Kaptchuk (2008), Components of Placebo Effect: Randomised Controlled Trial in Patients with Irritable Bowel Syndrome. (PRO)
Argument 1: Kaptchuk (2008) suggested that placebo effects (non-specific effects) include three components: a patients response to observation and assessment, the patients response to the administration of placebo treatment, and the patients response to the patient-practitioner interaction. Kaptchuk (2008) found that the symptoms of IBS patients in the condition with placebo treatment and supportive patient-therapist relationship ameliorated the most across all measures compared to patients with having only observation and the patients with only placebo treatment. Thus he claimed that a supportive patient-therapist relationship is the most potent component of placebo effects.
Argument 2: After three and six weeks, only in the condition with placebo treatment and supportive patient-therapist relationship, the symptom severity score of 60% patients decreased 50. Also Kaptchuk (2008) found that after six weeks, the change in life quality of patient in condition with only observation and the life quality of patient in condition with placebo treatment was similar, but the life quality change of patient with placebo treatment and supportive patient-therapist relationship was observable. So Kaptchuk (2008) suggested that a supportive patient-therapist relationship can enhance clinical improvement.
Argument 3: Kaptchuk (2008) also compared these IBS patients to the patients who received IBS drug treatment. He found that the patients with placebo treatment and supportive relationship had comparable symptom relief as those who with drug treatment. His finding was only applied to IBS patients with supportive patient-therapist relationship, thus he indicated that a supportive patient-therapist relationship could enhance the efficiency of clinical treatment.
Critique (or Strength): The result of the study done by Kaptchuk (2008) clearly demonstrated the importance of supportive patient-therapist relationship in medical treatment. However, Kaptchuk conducted the study on IBS patients, because he believed that placebo effects are most likely to be demonstrable in disorders defined by subjective symptoms. As Kaptchuk (2008) stated in limitation that he did not know if his finding could be applied to other illnesses, I also think that if Kaptchuk conducted his study on patients with the disease that has external causes, the results will be more convincing. One of important causes of IBS is stress, a subjective etiology. Thus a supportive patient-therapist relationship may have greater influence on IBS patient than the patient with other diseases, like flu.