Trial By Error: CBT and Irritable Bowel Syndrome

....and I have shares in the company.

 

Merged thread.

Time for Trudie Chalder, psychologist of the Institute of Psychiatry to target Irritable Bowel Syndrome patients this time with CBT - no surprise - because according to Chalder they should be forced to question their own reality, and to test out what they already know is harmful because avoiding harmful things is "bad", and patients are to be expected to identify the "behaviours" they are doing that "keeps them sick" (patient blaming) and challenge their presumed "false" or "unhelpful" beliefs (the C stands for Cognitive - the beliefs/thoughts).
Patients unable to find such beliefs or behaviors are totally unable to engage with such a treatment, it is considered "not acceptable to patients" rather than "entirely without scientific rationale" and utter <insert your choice of word>.

"A private company has signed a licence agreement with King’s College London with a view to bringing the Regul8 website (IBs/digestive health) product to the NHS and other international markets. TC will be a beneficiary of this license through contracts with their respective universities."
Long COVID Scottish declaration of interests (Dec 2020)​

With all appropriate use of CBT patients actually need to be assessed to discover if they actually have the beliefs being targeted by the psychotherapy - but that would rule out the treatment.

I cannot understand why the government including the NHS and NICE continue throwing money at at psychologists who claim that they can fix physical illnesses - Chalder is a former nurse and not a doctor. Not an expert in digestive system diseases. Such people have no role in devising nonsense psychobabble for conditions that they are absolutely NOT qualified to treat. Chalder is NOT a specialist in medically unexplained symptoms / persistent physical symptoms - she's a psychologist and a specialist in Psychologization who is unable to perceive that CBT is entirely useless as a primary treatment for anything other than cognitive or behavioral problems.

After earning undisclosed amounts from inflicting harm via her own Chronic Fatigue books, earning from assessing patients with ME/CFS and other illnesses for sickness insurance company policies (that would really rather not pay out), vast funding of the PACE trial (I think she was third author) it's time to extend this "quick fix" to another medical illness and sell it to the NHS for £££££.

Books so far

• Overcoming Chronic Fatigue Title (A Books on Perscription, now with a 2nd edition)
• Coping with Chronic Fatigue (Overcoming Common Problems)
• Overcoming Chronic Fatigue in Young People

Do those with IBS know how hard it's going to be to stop this oncoming train?

It's been 14 years since the NICE guidelines for "CFS/ME" inflicted cognitive behavioural therapy on patients and it's still not been officially scrapped and there's still a long chunk on it in the draft guidelines instead of the magic words "for mental health see the mental health guidelines".

Mental health crisis and IATP
Despite the apparent terrible state of mental health services and the huge rise in mental health conditions during the pandemic (the UK remains in lockdown number 3, I am not sure if we are in the 2nd or 3rd COVID-19 wave but apparently more are coming)... despite all of this IATP is diverting significant chunks of it's budget entirely away from mental health conditions.

IBS is not, and never had been, classified as a somatic syndrome and has is obviously a digestive disorder - yet IATP is reducing funding for desperately needed mental health services by yet again funding it's favorite money wasting researchers.

I have one positive thing to say about Chalder and that's in the PACE trial Freedom of Information Act transcript, where she describes the "patient harassment" as involving ONE person heckling her at a seminar held outside the UK. ONCE. The positive part of this being that she did not fabricate non-existent events like a number of others apparently have attempted to.


The whole thing is so much like the earlier "give everyone anti-depressants" approach. But without a Yellow Card Scheme and without any apparent regulation.

It appears any counselor, psychologist or psychiatrist can claim to be an "expert" in any physical illness and deliver any well known form of psychotherapy without any monitoring or disciplinary action taken for such malpractice as treating what they are not qualified to treat with treatments not shown to work for those illnesses.

But where are the psychologists for those harmed by such approaches and by medical malpractice? Where are the psychologists for medical PTSD - which is another comment result of severe COVID-19.

