<< Herb Silver, PT, MBA (but I also have a BA in psychology, hence my
leaning
towards to touchy feely side of things)>>
What's a BA, Herb? I like your point of view btw and I think that a
psychology degree is very valuable in PT. I've had many patients that spill
their guts out about family, work and all kinds of other problems. Sometimes
I feel more a psychologist than a PT.
Isaac
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Fra: Herb Silver, PT, [mailto:[log in to unmask]]
Sendt: 12. november 2000 18:48
Til: [log in to unmask]
Emne: RE: Belief and placebo
There is a difference between "the placebo effect" and patient/"healer"
interactions. I once told a class that empathy and all that go along with
it from listening certain environmental effects like ease in scheduling,
clean workplace, nice equipment, etc. all impact results independent of any
treatment skills--in fact, in many cases I would estimate that those issues
are responsible for over 50% of treatment. I think the variation in what
we are calling placebo from 40-70% depending on the study is the variation
that occurs when the practitioners are able to "enhance" non
pharmacological/physiological effects" and do not take into account
psychophysical effects compared to when these effects are not
"enhanced". For instance, I used to work in a privately owned physical
therapy clinic that was located on The Hughston Clinic Campus which is an
internationally known orthopedic facility--we used to say that people got
better to some extent just showing up. I am sure that is true when trials
are carried out at Harvard University or Emory University--even if you are
receiving a sham treatment at one of those locations, it is "better" than a
sham treatment in a dirty, inner city health clinic staffed by tired,
overworked, underpaid staff. So, my advice to my class was to do your best
at enhancing these effects--they are actually "free" since close to 50% if
not more of your treatment effect comes from just being a good person with
a nice facility with other caring staff members. (One of my students
misquoted me as saying "you want to do your best a faking yourself out to
the patient"--hardly what I said.) You want to enhance the non
physiological/pharmacological effects, which are mistakenly sometimes
referred to as placebo. In order to measure placebo, we have to be aware
of ALL the treatments, which include empathy and other psychophysiology
interactions.
Herb Silver, PT, MBA (but I also have a BA in psychology, hence my leaning
towards to touchy feely side of things)
At 11:25 AM 11/12/00 +0000, you wrote:
>Simon, I did a lot of reading around placebo effect for a recent uni
>assignment on 'human interaction and the healing process.' Some really
>interesting examples including cases of Voodoo death! Refer to chapter 1
of:
>Rossi E (1986) The psychobiology of mind-body healing. WW Norton & Company,
>New York.
>It makes you realise there is so much more to any treatment than the pure
>pharmacological/physiological effects, and that placebo is much more than
>'sham' treatment. I have many more references if you are interested.
>
>Linda
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