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Editorial critical of NICE bias towards psychosocial interventions for psychosis/schizophrenia

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15,786
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Cheshire

Senior Member
Messages
1,129
NICE draws its recommendations on CBT based on 31 RCTs (N=3052) of CBT versus any type of control. Based on this and another review on CBT for (only) those at risk for psychosis, NICE recommends CBT for all people with schizophrenia or psychosis at all stages of the illness, including those at risk for psychosis.

Where's the UK Health System's obsession with CBT coming from? CBT The cure for everything!!!

Therefore absence of evidence for adverse effects of psychosocial interventions should not be taken as evidence of absence, as it has been tested less rigorously.

@Valentijn had a look at ms Bavinton and yes she's a good one! First thing I saw "I am interested in therapeutic approaches that get people better" Waooow, incredible!!! What a professional ethics.
 

A.B.

Senior Member
Messages
3,780
Where's the UK Health System's obsession with CBT coming from? CBT The cure for everything!!!

1. Psychological explanations are used to deny patients with certain conditions the care they need, because psychotherapy is supposedly cheap whereas the alternative is not (at least that's how it was sold to health care providers). It also sends a clear message to patients with certain conditions: that they are not welcome and should not seek treatment.

2. Because psychotherapy is not grounded in reality and has become a pseudo-scientific cult where the followers truly believe it works for everything (mainly because of inexcusably poor methodology which gives the impression of effectiveness even when there is none). It's easy to pretend CBT works for everything when success is measured by questionnaire answers and CBT is capable of changing subjective perceptions.

3. Because medicine is still fairly unscientific and influenced by Freudian thinking. Medicine uncritically accepts the unproven existence of psychogenic illness. Human behavior is to prefer bad answers rather than admitting that no answers exist.
 
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SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
"Bosses" hear what they want to hear:
cheap,
fawning,
reinforces their arrogance, prejudices and callousness
etc

So given the option of long term, difficult expensive strategies that work
vs
mental masturbation that doesn't work but sounds good to them, they ALWAYS go with the bullshit
this is why we've had lunatic wars, wars on drugs, bankers printing money to keep them in gravy etc

being a LEADER is hard, it means responsibility, being the SERVANT
so we get lots of bosses instead
 
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1,446
This is probably off topic of the original thread, but, as Jessica Bavington has been mentioned:

.
Jessica Bavington's bio from 2005 - (She is not still at Barts).

‘Jessica Bavinton is a Clinical Specialist Physiotherapist in CFS, working at
the fatigue service at St Bartholomew's Hospital.

She is also a qualified Human Givens Therapist, and uses this counselling/psychotherapy training to integrate her therapeutic practice using a biopsycosocial model.

She is currently co-ordinating a group known as the Therapy Action Group (TAG),
with the objective of disseminating key messages for the therapeutic
management of CFS to Physiotherapists and Occupational Therapists.

Jessica is also leading on Graded Exercise Therapy (GET) in the PACE trial, a major
research trial running over the next 5 years designed to compare GET,
Cognitive Behavioural Therapy and Adaptive Pacing Therapy.

She is an active member of the CFS Network Group, and works in partnership with patient organisations to provide accurate information for patients.’



~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~




Jessica Bavington also has a private company (with other Physio's Ot's) called 'Vitality 360' - private fatigue and pain training etc

Vitality360 is a team of specialists who work with:

  • Proactive Rehabilitation
  • Chronic Fatigue Syndrome / ME
  • Fatigue Management
  • Fibromyalgia
  • Chronic Pain
  • Persistent Physical Symptoms
  • Sleep Difficulties
  • Vocational rehabilitation
  • Long-term conditions
  • Anxiety & Depression

http://vitality360.co.uk/



http://vitality360.co.uk/fatigue-pain/about-us/our-team/
Jessica Bavinton
Founder Director Vitality360 Limited + Specialist Physiotherapist
BSc (Hons) Physiotherapy, MCSP, PVRA, HG (Dip), MBACME


'Jessica is a national therapy leader in the field of CFS/ME, pain and persistent physical symptoms and is respected for her contribution to research, NICE guideline development and teaching in NHS services nationwide. Her patients appreciate her empathetic, structured and empowering approach, whilst companies working with her appreciate her reliability, straight-forwardness and her clinical outcomes. She is a keen ice-cream maker and cyclist, and supports the development of visually impaired tennis in her spare time.'


.
 
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Cheshire

Senior Member
Messages
1,129
1. Psychological explanations are used to deny patients with certain conditions the care they need, because psychotherapy is supposedly cheap whereas the alternative is not (at least that's how it was sold to health care providers). It also sends a clear message to patients with certain conditions: that they are not welcome and should not seek treatment.

2. Because psychotherapy is not grounded in reality and has become a pseudo-scientific cult where the followers truly believe it works for everything (mainly because of inexcusably poor methodology which gives the impression of effectiveness even when there is none). It's easy to pretend CBT works for everything when success is measured by questionnaire answers and CBT is capable of changing subjective perceptions.

3. Because medicine is still fairly unscientific and influenced by Freudian thinking. Medicine uncritically accepts the unproven existence of psychogenic illness. Human behavior is to prefer bad answers rather than admitting that no answers exist.

I also think doctors feel terribly frustrated because they can't do a lot to help us improve, so ordering CBT and GET makes them feel like they were doing something...
 

biophile

Places I'd rather be.
Messages
8,977
http://onlinelibrary.wiley.com/doi/10.1002/psb.1195/pdf

In our view NICE CG178 promotes some psychosocial interventions, especially CBT, beyond the evidence. NICE CG178 also makes strong non evidence-based recommendations, for instance that the course of CBT should be at least 16 planned sessions. The guideline’s research recommendations also appear to reflect the interests of the authors. [...] NICE CG178 should be constrained by the limits of the available evidence and it is unfortunate that the guideline appears at times to reflect the interests of its authors rather than impartial up-to-date evidence.

Sound familiar?
 

ukxmrv

Senior Member
Messages
4,413
Location
London
I also think doctors feel terribly frustrated because they can't do a lot to help us improve, so ordering CBT and GET makes them feel like they were doing something...

Some of them do genuinely seem to believe it though. I used to be seen at this medical centre and all of the doctors that I met there were fully paid up members of the IAIYH brigade. Look at their website under psychological therapy as an example

"We offer cognitive behavioural therapy (CBT) as our primary treatment approach, as it has strong research evidence and is recommended by the Department of Health. There is a Psychological Wellbeing Practitioner and a CBT therapist working at the Marylebone Health Centre"

http://www.marylebonehealthcentre.co.uk/info.aspx?p=20