“Talking your way out of chronic conditions, Festival of Science,” was written on 11/9/07 in the Times and today the same paper had another NICE CBT article called: “Cognitive behavioural therapy: Junk medicine: I think this might work.”
Now I always thought that there were a few things journalists had to do before writing an article. For example:
1. Read about the subject before you interview or quote someone, so that people can’t sell their baloney with the journalist just writing it down.
2. Ask critical questions.
1. Read about the subject before you interview or quote someone, so that people can’t sell their baloney with the journalist just writing it down.
2. Ask critical questions.
Apparently this is NOT the function of journalism anymore. They are just a medium to print whatever the CBT KINGDOM wants. I used to love reading Jeremy Clarkson’s stuff in the Sunday Times and it might be an idea for you, Mr Science Editor, to speak to him, as he seems to have a more critical mind about things than you. At the moment you just seem to be nothing more than a photocopier for the CBT KINGDOM. Apparently the title of Science Editor of The Times doesn’t mean anything anymore, just as we have seen with the BMJ editor. It doesn’t mean that you can spell the word critical reading, or have a clue what it is.
Just have a look at a few things the Science Editor wrote, might help to have a wonderful day and cheer you up.
“Cognitive behavioural therapy (CBT), which seeks to improve the symptoms of illness by changing patients' attitudes, thoughts and feelings, often strikes people as flaky.”
“Few psychiatrists, however, dispute that CBT can be helpful to patients with depression, anxiety and even schizophrenia.” Yeah, surprising, a psycho therapy that helps people with a mental health issue, isn’t that what it is all about? Funnily enough, few orthopaedic surgeons dispute the fact that my RATT (Ruptured Achilles Tendon Therapy, see my previous BLOGs) therapy works for ruptured Achilles tendons. I have phoned a few to suggest to treat these patients with CBT in the future. All I got as an answer was so much laughter that I might become a stand up comedian. All I have to do is use texts from the CBT KINGDOM and The Times and we all have a jolly good night.
I must say that I like the remark that “Cognitive behavioural therapy (CBT) is flaky”. Maybe an anti-dandruff shampoo might be of help?? Might even try it for depression, anxiety or schizophrenia and see if it works. What do you think, good therapy for these problems or will patients dispute the use of anti-dandruff shampoo for depression etc??
Professor Trudie Chalder, of King's College London, announced that it (=CBT) can help people with type 1 diabetes.” These are people who NEED INSULIN. No insulin means they are going to die. But from now on I will prescribe CBT instead of insulin. How quickly will this bring me before the GMC (General Medical Council) do you think??? But I will state there that I was just following Professor’s Chalder’s advise. And what will you say if it was your son, daughter or partner who died because I used CBT and not insulin?? Thank you very much, I’m sure.
“Cognitive behavioural therapy (CBT), which seeks to improve the symptoms of illness by changing patients' attitudes, thoughts and feelings, often strikes people as flaky.”
“Few psychiatrists, however, dispute that CBT can be helpful to patients with depression, anxiety and even schizophrenia.” Yeah, surprising, a psycho therapy that helps people with a mental health issue, isn’t that what it is all about? Funnily enough, few orthopaedic surgeons dispute the fact that my RATT (Ruptured Achilles Tendon Therapy, see my previous BLOGs) therapy works for ruptured Achilles tendons. I have phoned a few to suggest to treat these patients with CBT in the future. All I got as an answer was so much laughter that I might become a stand up comedian. All I have to do is use texts from the CBT KINGDOM and The Times and we all have a jolly good night.
I must say that I like the remark that “Cognitive behavioural therapy (CBT) is flaky”. Maybe an anti-dandruff shampoo might be of help?? Might even try it for depression, anxiety or schizophrenia and see if it works. What do you think, good therapy for these problems or will patients dispute the use of anti-dandruff shampoo for depression etc??
