Initial evidence for mind body retraining intervention ‘The Switch’ for those with idiopathic chronic fatigue, 2026, Barker-Collo & Abbott

Dolphin

Dolphin

Senior Member (Voting Rights)

Research Article

Initial evidence for mind body retraining intervention ‘The Switch’ for those with idiopathic chronic fatigue​

Suzanne Barker-Collo
&
Mel Abbott
Received 22 Feb 2026, Accepted 23 Jun 2026, Published online: 01 Jul 2026

ABSTRACT

Objective​

To examine the feasibility and efficacy of The Switch intervention in individuals reporting idiopathic chronic fatigue (self-reported diagnosis of Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) or long COVID) and to inform a clinical trial with power calculations.

Methods​

Of 127 individuals, 104 (81.8%) met the inclusion criteria (self-reporting CFS/ME [n = 75] or long-COVID [n = 29]; aged 16 +  who completed at least one Switch session). The 12-item Short-Form (SF-12) and Visual analogue scales (VAS) were completed pre-intervention, and 2- and 12-month post-intervention.

Results​

One individual withdrew from the intervention. At least 77% of measures were completed at each assessment. All SF-12 scales except for social functioning improved significantly to 2-months (range p < .001–.001). Significant improvements continued to 12 months for Role Limitations-Physical (p = .005) and Emotional Functioning (p = .02). Format (zoom vs face-to-face) did not impact change (p > .05). A conservative power calculation suggests 36 participants would be required for a clinical trial.

Conclusions​

The Switch shows promise as a feasible and effective intervention for those with idiopathic chronic fatigue. A randomised controlled trial with a small number of participants with verified diagnoses and more targeted outcome measures is the next step in establishing its effectiveness.
 
Dolphin said:
individuals reporting idiopathic chronic fatigue (self-reported diagnosis of Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) or long COVID) and to inform a clinical trial with power calculations.
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A very bad start given if these people have ‘Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) or long COVID’ that by definition means they do not have ‘idiopathic chronic fatigue’. Further what is the point of including people self reporting ME/CFS and/or Long Covid rather than those that have a confirmed diagnosis.
 
I think they probably had to call it idiopathic since it's self diagnosed.

And they talk about cognitive fatigue and post exertional fatigue not PEM.

Participants included 104 individuals who participated in The Switch from 1 January 2022 until 31 August 31 2024, who met the following inclusion/exclusion criteria:

(1) reported having received a diagnosis of CFS/ME or long COVID;

(2) being aged 16+ to provide informed consent to treatment and to the use of their de-identified data for research purposes;

(3) have voluntarily applied for The Switch, including completion of required pre-course exercises and application form; and

(4) have completed a pre-intervention assessment and have started attending The Switch programme. There was no requirement that they complete the programme.
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So they did their best to ensure only getting participants who were already in the program and fully signed up to believing all the nonsense.

So not really a clinical trial at all, just a selection of their current clients who self diagnosed ME/CFS or LC.
 
From the paper about what The Switch is:
A commercially available mind–body intervention offered to those with persistent fatigue is called The Switch. The Switch is a structured 4-day small group programme whose key premise is that chronic illnesses occur due to widespread dysregulation of the nervous, immune, digestive, and hormone systems, brought on by states of high and prolonged physiological stress. Before the body can heal, this dysregulation must be calmed, and body system functions restored. The Switch uses education, self-reflection, and structured techniques to help participants understand the wider framework of their illness, recognise and resolve the original stress, and modify current thinking, behaviour and belief patterns that might maintain an illness. The Switch is based upon several theoretical models for health behaviour change, including CBT, with a focus on identifying and changing core beliefs, identifying emotions and illness-related beliefs, using techniques such as visualisation to calm the body, resolve thinking patterns and address lifestyle factors. The Switch also draws upon the concept of self-efficacy [Citation31] in the health belief model, which focuses on attitudes and beliefs to explain behaviour for improving lifestyle changes. This combination of methods aims to foster a sense of self-determination, self-responsibility, and ownership, thereby enhancing motivation, satisfaction, and adherence to healthier behaviours [Citation32]. Further, it draws on principles of neuro-linguistic programming (NLP), seeking to understand the thoughts and behaviours that create positive or negative outcomes and then teach people strategies to create the outcomes they desire.

