Trial By Error: A Plea to Fiona Godlee on a Familiar Topic

[Mithriel]

It's from Bristol local authority's own safeguarding/child protection policies. She checked those with a colleague. However, it's a key point in many policies for protection of children and vulnerable people more generally, so the point should apply wherever the research is conducted.

The old policy for protecting vulnerable adults, for instance, was literally called 'No Secrets': https://en.m.wikipedia.org/wiki/No_Secrets_(adult_protection). This became part of the Care Act 2014 (i.e., it's now law).

Most policies talk about transparency, openness, etc. Children must be safe to talk about what's going on in their lives and adults should always be vigilant to maintain safety.

Adults are allowed to keep children's own secrets if appropriate (e.g., 'My mum has smelly farts,' which could be embarrassing or lead to bullying) but can't if they suggest a risk of abuse or an unsafe environment to the child or a vulnerable person ('I can't do my homework because we don't have any pencils at home,' for instance, might suggest neglect).

Adults should not ask kids to keep a secret, though, because that's a classic red flag for abuse. Obviously, there are some things parents will ask their kids not to tell people, which are private but not a risk to the child ('Auntie Sally is a lesbian, but she doesn't want anyone to know.'). But there shouldn't really be a situation where a teacher, doctor, researcher or trainer tells a child to keep a secret.

The Lightning Process falls into that secondary category because the 'trainers' are responsible adults with a duty of care. Researchers likewise have a duty of care and shouldn't let the trainers tell children to keep secrets about the process.

It is worrying, because how can you ensure the process is safe and that abuse isn't involved if no one in the room is allowed to talk about what happened? From a research perspective there's an additional problem in that you can't know which element, if any, is effective (or harmful).

ETA: I'm realising now you might have meant how did she know the process involves keeping secrets? If so, that's something that's been documented online by former participants.

When I was less ill, I was seconded to a committee on child and domestic abuse issues. It was not as rare as you would think for a psychologist or others to persuade vulnerable adult women that what was really sexual abuse would help them.

We also know that far too many adults finagle themselves into a situation where they can casually do things that confuse a child but are abuse. That is the reason for all the safeguards. Abusers congregate where there are opportunities so secret training will attract them like flies.

I wish I did not know what I know; you cannot see the world in the same way again. This whole situation appals me.

 

[adambeyoncelowe]

Which of course means the key argument that we should be pushing (and I know @dave30th does) is: How can any kind ethical approval ever be given to a childrens' treatment for which the details are concealed? It's absurd, and one of the most blatant and flagrant violations of childrens' and parental rights. It should be some the tick boxes an ethics committee is legally obliged to check: 1) are the treatment details open to scrutiny? 2) has it been scrutinised? and 3) does it pass that scrutiny? No to any of them should be an automatic fail on ethical grounds, and child protection.

Right. I

When I was less ill, I was seconded to a committee on child and domestic abuse issues. It was not as rare as you would think for a psychologist or others to persuade vulnerable adult women that what was really sexual abuse would help them.

We also know that far too many adults finagle themselves into a situation where they can casually do things that confuse a child but are abuse. That is the reason for all the safeguards. Abusers congregate where there are opportunities so secret training will attract them like flies.

I wish I did not know what I know; you cannot see the world in the same way again. This whole situation appals me.

Exactly. It does happen. People in positions of power are more easily able to abuse people and then cover it up.

 

[chrisb]

People in positions of power are more easily able to abuse people and then cover it up.

And then to cover up the cover up. As we have seen this week.

 

[Binkie4]

I fully agree with the argument that children should not be encouraged to keep secret anything that happened in a LP training session, but even before we get to considering this, there needs to be assurances that the trainers involved were CRB/DBS checked. Do we know this?

It is a purely practical question not a matter of opinion. Has anyone asked it?

Were the usual safeguarding procedures followed with regard to the adults who had access to the children?

The small charity I was involved with used to buy time from a major children’s charity to develop appropriate procedures which included police checking even those who had access to reports about the children.

 

[Skycloud]

I fully agree with the argument that children should not be encouraged to keep secret anything that happened in a LP training session, but even before we get to considering this, there needs to be assurances that the trainers involved were CRB/DBS checked. Do we know this?

It is a purely practical question not a matter of opinion. Has anyone asked it?

The therapy was conducted 1:1 but is it clear the parents weren't present?

(I seem to remember they were for the initial recruiting interviews in school)

 

[Sean]

Are we expected to believe that people with a specialist interest in ME/CFS at GOSH and UCL are unaware of the controversy surrounding the Lightning Process paper and of the caveat attached by the editor. If so, just how much reading do they do around the subject of their supposed specialism? It does not look good for them either way. Either they knew and yet gave their apparent approval. Or they did not, which may be even worse.

They have backed themselves into a corner from which there is now no honourable way out.

And that never ends well.

When I was less ill, I was seconded to a committee on child and domestic abuse issues. It was not as rare as you would think for a psychologist or others to persuade vulnerable adult women that what was really sexual abuse would help them.

We also know that far too many adults finagle themselves into a situation where they can casually do things that confuse a child but are abuse. That is the reason for all the safeguards. Abusers congregate where there are opportunities so secret training will attract them like flies.

