Professor & patients' paper on the solvable biological challenge of ME/CFS: reader-friendly version
Simon McGrath provides a patient-friendly version of a peer-reviewed paper which highlights some of the most promising biomedical research on ME/CFS ...
Discuss the article on the Forums.

Picariello, Chalder et al: "It feels sometimes like my house has burnt down,[...]"

Discussion in 'Latest ME/CFS Research' started by mango, Mar 30, 2017.

  1. mango

    mango Senior Member

    Messages:
    895
    Likes:
    4,858
    'It feels sometimes like my house has burnt down, but I can see the sky': A qualitative study exploring patients' views of cognitive behavioural therapy for chronic fatigue syndrome

    Picariello F
    1,2, Ali S2, Foubister C1,2, Chalder T2,3.

    Author information
    1. Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK.
    2. South London and Maudsley NHS Foundation Trust, London, UK.
    3. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
    Br J Health Psychol. 2017 Mar 28. doi: 10.1111/bjhp.12235. [Epub ahead of print]

    Abstract
    OBJECTIVES:
    Cognitive behavioural therapy (CBT) is currently a first-line treatment for chronic fatigue syndrome (CFS). Even though the results from trials are promising, there is variability in patient outcomes. The aim of this study was to explore the experiences of patients with CFS who undertook CBT at a specialist service for CFS.

    DESIGN:
    This was a qualitative study.

    METHODS:
    Thirteen patients with CFS, approaching the end of CBT, participated in semi-structured interviews. In addition, participants were asked to rate their satisfaction with CBT and perceived level of improvement. The data were analysed using inductive thematic analysis.

    RESULTS:
    The majority of participants were satisfied with treatment and reported marked improvements. This was evident from the ratings and corroborated by the qualitative data, yet recovery was in general incomplete. Participants often disclosed mixed feelings towards CBT prior to its start. Behavioural aspects of treatment were found useful, while participants were more ambivalent towards the cognitive aspects of treatment.

    The tailored nature of CBT and therapist contact were important components of treatment, which provided participants with support and validation. Engagement and motivation were crucial for participants to benefit from CBT, as well as the acceptance of a bio-psychosocial model of CFS. Illness beliefs around CFS were also discussed throughout the interviews, possibly impeding engagement with therapy.

    CONCLUSIONS:
    The results suggest that various factors may moderate the effectiveness of CBT, and a greater understanding of these factors may help to maximize benefits gained from CBT.

    Statement of contribution What is already known on this subject? CBT is effective in reducing CFS symptoms, but not all patients report marked improvements following treatment. Predictors of outcome have been explored in the literature. Few studies have looked at the experience of adult patients with CFS who have had CBT.

    What does this study add? Findings provide insights as to why variability in CBT-related improvements exists. Beliefs about CFS and CBT may shape engagement and consequently contribute to post-treatment outcomes. Flexibility and sensitivity are necessary from therapists throughout treatment to ensure full engagement.

    © 2017 The British Psychological Society.

    KEYWORDS:
    causal attributions; chronic fatigue syndrome; cognitive behavioural therapy; engagement; evaluation; fatigue; illness beliefs; intervention; myalgic encephalopathy; outcomes; psychotherapy; qualitative; thematic analysis

    https://www.ncbi.nlm.nih.gov/pubmed/28349621
     
    Hutan, Joh, Woolie and 1 other person like this.
  2. Marky90

    Marky90 Science breeds knowledge, opinion breeds ignorance

    Messages:
    1,156
    Likes:
    4,205
    Yeah, blame the patients for your valueless biased creations. Bunch of absolute knobheads, and that`s even an understatement.
     
    JaimeS, cfs6691, Mel9 and 27 others like this.
  3. trishrhymes

    trishrhymes Senior Member

    Messages:
    2,047
    Likes:
    16,471
    UK
    So what they found out is that it's important that patients believe in the BPS model so they will fill in the questionnaires in the way the researchers want them to and say they are feeling better.

    Whoopee-do!

    Come join our jolly BPS religion and we'll provide miraculous healing...

    Pass the sick bag.

    As for that wierd quote in the title - I can't decide if it's the patient or the researchers taking the piss.

    :vomit::vomit::vomit:
     
  4. A.B.

    A.B. Senior Member

    Messages:
    3,571
    Likes:
    21,665
    Possibly some poor patient feeling obliged to express deep feelings because that will surely help, said a certain Freud.
     
    JaimeS, suseq, sue la-la and 7 others like this.
  5. Effi

    Effi Senior Member

    Messages:
    1,491
    Likes:
    4,548
    Europe
    I wonder how they picked the 13 patients. Very selectively, I expect.

    The quote in the title is confusing. It could mean anything they want it to mean. Exactly like their studies, in fact.
     
    JaimeS, suseq, Hutan and 20 others like this.
  6. OverTheHills

    OverTheHills

    Messages:
    454
    Likes:
    938
    New Zealand
    I notice this is another adult study Trudy C has her name on. does anyone else get the feeling she is trying to build "credibilty" :aghhh::vomit::depressed::nervous::bang-head: In another area. Not content with torturing children, eyeing space left by Peter White departure etc.?
     
    JaimeS and MEMum like this.
  7. Invisible Woman

    Invisible Woman Senior Member

    Messages:
    1,018
    Likes:
    5,758

    Am I missing something or are you confusing her with Esther Crawley?

    Either way ... same cr@p different culprit!
     
