Archives for the month of: May, 2014

This post is best understood in the context of previous posts in this blog.

On Wednesday 28th May, at 8pm, in a quite unexpected way, the question of harassment was raised in relation to this blog. In the process, I enjoyed a conversation with a pleasant and constructive police sergeant, who was both careful and thoughtful in the long and interesting discussion which we had. This experience (which as I say was a good one) meant that I then carefully considered and reflected on my own motivations in blogging about, so far, Channel 4 and Betty TV, IAPT and the Linden Method. There are a range of immediate triggers and influences involved here, which are for the most part set out in the relevant blogs. However, I found it helpful to consider the values which underpin my motivation to put this stuff out there, and the extent to which these values lead to any kind of harassment. Although this is a simplification, the results of my reflection so far are:

All of us, within the limits of our capabilities, have a duty to bring attention to deception and dishonesty which demonstrably has a negative impact on those who are more vulnerable.

If we allow ourselves to be intimidated into not doing this when we truly can, then the total sum of decency in the world is diminished and we as individuals are seriously devalued.

Publicly identifying such falsehoods is not harassment. Publicly perpetrating falsehoods for personal or commercial gain is fraudulent and should activate our sense of duty to others.

Seeking to supress exposure or criticism of falsehoods perpetrated for personal or commercial gain is also fraudulent.

Now I am fully aware that those who take the moral high ground risk being buried in it, so I would be most grateful for comments from anyone who disagrees with me reasoning around these values, which, I think, are similar to those held by many others who publish blogs. In part this is about “public interest” but, I think, more about personal values.

By the way, the originator of the complaint of harassment made against me was one Lyndon Charles Griffiths alias Charles Linden. Extraordinary!

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I was surprised that Kingston University had allowed the use of their logo to promote the Lindon Method “research” study, so I asked them for clarification. Here is what they said (and copied to me):
Dear Kirsten:

I can’t find such a person registered on any course at present, and the name is not familiar from the past. I’ll circulate and see if anyone knows him. We certainly don’t endorse any such programme – can you arrange for a “formal” university request that the logo be removed from the site and that there be no mention of the university whatsoever in this context?

Regards,
Phil.

Then directly to me: Thanks for alerting us to the issue! He appears to be an ex-student who graduated with a BSc back in 2006; we can’t find any other link to the university.

Best Wishes,
Phil.

A reply from the British Psychological Society.

Dear Paul

Thank you for highlighting your concerns. I am currently in discussion with a member of the management team for the Linden Centre, and I have already requested that the Society’s main logo be removed from all of their websites. I will also highlight to them any statements that the Society deems to be factually inaccurate.

As far as I am aware, the Chartered Psychologist logo/title has been used to promote one of their support staff who is entitled to use this; the Chartered Psychologist logo has been displayed to clearly identify the Chartered member.

I hope you find this information useful, I would like to reassure you that this is being dealt with.

Once again, thank you for bringing your concerns to our attention.

Many thanks

Kajal

I am committed to and enthusiastic about the English Improving Access to Psychological Therapies national programme. It is barely five years old, and has acheived a great deal in this time. It is patchy in places, which is to be expected and needs to be dealt with. It is set to meet its target of 900,000 service users seen in the coming year.

The maths are compelling

900,000 treated.

400,000 predicted to resolve their diagnosed problem.

Of the 500,000 who do not, then lets suppose that 50% improve somewhat.

That proably leaves 250,000 passing through IAPT and who have failed to improve and with needs unmet.

The Elephant in the IAPT room is identifying a clear need for early stage treatment, meeting it for some but not being able to for others. It is quite appropriate that the needs of these people have been identified and their hopes for recovery or at least improvement raised. But what happens to those in whom hopes have been raised but not realised? Should they subside into their previous state and give up?
No, of course not. There is clear evidence that what is needed is stepping up…that is, the offer of higher intensity therapy; for example, in OCD, intensive CBT or CBT delivered in the context of more highly expert therapists. Similarly with other problems.

The Elephant in the room is that the success of IAPT inevitably means a very considerably greater demand for highly specialist treatment delivered by appropriately skilled and supervised therapists on the basis of best evidence. I have seen data which indicate that despite popular belief, the introduction of IAPT has not resulted in the disappearance of tertiary psychological treatment services; these have remained pretty constant, which is a relief. However, by any calculation I can make, this is not nearly enough in the context of a improving access appropritely stimulating need for advanced treatment for people experiencing more severe or more complicated problems. So what can we do?

While reviewing my critique of Jensen’s “research” in order to check the accuracy of what I had said, I noticed that there had been an addition in a webpage I hadn’t seen before.

http://www.thelindenmethod.com/evidence/

This says:

“The study applied a repeated measure design, which is also referred to as a controlled study and as such classifies as class II evidence.”

