Vincent Deary, a therapist from Kings College London (home of Simon Wessely and Trudie Chalder) was brought in to major sure the therapy was like what they used. As I recall, he lived over there for a while (at least person was wondering about Leonard Jason when they learned about it).I wonder if CBT proponents have responded with suggestions Jason et al cannot conduct CBT properly?The present study found few differential results among the non-pharmacologic interventions, although the COG condition appeared to have more positive change than the other conditions. On only three variables was one intervention clearly and significantly different from all of the other three conditions (depression and pain in joints for COG, and muscle pain for RELAX).
The CBT treatment regimen was developed in collaboration
with Vincent Deary, who has worked for many years
with the team that completed a successful controlled clinical
trial of CBT in CFS (Deale et al., 1997).
They also checked using fidelity ratings:
Fidelity Ratings
In order to verify the distinctiveness of the behavioral
treatments, a validation study was completed using a fidelity
rating scale developed for this study. A random sample of
audiotaped sessions were selected, and each session was
rated to the degree that the therapists exhibited behaviors and
introduced techniques that were unique to each of the four
treatment conditions. Fidelity ratings were implemented in
order to monitor the consistency of implementation of the
different treatment conditions, as specified in each treatment
manual, and to ensure that the treatment conditions were in
fact distinct. Ratings were conducted by a licensed psychologist
and a master’s level psychologist, both of whom
were familiar with CFS and who had training and experience
in cognitive behavior therapy techniques.
First, inter-rater reliabilities were computed for 34 audio
taped treatment sessions to ensure an acceptable level of
inter-rater reliability. For these sessions, median inter-rater
percent agreement for item reliability was .79, and these
were at an acceptable level (Steve Hollon, personal communication
reference, June 17, 1998).
Next, mean scores for 46 rated sessions indicated that
the four treatment conditions were significantly differentiated
by the questions tapping the corresponding categories
(see Table 2). There was some overlap between the COG
and CBT conditions, but that is because the COG condition
includes CBT cognitive issues. T-tests indicated that the
majority of the items that reflected the various cognitive–
behavioral techniques in fact discriminated between the
conditions at the p\.05 level. This suggested that the
therapists implemented the treatment conditions as specified
by the treatment manual. Further, high ratings on each
set of items were in the expected direction for each treatment
condition, when assessed by a clinical expert in
cognitive–behavior therapy. Thus, our fidelity rating scale
analyses indicated that the four treatments arms were
distinct and were implemented as specified in the corresponding
treatment manuals for each condition.