MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

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are the “solutions” that are to be applied to sick people suffering from ME/CFS, and who monitors the
appropriate degree of “outlandish” that may be perpetrated upon “these people”?
Therapists are informed that they must “Practice the strategy” and must use “role play”. How effective “role
play” might be in an MRC clinical trial that is allegedly aiming to help people with “CFS/ME” recover from
their illness is not clarified, but it is unlikely that “role play” would feature in an MRC Clinical Trial to help
people with Parkinson’s Disease or multiple sclerosis or motor neurone disease.
In the section “How to Structure Treatment Sessions”, the authors deem it necessary to remind the therapists to
“Read your previous session notes before the participant comes into the session” and to “Book the next appointment”.
Therapists are also reminded that “Every session should contain the following: A review of homework and the
participants diaries; Review of the APT model; Time to check out the participant’s understanding of any new
techniques you may have introduced during the previous session….(and) Time to plan homework”.
The next section of the Manual (page 36) purports to address: “Discussing what is required of the Participant”,
which includes:
• “To complete all records, e.g. daily diaries
• To commit to prioritising treatment over the coming months (“treatment” is not specified)
• To contact you as soon as possible if they are not going to be able to attend an appointment
• To keep you informed of any changes in medication
• To participate in setting an agenda each session so that all of their needs and requirements are met
• To feel able to tell you if they are not clear on any aspect of the treatment
• To attend appointments on time”.
This is followed by: “Helping participants to become their own therapist: The overall aim of therapy is to help people
learn to become their own therapist by helping them to become an expert in managing their own problems”.
This was to be achieved by:
• “Giving clear explanations about the APT model
• Repeating the rationale for APT to reinforce the model and to increase the participant’s level of
understanding
• Checking the participant’s understanding when discussing new strategies
• Encouraging participants to evaluate the progress that they have made since the last session
• Agree set‐back plans before participants are discharged…so that they feel confident in managing an increase
in symptoms” (an anticipated increase in symptoms seems to be more evidence that APT is not
“pacing” as generally understood).
The APT Therapist is then advised about “Involving a relative or friend in a therapy session: Participants may find
it helpful to have a partner, relative or friend to attend a session with them. It can provide them with support and
encouragement, particularly when they are experiencing difficulties with their APT programme” (which again
indicates that APT is not “pacing”).
The Manual continues: “For participants who do not want to have a relative or friend attend one or two sessions: Ask
the participant whether they would like their relative or friend to attend an appointment with them”.
Unaccepting of the fact that a participant may not want a relative or friend to be present, the therapist must:
“Ask the participant to suggest that the person reads the section at the back of the participants manual for partners,
relatives and friends” (because there must always be “positive reinforcement” – or “brainwashing” ‐‐throughout
the PACE Trial and this must take place not just during attendance sessions but also at home).