PowerTips August 2001

Power Tips

Electronic Journal for the New Psychotherapies - V17/8/01
The Official Journal of The Association for Meridian Therapies

Welcome all readers, old and new, to the August 2001 edition of Power Tips, the first electronic journal in the world for the new psychotherapies.

Our focus this month is on developing at least an awareness of evidence-based clinical operations, and hopefully will lead to a greater number of practitioners evaluating and demonstrating the efficacy of their work.

Particularly because our therapeutic approaches are so new, unless we are willing to engage in stringent evaluation of our work, we are not only open to charges of participating in pseudo-therapy, but we are also blissfully unaware of the true nature of the results our clients are getting or not getting.

Best wishes
Christine Sutherland

This month we have the following:

• News from the Association for Meridian Therapies. Announcing the download section and comments option!
• A model for ongoing evaluation of clinical efficacy. This is a relatively simple way to measure and track the progress of your clients. We also present a plan for engaging in international data collection on a range of approaches to the treatment of depression.
• A proposal for a clinical trial. Clinical research need not be expensive, nor complex. Here is a simple design for a clinical trial, leading you step by step through planning, running, evaluating and writing up your own research.
• Problem solving using Dilt's "neurological levels". Here is how an NLP concept can be used to solve problems relatively effortlessly, and congruent with our whole being.

Our new and advanced interactive web portal is now operational. It is still a work in progress but the main features are up and running and they include:

· A great downloads section where you can download longer files that are too cumbersome to display in web pages and including free books on EFT and BSFF

· Printer friendly options for all the articles (look for the little print icon on the articles and this will just print the article and not anything else, such as navigation bars etc, that appears on the page);

· The ability for anyone to *comment* on the articles and news items - if you register as a user of the portal, you can post comments with your name and otherwise, you can post anonymously;

· The ability for anyone to *submit news and content* with a simple form - you do not have to be registered with the site to tell a story, submit a case history or share an exciting discovery. Indeed, one of the nice features is that *articles are date stamped* - so if you have developed something new, it may be wise to post an announcement so no-one can say later that they invented it first;

· Web links section for you to add to your site;

· Reviews section so you can warn others of evil products or alternatively, recommend books, products and trainings you thought were excellent (reviews submissions *must be* signed with your name!)

This site is a community portal and anyone interested in or involved with Meridian and Energy Therapies is most welcome to use it as a platform to help inform the public and share their views.

Under construction are the new TheAMT.com electronic bookstore and the international practitioner referrals.

Any questions about TheAMT.com portal and attachment submissions including files to add to the downloads section to webmaster(at)theamt.com please.

How do we know that what we do is effective? Many of us are proud of the results our clients get, and for those of us who have been in the helping professions for decades, we are particularly excited about or even grateful for the seeming enhancement of our effectiveness since the advent of the "power" therapies or the "energy" therapies.

The truth is, unless we have documented evaluation in place, together with follow-up, we really do not know what our clients' results are in the short term, let alone the long term, and we have no right to make any claims relating to our effectiveness. Being subject to our own filtered perceptions, just like everyone else on the planet, we cannot know whether the odd client we get to hear about down the track is representative or not, or to what precise degree.

To make claims in the absence of satisfactory evidence is to hold ourselves up as a laughing stock. This does ourselves, our clients, and the wider community a greater disservice because it alienates the very people who most stand to benefit.

It is not enough to simply go on providing unevaluated therapy on the grounds that "love will lead the way". It has been pointed out to me that a person may be flying a plane across the Atlantic with all the love in the world, but unless he or she is adequately trained or qualified, it is unlikely to end in a soft landing. One only need look at some of the questions asked by "therapists" on the various energy and other chat lists to discover very rapidly what a tremendous number of ignorant people are out there ministering to the distressed with much love and very little else.

Stringent evaluation, participated in by competent therapists, not only provides a yardstick by which individual and overall efficacy can be measured, but if open to public inspection, becomes a way of protecting the public from the ministrations of the ignorant. You might like to think of the possiblity here of a long overdue exercise in quality control.

A Suggested Model

At Lifeworks we have designed and trialled an evaluation system based on clients' own ratings of the various symptomatology with which they have presented. A SUD rating is notated against each "symptom". Items which clients specifically choose to work with are flagged. On each successive visit, each item is revisited and a new SUD notated. We follow-up, with the client's permission, at 6 and 12 months post treatment.

This simple system, requiring almost zero statistical ability, allows us to determine the percentage improvement of the treated issues, as well as the percentage improvement overall, over time. We also ask for qualitative feedback concerning not just any improvement, but also relating to the client's experience of the therapist and the client-therapist liaison itself.

Documents relating to this system will be available in the near future from the GoE web site, on registration as a participating therapist. No information will be collected which could identify any client.

A Proposal for a Clinical Trial

Over and over therapists utilising more modern neuro-somatic (eg EFT, TAT, BSFF etc) or neuro-linguistic (eg NLP) techniques have been severely taken to task by colleagues, academics and professional associations or boards for not demonstrating the evidence base for our practices.

