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IAPT - Improving Access to Psychological Therapies - manages CG53!!

Discussion in 'General ME/CFS Discussion' started by Keela Too, Jul 24, 2017.

  1. Keela Too

    Keela Too Sally Burch

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    Mary Dimmock tweeted this yesterday. Did anyone else know this? I didn't. No wonder we are making no progress with the CG53 guideline. No wonder there is a psycho-social, behavioural bias!

    Duh.. just realised.. it's IAPT - Improving Access to Psychological Therapies - not "increasing" as I first put in the title. Duh.

     
    Last edited: Jul 24, 2017
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  2. alex3619

    alex3619 Senior Member

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    A psych organization developing NICE guidelines for CFS and ME?
     
  3. Barry53

    Barry53 Senior Member

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    "Liked" as liking for posting, but horrified by content.
     
  4. Hutan

    Hutan Senior Member

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    I don't think IAPT is managing the guidance for CFS. I think it is just that CFS is one of the conditions covered by the Improving Access to Psychological Therapies project.

    In which case, the list of NICE guidances given on the page is just provided as helpful information. I hope so anyway.


    (i.e. NICE guidances for 'conditions <that are> managed by IAPT')
    Regardless, having IAPT address CFS/ME is so wrong (and a waste of money).
     
    Last edited: Jul 24, 2017
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  5. alex3619

    alex3619 Senior Member

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    IAPT is within the NICE organization if I am interpreting the NICE logo correctly. So management of the guidelines is within a psych suborganization. That proves nothing but implies a lot.
     
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  6. Keela Too

    Keela Too Sally Burch

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    Ah @Hutan I see now how the page could be read that way. It's a strange one certainly.

    Edit to add: Yet they do say "managed" by IAPT, not that they provide complementary services towards the management of....
     
  7. alex3619

    alex3619 Senior Member

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    The question is to what extent IAPT are just using NICE guidelines, and to what extent are they influencing NICE guidelines?
     
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  8. Jonathan Edwards

    Jonathan Edwards Senior Member

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    In theory that may be the case. However, the more I see of this the more it seems to me that one has to conclude that there is a commercial marketing programme for therapist-delivered treatments heavily influencing NICE policy, which is treated quite differently from 'commercial pharma'. Would an 'Increasing Access to Drug Therapies' outfit be welcomed by NICE?
     
  9. alex3619

    alex3619 Senior Member

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    Just to highlight what we expect from their guidelines, the advice for SEVERE ME includes -

     
  10. Jonathan Edwards

    Jonathan Edwards Senior Member

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    Looking at the sites a bit more it seems that IAPT is some sort of policy unit within the NHS and IS managing NICE guidelines for ME. Effectively it is part of the NICE machinery. But I am pretty sure it also involves commercial interests, even if those are disguised as academic units making money out of training people in non-validated techniques. I think things are as bad as it looks.

    The whole problem, as I see it here, is that as long as peer review and validation is kept within psychological medicine there will be nodding through of therapies without any hard evidence. The NHS has been persuaded that therapists are cheap and so they are happy to buy in services.
     
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  11. Jonathan Edwards

    Jonathan Edwards Senior Member

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    "People with severe CFS/ME should be offered an individually tailored activity management programme (see recommendation 1.6.2.22) as the core therapeutic strategy, which may:
    • be delivered at home, or using telephone or email if appropriate
    • incorporate the elements of recommendation 1.6.2.22 and draw on the principles of CBT and GET (see recommendations 1.6.2.1–21)."
    This is a travesty of evidenced based recommendation. You do not recommend drug therapies 'drawing on the principles of clinical pharmacology'. You test specific regimens and publish evidence for their validity. Nobody knows if 'principles' of CBT and GET have anything to do with any efficacy of those treatments - especially when we have no such evidence of efficacy and nobody can agree what the principles really are.

    How on earth are we going to know that an email system that draws on principles is effective?
    How come if a digital system is being advocated that a book out of the library is not just as good?
    I have a suspicion the therapists may be marketing themselves out of business soon. After all, there is no evidence that the results of PACE cannot be obtained with robots.
     
  12. Jenny TipsforME

    Jenny TipsforME Senior Member

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    This is heart sinking :(
     
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  13. Jenny TipsforME

    Jenny TipsforME Senior Member

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    Perhaps perhaps they will be happy to be convinced that troublesome CG53 is misplaced under IAPT and will be keen to move us onto another department?!
     
  14. user9876

    user9876 Senior Member

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    But if NICE accept this approach in one area then perhaps the drug companies will argue that is is sufficient in other areas. Hence the drug companies could start arguing that NICE should accept the drug therapies that are 'drawing on the principles of clinical pharmacology'.
     
  15. Jonathan Edwards

    Jonathan Edwards Senior Member

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    But the drug companies are 'them' not 'us'. Simple human nature is capable of baulking such logical suggestions!
     
  16. Valentijn

    Valentijn The Diabolic Logic

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    Probably, if it were both sufficiently cheap and had an integrated mechanism for ignoring patients who say it isn't effective.
     
  17. MEMum

    MEMum Senior Member

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    @charles shepherd do you know about this?
    Can someone ?@Jonathan Edwards contact him directly
    This makes a complete mockery of any Guideline Review.
     
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  18. MEMum

    MEMum Senior Member

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    I have posted some info to MEA Facebook page.
     
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  19. lansbergen

    lansbergen Senior Member

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    :thumbsup:
     
  20. user9876

    user9876 Senior Member

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    One of the early AI experiments involved a psychotherapy program Eliza
    https://en.wikipedia.org/wiki/ELIZA
    and that was from 1966
     

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