Professor Trudie Chalder, of King's College London, announced that it (=CBT) can help people with type 1 diabetes.” These are people who NEED INSULIN. No insulin means they are going to die. But from now on I will prescribe CBT instead of insulin. How quickly will this bring me before the GMC (General Medical Council) do you think??? But I will state there that I was just following Professor’s Chalder’s advise. And what will you say if it was your son, daughter or partner who died because I used CBT and not insulin?? Thank you very much, I’m sure.
“Though her study has not yet been peer reviewed or published.” Doesn’t make a difference, no study from the CBT KINGDOM will ever be peer reviewed, it will just be published. Much quicker and easier. And if someone will make critical noises, they will just ignore those. Let me explain, peer reviewed means that others, NOT from the same institute, will read the article CRITICALLY and point out mistakes etc. One mistake the CBT KINGDOM makes over and over again is that they call ME CFS but they are actually just talking about people with chronic fatigue, so tiredness ONLY. As the CBT KINGDOM has friends at different medical journals, their articles are NEVER peer reviewed. The principle is simple, I do something for you and you do something for me, and so that saves a lot of time for the editor. If you think that only applies to ME, just have a look at my BLOG called:
http://niceguidelines.blogspot.com/2007/09/nasty-processes-produce-nasty.html
http://niceguidelines.blogspot.com/2007/09/nasty-processes-produce-nasty.html
It is about UTIs (Urinary Tract Infection) in children, and the enormous outcry, under paediatricians and kidney specialists, about the recent NICE guidelines and the editorial in the BMJ saying how lovely these guidelines were. Did the Editor have a critical look before he wrote his editorial? Just read my BLOG and you will not only know the answer but a whole lot more.
“The biology of cancer and diabetes is quite well understood, yet there is evidence that CBT can help and many patients are keen to have it. It is unfortunate that people with CFS do not think likewise. To embrace the one treatment that has been shown to be effective against their illness does not mean it is imaginary.” I really like this comment. The science editor has done his homework. He says here that CBT is an imaginary therapy, so just make believe, so even he thinks it doesn’t work, or does he mean something else??
So would you really think Mr Science Editor, that this hokus pokus therapy is as effective for cancer or diabetes as for example insulin or an operation to remove the cancer? I certainly agree. Just leave the cancer in place and revert to CBT; 12-16 sessions of talk therapy and if I would be the cancer I would run a mile as well. Now if you would be the cancer patient, would you see me for CBT, or go to a proper specialist? Oh yes, there will be people who need help coping with a horrible or even terminal illness, strange don’t you think??? But a good friend or partner and a good GP is usually all they need.
And “It is unfortunate that people with CFS do not think likewise,” you probably mean, it is unfortunate that the CBT KINGDOM, and you as a Science Editor, have no idea what ME is. But hey, we are all tired at times, just like people with ME right? Just like people with Alzheimer’s are all a bit forgetful. Or is that a misconception? We would obviously think likewise, if there would be a point in this CBT business for people with ME. Silly idea, I know.
I must say, you can write NICE sentences, unfortunately, that is all they are.
“To embrace the one treatment that has been shown to be effective against their illness.” If this was true Mr Science Editor, all people with ME would be RUNNING, if we could walk that is, to the CBT community to get this MIRACLE CURE. Unfortunately Mr Science Editor, it works as well for ME as it will help you grow your vegetables in your garden. If you would just read a few comments on the recent NICE guidelines either on my BLOG, or on the rapid responses on the BMJ site, you would have actually known something about ME. I know, just like with NICE itself, knowledge works counterproductive and would mean you would waste time on reading and especially critical reading etc, whereas just copying the remarks from the CBT KINGDOM is easier and saves you a lot of work and time. Does it make for good journalism? I’m afraid LOUSY is the word that springs to mind. Just ask yourself one little very simple question, even NICE acknowledges this fact. Why is it that we have people with severe ME who are bedbound, dependent on others for all sorts of things and NOT ONE CBT person has done a trial if CBT will cure or help these patients? Well let me help you out a bit. I’m one of those lucky people, and I have actually tried this hokus pokus therapy, because that’s all it is. It’s because it would show that CBT is just a lot of HOT AIR as you would probably call it.