The Switch overlaps in part (around 25–30%) with the Lightning Process (LP), particularly in explaining the role of the physiological stress response, thinking patterns, and behaviour patterns in maintaining illness. LP shares overlap with CBT in its approach to fatigue, but is distinct in its focus on language style, neurophysiological rationale, physiological change technique and mode of delivery [Citation33].

Both LP and The Switch use step-based techniques involving movement, visualisation, and self-coaching. The biggest differences between LP and The Switch are that The Switch includes: (1) exploring and resolving underlying trauma and core beliefs, incorporating inner child work to resolve any trauma identified; (2) identifying and addressing current emotions that need resolution; (3) discussing lifestyle factors informed by science and addressing obstacles to change, and (4) identifying core beliefs via muscle testing and using inner child work to clear long-held beliefs that are impacting health.
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I had a hard time finding information about The Switch but finally found:
empowertherapies.co.nz

The Switch®

Specialising in chronic illness recovery. Over 80% success rates. Treating the underlying cause to allow natural healing. Find out more. Free 45 minute webinar
empowertherapies.co.nz empowertherapies.co.nz

ETA:
Empower Therapies have a YouTube channel with over 120 inspiring videos such as:
 
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So, they totally did a trial, it failed, and they just turned it into a feasibility trial instead, asking for more money to do it again, just as poorly, right?
An increasingly dominant public narrative suggests persistent fatigue conditions are chronic and incurable
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It's very hard to find more blatant dishonesty than the nonsense medicine spews out to justify the worst of what they do. Everyone of average intelligence perfectly understands that by "incurable" it means that medicine cannot treat it, not that it's a permanent condition. This is where the absurd narrative, ongoing for decades and endlessly renewed, is over simply pretending that "people can recover" is some sort of gotcha. The dishonesty in this profession is completely off the charts compared to the other professions, it's more than all of them combined and by a very wide margin.
Once participants complete these activities, they fill in a longer application form reflecting their beliefs and readiness for recovery. This is followed by a phone call (with MA) to discuss readiness.
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It's as if evidence-based medicine is explicitly a rejection of every single lesson learned from scientific research and medical trials over the last century. It explicitly flips them upside down and makes a standard out its negative. Here they explicitly seek to exploit all the biases that can be imagined, which is a perfect description of trying to use "the placebo", which is just biases and poor methodology.
MA is the owner of Empower Therapies Ltd and was the therapist who provided The Switch to all participants.
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Just literally all the biases. It's not even subtle anymore, bias in favor of creating false outcomes is basically the mandate now.
 
Empower Therapies‘ The Switch has a self-proclaimed success rate of more than 80%.
However, Jessica Bavinton, the physiotherapist that co-wrote the PACE Trial GET manuals, says that their vitality360 rehabilitation programmes achieve 86% of return-to-work goals.

I’m lost, where should I spend my money?

ETA: The Switch is $2197 NZD. That’s approximately USD 1250.
That’s too much!
Vitality360 on the other hand delivers
Disability Impact Training via the government-funded scheme-Access to Work
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Chandelier said:
Empower Therapies‘ The Switch has a self-proclaimed success rate of more than 80%.
However, Jessica Bavinton, the physiotherapist that co-wrote the PACE Trial GET manuals, says that their vitality360 rehabilitation programmes achieve 86% of return-to-work goals.

I’m lost, where should I spend my money?

ETA: The Switch is $2197 NZD. That’s approximately USD 1250.
That’s too much!
Vitality360 on the other hand delivers
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Good luck to anyone that benefits but the reported success rate in such interventions is part of the therapy as is any proclaimed "understanding". Paper seems to assert that no relevant biological findings are out there.
 
