Therapists’ perceptions of barriers and facilitators to uptake and engagement with therapy in long‐term conditions - Oct 2020 Moss-Morris et al

https://bpspsychub.onlinelibrary.wiley.com/doi/10.1111/bjhp.12475

(only mentions 'chronic fatigue' but also LTC (long term conditions) and MUS)

eta:
All authors declare no conflict of interest.

 

So, no interest in Patient Public Involvement here then!

 

Which, in short, basically means: if we figure this stuff out, we'll have figured this stuff out. This could have been written verbatim a full century ago. It probably was. Multiple times. And many more times since. Because it's the whole problem: does this work? Nope, they just can't accept that. Instead they wonder how to better sell something nobody wants to buy because it's not what they need.

It's very telling that in trying to figure out how to retain patients, they ask the therapists. This supply-side approach to medicine is very, very dumb. Market solutions are not the way to fix those problems but it's very silly to have such absurd circumstances as there being a full supply of things that nobody actually wants, at least not this way. There should at least be some minimal connection between supply and demand. Reminds me of Soviets, frankly, trying to figure out what they think ordinary people need each month and producing accordingly, regardless of what's actually needed because they never actually ask or check, only work with what's possible to produce.

 

This is what gets taught in methods courses in qualitative research.

 

As well as the shocking conclusion section that deems that the aggregation of a few conversations about how some providers feel has scientifically 'demonstrated the importance of' dispensing a therapy in a certain way. Normally you need a clinical trial for that; of course 'flexible, tailored' psychotherapy is not scientifically testable so we'll have to allow feelings-based medicine in this case.

I think it can be useful to talk to providers and publish honestly presented qualitative findings. It's interesting to get a feel for what they think about things. But that's all it is.

 

Yep , had to fight to stay awake in that lecture

 

The full text is available here:
https://bpspsychub.onlinelibrary.wiley.com/doi/pdfdirect/10.1111/bjhp.12475

 

This is generic mumbojumbo. It's worth even less than a pet rock.

This is an evaluation of IAPT, a giant multi-billion dollar boondoggle to the CBT-specific segment of the medical pseudoscience industry. This is how this giant muddle of wasted funding and diminishing ethics is being evaluated.

And it's even less compelling than business consultants who complete a million-dollar plus contract with a short-list that includes ping-pong tables and free pizza Fridays. Even by the usual standards of politics this is extremely corrupt and wasteful.

Usually when people try to blame science for being useless it's almost always research using fireflies, which is massively more pertinent than this mumbojumbo. But this, this is pure waste, academic self-indulgence that basically amounts to a giant taxpayer-funded circlejerk. This is research where if it were simply ended and everyone working in it terminated, literally sent home and never employed again, it would be a massive net benefit, textbook addition by subtraction.

In my freelance days I worked on my share of projects that seemed rather pointless, usually short-lived projects for a time-limited campaign. And seriously nothing I did felt as much of a complete waste as this. I don't understand how people in healthcare can so willingly be less useful than a looped video of paint drying. It baffles the mind.

 

I'm trying to think of some of the funnier non-jobs there have been in the public or pseudo-public sector over the years, where some poor soul has had to go around doing something that never really had a purpose. I guess my closest thought is the EU common agricultural policies creating butter mountains (but at least those could theoretically 'keep'): https://en.wikipedia.org/wiki/Butter_mountain
Maybe someone was charged for a few of these things with persuading people they needed more butter in their life - surely this is the equivalent of asking said theoretical butter-sellers to save their own jobs by noting what barriers were standing in the way of end-consumers not wanting more cheap (in this case free) butter...

But then at least said people weren't also responsible for more butter being added to the already unused mountain because of this..

exactly the sort of language and research that a marketer would do - 'barriers to entry' (e.g. people not wanting to give all their personal details just to access a website). Except normally it is something that somone might find attractive and choose to access. When it is drop-off after visiting said webpage, or choosing 'no' after realising what something is or trying it out then the issue is 'wrong product for target market'. Except how do you square that circle when a different person is paying for it on the basis of it being 'good for someone else'..

Anyway, I find it hard to be convinced therefore that this is genuinely being done for the right reasons the right way (even if some of those commissioning or doing it might believe they are - lesson: those commissioning need to have better job requirements to be able to ask for measures that matter if so). Someone somewhere is being conned into thinking they want those with LTC shoved into this (and just need to be persuaded of what is good for them), but on what basis and are the facts correct or appropriate?

I guess at least this research keeps the distraction up from anyone questioning as to whether the product is useful whilst you've got them looking at this 'research' instead, and the salespitch to those funding it is 'missing the point' in its measures if you are getting them to 'look at the big aeroplane over there' of 'patients being reluctant for reasons made up by the therapists whose livelihood depends on placing the issue on patients and not whether what they are offering is any good'.