Funding again is not based on past quality of research, it's not based on patient needs, it's not based on what is likely to improve patient's health, it's based on being one of the "in crowd" who knows how to get the grants, and can get their research passed without proper examination time and again (Esther Crawley being a prime example of fabricated and false statements being rubber stamped without even checking things like the ethics approval).

 

My memory of that is a little different. I remember it as her being asked (by the tribunal) to give examples of the harassment she kept referring to and this was the only example she could come up with when pressed.

 

Another patronising study name.

 

Daftasabrush, sadly, IBS is firmly classed as a functional disorder nowadays.

 

That product is a scam.

 

1 April 2021

IBS Digital therapeutic Parallel™ developed by King's researchers gets approval in UK and US

https://www.kcl.ac.uk/news/ibs-digi...-kings-researchers-gets-approval-in-uk-and-us

maybe someone should inform NICE about the 'evidence' behind this therapy(?)

 

https://twitter.com/user/status/1377572734276927496

 

At least if it were a leaflet on paper one could find a use for it.

 

My bold...

Why does CBT have to be prescription-only? It's not as if it is poisonous.

I'm guessing it has to be prescription-only so that the NHS can be charged for it. Gotta make sure those profits go to the shareholders!

 

What a disgusting joke.

 

"Evaluation in Practice by the National Institute for Health and Care Excellence (NICE)"
trying to find out about the NICE process for this.
It's (Parallel) not on the products considered for selection list (afaik)
https://www.nice.org.uk/about/what-...ice-medical-technologies-evaluation-programme
there is an email contact address for inquiries at that link.

NICE recently reviewed their methods for health technology evaluation;
this guy was on the review committee

https://www.nice.org.uk/about/who-we-are/senior-management-team

 

The Golden Age of medical pseudoscience is happening. Not in 1921 or 1821. No, in 2021. It's a kind of twist on late-stage capitalism and its weird excesses. Except it's experts doing their expert thing and still failing in the worst possible way while utterly convinced that they are succeeding.

And they call us anti-science, as they promote quackery that they actually KNOW doesn't work. Amazing. This is what happens when practice is detached from all relevant feedback. No one can succeed without feedback on what they are doing and obviously, no, people can't simply use their own feedback about their own performance, not even experts, not even when dealing with actual life-and-death matters. Self-regulation is simply not possible, not even in the best possible circumstances.

 

A very good point. Things only need to be prescription - only if potentially harmful.
I wonder if the people marketing it realise this.

I suspect that indeed this is a clever ruse for making it look as if the treatment is somehow 'official' and therefore a must-have for the NHS.

I guess it is a bit like free hearing aids. you can get free hearing aids but only with a prescription. Worth noting that on the whole you get an outdated model. The decent stuff you have to pay for.

 

In the US, if it's prescribed, more likely health insurance will cover it. if it's just some program you download on your own, no chance.

 

Does NHS cover these? Insurance largely doesn't here--or just a bit. And they can be like $5,000 a pair for decent ones.

 

That will be it.

Yup, NHS covers hearing aids if you are deaf. And you don't need to be that deaf. My GP said the main problem was that deaf people didn't think to ask - which probably meant that aids were not deducted from his budget but paid for centrally.

The system is that you get the slightly out of date ones on NHS. Pairs cost around £4,000 but then you are paying for the new ones. The outdated ones are probably almost commercially worthless.

 

Does prescription only imply that it could gave a yellow card system?

 

Probably not, as CBT isn't covered.

The scheme collects information on suspected problems or incidents involving

1. side effects (also known as adverse drug reactions or ADRs)
2. medical device adverse incidents
3. defective medicines (those that are not of an acceptable quality)
4. counterfeit or fake medicines or medical devices
5. safety concerns for e-cigarettes or their refill containers (e-liquids)

from https://yellowcard.mhra.gov.uk/the-yellow-card-scheme/