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A 4-day mindfulness-based cognitive behavioural intervention program for CFS/ME. An open study, with one-year follow-up, 2018, Stubhaug et al

Discussion in 'PsychoSocial ME/CFS Research' started by JaimeS, Dec 14, 2018.

  1. NelliePledge

    NelliePledge Senior Member (Voting Rights)

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    Nice one
     
  2. ScottTriGuy

    ScottTriGuy Senior Member (Voting Rights)

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    I can't seem to access that particular page to extract the quote.

    Was any one else able to locate it?
     
  3. Sean

    Sean Senior Member (Voting Rights)

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    This is exactly the sort of person we need to get onto the scent.

    People that Wessely et al can't so easily dismiss or ignore.
     
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  4. chrisb

    chrisb Senior Member (Voting Rights)

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    The full paragraph reads:

    Planning therapy

    It is useful at this point to consider how much treatment the patient needs. Some patients find the initial formulation not only acceptable but a revelation. They may immediately start making suggestions about how they could change their attitudes, behaviour, and lifestyle in a way that will unlock them from the vicious circles they now perceive. These patients may only need encouragement and follow-up to check that they remain on course. I have known patients who have recovered after a single telephone conversation that enabled them to reconceptualise their illness, reduce their fear of symptoms, and overcome their avoidance.

    It may be helpful and fair to continue with continue with the description of more intractable cases

    The difficulties of other patients are so long standing and rooted in intractable social or personality difficulties that brief cognitive behaviour therapy may be appropriate. For these patients, one strategy is to manage them within a cognitive behavioural framework but to do so in a "slow motion" way, seeing them intermittently for months or even years.

    Most of the patients will fall into a middle group. These are patients who had a good pre-morbid functioning, but who need help in re-evaluating their understanding of the illness, improving their coping behaviour, and perhaps also making occupational, social and lifestyle changes. This is the group we will focus on in the following account of therapy.

    It is surprising that the alleged success with the first group does not lead to any doubt as to the categorisation or diagnosis. It is also surprising that the possibility of unrecognised illness is considered in the difficult cases. Social and personality deficiencies is the only show in town.
     
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  5. Kalliope

    Kalliope Senior Member (Voting Rights)

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  6. inox

    inox Senior Member (Voting Rights)

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    Isn't this basicly LP? "Stop 'doing' ME" and ingrain in people that their attitude will be determinent in their chance of recovery.

    Then ask people about how they feel and what they think about the intervention - guess what they will answer....? Oh - and also, in LP-style, make sure to beforehand exclude anyone that don't belive in the treatment .

    Add only subjectiv measurements in an unblinded trial, the bias of the main author also beeing the main (only?) therapist, the COI of the main author owning the center offering the treatment. /sigh.... :-/
     
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  7. Kalliope

    Kalliope Senior Member (Voting Rights)

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    I've never considered going myself, but I've talked to a few who have been there. Apparently Stubhaug is an opponent to Lightning Process (TM), but the biggest LP-coach and Recovery Norge on the other hand seems to be very enthusiastic over him. I think the main difference is that Stubhaug's programme is free for patients (but not for tax payers).

    Another anecdote about Stubhaug is he claims that all fatigue is the same, and ME is just a down period. According to Stubhaug one can have ME for instance in a marriage :confused:

    Edited for clarity.
     
    Last edited: Jan 10, 2019
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  8. strategist

    strategist Senior Member (Voting Rights)

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    They lack the ability to distinguish between having an illness and having emotional difficulties.
     
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  9. Kalliope

    Kalliope Senior Member (Voting Rights)

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    I believe you just summarised psychiatry..
     
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  10. Trish

    Trish Committee Member

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    When I told a doctor my marriage had ended they said I would recover from my ME as a result. If only.
     
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  11. Kalliope

    Kalliope Senior Member (Voting Rights)

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  12. chrisb

    chrisb Senior Member (Voting Rights)

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    That indicates the success of the Oxford Criteria. They are doing what they were designed to do.
     
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  13. Kalliope

    Kalliope Senior Member (Voting Rights)

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  14. rvallee

    rvallee Senior Member (Voting Rights)

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    LEVIOSAAA!

    Literally wishful thinking

    What does that even mean? Is this like chakra realignment or immune system modulation through crystallography optimization?

    Fatigue? That's ME. Coughing on a hairball? That's ME. Brain freeze from eating ice cream too fast? That's definitely ME.
     
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  15. Kalliope

    Kalliope Senior Member (Voting Rights)

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    Helse Fonna Fonna is a local health trust which Stubhaug has a contract with. All patients with suspected ME in this area will be referred to him (if I've understood things correctly). Patients from other areas can come too. There's an ongoing debate about their article on Stubhaug' publication on their Facebook page. This is what they wrote today when trying to answer some of the questions asked about Stubhaug and his study (translated mainly by google):

    • The diagnosis of CFS / ME may be given after it is excluded that the patient may have other diseases as an explanation for the symptoms. The Norwegian Directorate of Health's national guideline for CFS / ME has no requirement that neurologists should diagnose or diagnose patients in this group. The guideline points out that assessment and diagnosis take place at the GP. Psychiatry is a medical education, so it is not contrary to the guideline that a psychiatrist is responsible for the assessment and treatment of this patient group.

    • Patients in Health Fonna with symptoms of CFS / ME may be referred to the Clinic for Stress Medicine for assessment and treatment. Patients are therefore referred from GPs and hospital doctors. Patients from other enterprises in Helse Vest can also be referred to the clinic. This treatment is part of the Norwegian public health system.

    • The study that has been published was carried out during the period 2009-2013. After this, the Norwegian Directorate of Health has recommended that Canadian criteria be used to diagnose CFS / ME, but the Directorate emphasizes that there is no research-related evidence to say that one of the diagnostic criteria is better than others to identify patients with specific "only organic" disease. There are also several publications that show that there are no biological differences between those that satisfy stricter criteria and those that do not. Obviously, we are following research on CFS / ME closely and will carry out knowledge-based dissemination and treatment in line with national guideline. The article is critically evaluated by international peers who believe the study meets the requirements for good research and that the article is good and well worth publishing.
     
    Last edited: Jan 10, 2019
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  16. Andy

    Andy Committee Member

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    Really? Would be interesting to find out what references they give for that claim.
     
  17. Esther12

    Esther12 Senior Member (Voting Rights)

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    I'd assume that they're referring to this, from Larun & co of the piss-poor Cochrane exercise review: https://bmjopen.bmj.com/content/4/2/e003973

    I have seen criticism of the above paper, but I can't remember the details.
     
  18. inox

    inox Senior Member (Voting Rights)

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    It's our local bps-brigade in action :sick:

    Here's the current national guidelines (last updated 2015), only available in norwegian and pdf-format, :
    https://helsedirektoratet.no/Lists/...944-Nasjonal-Veileder-CFS-ME-Hovedversjon.pdf

    Here's the bit they are refeering to - page 14-15 (via google translate):

    Edit: "Kunnskapssenteret" = Norwegian Institute of Public Health, also the home of Cochrane Norway.

    [bolding and line break mine]
     
    Last edited: Jan 10, 2019
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  19. inox

    inox Senior Member (Voting Rights)

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    Thought there was a thred on phonix rising, that I always ment to read, but never got around to - couldn't find it now.

    Also this: http://occupyme.net/2014/03/06/systematic-overreaching/


    Edit:
    The Brurberg, Larun paper contains among other gems this quote, (no wonder the feeling of bias in the Cochrane reviews.....):

     
    Last edited: Jan 10, 2019
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  20. Snowdrop

    Snowdrop Senior Member (Voting Rights)

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