The CDC on Graded Exercise Therapy (GET) and CBT - from latest paper

Discussion in 'Fibromyalgia Main Forum' started by QuayMan, Oct 13, 2009.

  1. QuayMan

    QuayMan Member

    (From Co-Cure)

    Buried in the latest CDC paper on CFS (corresponding author is James (Jim)
    Jones and Bill Reeves also signed it:

    An evaluation of exclusionary medical/psychiatric conditions in the definition of chronic fatigue syndrome.
    Jones JF, Lin JM, Maloney EM, Boneva RS, Nater UM, Unger ER, Reeves WC.
    BMC Med. 2009 Oct 12;7(1):57.

    is the following:

    "As those with CFS suffer from personal, social, workplace [1] and observed
    financial losses [23], should not all individuals fulfilling CFS inclusion criteria,
    with or without exclusionary diagnoses, be considered in future public health planning? For
    instance, would both groups benefit from prevention and intervention efforts such as
    cognitive behavioral therapy and graded exercise therapy [24, 25]? A similar question
    could be asked of those who are unwell but who do not reach the diagnostic

    24. Edmonds M, McGuire H, Price J. Exercise therapy for chronic fatigue
    syndrome. Cochrane Database of Systematic Reviews 2004, (3):
    25. Price JR, Couper J: Cognitive behaviour therapy for chronic fatigue
    syndrome in adults. Cochrane Database of Systematic Reviews 1998, (4):

    This comment seems to presume that

    (i) public health planning should plan for CBT and GET for those with CFS


    (ii) that it could be unfair if those that had a CFS-like illness but had an
    unexclusionary diagnosis, as well as those who are unwell, are not offered
    these interventions.

    This gives an insight into what the CDC has in mind for CFS.

    Even this talk of CBT and GET as prevention for CFS is a thing that only
    "extremists" (in terms of GET for CFS) like Peter White talks about.

    Of course, at the last CFSAC meeting, Dr Reeves said the following about
    Peter White:
    "He's an unusually intelligent individual"
    (see below for a repeat of some of the comments referencing the UK system).

    So, I think if people are not careful, the CDC are going to be coming with
    guidelines similar to the (UK) NICE guidelines recommending GET and CBT
    based on GET (see more quotes below).

    This will not just affect people in the US but people around the world - in
    Ireland up to now, we have been able to use some of the information on the
    CDC website to counterbalance guidelines such as the NICE guidelines.

    But if the CDC guidelines also recommend GET and CBT based on GET,
    everything becomes more difficult.

    Tom Kindlon


    At the May 2009 CFSAC meeting, we heard :)

    - "CBT GET. We are in the process of planning a cognitive behavioral therapy
    (CBT) and graded exercise (GET) trial as part of the provider registry
    population in Macon. We're going to do that in collaboration with the
    providers in
    Macon, with Mercer Medical School, ***with the U.K. group***, and with Mayo
    Clinic. Obviously, CBT GET is not the cure for everybody. Nobody knows for
    how many it is. It probably applies to a subset."

    - ""International Workshop - Research, Clinical, and Pediatric Definitions
    CFS - I would like to try to get together by the winter of 2009. I know the
    is interested in this. We want to include countries such as UK that have CFS
    care completely integrated into their healthcare system."

    - "Dr. Reeves: An excellent comment. Our focus is obviously on the United
    There are three important reasons for international collaboration. One of
    them I alluded
    to. There are countries that have put CFS evaluation, diagnosis, and
    management into
    their national health systems. The UK is one of those. An international
    provides the chance to learn from another government that has embraced this
    illness- perhaps not to the extent that everybody would like-but is trying
    to work
    with it as a national health service."

    - "Peter White, the psychiatrist that we work with at Emory, does not look
    upon CFS as a
    psychiatric illness. What they are extremely interested in at Emory are the
    and brain pathways that mediate this. That is one of the things that Peter
    really added to the peer review-he is an expert on autonomic nervous system
    function. The
    fact that certain investigators have a reputation in a certain component of
    community for thinking that CFS is all in the patient's head is a result of
    the CDC's
    problems with communication."

    - "Dr Bill Reeves: "The collaboration with Peter White is largely because
    Peter White came to us when the national health service in the UK was trying
    design its program and formulate recommendations about what the health
    service in the UK should do.
    We've consulted with them as far as our ideas and our expertise, and we
    collaborate with Dr. White on the PACE trial. He's an unusually intelligent
    read some of his comments on some of our articles-whom we enjoy sparring
    with. He is an
    expert on autonomic nervous system function and he's highly instrumental in
    all of the hurdles, both with patients with the government and with
    physicians, in
    trying to put together, given the current state of knowledge, a national
  2. meditationlotus

    meditationlotus New Member

    that the new discovered retrovirus can enlighten these people. We need to get the corruption out of the CDC
  3. QuayMan

    QuayMan Member


    Thanks for that.

    Well done on another useful YouTube clip.

    If you had time, if you could even write a paragraph or two to the CFSAC challenging Bill Reeves claim [''That is one of the things that Peter White really added to the peer review-he is an expert on autonomic nervous system function.''] .

    Unfortunately you don't have much time (has to be E-mailed by 10pm UK time tomorrow). It would then be circulated to the members of the CFSAC, attendees and, if you want, put on the CFSAC website.

    You only get 5 pages now and I didn't have "space" to challenge it or give out as much as I would have liked about Peter White. We need people this side of the Atlantic to do it - people in the US probably don't know much about him (or at least probably won't mention him much). They might mention Wessely but it's really White who is close to the CDC these days.
  4. QuayMan

    QuayMan Member