Surprisingly, of the 17 clinics that provided data on harms, all reported that no harms had occurred in their clinics in the year-long period that we’d asked about. But surveys done by ME charities show that large numbers of patients report deteriorating after CBT and GET – and so do the clinics’ own data, according to a recent study conducted by Simon Collin and Esther Crawley:
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-017-2437-3
So this claim by the clinics in our survey that no harms occurred seems a bit optimistic. Why the mismatch?
One possibility may lie in the fact that, in every one of the few clinics that were able to report their drop-out figures to us, all had patients who dropped out of the therapies for unknown reasons. How many of these patients could have been harmed by CBT or GET but found it easier to drop out than to report it? In addition, a number of clinics reported tailoring each patient’s treatment individually, and we do not know whether a patient would be counted as a dropout if they felt worse on GET and chose to stop it but continued to see the therapist as part of their individualised therapy.
Also, no clinic reported telling patients explicitly that they could be worse after their course of therapy than before. This raises doubts as to whether many clinics are even on the lookout for adverse side-effects to their therapies, and whether patients feel able to raise such concerns. Indeed one booklet on GET advised, “If GET is correctly undertaken it will not harm you.” Patients might take that to imply that if they are harmed by GET, it’s the patient’s fault for doing it incorrectly – making it less likely that a patient will report the harm.
