NelliePledge
Senior Member (Voting Rights)
Agree - the BPS foolishness is no longer second hand through the example of how patients with ME or MUS are dealt with. Long Covid is well and truly in their domain as they see it.
Protocol ReCOVer: A RCT testing the efficacy of CBT for preventing chronic post-infectious fatigue among patients diagnosed with COVID-19.
- Thread starter Grigor
- Start date
Barry
Senior Member (Voting Rights)
And of course if you are being encouraged to ignore your body's alarm signals, which online CBT can do as effectively as any other CBT, then you can still deteriorate and be harmed by it.
NelliePledge
Senior Member (Voting Rights)
True and if you’re not face to face with a therapist probably at greater risk of them not engaging some humanity and saying you should actually stop. The robot therapist mentality is likely easier to maintain at a distance. And that opportunity won’t exist in a programme that doesn’t involve actual human involvement
Barry
Senior Member (Voting Rights)
Yes. "Evidence-based" is little more than a sound bite for many supposed scientists.
Peter T
Senior Member (Voting Rights)
Yes, you do read accounts of some people’s experience of say GET where the practitioner is so skilled at getting participants to a stable base line and at encouraging them not to over exert that it becomes more like a form of pacing. Also I have read people saying such as ‘my health was getting out of hand, so I did a few weeks GET to get back on track’, presumably this was getting to a stable baseline activity level rather than increasing activity by small increments. Online intervention will prevent the caring and compassion of the practitioner from interfering with the process.
NelliePledge
Senior Member (Voting Rights)
Yes @Peter Trewhitt i don’t think those who report relatively positive experiences of CFS clinics are all having the wool pulled over their eyes or have other conditions causing fatigue.
I think it is quite likely that some staff within those clinics are either deliberately operating under the radar in terms of not operating within the BPS spirit in their individual dealings with patients. Or they are not consciously going against the BPS approach but their previous training and humanity is making them naturally shrink back from full on bullying people to ignore symptoms.
I think it is quite likely that some staff within those clinics are either deliberately operating under the radar in terms of not operating within the BPS spirit in their individual dealings with patients. Or they are not consciously going against the BPS approach but their previous training and humanity is making them naturally shrink back from full on bullying people to ignore symptoms.
Wonko
Senior Member (Voting Rights)
Think is, if people actually manage to do as told, to ignore their symptoms and carry on, then there will be no need for any medical services ever again, apart from undertakers, who aren't typically regarded as part of the 'health' services.
People only go to doctors because of symptoms, if they are ignoring all symptoms, then no GP visits, which means no hospital referrals, for anything, including psychiatry/psychology.
They might get the odd person whose chopped off an arm with a combine harvester or something, but probably not early enough to be useful - and even that's doubtful as in a culture where all symptoms are to be ignored.....
The payoffs would however be substantial, a saving of at least £120 billion a year, in the UK alone, on healthcare, and a boon to the undertaking industry.
That's probably at least 6 Bentleys.
Win win - unless you're a psychiatrist
People only go to doctors because of symptoms, if they are ignoring all symptoms, then no GP visits, which means no hospital referrals, for anything, including psychiatry/psychology.
They might get the odd person whose chopped off an arm with a combine harvester or something, but probably not early enough to be useful - and even that's doubtful as in a culture where all symptoms are to be ignored.....
The payoffs would however be substantial, a saving of at least £120 billion a year, in the UK alone, on healthcare, and a boon to the undertaking industry.
That's probably at least 6 Bentleys.
Win win - unless you're a psychiatrist
rvallee
Senior Member (Voting Rights)
In the description they lump all symptoms under the label of fatigue. So a symptom has its own symptoms. Despite being known for being its own thing. Makes sense. Totally good science. Smart science.
Textbook "I reject reality and substitute my own".
rvallee
Senior Member (Voting Rights)
Interesting comment from Goudsmit. I, too, would love this trial to include medical professionals, this would give them a good opportunity for the time to actually look at the actual substance of this ideology.
Seriously, I would very much like physicians suffering from post-COVID-19 illness to go through that. With comments and parting words and all. Definitely do this.
Although with an invalid methodology, biased researchers with massive conflicts of interest and no objective assessment the scientific value of this experiment is exactly zero. And, again, not controlled. There literally is no treatment as usual yet and anyway it would still be a bunch of different things so not even close to being a valid control. It's a randomized experiment, not even worth calling this a trial. I hate liars like that but most of all I don't understand how they get away with lying constantly. What a broken mess, evidence-based medicine is a catastrophic failure.
Grigor
Senior Member (Voting Rights)
I wondered about that as well. I know that Knoop feels that the rationale behind the treatment of fatigue is the same. Regardless of the condition. So he'll probably treat "chronic fatigue" as usual.
Here's an article about that subject in Dutch. He published a study about it as well but I don't remember which one it was.
https://www.lvmp.nl/interview-met-hans-knoop/
Edit: I think the study was discussed here;
https://www.s4me.info/threads/is-fa...onditions-dutch-cbt-proponents-involved.4327/
Last edited:
That is the most important issue of all in this brutal farce: How have they have got away with it for so long, and indeed been lavishly rewarded for it?