Opaque methodology, plus having the power to declare your victim delusional or deviant, has never been a safe mix.

 

[Trish]

The therapy was conducted 1:1 but is it clear the parents weren't present?

(I seem to remember they were for the initial recruiting interviews in school)

The school recruiting study was a different study. The LP trial was based on kids referred to their clinic, I think.

 

[Skycloud]

The school recruiting study was a different study. The LP trial was based on kids referred to their clinic, I think.

Thanks Trish of course - brain fog

 

[dave30th]

I just don't think it is necessarily fair to think they would have an obvious way of finding out. We are bombarded by information but we are used to specific channels. Those of us here think David's blog is blaring out across the Atlantic. But for 99.95% of the population it is completely invisible.

I have to agree with Jonathan here. Everyone is bombarded full-time with information--including clinicians. One of the things I'm trying to do, especially with the open letters and the cc-ing, is to create a public record available to review when this all comes tumbling down. I want to make sure at least some people dealing with this stuff in UK cannot say they haven't heard or seen anything about this stuff. The open letters have also been helpful in getting some press coverage. I have found that just pointing out mistakes doesn't work, especially if the mistakes just appear on Virology Blog. It's great, as Jonathan says, that the PACE/CBT/GET critiques are now all in the peer-reviewed literature now, with more coming.

I had obviously targeted the LP study before, but now with this uncritical mention in the review it seemed imperative to take it up a level. I also plan to write directly to the senior author and the journal pointing out the problem.

 

[rvallee]

Such a useful phrase!

It's not brainwashing, it's cognitive cleansing!

 

[DokaGirl]

An appalling treatment of children - coaching them to deny their experiences, and lie. And, to hide what goes on in this "treatment" process - is one of the main pillars of child abuse, and cults. Very concerning that a well known and influential medical journal, and all connected with these studies, would condone such treatment of children.

Re the statement about low bias, if something is for sale - there is bias, and lots of it.

 

[dave30th]

They have backed themselves into a corner from which there is now no honourable way out.

I don't blame the review authors for not seeing an editor's note that does not seem to have been meant to be seen, given where it was placed. It is a different matter if the review authors fail to address this issue now that they have been alerted to it.

 

[Alvin]

It was not as rare as you would think for a psychologist or others to persuade vulnerable adult women that what was really sexual abuse would help them.

I am reminded of this quote that i have posted elsewhere on the forum

Now if we could go back in time and talk to those women, we would say, “Yes, you have everything you could possibly want by the standards of the culture.” But the standards of the culture are simply wrong

https://www.vox.com/the-big-idea/20...-prozac-social-environmental-connections-hari

Finally psychiatry has a dark underbelly to its history that a few have written about but have never publicly been acknowledged or atoned for

 

[chrisb]

I don't blame the review authors for not seeing an editor's note that does not seem to have been meant to be seen, given where it was placed.

Is it simply the three authors who might, or might not, have been expected to see the editor's note? Would there have been peer reviewers, (and it would be interesting to ponder who they might have been) supposedly familiar with the subject matter? What about the editor him/herself? Before giving go-ahead and publishing claims that some apparently absurd, secret process is medically effective does one not take reasonable measures to check the veracity of the claim? That should include not only reading the article but also scanning any ancillary pages.

The man on the Clapham omnibus would have doubts about this quack process. Do not sophisticated readers of medical literature have doubts? The senior author apparently studied at Bristol. Is there no grapevine by which people hear what is going on?

 

[Barry]

an editor's note that does not seem to have been meant to be seen

When they first did that it came across as underhanded lip service, so they could just claim to have done something, and their inaction since shows that to be true I think.

 

[Jonathan Edwards]

The man on the Clapham omnibus would have doubts about this quack process. Do not sophisticated readers of medical literature have doubts? The senior author apparently studied at Bristol. Is there no grapevine by which people hear what is going on?

I think we are all agreed that the review authors should have realised the problems with LP. A grapevine is also highly likely to exist. However, that still leaves the possibility that they were unaware of David's existence until now. All that I think David and I are pointing out is that they cannot really be blamed for not noticing his work up until now - if that was the case.

 

[Jonathan Edwards]

The issue of peer reviewers not challenging the uncritical mention of LP is important though. It seems to show that biomedical science exists within an intellectual framework where quality is irrelevant. And that of course has direct implications for the impact on guidelines.

 

[chrisb]

I think we are all agreed that the review authors should have realised the problems with LP. A grapevine is also highly likely to exist. However, that still leaves the possibility that they were unaware of David's existence until now. All that I think David and I are pointing out is that they cannot really be blamed for not noticing his work up until now - if that was the case.

All I was trying to do was indicate that the number of people who failed to notice, and who should have done, is possibly double that first discussed.

 

[Jonathan Edwards]

All I was trying to do was indicate that the number of people who failed to notice, and who should have done, is possibly double that first discussed.

Yes, and I think that is a very good point.

 

[NelliePledge]

I don’t know if this term is widely used but in my organisation we used to say people (more senior managers) who would readily sign things off based on the covering one sheet document were just “top sheeting” relying on what had been presented without putting any effort in.