“The biology of cancer and diabetes is quite well understood, yet there is evidence that CBT can help and many patients are keen to have it. It is unfortunate that people with CFS do not think likewise. To embrace the one treatment that has been shown to be effective against their illness does not mean it is imaginary.” I really like this comment. The science editor has done his homework. He says here that CBT is an imaginary therapy, so just make believe, so even he thinks it doesn’t work, or does he mean something else??
So would you really think Mr Science Editor, that this hokus pokus therapy is as effective for cancer or diabetes as for example insulin or an operation to remove the cancer? I certainly agree. Just leave the cancer in place and revert to CBT; 12-16 sessions of talk therapy and if I would be the cancer I would run a mile as well. Now if you would be the cancer patient, would you see me for CBT, or go to a proper specialist? Oh yes, there will be people who need help coping with a horrible or even terminal illness, strange don’t you think??? But a good friend or partner and a good GP is usually all they need.
And “It is unfortunate that people with CFS do not think likewise,” you probably mean, it is unfortunate that the CBT KINGDOM, and you as a Science Editor, have no idea what ME is. But hey, we are all tired at times, just like people with ME right? Just like people with Alzheimer’s are all a bit forgetful. Or is that a misconception? We would obviously think likewise, if there would be a point in this CBT business for people with ME. Silly idea, I know.
I must say, you can write NICE sentences, unfortunately, that is all they are.
“To embrace the one treatment that has been shown to be effective against their illness.” If this was true Mr Science Editor, all people with ME would be RUNNING, if we could walk that is, to the CBT community to get this MIRACLE CURE. Unfortunately Mr Science Editor, it works as well for ME as it will help you grow your vegetables in your garden. If you would just read a few comments on the recent NICE guidelines either on my BLOG, or on the rapid responses on the BMJ site, you would have actually known something about ME. I know, just like with NICE itself, knowledge works counterproductive and would mean you would waste time on reading and especially critical reading etc, whereas just copying the remarks from the CBT KINGDOM is easier and saves you a lot of work and time. Does it make for good journalism? I’m afraid LOUSY is the word that springs to mind. Just ask yourself one little very simple question, even NICE acknowledges this fact. Why is it that we have people with severe ME who are bedbound, dependent on others for all sorts of things and NOT ONE CBT person has done a trial if CBT will cure or help these patients? Well let me help you out a bit. I’m one of those lucky people, and I have actually tried this hokus pokus therapy, because that’s all it is. It’s because it would show that CBT is just a lot of HOT AIR as you would probably call it.
Oh by the way, those BMJ comments are available at:http://www.bmj.com/cgi/eletters/335/7617/446#176151
Or comments on the BMJ editorial about the NICE guideline at:http://www.bmj.com/cgi/eletters/335/7617/411#176030
Or comments on the BMJ editorial about the NICE guideline at:http://www.bmj.com/cgi/eletters/335/7617/411#176030
If you would just Google a bit, or even mail me the next time, before you write these so called editorials, you might be well informed for a change, and it would only take you a few minutes to be up to date. You might even be able to ask a critical question or so, as one would expect from a journalist or Editor.
But apparently, you prefer the same principles as the CBT KINGDOM. The less you know about the subject the easier it is to have an opinion and write about it. But you have more interesting things up your sleeve.
“Even when diseases have a clear physical cause – a virus, as in HIV, or an auto-immune reaction, as in diabetes or arthritis – psychological factors can have a major effect on outcomes. Compliance with treatment regimens, diet and exercise, and background mental health are often critical to a good prognosis, and CBT can improve all of these.” Dear Mr Science Editor, all you need with these conditions is common sense. Yes, if you have a positive outlook on life that will help, but do you really need CBT for that? A NICE talk with a friend, a NICE game of football, a NICE meal, a romantic evening etc are more beneficial than these psycho people. But they want to earn a living and have their name in the spotlight. And thanks to people like you, who believe everything at face value, they do succeed.
