Jo Daniels (on CBT, ME/CFS and Long Covid)

Long Covid: what teachers and pupils need to know

https://www.tes.com/news/long-covid-what-teachers-and-pupils-need-know


(Split thread:
Jo Daniels is quoted, defending CBT for ME/CFS and for Longcovid. Her quotes come towards the end of the article.)

 

Jo Daniels mis-representing CBT for ME again @dave30th

 

The claim skirts the issue, each point is more or less correct, but the implications are not. The author did not state the implications, surely its not their fault if people misinterpret the statements? I have to wonder if this is deliberate or simply lack of awareness? My suspicion is its carefully done.

In either case its worth noting the shift to the classic view of CBT, which is different from CBT in the PACE trial.

 

From Daniels:
“The point of CBT is to improve quality of life and reduce psychological distress. The main focus isn’t to ameliorate physical health symptoms, although this is a common misunderstanding. We do see improvements in symptoms, but this is not the primary target.”

She believes CBT may be a useful treatment for symptoms associated with long Covid, too.

At least things have got to a point where CBT enthusiasts have to go through this sort of intellectual contortion to justify their recommendations.

It isn't really for symptoms but it might help - and of course it might help them in Long Covid too. This is really solid evidence-based thinking.

 

I think it's motte-and-bailey fallacy.

The motte-and-bailey fallacy (named after the motte-and-bailey castle) is a form of argument and an informal fallacy where an arguer conflates two positions which share similarities, one modest and easy to defend (the "motte") and one much more controversial (the "bailey").[1] The arguer advances the controversial position, but when challenged, they insist that they are only advancing the more modest position.[2][3] Upon retreating to the motte, the arguer can claim that the bailey has not been refuted (because the critic refused to attack the motte)[1] or that the critic is unreasonable (by equating an attack on the bailey with an attack on the motte).

https://en.wikipedia.org/wiki/Motte-and-bailey_fallacy

When they promote CBT for MUS/CFS/etc to the broader public or when debating critics, they present it as similar to supportive counseling (goal is reduce distress, not cure patients). They can then claim that the critics are unreasonable or misunderstand the therapy. Who could possible disagree with giving patients in distress access to therapist to talk about their situation?

When they promote it other medics and policy makers and publish in journals, they make these absurd claims of CBT targeting the causes of the illness and leading to improvement in the illness and even recovery.

It's obvious what they really believe. They're feigning innocent and reasonable views so they can better deliver their harmful and unreasonable views.

 

I think I'd prefer to try another approach, that isn't really for symptoms, but might help me feel better.

Instead of a course of CBT, can I have cash? A few million should be enough to see if it has a measurable effect on my short, medium, and long term sense of well being.

 

I was wondering too about this formidable evidence base for CBT for Everyotherchronicconditionknowntoman. Surely if it is not for symptoms the outcome measure must just be 'did the nice therapist make you feel happier?' administered as a questionnaire by the nice therapist. Not even any objectively measurable things to forget to measure (or decide not to measure after all) here. And not very blinded.

I am also wondering, though, because I suffer from a chronic condition characterised by persistent pain in more than three places, fatigue, poor sleep, tinnitus, poor vision, difficulty getting up off the floor if I fall over, inability to remember things or concentrate for very long and so on. I suspect about 25% of the population also have this. It is called getting older. Surely CBT would help me understand that all these things are really just unhelpful thoughts of mine. It would save me going to the GP when I get cancer and stuff like that.

 

If they gave us all a couple of million and we donated half to research we could solve the problem.

 

That's the study I want to see, and be in.

One thing having ME has taught me is that social interaction (and I include politics in that) is a huge part of what human brains are set up to do. Even the most enjoyable socialising is very draining for me.

 

Bits of this were hilariously funny --- some not so! Thank you very much for summarising it so accurately.

 

"“Psychological therapy is useful for a range of medical conditions, with a strong underpinning evidence-base supporting its use."

This is classic Doublespeak! Misleading. Me thinks she is a politician

Yes, psychological therapy is used for a range of medical conditions - but it is not used to try and cure them - that is a massive difference between Wessely School CBT and what goes on in supportive psychological care (can be CBT based) for, for example, pwCancer, Heart Disease etc who are distressed. Also, people with such diseases are not having CBT foisted upon them ALL. pwME/CFS are, which is offensive to some - understandably so. Many patients are managing incredibly well and are highly resilient people in the face of enormous debility, suffering and so forth. Undermining that is not helpful

 

"The main focus isn’t to ameliorate physical health symptoms, although this is a common misunderstanding."

That is a complete misunderstanding of what Wessely School (WS) aimed to do and what has been foisted on my pwME/CFS. WS aimed to cure patients. Period. That is their model. To pretend this did not happen is to erase history. The history needs to be approached, examined, cast aside and then patients can move on. Ignoring this because it might feel uncomfortable or difficult is not helpful.

 

That's good

 

hmm
Recovery from chronic fatigue syndrome after treatments given in the PACE trial
https://pubmed.ncbi.nlm.nih.gov/23363640/

 

"Dr Daniels has recently been appointed to co-chair of the British Association of Behavioural and Cognitive Psychotherapy Scientific Committee, following several years of advisory roles on national and international editorial boards and scientific committees. Dr Daniels is committed to evidence-based approaches to the management of distress and destigmatisation of mental health in healthcare. "

https://www.som.org.uk/events?page=1