Countrygirl
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Trial By Error: NICE Draft Rejects GET, Lightning Process, and CBT-As-Cure
10 NOVEMBER 2020
https://www.virology.ws/2020/11/10/..._2XOFX0Eh3Lnvs-zglOjd3NsghN-x7XC5PTyaZVhKtpo4
By David Tuller, DrPH
10 NOVEMBER 2020
https://www.virology.ws/2020/11/10/..._2XOFX0Eh3Lnvs-zglOjd3NsghN-x7XC5PTyaZVhKtpo4
By David Tuller, DrPH
Not surprisingly, the Science Media Centre has rounded up some of the leading lights of the biopsychosocial ideological brigades to offer comment—Professor Sir Simon Wessely, Professor Michael Sharpe, Professor Trudie Chalder, Professor Alastair Miller and Professor Peter White. I’m not going to bother quoting any of their comments here. They bleat in protest at the content of the draft, once more citing their flawed body of research. .The draft of the new ME/CFS guidance from the UK’s National Institute for Health and Care Excellence is out–posted just after midnight, London time, on Tuesday, November 10. This is the headline: The draft represents a repudiation of the GET/CBT paradigm and the deconditioning hypothesis.
Here are key take-aways:
*Graded exercise therapy, other interventions based on the assumption that deconditioning plays a causal role, and the Lightning Process are explicitly NOT recommended.—they fall under a “do not offer” category.
*Cognitive behavior therapy as a cure or as a treatment for the illness itself is explicitly NOT recommended.
These positions have nuances. While GET is disavowed, the draft provides guidelines for physical maintenance and physical activity programs. While CBT-as-cure is out, the draft includes guidelines for providing CBT as adjunctive care for patients seeking psychological support and/or help managing their symptoms.
Many will object to some language and phrasing or find it to be ambiguous. Others will argue that proponents of GET and PACE-type CBT could cite passages selectively in an effort to bolster their claims. Certainly stakeholders on all sides will deconstruct the draft and submit their comments over the next six weeks. I’ll certainly write more about the draft and subsequent developments in the next few months.