Let me ask you a question, does the Times want to be a proper and serious newspaper or is nonsense enough?? Isn’t REAL journalism about trying to find the answer behind the answer. To get to the bottom of a problem, or was that only a principle applied by journalists who unveiled Nixon and his Water problem?? I know, that took them a lot of time and effort. Much easier to copy and write everything down, so you can be in the PUB to have a drink and watch your favourite football or rugby team on time. All that digging and reading and so, it is a bit like medicine, I like medicine and so, but it is a shame that you have to see patients as a GP. Now would you copy such a comment, or would you start thinking, and maybe have the urge to ask me a critical question? But be careful, the CBT KINGDOM is known for it’s severe shock like reactions to critical questions. And I might adopt a similar approach.
“It is decidedly not a treatment that can help only when illness is all in the mind. That misleading impression, however, still inspires hostility towards CBT among people who might benefit greatly. Chronic fatigue syndrome (CFS) is a case in point. The National Institute for Health and Clinical Excellence has recently recommended CBT and a related strategy, graded exercise, for the condition, on the back of good randomised clinical trials that indicate a benefit. There are no other therapies for CFS with such good evidence in their support, yet some patient groups have reacted with anger.”
I’m afraid Mr Science Editor, GOOD randomised clinical trials for CBT do NOT exist. Like I said, for starters they DO NOT even get the diagnosis right. But have a look at a recent so called randomised CBT trial published in April 2007, in the journal for psychotherapy and psychosomatics. Yes I know, the place to be for a NEUROLOGICAL illness, my article about surgery for ruptured Achilles tendons will appear in their next issue. But what did they say? They informed us that they CURE 69% of patients with ME. Now, even if you believe the NICE guidelines Mr Science Editor, you will see that they will advocate CBT to COPE with ME. So even NICE says, without using those words, that CBT is rubbish. But I agree with you, you would have to read their report, instead of just looking at the conclusion. TOO MUCH EFFORT FOR BUSY EDITORS. I fully agree. Your counterpart at the BMJ (British Medical Journal) shared your view. Just copy and you could be on the golf course or so after lunch, instead of doing a proper job.
“For these critics, CBT is part of a medical crusade to write off their condition.” As I said before you have a NICE way with words, shame that you don’t know what you actually talk about. Do you actually know what the CBT KINGDOM says about people with ME?? No, I thought NOT. We are all malingerers, hypochondriacs, people with personality disorders and more NICENESS. I wanted to write a few of these quotes in a BLOG but then someone mentioned your glorious articles so I had to divert. For starters, CBT is a way by the CBT KINGDOM to write ME off as a psycho illness, their TOP man has been trying for years to get it marked as a mental illness, and he is still trying, even though the WHO has classified it as a neurological illness for decades. Secondly, like I said before, many people with ME have tried CBT, just as we have tried homeopathy, Chinese medicine, acupuncture, orthomolecular medicine etc and you know what? They are all NICE ways to pass the time, NICE ways of hoping for a remedy, and all might work for other problems, but they do NOT work for ME. Full stop, unfortunately.
I also like your following comment, top notch.
“It is unfortunate that people with CFS do not think likewise. To embrace the one treatment that has been shown to be effective against their illness does not mean it is imaginary.”
If you would just have a look at the BMJ link I placed earlier, and then READ the comment about the Belgium CBT clinics, then you know it all Mr Science Editor. 18% of patients with ME, no patients with severe ME are seen there either, because you have to get there and even if you would be able to get there, they would exclude you, because you can’t walk. But anyway, before CBT 18% of patients worked, after CBT only 14% was still at work. Would you call that effective treatment??? And keep in mind that another CBT KINGDOM says we CURE 69% of ME patients with CBT. So that would mean that if 18% works before treatment that 18 plus 69 = 87% should work after treatment. Simple, a seven year old child could do the maths. But NICE couldn’t, the BMJ editor couldn’t, and you apparently can’t either. Now 87% sounds different than 14% doesn’t it? So how effective is your CBT treatment really?? And why are you NOT writing about these major inconsistencies??? Yes I know, you think that if the CBT KINGDOM says something, that you believe them at face value. Modern journalism, what a delight.