The change in SF36 physical functioning is massive compared to anything we've seen in randomised trials of physician-diagnosed ME/CFS: 34 at baseline to 82 at 2 months, a 48 point difference (see table below). Compare that to 10-12 with CBT/GET at 12 weeks in PACE, and 6 points in Fluge & Mella's placebo group at 3 months in the rituximab phase III.

1783002533823.webp


My guess is that if this study were repeated with consecutive patients diagnosed with ME/CFS by physicians, instead of this self- and therapist-selected group of patients, that 48-point improvement would plunge.
People voluntarily apply for The Switch from the following sources: 60% word of mouth,15% medical referral, 14% internet search, 6% social media, and 5% other. Once the initial short application form is received, an auto-email is sent with further information, an e-book, and movie link for preparation for the course. Once participants complete these activities, they fill in a longer application form reflecting their beliefs and readiness for recovery. This is followed by a phone call (with MA) to discuss readiness. The SF-12 and VAS are then completed as is a form for significant others if they want this person to attend and observe the course. [bolding added]
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A 4-day intervention of 6+ hours per day is a lot for a group with baseline SF36 PF of 34. Would be a lot at any severity of ME/CFS, to be honest. PACE's sample was capped at 75 whereas there's no cap here. So these people are self-reporting poor physical function, on average at the border of moderate and severe ME/CFS*, but signing up to attend a course for 4 consecutive days. 40 did it in-person (baseline SF36 PF 30), 54 on Zoom (baseline SF36 PF 37). Who would assess their physical functioning low/very low and their ability to attend a 4-day course high?

*If van Campen 2020's categories of SF36PF 0-29 as corresponding to severe ME/CFS on International Consensus Criteria, 30-59 as moderate and 60-100 as mild hold out.

Compliance was measured:
Compliance with the intervention will be assessed as the number of sessions of the four-session Switch programme that are attended. [bolding added]
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but I don't see it reported. Did I miss it somewhere?
 
We should not take any of these subjective outcome seriously. The Switch is a version of LP with some very dodgy sounding psych therapy stuff added. I assume part of the treatment is the LP instruction to say you have recovered regardless of how you feel.

At least they admit a proper study would need objective outcomes.
 
In addition, it should be noted that all measures used were self-report. While the presence of significant improvements in the current study suggests positive impacts, the extreme level of improvements seen in the data (e.g., physical functioning, which improved from severe to excellent) is likely to reflect a combination of actual improvements in function, as well as shifts in how participants view/rate their functioning, as well as placebo effects.
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Here we go with biased interpretation. There is absolutely no way to know if there was any effect at all, so to deem it likely that it was a significant contributor is just wrong. This is PRT all over again.
There is therefore a need in future studies to include not only a control condition to tease out placebo and practice effects, but to include objective assessments of outcomes (e.g. 6-min walk test or actigraphy).
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At least we have receipts if they do any future studies without objective measurements.
 
abstract said:
A conservative power calculation suggests 36 participants would be required for a clinical trial.
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Is it reasonable to calculate the number of participants needed for a clinical trial (that presumably will be looking at the difference between change from baseline for people getting the intervention and for controls) from what was essentially an observation study that was just looking at the change from baseline? Seems to me, if you think there is likely to be some improvement in controls over time (and I would expect that), you would need more participants than what the observational study suggests.

Yes, I know, the least of our worries.

Perhaps the plan is to have a clinical trial with no controls - it is not clear whether that 36 is the total study size or the number for each treatment arm. Perhaps the plan is for controls to be languishing on a wait list having signed up on condition that they can do a discounted course once the trial has finished?

I don't know if there is anything we can do. Bad quality research continues to be supported and produced, and continues to harm our community.
 
Another case of how to build a business case for a promotional publication of MMaS (marketing masquerading as research)?

