Even by the standards of "Imagine a world"-based medicine, this is a new low. "Imagine a group of controls who would have done what we wanted them to do". How did they determine controls who would have? With our friends: lies, damned lies, and statistics:
Why would a serious medical journal publish nonsense like this? The Lancet seems not much interested in being serious.
They don't appear to include the numbers who did, which suggests that probably none did.
"A theoretically informed logic model" is some grade A bullshit when you can't use theoretical because there is no actual theory behind this, just wild speculation. How does crap like this even get published?
They defined 'compliance' as 4 sessions. The program is designed for 12. This is terrible adherence.
This is almost a universal pattern, and it has been massively abused on the fiction of needing 'boosters', when in fact it's just a reflection of the bias in the trials.
And, see, they simply decided that it didn't work because of low adherence, so they simply have to figure out how to get people to adhere/comply and job's done:
I don't know if this is the first time it's happened or I just happened to notice, but the framing of compliance, rather than adherence, is very odd. Especially as they switch back and forth as if they are equivalent.
And of course you have to imagine a totally different health care system that could provide such a thing, which they acknowledge it does not support their wild fantasy that they simply need to do more to get the compliance they assume would magically work:
So this is very much like the delusional PACE model, which even Wessely acknowledged was not feasible for requiring resources that simply don't exist. But they got away with it. In both cases out of null result.
The ideology can never fail, it can only be failed. What a complete waste of resources. The people in charge of medical research are doing a terrible job for encouraging junk like this. All this money could have gone to real research instead, but it's completely wasted.
"The decision to use non-CBT-trained facilitators for IBD-BOOST was pragmatic as few gastroenterology services in the UK have access to trained CBT therapists, but nearly all have IBD nurses. The choice of only one 30-min session with a facilitator alongside on-site messaging once per week was based on interviews, which suggested IBD nurses would not have time for more support.
26 This amount of time might have been insufficient to maximise uptake."
These aren't therefore just nurses being asked to give a pill at the right time to someone and then if the experiment shows it didn't work they go away unchanged. Or learning to keep a straight face for 10secs even wilst they deliver a lie, fully knowing this is a lie that
may or
may not work for the purposes of an experiment (so don't take it on board too much). They are getting trained in something that is intended to embed and inbue itself on how they look at their entire patient cohort from this point forward. Claiming it's 'therapy'. And the experiment bit is just forgotten.
They'll forever now think differently and probably think
that's 'a therapy' even though this sort of thing proving it neither works nor doesn't harm means it
isn't a 'therapy' because it doesn't help and now can't be said that's what is foreseeable from doing it to someone. We need a new term for things that are just meddling 'interventions' that never had any benefit at all, and require people like the authors above to call themselves 're-thinking techniques that might cause harm' until it is proven otherwise with every single person they train in it, so they don't go around misinformed and using it on people under the
false pretence it
does good by using that inaccurate term of therapy.
I'm not being cynical in also thinking that of course even if the therapy turns out to not just be useless in what it claims it will do, but harmful in its intention ('have you tried thinking your way out of fecal incontinence' is required before someone gives adjustments or signs it off as a disability)
The main reason for training nurses and staff in these clinics is actually to change
their mindset. And then even
when it turns out to be BS and harmful they don't and can't remove what is effectively nonsense-thinking out of their head and deprogramme them. SO they then have
really done what might well have been the intention all along which is to convert people who are supposed to have been trained in medicine and facts based on the illness in their propagandic manifesto of the opposite.
If you'd just had x number of days of being corrected and forced to now communicate with people in a certain way - trouble enough, and should
not be sneaking its way into healthcare to use CBT style - and in 'ideas' even if they are as evidenced as spoon-bending that
maybe thinking will change people's symptoms so those with bad symptoms maybe aren't working on their thinking enough. Then
most won't just 'drop it' and be able to shake it off and go back to who they were before.
SO they've now been trained in a certain attitude to patients and a certain distorted filter for hearing them or seeing straight on symptoms.
Even when post-hoc the claim of 'it might work' has been proven to be nonsense. So was used as an excuse to get the foot in the door and all of these people have now had their minds distorted, people who are on the front line and who are hearing what a patient says, does or their symptoms and translates that into what actually goes into their notes and history.
ANd of course even if those licensed in these areas so they had oversight and regulation on delivering these 'therapies', so that if it turns out one was dangerous you'd hope the licensing organisation of the CBT people would
require them to deprogramme themselves and stop doing it, even if it was them that let them be trained, they are picking on focusing on spreading it out specifically to those who aren't regulated or licensed
for this. SO that never happens.
I just see this kind of thing as a weapon/mechanism that allows propagandic training that somehow they aren't responsible for either the consequences of or undoing. Just like the fake research is. But worse. And it needs to be stopped being left open as a loophole.