But apparently, you prefer the same principles as the CBT KINGDOM. The less you know about the subject the easier it is to have an opinion and write about it. But you have more interesting things up your sleeve.
“Even when diseases have a clear physical cause – a virus, as in HIV, or an auto-immune reaction, as in diabetes or arthritis – psychological factors can have a major effect on outcomes. Compliance with treatment regimens, diet and exercise, and background mental health are often critical to a good prognosis, and CBT can improve all of these.” Dear Mr Science Editor, all you need with these conditions is common sense. Yes, if you have a positive outlook on life that will help, but do you really need CBT for that? A NICE talk with a friend, a NICE game of football, a NICE meal, a romantic evening etc are more beneficial than these psycho people. But they want to earn a living and have their name in the spotlight. And thanks to people like you, who believe everything at face value, they do succeed.
Let me ask you a question, does the Times want to be a proper and serious newspaper or is nonsense enough?? Isn’t REAL journalism about trying to find the answer behind the answer. To get to the bottom of a problem, or was that only a principle applied by journalists who unveiled Nixon and his Water problem?? I know, that took them a lot of time and effort. Much easier to copy and write everything down, so you can be in the PUB to have a drink and watch your favourite football or rugby team on time. All that digging and reading and so, it is a bit like medicine, I like medicine and so, but it is a shame that you have to see patients as a GP. Now would you copy such a comment, or would you start thinking, and maybe have the urge to ask me a critical question? But be careful, the CBT KINGDOM is known for it’s severe shock like reactions to critical questions. And I might adopt a similar approach.
“It is decidedly not a treatment that can help only when illness is all in the mind. That misleading impression, however, still inspires hostility towards CBT among people who might benefit greatly. Chronic fatigue syndrome (CFS) is a case in point. The National Institute for Health and Clinical Excellence has recently recommended CBT and a related strategy, graded exercise, for the condition, on the back of good randomised clinical trials that indicate a benefit. There are no other therapies for CFS with such good evidence in their support, yet some patient groups have reacted with anger.”
I’m afraid Mr Science Editor, GOOD randomised clinical trials for CBT do NOT exist. Like I said, for starters they DO NOT even get the diagnosis right. But have a look at a recent so called randomised CBT trial published in April 2007, in the journal for psychotherapy and psychosomatics. Yes I know, the place to be for a NEUROLOGICAL illness, my article about surgery for ruptured Achilles tendons will appear in their next issue. But what did they say? They informed us that they CURE 69% of patients with ME. Now, even if you believe the NICE guidelines Mr Science Editor, you will see that they will advocate CBT to COPE with ME. So even NICE says, without using those words, that CBT is rubbish. But I agree with you, you would have to read their report, instead of just looking at the conclusion. TOO MUCH EFFORT FOR BUSY EDITORS. I fully agree. Your counterpart at the BMJ (British Medical Journal) shared your view. Just copy and you could be on the golf course or so after lunch, instead of doing a proper job.
“For these critics, CBT is part of a medical crusade to write off their condition.” As I said before you have a NICE way with words, shame that you don’t know what you actually talk about. Do you actually know what the CBT KINGDOM says about people with ME?? No, I thought NOT. We are all malingerers, hypochondriacs, people with personality disorders and more NICENESS. I wanted to write a few of these quotes in a BLOG but then someone mentioned your glorious articles so I had to divert. For starters, CBT is a way by the CBT KINGDOM to write ME off as a psycho illness, their TOP man has been trying for years to get it marked as a mental illness, and he is still trying, even though the WHO has classified it as a neurological illness for decades. Secondly, like I said before, many people with ME have tried CBT, just as we have tried homeopathy, Chinese medicine, acupuncture, orthomolecular medicine etc and you know what? They are all NICE ways to pass the time, NICE ways of hoping for a remedy, and all might work for other problems, but they do NOT work for ME. Full stop, unfortunately.
