Wow that's a banger. Get random noise as a "result"? Naw it's heterogeneous. Null result? Heterogeneous result.
User-centered design approach
Meaningless waffle. Just stringing words that sound convincing to a random focus group.
Brainwashing in action. Patients feed back to investigators what they have been told on the course:
Actual stochastic, I'm sorry, heterogeneous, parrot. Stochastic parrot is a popular dismissive term about LLMs. Frankly, LLMs have been much smarter than this for years and they aren't even smart in a real sense yet.
One thing that strikes me about all these CBT for physical symptoms programs is the structure is the same.
Structure and content. An entire industry built on simple copy-paste.
Three themes were identified: 1) “Helpful - but not Enough” explored the participants' descriptions of the changes they observed following treatment, 2) “Reversing a History of Overexertion” described how participants had engaged with the treatment content, and what they had found helpful in their therapeutic process, 3) “Psychotherapy is Hard” addressed the factors that facilitated or hindered engagement with the digital treatment.
This reads exactly like one would expect out of something that isn't useful, but coming from people who were told to repeat back that it's useful. People who were selected for their potential to be polite and agreeable, to say "thank you" for no other reason than that it's polite by convention.
What does "regulating the nervous system" mean? And why is no one involved offended by how blatantly it's bullshit that doesn't actually exist?
Also, "one step at a time" reminds me too much of What about Bob?, although the title of the book was "baby steps". Same difference.
One notable thing about the "Reversing a History of Overexertion" part is that quotes essentially reflect how doing GET was the problem and resting instead was the solution. Funny how that works when nothing matters. Literally:
In all cases, this improvement was described as associated with overcoming overexertion, often through changes in their occupation or life circumstances.
Just completely back-asswards with the model, but it doesn't matter because the model, being a bunch of hot air, is infinitely flexible. In fact, this might be described as a convoluted form of pacing, something like the "adaptive" pacing in PACE:
The internet format was described as making the treatment more tolerable, allowing participants to work at their own pace, set their own goals and structure engagement in ways that aligned with their condition
Pacing without using the pacing, or understanding its purpose.
While most participants found the treatment helpful, many participants also voiced a need for further treatment after concluding the iCBT treatment.
Very common thing to say about effective treatments that have helped for real thank you doctor you are so, uh, there.
Participants generally indicated that the 14 weeks of treatment were insufficient to enact the changes they felt were necessary to alleviate their condition. As one participant described it:”This is not a 6-month treatment. It's a 5-year treatment or something like that. And it's not a treatment that stops because it's all about forming new habits and regularity in my life to continually keep the symptoms ‘at bay’ (4)”. Thus, at 6+ months post-treatment, most participants described the treatment as helpful, but ultimately not sufficient – a process still underway.
Most habits can be developed in a few days. This is obviously ridiculous, none of this has anything to do with habits.
It's very clear how this treatment model simply doesn't work at all. All it can achieve is get people to parrot back what they were told to parrot back, while also politely saying that it's basically not useful but they want to be positive and polite so it can be interpreted this way. As usual this is basically the most favorable level of review they can get, something they mention but don't seem too bothered by:
Another important feature to consider is the fact that the participants represent a selected sample as they had been referred, diagnosed, included in, and completed the RCT and had agreed to be interviewed. Individuals holding more negative views may have been filtered out at earlier stages, why their voices might not be captured here.
There is simply no other context in which anything that performs this poorly would be seen as anything but a giant failure. This isn't some pilot test, this vague treatment model has been used on millions of people for decades. And this is the very best they have to show for it. How utterly pathetic.
And around a third of all the participants realise its all nonsense or harming them and walk out mid study and the researchers don't even consider asking the question why that happened. The longer the study is the more that drop out, likely due to pacing up causing them crashes that remove their ability to participate.
LMAO they went with this pathetic excuse:
Targeted recruitment of dropouts was beyond the scope of the present study, but the experiences of participants who disengage from iCBT for FSD remain an important question for future qualitative work.
"Out of scope". Absolutely ridiculous. This excuse has been used by every single trial for decades. It's hard to get anything this inept even in a fully-controlled nepotistic organization run by grandfailsons of failsons.
