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

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Three months after the end of session 14 there is to be a “Follow up” to:
“Review programme:
• Daily plans
• Weekly plans
• Activity analysis and modification
• Energy conservation and regulation
• Use of rest and relaxation
• Sleep pattern
• Aims, targets and priorities
• Balancing life”.
The remaining pages of the APT Therapists’ Manual are Appendices 1 – 4.
Appendix 1 consists of “Diagnostic criteria” and includes photocopies of the Fukuda et al 1994 CDC criteria;
the 1991 Oxford criteria, and appendix II to the “CFS/ME Working group report 2001” – existing diagnostic
criteria (adults)”.
Appendix 2 consists of “Tools for recording sessions and information” and includes “Record of attendance for
APT”; “PACE Trial Session Record”; “Unplanned Telephone Call record”, and “Reflective Review of Session”.
Appendix 3 consists of “Therapist resources” and includes “Relaxation 1 (Warmth and Light); Relaxation 2 (At
Peace with Pain)”; “Activity Analysis Overview: Physical; Sensory; Perceptual; Cognitive (but cognitions were to
be excluded from the APT model); Emotional; Social; Cultural; Environment (sic)”. The therapist is advised:
“You may wish to add your own local contact resources here. Suggested contacts/information sources: Citizens Advice
Bureau (exactly how much accurate information the CAB might hold about ME/CFS is not clarified);
Employment and educational schemes such as Job Centre Plus, Learn Direct etc; Welfare Rights; Locality issues;
PACE Trial integrity Rating Scale”. Pages 105‐111 are the same as pages 95‐100 of the CBT Participants’
Manual, though the sections appear in a different order.
Appendix 4 consists of “Participant handouts”; pages 114‐183 appear to be the APT Participants’ Manual.
A number of senior clinicians, medical scientists, statisticians and health analysts who are conversant with
this Manual have been derisory about it, variously describing it as “asinine”; “puerile”; as having “nothing
to do with medical science”, as “a disgraceful waste of money” and as “bringing disrepute upon the MRC”,
amongst other comments.