I also like your following comment, top notch.
“It is unfortunate that people with CFS do not think likewise. To embrace the one treatment that has been shown to be effective against their illness does not mean it is imaginary.”
If you would just have a look at the BMJ link I placed earlier, and then READ the comment about the Belgium CBT clinics, then you know it all Mr Science Editor. 18% of patients with ME, no patients with severe ME are seen there either, because you have to get there and even if you would be able to get there, they would exclude you, because you can’t walk. But anyway, before CBT 18% of patients worked, after CBT only 14% was still at work. Would you call that effective treatment??? And keep in mind that another CBT KINGDOM says we CURE 69% of ME patients with CBT. So that would mean that if 18% works before treatment that 18 plus 69 = 87% should work after treatment. Simple, a seven year old child could do the maths. But NICE couldn’t, the BMJ editor couldn’t, and you apparently can’t either. Now 87% sounds different than 14% doesn’t it? So how effective is your CBT treatment really?? And why are you NOT writing about these major inconsistencies??? Yes I know, you think that if the CBT KINGDOM says something, that you believe them at face value. Modern journalism, what a delight.
But your title was spot on: Cognitive behavioural therapy: Junk medicine at the festival of Science.
Have a NICE day,
Dr Speedy.
Just to clarify:
ReplyDeleteWhat the Belgian Clinics found was that on average people worked 18.3% a week (based on a 38-hour week) before the program, and 14.9% a week after the program. This translates to 6 hrs 57 mins (6.954 hrs) before the program; 5 hrs 40 mins (5.662hrs) after the program. (This is in the top bit of table 69).
This also shows that 6% of people worked more and 10% of people worked less after the program.
It looks like from table 71, that 27% worked before the treatment, 25% after the treatment (profession propre). I think it's a pity they used this phrase which I think means "their own profession/job" as it would have been interesting what percentage having to switch careers.
In terms of curing people, table 70 has some interesting figures: of 266 people who had no job at the start, it gives a breakdown of the people who took up work.
Just 5% were doing any paid work at the end of the program; this rose to 8% 6 months after they finished the program and was at 8% 12 months after they finished the programme. It says that 82% of working part-time (so 18% must have been working full-time). 18% is 3.8304 - which is where the figure of four working full-time comes from. 4/266=1.5% This is probably a particularly useful figure if dealing with any pushing people to do them to get back to work [e.g. insurance companies, (maybe more in the future) benefit agencies, etc]. And of course, just because they were working full-time at this particular time doesn't mean that they kept it up indefinitely.
Tom
I've just thought of something:
ReplyDeleteAs it looks like only 27% were working at the start, but overall 10% were working less that means that 10/27 = 37% of the people who were working at the start, were working less! [The people who weren't working at the start couldn't reduce how much they're working so the 10% had to come from the group that were working] That's a huge percentage.
Given that we know that 5% of the people who weren't working at the start were working at the end, then they make up .05*.73=3.65% of the 6% who were working more. So the existing workers only make up 2.35% of this (approx.). That means that, if one lets x=% working more: x*(27/100)=2.35, x=8.70 so only 8.7% of the people who were already working, worked more compared to 37% working less.
Also given that 27% were working were working at the start and we know 3.65% of the total are now working (the 5% of the 73% who weren't working at the start), that goes up to 30.65%. But we know that only 25% of the whole group are working at the end, so the drop of 5.65% must come from the group who were working at the start. This means that 5.65/27 = 20.93% of the people who were working at the start had given up work completely at the end of the program.
[Proviso: None of these figures are likely to be exactly correct as we're dealing with round figures (6%, 10%, 25%, 27%) but useful none the less]
Let me know if I've made a mistake anywhere.
Tom