(2001) Effect of Dr-recommended treatment on mental health practitioners' attributns

[Dolphin]

This isn't new but I thought it was interesting. I've often heard it said that CBT shouldn't have negative connotations and patients shouldn't make that point but that's not the way professionals think!

http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=2001-00865-005&CFID=6958449

Effect of physician-recommended treatment on mental health practitioners' attributions for chronic fatigue syndrome.

By Taylor, Renee R.; Jason, Leonard A.; Kennedy, Cara L.; Friedberg, Fred

Rehabilitation Psychology. Vol 46(2), May 2001, 165-177.

Abstract

Objective: To evaluate whether differing treatment recommendations for chronic fatigue syndrome (CFS) by physicians influence attributions about CFS among mental health practitioners.

Participants and Study Design: 93 mental health practitioners were randomly assigned to 1 of 3 conditions. All groups read the same case study of a person diagnosed with CFS, with the only difference between groups being the type of treatment recommended by a physician. The treatment conditions included a drug trial (Ampligen) or 1 of 2 differing psychotherapy approaches, cognitivebehavior therapy with graded activity or cognitive coping skills therapy.

Results: Ss in the 3 groups did not differ with respect to their prior familiarity with CFS. Ss who read the case study proposing treatment with Ampligen were more likely to report that the patient was correctly diagnosed and more likely to perceive the patient as disabled than those whose case study described cognitivebehavioral therapy with graded activity as the treatment.

Conclusion: Results of this investigation support the hypothesis that physician recommendations for CFS treatment can influence subsequent attributions about a patient's illness among mental health practitioners.

(PsycINFO Database Record (c) 2009 APA, all rights reserved)

 

[garcia]

This would be a good article to have in the library, and a good article to show doctors as ammunition against CBT/Graded exercise.

 

[Dolphin]

I've read the full paper now.
What I've found with at least some Lenny Jason papers is that he doesn't tend to mention values where the p-value is over 0.05. I think this can be unfortunate.

There were two values where there were trends (i.e. didn't quite meet the p<0.05 threshold):

Likelihood that it will improve in the next two years: p=.07.
The group who had been shown a case study with CBT were more likely to believe this compared to the Ampligen group and the Cognitive coping groups. (pacing/energy management-type).

---
Factors responsible for the illness: p=.06

There were two additional qualitative questions assessing: what respondents considered as the cause of the illness, and how respondents thought a medical doctor might treat the illness. For both questions, all responses were independently coded by the first and third authors into two dichotomous categories: (1) psychiatric or (2) medical.
Inter-rater reliability for the coding of responses into either psychiatric or medical categories was 100% for both questions. The psychiatric category included only responses that considered etiology and/or interventions as psychiatric, psychological, or psychosocial. The medical category included responses that considered etiology and/or interventions as medical. In cases where both medical- and psychiatric-types of responses were provided, all respondents listed medical responses first, and as such, all mixed responses were coded as medical.

The percentages were:
Medical: 76.5% (Ampligen); 52.4% (CBT); 80.3*% (Cognitive coping)
Psychiatric: 23.5% (Ampligen); 47.6% (CBT); 16.7*% (Cognitive coping)
(these two numbers don't match up - I'm guessing one is 3% out)

 

[Esther12]

Thanks for pointing this out/your thoughts. I think I may have half read this myself some time ago (maybe just the abstract?), and then jumbled up what it actually said. Bookmarked for more thorough reading later (do you think it's worth reading? If not, I might skip).

 

[Dolphin]

Thanks for pointing this out/your thoughts. I think I may have half read this myself some time ago (maybe just the abstract?), and then jumbled up what it actually said. Bookmarked for more thorough reading later (do you think it's worth reading? If not, I might skip).

It is a piece that is relatively easy to understand compared to some more biological pieces (for those of us who didn't do biological science degrees), so that's a plus. Not too much focus on statistical calculations which might frustrate some. It's a sympathetic piece. And it talks about the problems about stigma for people with chronic fatigue syndrome. And references other papers from the 1990s that wouldn't get mentioned much now. So it might be something that might be of use to you or somebody interested in that angle at some stage. But of course a lot of the points made could probably have been guessed anyway. So depends if somebody wants to spend an hour or whatever reading it.

 

[WillowJ]

very interesting, thanks for posting about this