This is a valid criticism and I join with them in agreeing that "extraordinary claims require extraordinary evidence". Fully aware that I am stepping into a minefield, I have to state that I believe our extraordinary claims can certainly be backed up by clinical research. I also believe that any such research findings will one day be disproved. All we can demonstrate for now is efficacy. I do not believe we can provide evidence for precisely what it is that is working, nor can we provide acceptable theory. If that knowledge is available (eg the excellent work of Furman and Gallo - "The Neurophysics of Human Behavior"), it is certainly not widely so, and is therefore unlikely to be acceptable to critics.

So what is it that we can demonstrate? I believe that we can demonstrate that when a number of practitioners utilise a range of neuro-somatic or neuro-linguistic (or spiritual) therapies with people suffering mental distress, there is clinical and statistical evidence for the superior efficacy of those therapies over a "no treatment" group (the control group) and also over an "alternative treatment" group (eg, where a widely accepted therapy, such as CBT, is utilised).

So how do we go about planning, executing and evaluating such a trial? After all, a relatively sophisticated grasp of statistics is required, so that the results can be properly evaluated and errors avoided as much as possible. The GoE, in collaboration with Lifeworks, proposes the following:

• That suitably experienced and qualified therapists around the world are invited to participate in a clinical trial on utilisation of the new psychotherapies for depression. We have chosen depression because it is one of the most common and rapidly growing mental health problems on the planet, and is predicted by Murray and Lopez (commissioned by World Health Organisation) to be our major health cost by 2020.
• That some therapists will undertake to use only the new psychotherapies, while some will undertake to use only CBT.
• That each therapist will have a third party randomly compile a control group and a treatment group, with members of both groups self evaluated using the Montgomery Asberg Depression Rating Scale and The Lifeworks Joy Inventory.
• That the treatment phase be no longer than 2 full days. (We set that limit firstly because the trial must not be a financial or time burden to participating therapists, and secondly because Lifeworks recently ran a clinical trial on depression and achieved 100% elimination of depression after 6 days, we believe we can be reasonably assured, after 2 days, of an effect size which demonstrates clinical and statistical advantage.)
• That on day 3 of the trial, participants and control group again self evaluate using the same rating scales.
• That at 6 months and 12 months, participants and control group again self evaluate using the same rating scales.
• That data from these 4 evaluation phases be remitted to the GoE for statistical analysis and compilation into a technical report which contains a review of the literature relating to depression and depression treatment, abstract, hypothesis, method, description of instruments, procedure, results, discussion, and references.
• That the technical paper be submitted to reputable medical/scientific journals for review.
• That copies of the paper be made available electronically to therapists who have taken part in the study, as well as to other appropriate interested parties as determined by the GoE and Lifeworks.
• That copyright remain with the GoE and Lifeworks.

Please register your interest in taking part in this trial by sending an email to Christine@lifeworks-group.com.au. All participating therapists will need to provide documented evidence of their qualifications and level of experience with the particular technique/s they propose utilising.

Problem Solving using Dilt's "Neurological Levels"

The NLP model of “neurological levels” was originated by anthropologist Gregory Bateson and developed by Robert Dilts. These are

Identity: Who am I?

Beliefs & Values: What do you believe? What’s important to you?


Capabilities: What capabilities govern a behaviour?

Behaviour: Particular behaviours one undertakes

This is a kind of chunking, isn’t it, with each level containing the information for the level below it.

If we change something at one of the lower levels, it does not necessarily change that something all the way up the hierarchy. However if we change something at one of the higher levels, it causes changes in every level below.

You can use logical levels to problem solve, to goal set, or to achieve more congruency in the way you live.

Today we'll look at problem solving using a floor exercise which steps us through the neurological levels of the experience of "having the problem". Here are the instructions:

As a floor exercise, step out the various logical levels, commencing with the environment level and ending with the spiritual/purpose level, in each case describing out loud the significance of the level to that state.

(Eg, at environment level, describe where you are, having that problem; at behaviour level describe what actions you are engaging in that cause or reflect the problem; at capability level describe the skills and knowledge involved that allow you to engage in or tolerate that behaviour; at beliefs/values describe what you believe about the problem that allows you to use those capabilities; at identity level describe who you are that would have that problem, at spirituality/purpose describe your overall purpose or vision for your life (perhaps as a symbol) in having that problem.)

At what level does that problem "break down"? Particularly notice how your vision or insight of your purpose affects every other level.

Maintaining that clarity of vision/purpose, step back into the level of identity and feel your identity merge with your purpose.

Maintaining your purpose and identity, step back into the level of beliefs and feel them all merge.

Continue stepping back into each level, bringing the merged qualities of the other levels with you, until you are back at the level of environment, knowing that you have all these resources at your fingertips, perfectly aligned and congruent, whenever you wish to use them.

Where is your problem now?

Note: There are very many ways to run this exercise. For instance, instead of starting at the level of "environment" with the problem, one could start at that level "with the problem gone". Remember this exercise is only partially for the benefit of the conscious mind: far more is going on unconsciously.

We welcome your comments and suggestions to Editor@lifeworks-group.com.au.