I wonder how Suzanne Barker-Collo got herself involved in this. A quick skim of her university profile suggests she should have a better grasp of methodology than the present paper suggests (I assume I have the right person, it's not a super common name)

Discovery

profiles.auckland.ac.nz profiles.auckland.ac.nz
 
Not so sure about that @Ravn - here's a recent paper suggesting that she could be quite a problem when people with severe ME/CFS get admitted to hospital due to inability to eat:

Functional dysphagia: Developing a framework for assessment and treatment.
Apr 2026International journal of speech-language pathology28(2):155-170
Co-authors: Miles A, Baker J, Barker-Collo S, Leadley Sshow fewer
DOI: 10.1080/17549507.2025.2473071

PURPOSE: Functional dysphagia is complex, affecting physical health as well as wellbeing. In this expert opinion paper with associated exemplar case series, we propose a framework for understanding functional dysphagia.​
​
METHOD: A literature review of approaches to understanding and treating functional dysphagia are presented, moving beyond the predominant medical model to encompass psychosocial aspects of the condition. An exemplar case series of six clients is then given. Learnings from fields of laryngology and cognitive and applied behavioural psychology are discussed; and a biopsychosocial framework for assessment and therapy are proposed.​
​
RESULT: Client presentations can be vastly different yet, for many, relatively quick return to normal eating can be achieved with targeted therapy. Using a biopsychosocial framework allows comprehensive assessment and targeted interventions.​
​
CONCLUSION: We should consider a broader biopsychosocial framework in dysphagia practice so that those with functional dysphagia no longer go through a process of diagnosis through exclusion. While large scale randomised efficacy trials do not exist-and may not be feasible or useful-clinicians can learn from associated fields of laryngology and psychology, and confidently develop therapy programmes for their clients. The biopsychosocial framework developed in this paper provides guidance to clinicians working in this field.​

Looks like the authors are advocating for fewer tests and just jumping quickly and confidently to therapy programmes. They suggest not worrying about the lack of evidence, instead following the example in 'associated fields of .. psychology'.
 
I thought it interesting that a Professor of Neuroscience at Auckland University has wasted her time on Mel - who is an alternative health practitioner. Mel has used her B.Psych, she got in the 90's, to talk the talk and manages to convince people with her spiel.

If only the Professor could see some of the videos Mel has done at some of these GP conferences claiming to have cured her goitre through positive thought and more recently in Mel's advertising curing her hypercortilism with her ever-evolving therapy based on NLP, LP, cobbled together with bits of other psychological theories she may have read and claiming the latest neuroscience informs her "work"

Mel in her latest advertising is now doing trauma work (via accessing the inner child - more pop psychology from the 80's) The fact she has no post-graduate qualifications in clinical psychology and likely has no clinical supervision doesn't seem to worry these academics in Auckland. (It sure worries me being a retired mental health clinician). Mel, of course, believes fatigue and ME is due to childhood trauma, epigenetic changes, (anything really, as long as it sounds good enough to peddle it as a pseudoscience)

I read through Prof Barker-Collo's limitations of this "feasibility trial" and she is quite clear that idiopathic fatigue is not ME and the subjects of this trial self reported this diagnosis and any proper trial would require proper diagnosis via IOM criteria by a medical practitioner. I found her remarks in line with an academic professional - discussed bias, self selection, clinician (therapist) effect etc. I didn't get the impression she thinks Mel has a viable case for a clinical trial but no doubt Mel will milk these results and the association with a Neuroscientist to the max now she is a co-author of a "scientific" paper.

Call me a cynic, but I wonder if the Professor of General Practice at Auckland Uni, Bruce Arroll, who likes to hold "Fatigue Symposiums" at his GP CME conferences asked her to help Mel with getting a trial on her alternative psychological "treatment". Mel didn't manage to convince Otago's Prof of General Practice or any med students to help her as she requested on one of her videos done by that professor. Prof Arroll also has the problem of conflating fatigue with ME while promoting LP and doing dubious "audits" of LP practitioners and publishing them.
 
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