  8. sarah darwins

    sarah darwins I told you I was ill

    Messages:
    2,415
    Likes:
    10,004
    Cornwall, UK
    Somebody is. Are they actually suggesting that there's a bright side to having your house burn down — it's really great for astronomy? I mean, what sort of emotionally tone deaf, bone-headed person would use that as the title for a paper about people whose lives have been wrecked by illness?
     
    TiredSam, Hutan, Mary and 15 others like this.
  9. arewenearlythereyet

    arewenearlythereyet Biscuit Antagonist

    Messages:
    1,289
    Likes:
    5,599
    Uk
    The really awful sort

    I have visions of them rounding up the 13 in a van that has driven up and down the country....."ok. Thirteen will have to do .....go go go!"

    I hope they removed the sacks from their heads before they forced them to fill in the questionnaire.
     
    MEMum, Woolie, Solstice and 6 others like this.
  10. OverTheHills

    OverTheHills

    Messages:
    454
    Likes:
    938
    New Zealand
    Quite likely , I do get them confused foggy brain. Ignore me, thankyou Invisible Woman glad someone is sharp.
     
    MEMum, trishrhymes, Solstice and 2 others like this.
  11. Starlight

    Starlight Senior Member

    Messages:
    115
    Likes:
    564
    It is unbelievable that these guys are still churning out this junk....it makes me want to scream. They have brass necks and tunnel vision. Will they ever ever go away and stop this junk.
     
    suseq, Mary, MEMum and 5 others like this.
  12. A.B.

    A.B. Senior Member

    Messages:
    3,571
    Likes:
    21,665
    Of course it matters what patients believe, because CBT is a placebo. All their work revolves around creating, optimizing, and documenting placebo effects, and then misrepresenting them as actual improvement in health rather than biased reporting.

    Just like a placebo is "effective at reducing asthma symptoms" if one relies on measures of health that are easily influenced by expectation, hope, etc.:

    [​IMG]
    That CBT doesn't lead to improvement in objective measures of health, for example these step test results from the PACE trial, strongly suggests that it's merely a placebo treatment:

    Chalder2015 fitness and legend.jpg
     

    Attached Files:

    Last edited: Mar 31, 2017
  13. Revel

    Revel Senior Member

    Messages:
    390
    Likes:
    2,271
    I was offered CBT by my doctor. I refused it on the grounds that I felt it would be a useless waste of time for me.

    My doctor's terse response? "Well, it won't work if you don't believe in it!".

    So, I have cast the notion of CBT aside, along with Santa Claus and the Tooth Fairy . . . :cautious:.
     
    Mel9, TiredSam, Snow Leopard and 26 others like this.
  14. user9876

    user9876 Senior Member

    Messages:
    2,414
    Likes:
    16,369
    I quite like the quote it is basically saying things are really bad but I'm trying to look on the bright side so I will fill out questionnaires with slightly better scores.

    I think that just about sums up CBT
     
  15. Solstice

    Solstice Senior Member

    Messages:
    567
    Likes:
    1,866
    [​IMG]
     
  16. Kina

    Kina Admin Support Staff

    Messages:
    10,042
    Likes:
    15,976
    Ontario, Canada
    METHODS:
    Thirteen patients with CFS (how were they chosen, based on what criteria)(13 is not even approaching statistical significance)

    approaching the end of CBT, participated in semi-structured interviews. (Semi- structured as in basically making shit up as you go along. Why not have them fill out a biased poorly designed questionnaire)

    I see they are still living the delusion that CBT is an effective treatment. If they have used the PACE trial as 'proof' of this then the research should be retracted as should the PACE trial. I wish we could see their reference list.

    There is are a few words missing from the Keyword list -- 'delusional bullshit'.

    What a stupid title for a research study and "patients' view" should be changed to "researchers' view"
    :bang-head::bang-head::bang-head::bang-head::bang-head::mad::mad::mad::mad::mad:
     
    TiredSam, suseq, Hutan and 18 others like this.
  17. Jonathan Edwards

    Jonathan Edwards Senior Member

    Messages:
    5,022
    Likes:
    29,142
    I actually thought when I first saw this thread title that this was a quote from what Chalder was feeling. Didn't someone say all this criticism was causing staff a bit of distress?
     
    Snow Leopard, suseq, PennyIA and 12 others like this.
  18. Sean

    Sean Senior Member

    Messages:
    3,181
    Likes:
    17,317
    In this field saturated with pointless, methodologically dodgy, pseudo-studies, this one is a strong contender for a medal.
     
    TiredSam, suseq, Hutan and 5 others like this.
  19. Chrisb

    Chrisb Senior Member

    Messages:
    955
    Likes:
    4,346
    Does this prove that there are just too many journals looking to fill space, no matter how? The economics of that industry must be worthy of study.
     
    SamanthaJ, Mary, Orla and 4 others like this.
  20. Santilion

    Santilion

    Messages:
    10
    Likes:
    9
    The CFS definition is quite broad, often misunderstood and could allude to a list of conditions of an almost astronomical number. One can wonder what underlying diagnosis they are refering to in the study.

    To name a few: AIDS, MS, anemia, congestive heart failure, bronchitis, hypoglycemia, anorexia nervosa, cancer, hypothyroidism, depression, bubonic plague, congestive cardiomypathy, emphysema, ME, diabetes, vitamine deficiency, chronic kidney disease and so on..

    I could see why their treatment would help those with depression at least, but the rest?
     

See more popular forum discussions.

Share This Page