ME/CFS and the biopsychosocial model: a review of patient harm and distress in the medical encounter - Geraghty et al. 2018

Yes, it's as if SW, MS, et al have this way of hijacking the names of things that make sense, and then corrupting them to a nonsensical form of their own manipulative choosing ... but still use the same name. CBT, BPS, etc. A bit like the way invaders throughout history have superimposed their own ceremonies and festivals onto those pre-existing ones of indigenous populations, so the subterfuge is less obvious. And in more modern times when a company is bought out, and a brand name is perpetuated even though the product is by then completely different. This has invariably been a conscious strategy, and I'm sure with SW/MS/etc it is the same.

 

The ME Association has written a summary of the paper.

Direct link to summary.

 

I think the main problem with models like these (which others have basically already pointed out, and this paper demonstrates) is that they allow everyone to make assumptions, explicit or not so explicit, about the conditions and the sufferers that go much further than what evidence actually shows. Categories like functional disorders and the biopsychosocial framework are almost true by their definitions (ie. unexplained illness or biological and psychological factors both being relevant - like almost everything), but many assumptions and implications are attached to the use of them which aren't properly supported. It's difficult to stop their use though, because the models are true by their definitions.

 

I think Tina displays all the cognitive dissonance of a CFS/ME clinic!

 

I'm not aware of any model of disability that denies that humans are more than a set of symptoms, have a mind, live in a specific environment etc. The problem with the biopsychosocial model is that it seems to encourage doctors, OTs, etc to imagine that they are able to understand how all these factors should be taken into account in the way that their patients are treated, when very often they're acting on nothing more than a series of hunches and prejudices that would be best put to one side. If medical staff were all perfect, the biopsychosocial model might very well be a good thing, but as things are, attempts to adopt a biopsychosical model often do more harm than good.

 

No they don't. Unless the patient specifically requests it. Even then the things on offer should be based on informed consent and should be objectively evidenced based. The problem with state employees in certain capacities is that they use appeal to authority and even assume a authority over the patient whilst pretending it's a "joint patient/therapist" relationship. Even if the whole model is moronic there will be numbers of people who just accept it in blind faith.

It is the fault of the model because the model is designed as a brand so that repeaters like her think it has some objective value. She is proving that very point by her own words.

Just throw out the bath water keep the baby that's the whole point. The bathwater is the garbage BPS model of collecting tick box questions designed to make ones service appear to be doing something objective.

Bollocks! Shows how much she knows about the objective facts of GET and CBT in ME.

If writing to employers to ask for a better chair or coming out to your house to permit you a handrail near your toilet is the extent of occupational therapy it shows what gobshite it actually is. You might even find doctors blocking such things on the grounds of denial of the biological in ME.

This holistic model nonsense is more likely to end up as state control gatekeeping over what you can and cannot be granted when the logistics of what a given person needs is common bloody sense. Why should people have to go cap in hand to "occupational therapists" to be adjudicated over by the state gatekeepers who at best provide common bloody sense but at worst can impose regimes on people that make them worse because of their ignorance.

Why not just have a biohomeofaithreiki BHFR model and then just say, lets not throw out the baby with the bathwater.

Seems to me this is like saying lets chuck out bad homeopaths/faith healers/reiki masters and only keep the good ones.

Pseudoscience is pseudoscience there's no good pseudoscience.

People can choose all sorts of things with their own will with informed consent but garbage should not be part of the public health policy model.

 

https://twitter.com/user/status/1019331168632745984

 

https://twitter.com/user/status/1019333319933284352

 

https://twitter.com/user/status/1019343672733831168

 

Tina, how would you describe your approach? Perhaps you consider it important not just to address the medical needs of the patient, but also their social and physical environment - for example, educating their families on how they can support their loved ones, and offering advice on physical modifications to the home environment that may make their lives easier?

If your approach is something like this - an integrated approach - then say that. Just don't use the word "biopsychosocial" as it means so many different things to different people - and in ME/CFS, it is used to provide cover for a whole host of harmful practices.

I think the label "biopsychosocial" should be banned, and all practitioners should be encouraged to state what their approach is in words.

 

In case you missed it, the comment was posted on the ME Association website. You could post your comment there also.

 

Thanks, Tom. I figured she'd find her way here.

 

https://twitter.com/user/status/1019364518470791170

 

There's only correct medical advice or incorrect medical advice.

Biopsychosocial is just a bollocks word, it allows any claim to be made without that claim needing to be falsified.

The other favourite word from this kind of nonsense is "multidisciplinary". Which just means referring on, ignoring and dumping and lumping together.

It's not scientific and it impairs scientific development.

 

I am a registered nurse and when I was trained we learned about the bio-psycho-social model of care. I believe it is thought across all allied health care fields.

i believe there is a time to address ‘bio-psycho-social’ dimensions, usually it is when the patient asks for it. The medical and physical needs always come first.

There has been trends as of late for physicians to address psycho-social needs, coming from accreditation agencies, so I hear. Also my government has given a lot of money as of late for mental health, and I believe it is the trend in the UK as well.

In the context of our disease, I find addressing psycho-social needs first instead of performing testing to find out what the heck is wrong, or planning research or clinical trial, is an insult and complete disregard of what is most needed, competent medical care, mere curiosity from physicians to find out what is going wrong in each of us. Instead we are being hearded in group therapy to learn about grieving and managing our symptoms, and to get education about central sensitization.

Governments, socialized health care systems, and insurance companies know that by not addressing a disease at a medical level, they are saving themselves billions of dollars. They can simply do symptom management and call this health care.

While addressing psycho-social needs is important (and I will include access to disability insurance and social benefits in this category), it is usually not on the top of the priority list when someone presents with ME. Just like someone with a stomach ulcer does not need to see a psychologist as first intervention.

Then this begs the question: what do you need and how do you want to be treated?