. I do wonder if BACME are aware of this encroachment on their territory. ;)

Wishing everyone improved health and every happiness. John :)
 
Chronic fatigue syndrome (CFS) is a condition mainly associated with extreme tiredness
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This doesn't give much confidence that they understand the difference between 'chronic fatigue' and Chronic Fatigue Syndrome.
Participants are asked to complete questionnaire assessments
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A quick scan of the info hints at open label, no control group, and self-reported subjective outcome.

I'm not holding much hope for a sensible outcome.
 
This actually sounds like a neat service if just used to help the pairs come to terms with the realities of the condition and cope as best they can.
The part that makes me scratch my head is:
partners and family members can offer valuable support... in promoting health-related lifestyle changes.
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I'd like to know what they have in mind...

I'm not in the UK but I understand you all have strong grounds for skepticism.
 
I think that last post encapsulates the problem. Many of us will be aware of the problems the illness can impose upon relationships. It is entirely possible that this is a well meaning attempt by a caring doctor to address the problem.

People would need to use some term other than CBT in such cases. Possibly CBT like CFS describes a heterogeneous group.
 
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Well, I mentioned it to my partner and he just cackled evilly......

He reckons it would be entertaining to hear what pearls of wisdom were dispensed and then watch my face. He says it would be essential for me to rest up properly though, because I argue so much better then.

Wants to know if popcorn is sold on the premises.
 
chrisb said:
I think that last post encapsulates the problem. Many of us will be aware of the problems the illness can impose upon relationships. It is entirely possible that this is a well meaning attempt by a caring doctor to address the problem.

People would need to use some term other than CBT in such cases. Possibly CBT like CFS describes a heterogeneous group.
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So young, so naive it brings a tear to the eye :hug: or was that sarcasm?
 
Mithriel said:
So young, so naive it brings a tear to the eye :hug: or was that sarcasm?
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Wrong on all counts, I fear. Old, cynical and,for once,not sarcastic.

We should not commit the fallacy of inductive reasoning. Metrly because encounters with known practitioners are known to be unsatisfactory does not enable us to form a definite view of an unknown practitioner. Evidence is helpful.
 
James Morris-Lent said:
This actually sounds like a neat service if just used to help the pairs come to terms with the realities of the condition and cope as best they can...
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You are very generous here I think ;). But I've read so many of these now, you get to pick up on the subtext very quickly.

".. partners and family members can offer valuable support both on an emotional level and in promoting health-related lifestyle changes. " (as you noted, very clear what's being implied here: if patients could be convinced to modify their activities, they would get better").

" There is evidence that cognitive behavioral therapy (CBT) (a type of talking therapy) can help people with CFS to manage their symptoms. However, fatigue and other symptoms experienced by this patient group can make CBT, which is quite an ‘active’ therapy, quite difficult to engage in." (subtext: PwMEs are resistant to change and need help from their partners to make changes).

Pro-BPS authors aren't going to say up-front that they believe ME to be a behavioural-deconditioning-belief disorder, they know that'll put people off. But if they don't explicitly reject that view, then 9 times out of 10 it means they endorse it.
 
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I would also like to point out that CBT is still CBT, whatever your underlying illness model is. And that's not very nice. One of its primary guiding principles is that psychological problems are a product of dysfunctional cognitions and beliefs, and that those need to be "corrected" by the all-knowing, all-wise psychologist.

Its profoundly arrogant.

You should hear the way advocates of CBT talk about depressed people. They not only have maladaptive and dysfunctional beliefs, but they have all sorts of deficits that prevent them from controlling their thoughts like a normal person.

In my view, therapy can potentially be positive and harmless, but it only if the therapist explicitly rejects those assumptions.
 
Woolie said:
".. partners and family members can offer valuable support both on an emotional level and in promoting health-related lifestyle changes. " (as you noted, very clear what's being implied here: if patients could be convinced to modify their activities, they would get better").
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Nice of the BPS crew to try and bugger up the only support system some pwme might have left.
 
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