Protocol Effectiveness of two interventions to optimize expectations in psychosomatic rehabilitation of post-COVID patients: ... 2026 Wedekind et al

[Andy]

Full title: Effectiveness of two interventions to optimize expectations in psychosomatic rehabilitation of post-COVID patients: study protocol for an integrative approach

Abstract​

Background:

Most prevalent symptoms of post-COVID syndrome (PCS) are fatigue, shortness of breath, cognitive impairment, and pain. Comorbidities such as depression and anxiety are common. The diagnosis PCS is confirmed if symptoms persist for longer than 3 months and are not better explained by another medical condition. About half of the patients are still not fit for work after psychosomatic rehabilitation. From psychotherapeutic research, it is known that a relationship-based approach is decisive for treatment efficacy. Here, the patient’s expectation that the treatment will help is one central pathway that contributes to symptom reduction and an increase in quality of life. Using positive expectations, respectively, the placebo effect in medical settings has already been proven to be beneficial.

Objective:

Evaluation of two expectation-focused interventions for patients with PCS to optimize the rehabilitation process. The interventions aim to focus on positive expectations and imaginations. Thus, the project should lead to further improvement in the rehabilitation of patients with PCS.

Methods:

The study implements a 3-arm, parallel group, longitudinal non-randomized controlled, sequential cohort design. The trial is designed to estimate the effect of 1) a 3-session psychotherapeutic expectation-focused integrative, manualized intervention, and 2) a brief intervention where patients are asked to write down their expectations on their own in a journal, compared to 3) a treatment-as-usual-only control condition (usual treatment in rehabilitation, no study intervention). Since the predominant symptoms in PCS patients vary a lot, the Work Ability Index (WAI) is considered as a proxy for earning capacity as primary outcomes.

Discussion:

The analysis will provide insights into the extent to which the interventions improve PCS. This approach was chosen to enable a larger number of practitioners to provide more specific therapeutic support for patients with PCS. The study serves as proof of principle for further research and development of more effective therapies. It emphasizes the urgent need for interdisciplinary, integrative treatment and research to better understand and manage PCS.

Clinical trial registration:

German Clinical Trials Register https://drks.de/search/en, DRKS00034671.

Open access

 

[Turtle]

Authors want to treat positive expectations and imaginations, not symptoms?
Dupe and be duped, when will this kind of nonsense stop?

 

[Peter T]

Before looking at the abstract, my first thought was that ‘psychosomatic rehabilitation’ means rehabilitation aimed at convincing the subjects they were getting better without actually treating their actual condition. Then I read the abstract and realised that was what happened.

 

[bobbler]

Before looking at the abstract, my first thought was that ‘psychosomatic rehabilitation’ means rehabilitation aimed at convincing the subjects they were getting better without actually treating their actual condition. Then I read the abstract and realised that was what happened.

It would be unethical but you could pretty easily show this up as the con and coercion communication that it is by taking serious illnesses where there a objective things to measure like cancer tumours and I’d say MS lesions but how gaslighting can psychosomatic be if you have a muscle twitch or stop being able to walk

Of course it needs to be newbies and you’d have to ban all medics from seeing them by writing Mus or whatever flag temporarily in their file to make sure everyone tells them to carry on with the no napping and blames their behavioural attitude fir sleeping in or losing weight with further passive aggressive abuse and then tells them they feel sad (due to the new abuse they live under) so it’s that causing anything they have so try not telling anyone of whinging about their symptoms

Then you know see how many are alive and deteriorated when you allow them back to their specialist teams in a years time vs what the ‘measures’ that are supposedly not dodgy from bps claimed about them ‘being improved’

You can coerce the answers despite it making people worse etc.

Given even if someone has something serious most therapists don’t want to know and assume it’s a misdiagnosis particularly now they’ve realised they’ve perfected the tools and oversight to cover it up so blinding from that side isn’t such a problem . Plus I’m sure some of the more extreme bps loving will believe anything as long as there’s an abstract saying it fixes that illness. No methodology needed to be worried about as I don’t think they are too critical which I guess is due to culture of that area.

But you wouldn’t because people will unnecessarily die, be traumatized forever and rightly not be able to trust humans again having seen into the eyes of that as they get worse in a way they lose everything about their life whilst no one cares and lets it all disappear. And it would take down all dependents too. And would mean unnecessary disability long term that may not ever be undone.