It shows beyond any doubt there has been a major, critical, and sustained failure of both technical and ethical standards in medicine, particularly in the UK.
rvallee
Senior Member (Voting Rights)
A randomised controlled trial testing the efficacy of Fit after COVID, a cognitive behavioural therapy targeting severe post-infectious fatigue following COVID-19 (ReCOVer): study protocol
https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-021-05569-y
Same basic formula as always. Complete waste of research funding.
I'm fairly sure that "cognitive behavioural variables" is not a thing. Whatever, everything is made-up and nothing matters in BPSland.
https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-021-05569-y
Same basic formula as always. Complete waste of research funding.
The ReCOVer study is a multicentre 2-arm randomised controlled trial (RCT) to test the efficacy of Fit after COVID on severe post-infectious fatigue. Participants are eligible if they report severe fatigue 3 up to and including 12 months following COVID-19. One hundred and fourteen participants will be randomised to either Fit after COVID or care as usual (ratio 1:1).
The primary outcome, the fatigue severity subscale of the Checklist Individual Strength (CIS-fatigue), is assessed in both groups before randomisation (T0), directly post CBT or following care as usual (T1), and at follow-up 6 months after the second assessment (T2).
In addition, a long-term follow-up (T3), 12 months after the second assessment, is performed in the CBT group only. The primary objective is to investigate whether CBT will lead to a significantly lower mean fatigue severity score measured with the CIS-fatigue across the first two follow-up assessments (T1 and T2) as compared to care as usual.
Secondary objectives are to determine the proportion of participants no longer being severely fatigued (operationalised in different ways) at T1 and T2 and to investigate changes in physical and social functioning, in the number and severity of somatic symptoms and in problems concentrating across T1 and T2.
The "intervention":The primary outcome, the fatigue severity subscale of the Checklist Individual Strength (CIS-fatigue), is assessed in both groups before randomisation (T0), directly post CBT or following care as usual (T1), and at follow-up 6 months after the second assessment (T2).
In addition, a long-term follow-up (T3), 12 months after the second assessment, is performed in the CBT group only. The primary objective is to investigate whether CBT will lead to a significantly lower mean fatigue severity score measured with the CIS-fatigue across the first two follow-up assessments (T1 and T2) as compared to care as usual.
Secondary objectives are to determine the proportion of participants no longer being severely fatigued (operationalised in different ways) at T1 and T2 and to investigate changes in physical and social functioning, in the number and severity of somatic symptoms and in problems concentrating across T1 and T2.
The main part of the intervention is based on an existing CBT manual for Chronic Fatigue Syndrome (CFS) by our research group [46] and was adapted by experienced cognitive behavioural therapists (HK, TK). As the original CBT manual for CFS, Fit after COVID is based on a cognitive behavioural model of fatigue [26].
According to this model, a disease or stressor (here: COVID-19) initially triggers fatigue while cognitive behavioural variables perpetuate fatigue. The seven perpetuating factors addressed in Fit after COVID are (1) disrupted sleep-wake pattern, (2) dysfunctional beliefs about fatigue, (3) low or unevenly distributed level of activity, (4) perceived low social support, (5) problems with processing the acute phase of COVID-19, (6) fears and worries regarding COVID-19, and (7) poor coping with pain.
According to this model, a disease or stressor (here: COVID-19) initially triggers fatigue while cognitive behavioural variables perpetuate fatigue. The seven perpetuating factors addressed in Fit after COVID are (1) disrupted sleep-wake pattern, (2) dysfunctional beliefs about fatigue, (3) low or unevenly distributed level of activity, (4) perceived low social support, (5) problems with processing the acute phase of COVID-19, (6) fears and worries regarding COVID-19, and (7) poor coping with pain.
I'm fairly sure that "cognitive behavioural variables" is not a thing. Whatever, everything is made-up and nothing matters in BPSland.
NelliePledge
Senior Member (Voting Rights)
12 days is going to give zero information of any value
That is utterly outrageous. I wonder how they will go with recruitment if they are upfront about the disease model they are addressing with the CBT.
Grigor
Senior Member (Voting Rights)
I think the trial has already started and I guess they didn't explain this way?
Esther12
Senior Member (Voting Rights)
I feel as if it gives useful information about that point of time. That they're only collecting it right after the intervention, before patients have had time to see how this approach fit within their lives over the longer term is more of a problem imo.
Such a short period of time makes it unreliable. It's a lot like the 6 minute walk test - it's very subject to voluntary effort.
The act of measuring is likely to influence activity levels over that period. People who want to believe they are cured and want to please their therapist will often be able to maintain an unsustainable level of activity for two weeks.
It also doesn't take into account that cumulative activity may gradually reduce activity capacity.
The length of activity assessment needs to be at least a month and ideally three months. Activity trackers make such an assessment entirely feasible. I think we should push back against any studies that monitor activity for less than a month.