Healthwise has a new "eBrief" out, called "Behavior Change: Improving Outcomes by Guiding People to Success". I'm just going to type up a bit about it here because I don't feel like creating a new thread.
https://pages.questexweb.com/rs/294-MQF-056/images/8386.pdf?aliId=5084751842
This document gives some background as to why Healthwise was so reluctant to abandon PACE behavioral interventions for ME/CFS. The belief that behavioral science tells us that chronic diseases are largely preventable/treatable by behavioral changes. It should also serve as a caution, as we are
well aware of the flaws in many behavioral studies.
Healthwise eBrief said:
Behavior change promises to be the most revolutionary movement in health care in the 21st century. It’s a personal process that belongs to every individual. Our job in health care is to simplify that process using the most effective practices and tools. Fortunately, there are more than 50 years of behavioral science that inform us about what works.
Best practices in behavioral science begins with listening to people, helping them identify personal motivators for change, and guiding them toward success experience—successes that create confidence in people tryingto achieve behavior change. Health coaches and care managers are most effective at following these best practices when they are embedded into their workflow. When behavioral science sits at coaches’ fingertips, your staff will become powerful change facilitators. This sets your organization ahead in achieving the Triple Aim of increasing satisfaction, lowering costs, and improving outcomes.
This eBrief shows what an uphill battle those with ME/CFS still have. This is a glimpse at the immediate future of medicine. A dramatic increase in behavioral treatments for chronic diseases, with a corresponding reduction in medical treatments.
Medicine believes it has solved the major bacterial and viral diseases. That what remains are chronic illnesses preventable/treatable by changing patient behavior.
We are in the position of proving to doctors that, unlike "heart disease, cancer, and COPD", ME/CFS is not caused by maladaptive behavior preventable/treatable by behavioral interventions (unless you want to call pacing a behavioral intervention). A full year after rejecting PACE, Healthwise still clung to the belief that graded exercise therapy (a behavioral treatment), must be appropriate for ME/CFS.
I'm not saying that changing behavior won't help many chronic diseases. Diabetes can certainly benefit from dietary changes. The danger is the misguided implication that all chronic diseases can be helped by behavioral changes. That ME/CFS might be improved by "motivational interviewing" or "change talk", which assumes the patient has the power to change their health. An ME/CFS patient can commit to increasing exercise (change talk), but that doesn't mean they can.
To behavioral medicine, patients are prevented from positive "Change Talk" by negative "Sustain Talk". But in the context of ME/CFS and exercise, "Sustain Talk" is not a lack of willingness to change, but a physical inability to do so. Do doctors understand this?
Sorry for the long ramble. But if you're like me and were wondering why some of your doctors are constantly pushing MECFS-inappropriate behavioral changes, and why some medical professionals firmly believe behavioral changes are preferable to/can replace actual medical treatment, this eBrief explains it all.
