Worryingly, not only has the psychological medicine approach failed but its proponents have shown no recognition of their lack of understanding of either the illness or research methodology (White, Anomalies paper). This is hard to square with the fact that there is no evidence for any reduction in the prevalence of the illness and people are still dying of avoidable dehydration.
I'm not sure the 'reduction in prevalence' is a good argument for psych factors being wrong.
And should it be 'dehydration and starvation'?
For about 2 decades the psychobehavioral treatment approach has dominated with what is claimed to be an effective treatment modality. An effective treatment would obviously reduce prevalence, it can't not.
Sorry if I am too late with this, but it seemed to me when I read it that inclusion of 'treatment' in that first sentence is needed to make the second sentence true. Rvallee expanded on the reasons. So:
"Worryingly, not only has the psychological medicine approach failed but its proponents have shown no recognition of their lack of understanding of the illness or its effective treatment, or indeed even of research methodology (White, Anomalies paper). This is hard to square with the fact that there is no evidence for any reduction in the prevalence of the illness and people are still dying of avoidable dehydration and starvation."
I single out physios and psychologists because in my experience the situation for OTs, nurses and doctors is significantly different. Their jobs are seen in terms of doing whatever there is good reason to do and not treating simply for the sake of filling an assignment slot. Physios and psychologists have traditionally been expected to treat if asked to. I agree that that is as much a problem with those asking for treatment but in practical terms I am not sure that is relevant to the context. We would be better off without physios and psychologists being substantive members of a team as far as I can see and their lack of being prepared to say they have nothing to offer is the crunch.
I agree with the comments about focussing more on what we want people involved in the care of people with ME/CFS to be able to do (and/or what we don't want them to do), rather than criticising specific professions. Not everyone will need an OT, just as not everyone will need a physiotherapist or a psychologist. But, my understanding is that someone who is bedbound could well benefit from a well-trained physiotherapist who can help minimise the risk of medical complications of immobility. (If I'm wrong in that, someone needs to tell me, because I have been recommending that clinical guidelines suggest that people who are bed bound are given advice on how to prevent complications from immobility.) And someone who is having a really hard time dealing with their situation may benefit from time with a psychologist or counsellor who has a lot of insight into the impact of debilitating chronic conditions and how to best cope. We all know that some nurses and doctors can do plenty of harm as a result of accepting 'this is the way it has always been done' too. Psychology is a very broad field, and there are certainly some branches of it that involve critical thinking and attention to evidence, even if the aim of some of that thinking is only to sell more of something.
Re 'Conceptualising ME/CFS'
The article is not about some new conceptualisation of ME/CFS or something emerging. The concept I am talking about has been around for twenty years and has been well described by others.
I agree, I don't think 'conceptualising' is an improvement. It makes it sound as though this is something happening now, and, by implication, an innovation by the author. Whereas 'the concept' makes ME/CFS sound more like a real discrete and current entity, albeit something of a placeholder. I'm actually not super keen on 'concept' either. Synonyms include 'belief', 'conviction', 'opinion', 'conceit'. I mean, I don't think people would write about 'The concept of malaria', for example. It signals that ME/CFS does not yet qualify to be a disease, that instead it is a drawing of a circle around a collection of symptoms and the people who have them and that there is uncertainty about whether that circle is describing something discrete. But, the first paragraph sets things up well, as an answer to the question of why the concept of ME/CFS is justified. And perhaps, until we know more, 'concept' is the best we can do.