NHS: The Improving Access to Psychological Therapies Manual, June 2018

That is useful. I think that what I was trying to show is that this problem was known to the creators of this whole house of cards, and should not now come as surprise.

 

I think part of the problem is the questionnaires that always get used. They claim to be measuring certain aspects of 'fatigue', but psychologists interpret some answers as signs of depression.

I think it's probably also the case that a person may have one or two symptoms that overlap with a mood disorder, and researchers (lazily) assume this means they have a full mood disorder. It's like how Crawley now uses the symptom of 'chronic disabling fatigue' to stand in for CFS in her studies.

 

Oops! Our posts crossed. This, too. HADS is a problem, as is the Chalder Fatigue Scale and similar questionnaires which supposedly capture 'mental' fatigue as well as physical fatigue.

 

At least the use of these questionnaires provides an answer to the old conundrum: is medicine an art or a science?

Now it often seems to be neither.

 

I've pulled up these links from the big MUS, PPS and IAPT thread on another platform:

https://forums.phoenixrising.me/ind...pening-across-the-uk.48710/page-6#post-802239


Some of these "early implementer" sites had included development of services for CFS and ME:

https://www.england.nhs.uk/mental-health/adults/iapt/mus/


"Call to bid" document from December 2016 included bids for developing services for MUS, LTCs, IBS and CFS.

https://www.england.nhs.uk/wp-content/uploads/2016/12/mental-health-call-to-bid.pdf

Page 3:




https://www.ncbi.nlm.nih.gov/books/NBK83456/

6.1.1. Definitions of low-intensity interventions
Although there is no agreed definition on exactly what constitutes a low-intensity intervention they share several common characteristics. Low-intensity interventions use fewer resources (virtually none in the case of non-facilitated self-help) in terms of healthcare professional time than conventional psychological therapies. However the interventions are not necessarily less intensive (for example, the time taken to go through the self-help materials) for the individuals using them. These interventions are often delivered and/or supported by mental health workers without formal mental health professional training, who have been specifically trained to deliver low-intensity interventions (including primary care graduate mental health workers and psychological wellbeing practitioners).


https://www.healthcareers.nhs.uk/ex...ical-therapies/roles/high-intensity-therapist

High-intensity therapists

 

What the heck is one of those?

Is this my dog's new job title?

 

If only you had...

 

This is going backwards. Very troubling.

 

One can hope!

 

"psychological wellbeing practitioners"

https://www.healthcareers.nhs.uk/ex...es/roles/psychological-wellbeing-practitioner

 

Day release for roughly a year and 4 days supervised training....
2.5 times longer than being. LP provider, no medical experience required ...quality stuff

 

It's worth mentioning that according to the IAPT-LTC Full Implementation Guidance, there is no "low-intensity intervention" for CFS. GET and a "specialised form" of CBT are delivered as "high-intensity interventions".

 

It is so like homeopathy.
There is a provision for every ill, with nothing in it.

 

Not sure if this was noticed and discussed when it came out but the IAPT Manual links to this:
NATIONAL CURRICULUM FOR CBT IN THE CONTEXT OF LONG TERM PERSISTENT AND DISTRESSING HEALTH CONDITIONS Version 2.0 June 2017

Which includes a unit on CFS/ME and these under "Competences to be demonstrated in this unit":

Anyways, I just wanted to make a record of this. I'm not surprised this is still being taught to CBT therapists, but I'll never stop being shocked.

 

A nice demonstration of just how transparent the bullshit is (to mix metaphors) when you see how they chat about it. Not only should the student know the non-facts but they should be able to draw on this knowledge. Presumably that means deciding that it was the perfectionism that caused Mary's ME and telling her so - very useful no doubt. In other words demonstrating superior knowledge to patients in such a way as to make them feel small - what they call empathising I think.

 

http://www.virology.ws/2018/06/13/trial-by-error-a-curriculum-for-treating-cfs-with-cbt/

Trial By Error: A Curriculum for Treating CFS with CBT

13 JUNE 2018
By David Tuller, DrPH

 

https://twitter.com/user/status/1006920453305315328


http://journals.sagepub.com/doi/abs/10.1177/1359105318781873

Transforming Improving Access to Psychological Therapies

Michael J Scott
First Published June 12, 2018


https://twitter.com/user/status/1000678851830304773