Transcript THE EFFICACY OF MULTI-CONVERGENT THERAPY Marie Thomas Funded by The Gatsby Foundation and HMAW.

THE EFFICACY OF
MULTI-CONVERGENT THERAPY
Marie Thomas
Funded by The Gatsby Foundation
and HMAW
MCT
 MCT
 Developed in Cardiff by a Physiotherapist
Michael Sadlier
 Chronic Fatigue Syndrome,IBS, tinnitus,
vertigo, hyperventilation syndrome and
anxiety
MCT
 Reflects a bio-psychosocial and
philosophical approach to health
outcome2
 Advocates more active integrative role
for therapists in the assessment and
management of beliefs and emotions
2 Engle, 1997
MCT
 Combines CBT and GET
 CBT
 Aims to identify factors – predisposing,
precipitating and perpetuating
 Improve sleep quality
 Restructuring of beliefs, thoughts and
behavioural patterns
 GET
 Introduction to planned activity and rest
(pacing)
 Is introduced after exploration of
relationship between fatigue and
cognitions
 Follows the rationale suggested by
Noakes et al (2005)
MCT
 Also included:
 Mindfulness meditation
 Heart Rate Monitors
MCT
Treatment trial conducted to formally
evaluate MCT in severe disability
(CFS)
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35 patients
 12 MCT
 14 Relaxation
 9 non-intervention controls
MCT for CFS
 Primary outcome measure3
 Functional performance
 Above 80%
 Secondary outcomes4
 Improvements in overall illness condition
 Improvements in fatigue
 Improvements in disability
3 Sharpe et al., 1996
4 Deale et al., 1997
MCT for CFS
100
90
Improvement in condition (%)
80
70
60
50
40
30
20
10
0
Pos t-therapy
6 months
MCT
Pos t-therapy
6 months
Relaxation
Pos t-therapy
6 months
Control
MCT for CFS
80
Reduced Disability (%)
70
60
50
40
30
20
10
Pos t-therapy
6 months
MCT
Pos t-therapy
6 months
Relaxation
Pos t-therapy
6 months
Control
MCT for CFS
80
Reduced Fatigue (%)
70
60
50
40
30
20
10
Pos t-therapy
6months
MCT
Pos t-therapy
6 months
Relaxation
Pos t-therapy
6 months
Control
MCT for CFS
 Other improvements in the MCT
group included:
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Improved sleep quality
Improved activity levels
Lower symptom scores
Improved cognition
MCT for CFS
 A recent follow-up assessment of MCT
participants, 3 years post-therapy:
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Continued improved functioning
Lower levels of fatigue
Lower levels of disability
Continued improved sleep
Continued improved activity
Lower symptom scores
MCT
 To summarise:
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Improves physical functioning
Improves overall illness condition
Reduces fatigue
Reduces disability
Improves sleep quality
Improves activity levels
Improves the chance of return to work