Does CBT or GET Therapy Reduce Disability in CFS? Objective Measures Are Necessary (Kewley, 2013)

[Dolphin]

Congratulations to Andrew Kewley on the publication of this paper (note: I had to shorten the title to get it to fit into the title of this thread)

http://onlinelibrary.wiley.com/doi/10.1111/cpsp.12042/abstract

Does Cognitive Behavioral Therapy or Graded Exercise Therapy Reduce Disability in Chronic Fatigue Syndrome Patients? Objective Measures Are Necessary
Commentary

Andrew James Kewley*

Article first published online: 16 SEP 2013

DOI: 10.1111/cpsp.12042

Clinical Psychology: Science and Practice

Volume 20, Issue 3, pages 321–322, September 2013

Author Information

Flinders University, SA
E-mail: kewl0001@flinders.edu.au.

Keywords:

actigraphy;
actometer;
chronic fatigue syndrome;
cognitive behavioral therapy;
disability;
graded exercise therapy;
myalgic encephalomyelitis;
neuropsychological testing

Clinical trials of cognitive behavioral therapy and graded exercise therapy have consistently demonstrated improvement in self-reported quality of life and improvement of symptoms.

However, due to the nature of these therapies, it is not possible to carry out a double-blinded trial design or fully control for reporting biases.

Therefore, to make strong claims about efficacy and reductions in disability, objective methods should be used such as neuropsychological testing, actigraphy, and repeat exercise testing.

 

[Esther12]

Did some sanity just slip into the literature on CBT and CFS? This feels so wrong.

 

[Sean]

Well done, Andrew.



(Don't worry, Esther, I'm sure the usual shabby insanity will shortly be resumed.)

 

[Marco]

In the wake of PACE I wrote a response to the Lancet (not published - shucks) that suggested that the PACE trial was not 'well-anchored'.

There's an established literature on the concept.

In short in most clinical (physiological) interventions you probably have a one or more objective measures (therapy given and physiological correlates) but its then desirable to have subjective responses from patients (reduced symptoms, overall QOL) to determine if physiological measures correlate with subjective well being.

As you are all painfully aware PACE starts and ends with subjective responses, which the therapy aims to manipulate, with no objective data to 'anchor' these data.

Impossible to infer anything from PACE.

 

[Dolphin]

In the wake of PACE I wrote a response to the Lancet (not published - shucks) that suggested that the PACE trial was not 'well-anchored'.

There's an established literature on the concept.

In short in most clinical (physiological) interventions you probably have a one or more objective measures (therapy given and physiological correlates) but its then desirable to have subjective responses from patients (reduced symptoms, overall QOL) to determine if physiological measures correlate with subjective well being.

As you are all painfully aware PACE starts and ends with subjective responses, which the therapy aims to manipulate, with no objective data to 'anchor' these data.

Impossible to infer anything from PACE.

The unpublished letter is here: http://forums.phoenixrising.me/inde...-not-accepted-by-the-lancet.9761/#post-178595 in case anyone is interested.

 

[Dolphin]

For Dutch speakers, Frank Twisk has done a piece on Andrew's commentary:
http://www.hetalternatief.org/CGT GET Onderzoek Methodiek Maatstaven 2013 1161.htm

 

[WillowJ]

excellent!