Lightning Process study in Norway - Given Ethics Approval February 2022

This is disappointing:

But this is more interesting:

 

This could be a serious obstacle to any further LP studies. It's at the core of what is LP is and how it's supposed to work which seems to imply that LP studies are inevitably fatally flawed. Unless they use objective outcomes but I think Landmark is clever enough to avoid them. They're likely to show no benefit and this would risk showing that LP is ineffective which is contrary to her goals.

Modifying LP to avoid the "telling others you're recovered/improved" issue risks weakening the effect (probably quite substantially). Even if a hypothetical study obtains a positive effect with a modified LP, it could fail to give credibility to the unmodified LP. The "telling others you're recovered/improved" component of the unmodified LP is also important in promoting LP via testimonials so it is not desirable to actually use the modified LP even if achieved a positive study result.

She might just decide that it's not worth pursuing this further.

 

Surprising good news. In hindsight maximizing bias and conflicts of interest was very foolish, but this is the only way they could manufacture their evidence.

 

Im so fucking ecstatic Jonathan.

I was one of the ones who sent appeals with the methodological concerns, and to see The Research Ethics Committees explicitly acknowledge what we wrote and agree has given me som belief in the system again. This was a HUGE decision for us. That study would have been a disaster, everyone could see it except REK-midt and the researchers. Lets go!

 

Also, after i got ridiculed by the researchers, media and on social media after instigating a signature campaing pointing out the methodological flaws, this feels so much sweeter!! Whos laughing now baby!

 

The initial assessment is a fundamental part of the LP. Allegedly, it assesses if you are "ready" or "suitable" for treatment. As far as I know every LP participant has to undergo this first.

It makes a nonsense of objective research because it is an ideal opportunity to cherry pick people who are most likely to be compliant during the course and tell the course leader what they want to hear.

 

Everything about LP is designed to maximize bias and placebo effects.

This ruling is very satisfying and encouraging. Hopefully it signals better days to come.

 

When Esther Crawley published her Lightening Process study in 2018 I thought great, the whole methodology of open label trails with subjective outcomes in ME will be seen for what it is, this study being the ‘reductio ad absurdum’ of this approach when it purportedly endorses such a patently nonsensical intervention. Unfortunately the reverse seemed to happen and apparently serious scientist had taken the author’s and the LP’s claims on face value.

So it is great news that Lightening Process empire building in Norway has received this set back, which hopefully is reported world wide. Well done to all who fought it.

 

The committee's view that wait list controls are adequate is odd. It's easy to find critiques of the wait list control groups in psychotherapy research. It has even been argued that they could be a nocebo.

This raises an interesting question about what control group would be ideal. Given the reports of deterioration following contact with the healthcare system as well as widespread dissatisfaction, care-as-usual for ME may also be a nocebo.

Things are so much easier with a placebo control group.

 

I agree it's easy to criticise, but waiting list controls is acceptable in psychological research, as far as I understand..

 

This come right after Live Landmark, the Ph D candidat and ovner of LP in Norway tweets this
https://twitter.com/user/status/1400745469073055744

and this (I deleted this as it came with tweet from a third person)
(I hope it is easy to translate from Norwegian in Twitter, it uses to be that.)

Quite convenient that those attitudes got negatively rewarded today!

 

Presumably they can alter this and resubmit... but still, that was part of the problem with the study, and I'm surprised by an ethics committee taking a serious concern about a study like this seriously. As a sign things aren't as bad as I expected, that's got to be good.

It's a bit grim that things are so bad that I can be unsure whether making improvements is useful or not: maybe it's better to have things being as transparently terrible as possible?

 

It may be used by some but I think there is no good justification for this. It is not hard to see why a waiting list control is highly problematic. A child could understand it.

So if the field finds this acceptable, then psychological research would simply be unacceptable.

I really think things are getting better and I would take any improvement no matter how small.

That said, a couple of years ago I thought Norway was a leading example in ME/CFS research, so it has been sad to watch this whole episode about the Lightning Process and CBT + Music therapy, Larun accusing activist patients of attacking her review, and now the study by Gotaas.

 

NEM's clear recognition of this must surely have implications beyond the LP, because ME/CFS trials for CBT and GET have been plagued with the same sort of bias.

 

I really hope so.

It also tells us that they wouldn't have found La Crawley's LP study acceptable.

I wonder what she and the powers that be at Bristol make of that?