Tollerance for misleading 'positive' claims about treatments

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Laurellen
Posts: 18
Joined: Wed Aug 14, 2013 3:25 pm
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by Laurellen on Wed Oct 16, 2013 2:42 pm

Tollerance for misleading 'positive' claims about treatments

There seems to be a culture within mental health care of tolerating false, misleading and dishonest claims about treatment efficacy, often justified with vague references to 'hope', encouragement, etc.

When those involved in alternative medicine (homeopathy, etc) behave in this way, they are rightly condemned as quacks. Within mental health, there still seems to be a fairly widespread sense that patients whose cognitions or behaviours have been medicalised deserve to be treated this poorly, and do not have the normal right to be spoken to honestly and clearly.

What can be done to change this? How can we ensure that those who have routinely made false and claims to patients are not allowed to continue to operate in positions of authority?

Few lessons seem to have been learnt from the social problems caused by the false claims made about the extent to which psychosocial 'treatments' could allow people to change their sexuality, and the way in which these claims fed into the stigmatisation of GLBTs. Indeed, those responsible for this quackery seem to have almost universally escaped paying any price for it, with many of them going on to retire to a level of financial comfort far beyond that available to those who had been mistreated as a result of their work.

As a contemporary example, I'll point to Trudie Chalder, who is the current president of BABCP, which supposedly maintains standards for those providing CBT in the UK. In 2003 she was involved in a trial assessing the benefits of 'psychosocial education' for preventing prolonged disabling fatigue after mononucleosis. Although the control group received no therapist time, there was still no statistically significant difference between the control group and psycho-education group. The primary impact of the intervention seemed to be that it led to those who recovered felt more willing to fill in their questionnaires at six months, leading to a big difference in return rates and rates of reported recovery at that point.

Ful paper: https://docs.google.com/viewer?a=v&q=ca ... tg0DJoc_Kw

Results:

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When discussing these results in 2011, Chalder omits the 12 month data:

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http://www.mental-health-forum.co.uk/as ... FORMAT.pdf

Her colleague Peter White does the same thing in a recorded presentation (starting at 14 minutes): http://www.scivee.tv/node/6895

And in his presentation to the Gibson Enquiry:

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Claiming that a non-blinded and poorly controlled study which found no significant difference between groups at 12 months showed "a huge effect size" and halved the incidence of prolonged fatigue based on the six-month data, without mentioning the 12 month data, is pretty shameful.

Both of these researchers have more recently been claiming that their treatments get 30% of CFS patients "back to normal", following a large publicly funded trial. They developed post-hoc criteria for 'normal' which were so loose that they overlapped with their own criteria for severe and disabling fatigue, so a patient could be classed as "back to normal", even if their condition had worsened during treatment. They are currently refusing to release the outcome measures that were laid out in the trial's protocol: https://www.whatdotheyknow.com/request/ ... tes_and_po

In this case, there are attempts to pretend that the anger and distrust which has resulted from these misleading claims is a result of patients attempting to deny the efficacy of psychosocial interventions for fear of stigma. It seems more likely to me that this explanation itself stems from stigmatising prejudices, and that the tolerance for the exaggerated claims being made to patients is indicates the pernicious stigma patients already face. I do not think it would be seen as acceptable a pharmaceutical company selling a cancer treatment to behave in this way.

There are of course other cases, and there does seem to be a growing awareness of the problems to be found within psych research. Is there ever going to be any real accountability for these sorts of things? Or will it continue to be the case that, for those working in mental health, the best thing for one's career is to make exagerated claims about one's expertise, and then try to spin the data to support it? If colleagues are not terribly concerned about patients being misled, or commited to ensuring that patients have access to accurate and fairly presented data that would allow them to make their own decisions about their health care, and provide informed consent for the treatments offered, then there will be no real sense of outrage, or commitment to change.
Last edited by Laurellen on Wed Oct 16, 2013 3:35 pm, edited 1 time in total.

Laurellen
Posts: 18
Joined: Wed Aug 14, 2013 3:25 pm
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by Laurellen on Wed Oct 16, 2013 2:44 pm

Re: Tollerance for misleading 'positive' claims about treatm

Some of the above images seem to have been formatted in a way which cuts of their edges. One can right click, and choose to 'view image' to see them properly. Sorry.

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