Psychologists Blast NICE Guidelines

http://www.bps.org.uk/media-centre/press-releases/releases$/statements-and-policy-documents$/cfs.cfm

Psychologists criticise NICE guidelines for those with Chronic Fatigue Syndrome

The British Psychological Society has criticised the recommendations outlined in NICE guidelines for Chronic Fatigue Syndrome (CFS), ahead of judicial review.

The Society feels that the three therapies recommended by NICE in its guidelines (published in August 2007) do not recognise the multifaceted nature of CFS and the different ways in which individuals respond to this illness.

The Society is reiterating its comments in light of a judicial review which is expected to be submitted to court on Thursday 22 November by the One Click Health Advocacy Pressure Group. Although the Society has had no contact with this group, and is no way aligned to it, the Society has independently submitted its own concerns about the guidelines and feels they should be revisited.

Dr Ellen Goudsmit, who helped draft the Society’s response, said: "NICE has offered three treatments in its guidelines that limit psychologists to a comparatively inflexible regime which we feel is not appropriate for many patients with CFS.

"We believe psychologists have more to offer people with CFS and are disappointed that NICE rejected the alternative treatments we suggested, despite the fact that they were based on sound scientific evidence, including randomized controlled trials."

The Society wrote to NICE in August 2007 to voice concerns over:

• activity management, a way for people to manage their symptoms by learning to analyse and plan activities so that they can achieve more at home, at work and at leisure.
• graded exercise therapy (GET), which plans increases in activity or exercise, working towards goals that are important for the person with CFS/ME.
• The model of cognitive behavioural therapy (CBT) being recommended.
  

Dr Martin Crawshaw, Chair of the Society’s Professional Practice Board, added: "Activity management is untested and there is no advice for those who cannot increase activity levels, while advocating CBT and GET limits a flexible approach. In some cases all some patients need is a brief period of counselling, support and information about a practice called pacing - the aim of which is to balance rest and activity to avoid making fatigue and other symptoms worse.

"If psychology is to take over the majority of the work regarding the management of CFS patients then we need to be able to use our judgement."

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For the British Psychological Society to say that psychology is not the cure for CFS is a step in the right direction.  It's a sign that not all psychologists side with Straus/Wessely/Reeves in their quest to wipe out all reference to the initial virus reported by patients and (using the similarity in names between CFS, chronic fatigue, and Fatigue Syndrome to advantage) to convince people that this is purely a psychological problem.

In fact, many CFS patients report that years and years of psychotherapy did not help them at all.  Repeated research has confirmed that anti-depressants are useless.  Yet, there is still the misguided quest to classify CFS as a psychological, not neurological, condition, which benefits the pocketbooks of psychiatrists who provide those decades of useless therapy, but does nothing to help the patient: talking about it will not cure a virus.

Tags: CFS, psychology, psychologist