I’m afraid not. No one aware of trial design would call this a controlled study.

Anyway, I’m looking forward to seeing this paper in a quality peer review Journal. Perhaps the Lancet or BMJ? Good Luck with that.

Pot-Kettle?

http://www.cps.gov.uk/legal/s_to_u/stalking_and_harassment/

Watch this space!

Ahaaha…..Update needed. In addition to the various pages being taken down by the Linden Method group, some of the webpages alluding to organisations which dont support them, there have been a number of changes to other webpages, which all have the effect of making them a tad more honest. So credit to them.

In case the Web Editors at TLM are listening, the Universities of Kingston and Copenhagen dont believe themselves to have endorsed you, so you mgiht want to look at that too? Good to see the removal of the University of Copenhagen stuff from Charles FAcebook Page.

I am also delighted to see that the webpage for the “Linden Foundation” quasi charity has been removed.

All that remains now is

(1) Wider dissemination of the concerns raised in this blog and, increasingly, elsewhere. Please feel free to attributably quote this blog or link to it, but be aware that some of the things I linked to have now been removed (for obvious reasons, as indicated above)

and

(2) for TLM to remove their overblown claims for effectiveness

Thaks also for the range of positive feedback on these posts; it has made the ridiculously large time investment in creating these posts worthwhile.

Paul

Martin Jensen, claimed by Linden Method to be an independent researcher but who is in fact the Danish Linden Method Manager, took the time and trouble to respond, after a fashion, to my critique of his “research”.

https://psychonoclast.wordpress.com/2014/05/20/more-utter-and-complete-tripe-masquerading-as-research-on-the-linden-method/comment-page-1/#comment-36

Worth a response, I thought, so here goes:

To Martin Jensen, in response to his comment:

Thank you for taking the trouble to get in touch

The reasons for my recent re-activation of interest in the Linden Method is identified in detail in the blog; if you want to understand why I have recently made time to follow up my ancient review, please read it there.

You are right about the need for hard evidence. Your piece in the Linden Method website is not such evidence, not even close.

I made 14 points regarding your “research”; it took ten minutes. Literally, before breakfast this morning. Can I suggest that you deal with these? As you appear to be short of time, I have reproduced them at the end of this reply. I of course missed out the really really big one, because it is altogether too obvious: that this bears no resenblance to a randomised controlled trial, the only evidence of efficacy that is acceptable.

For some reason, you only comment is on something I did not remark on in detail, which is the statistics. Can I remind you of what Mark Twain said:
“There are three kinds of lies: lies, damned lies, and statistics.”
By this he meant that statistics can be used to lend authority to spurious assertions, which is what you have done with statistics. Although I commend you on your use of SPSS (something every undergraduate can do), your shortcomings in the understanding of statistics are indicated by your assertion that the GAD-7 is an ordinal scale. This is only true of the individual items, not the scale as a whole.

You assert that the statistical analysis somehow deflects criticism. This is like saying “it must be right because I used a computer”. There is another relevant phrase here: “Garbage in, Garbage out”. Statistical analysis is a tool in order which is part of a process of establishing validity of an appropriately conducted study. The statistical analysis would be sort of OK (but only sort of) if the study were well conducted; however, see the problems identified below.

You can’t make a silk purse from a sow’s ear….so I will not waste my time on your fatally flawed “data” embedded as it is in a fatally flawed study, but thanks for the disingenuous offer.

Regarding the Copenhagen CTU: you may not have said you were associated with it, but the Linden organisation did. A webpage in the Linden network (link in my blog section with the title “Tripe”) indicated that this (your) study was coming and that it had been approved by the University of Copenhagen CTU, a group I have worked with on a clinical trial in recent years. I contacted them (and you can see their reply in the same post about Tripe) about this . Shortly afterwards the webpage removed reference to the CTU, I’m guessing because they didn’t like their organisation being associated with your study. I have, of course, kept a screenshot of the original. You may want to think about your own work carrying the logos of the University of Copenhagen and Kingston Universities, and your misrepresentation of the Linden “therapists” as BPS and BACP registered.

I have spent too much time on this again; I hope you understand the brevity of my response, and thank you for clarifying your position.