Which is where their supposed beliefs bit for bps and me/cfs start to smell of superficial bs to me - post-hoc justification for what it actually is which might be the right to treat ‘people like us’ that way and for our deterioration to be disappeared

Because they know Pwme die and sometimes that’s caused and/or directly contributed to by one or two individuals insistent actions as the last thing they never recovered from, always its many more before that having done the same to them and their life making them significantly more ill fit the next person to pick up assuming it’s caused by the opposite and they just need to bullied harder for being more harmed.

I’m not actually 100% sure we should give all and the system this cop out that doesn’t exist of not looking into notes and those being distorted by previous ones who harmed not being candid about cause and effect when what they did harmed

And I think and note as the issue of ‘pathway’ even when someone lands in a generic hospital for emergency or eg a planned gastro keeps being said it feels like the issue of who those other illnesses get directed under. And that if it’s one of those other illnesses general staff learn where it counts because that service that takes charge can reprimand or report it or confirm it was wrong. I don’t know how it works

I think the issue is that who speaks ‘for’ us in the sense of over us and stealing our voice just isn’t of the same personality or the same oaths or the same concept that they’ll ever get held to account. And the immediate jump to mess with and distort what gets measured to think one’s being sly changing the concept of an illness in their ‘measures’ by hiding it under Rasch thinking we are all too stupid to not have any within us who know what us allies to that last point. There’s always with these things not an incompetent vs bad but it’s normally requires a bit of both in some proportion if it continues and if the underlying science problems and attitudes to principles of science/measure get worse. Even if bad includes choosing to close eyes justifying to oneself those harmed have something minimised so you can mentally excuse the issue vs ‘I’m trapped in this job now and will lose it is my figures aren’t good and I’m not saying the right things and am tired too, have kids and more on the human excuse line’.

And people who believed it when like us they were new and hadn’t tried it every way yet but were sure it would be ‘the way’ so sewed their career into it, but now that’s their career and they are ill so that’s gotta be what they keep selling even if it doesn’t work because they have to survive. No easy step-down option or whatever the phrase is in an argument where you give someone a graceful ‘out’ where their dignity and other things aren’t so in the line.

I think those talking about whilst being the ones pushing the bps as ‘beliefs’ are the ones who don’t have them in their own healing medicine just the ends they want. And dotted others. But the rest is how a system works with a normal distribution of people that isn’t the same as the normal distribution you get in those other pathways. Stoked by that idea of this being deserved.

At the time one could have thought pace was dangerous guinea pigging but worth a try once in that lifetime assuming they were asking GP to be honest and noting harms like you’d assume happens for all illnesses.

As soon as it came out the fraudy stuff that went on with measures there so no negative could be noted and that GP propaganda and guidelines and rules were being used to distorted that ‘what you see with your eyes’ nevermind block reporting, I think this became something different. Even if people didn’t have any of these beliefs they can’t act outside it.

To be fair this is where some of the long covid stuff has differed in that there is at least when pushed acknowledged not all recover and PEM got pushed in by charities etc. But it’s not realised the ‘bit left over’ that their rehab couldn’t recover was probably made worse and is actually those with ‘the disease’ IF they had just been studying me/cfs but they weren’t as it was the whole cohort of those who took a bit longer to recover from COVID. Maybe post-viral syndrome responds to cutting back then gentle return (maybe cos it’s self-limited, as long as you aren’t pushed past your limits whilst ill)

And the issue for me/cfs in pace etc /bps is that those who had the illness were being treated with collateral damage therapies that made them worse and the expense of maybe other cohorts who weren’t made as badly worse to be funded in their name. And those who did that didn’t care or would look to see as they made them worse.

But worryingly those in that covid cohort of new establishment don’t want to acknowledge the bits their rehab doesn’t work for and calling them Mr/cfs puts them back under the power territory of that original ownership who aren’t going to be allowing them to suggest their old outsmarted idea of us doesn’t work cos politics.

And it’s attracted now people who don’t want to look too hard either because they want to believe they are good (at methodology - and it’s just random they find this area easy to do research in where every other bit of real science has been hard) or they are the personality type to think these things of other people and at the same time think they deserve this.

And then there’s those who want to expand the emperors new clothes kingdom further and further . But it seems to use propaganda and a lot of personality insinuation techniques to do so. And begin with cutting off access to medical professionals for that area with manifestos calling ‘that thing’ now a ‘functional version’ which must be sent to the other department and ‘not medicslised’ which as well as the health outcome issue means no one is seeing whether that ‘medical arm’ option (if you think of it as a trial) really does do the harm they fictionslise. But don’t evidence.