Paul

So, to remind you: the critiques I made were

1. This is not a peer reviewed article. It is on Linden Webpages.
2. It is not independent. The author, Martin Jensen, is Manager of Linden Method Denmark
3. It is not an efficacy study
4. Kingston University and University of Copenhagen are unlikely to have authorised the use of their logos.
5. The introduction contains no references to published authorities
6. Those who completed questionnaires were chosen and contacted by “specialists” (alleged therapists) working for TLM. Massive source of bias
7. The specialists are falsely described as registered with “British Association of Chartered Psychotherapists” (sic) and The BPS. Clearly false claims.
8. Adherence is specified as a selection criterion!
9. Even given the extraordinary method of sampling, 39% refused to participate! Only the 61 who complied were included
10. The GAD-7 was used. Only it wasn’t! in the “measure” section it specifies that it was phrased “Prior to doing the Linden Method, how often have you been bothered by the following problems?”. I’m pretty sure that the copyright holders did not permit this change, and the change means that it is not the standardised measure it is supposed to be.
11. Two measures…but not. They completed both “before” and “after” measures at the same time After. Hah! Do I need to spell out how inappropriate that is?
12. Analysis: the data were said to be ordinal. Wrong.
13. The discussion reads as a faux cautious advert for the linden method.
14. There is a limitations section. Heck, the whole paper is a limitations section.

Although I realise how busy you are, I would be happy to look at your responses to these important issues.

Update: So far no response From Martin. However, I notice that on facebook Charles Linden has removed his puff-piece on the so called clinical tripal sorry trial. This may or may not be connected with my contacting University of Copenhagen about his use of their logo? Or possible adverse comment from people referring to my actually independent review of the efficacy study which wasn’t? Or both? Or something else? Good to see Charles Linden maintaining a dignified silence too. Now I did the same despite his critiques of my review from 2006-20014, so if it follows the same pattern then all will remain silent until 2022? Means i can go back to my day job!

The claims made for the linden method have kept on coming. The latest has just (May 2014) been put up with a fanfare that it is an independent piece of research.
http://www.thelindenmethod.co.uk/clinical/
On his facebook page, Charles Linden claims, in response to question about whether the study was peer reviewed…..
“it has been peer reviewed by psychologists and psychotherapists. No one else uses The Linden Method in practice Jess so the trial process chosen makes allowances for this. It was very strictly controlled and monitored.”
I thought it worth a brief shove to demolish it, not least to show how extraordinarily distant from anything resembling science it is. So here are a few points which any undergraduate could identify. This is not a complete list, just the “smack you in the eye” obvious ones
1. This is not a peer reviewed article. It is on Linden Webpages.
2. It is not independent. The author, Martin Jensen, is Manager of Linden Method Denmark
3. It is not an efficacy study
4. Kingston University and University of Copenhagen are unlikely to have authorised the use of their logos.
5. The introduction contains no references to published authorities
6. Those who completed questionnaires were chosen and contacted by “specialists” (alleged therapists) working for TLM. Massive source of bias
7. The specialists are falsely described as registered with “British Association of Chartered Psychotherapists” (sic) and The BPS. Clearly false claims.
8. Adherence is specified as a selection criterion!
9. Even given the extraordinary method of sampling, 39% refused to participate! Only the 61 who complied were included
10. The GAD-7 was used. Only it wasn’t! in the “measure” section it specifies that it was phrased “Prior to doing the Linden Method, how often have you been bothered by the following problems?”. I’m pretty sure that the copyright holders did not permit this change, and the change means that it is not the standardised measure it is supposed to be.
11. Two measures…but not. They completed both “before” and “after” measures at the same time After. Hah! Do I need to spell out how inappropriate that is?
12. Analysis: the data were said to be ordinal. Wrong.
13. The discussion reads as a faux cautious advert for the linden method.
14. There is a limitations section. Heck, the whole paper is a limitations section.
There is more that could be said, but it is not worth the reader or writers time here. Individually, each of the items above would rule out regarding this as “research”. This is not just a useless paper: it is actively misleading, and in my view shows signs that it was intended to be so, as does its representation in the Linden publicity machine. A shameless piece.

In my original review, I pointed out that extraordinary claims, such as those made for the Linden Method, require extraordinary evidence. Well, I got the extraordinary evidence in this “research”. However, this was definitely not what I meant!

I wrote an email to Queens University Belfast about their apparent support for the Linden Method. I have not heard directly from them, but guess what? The webpage has been taken down. Might there be a connection? Did Queen’s University Belfast by some chance not approve of their reputation being used in this way?

the email I sent to their comms team was:

Dear Sir/Madam
Not entirely sure who to address this query to; please feel free to forward it.
I have recently been looking into “the Linden Method”, a high-cost anxiety self help programme. A couple of years ago I had been contacted by a Dr Francis Teeney who indicated that he was from QUB; he sought to persuade me of the merits of this programme. More recently the programme came to my attention again, and I came across this website:

http://www.anxietyrecoveryretreat.co.uk/emotionsresearchconsortium.html
There are other similar references on the web. So: my question is as to the status of this “research consortium” which appears to be based in QUB and drawing on your reputation.

I look forward to hearing from you in due course
With best wishes
Paul Salkovskis