BBC and ASA on CEASE therapy and the Society of Homeopaths

It's been known for a week or so that the BBC Breakfast report of 22/04/2019 on CEASE therapy was coming. It wasn't known until more recently that there would also be a report on BBC Radio 4 You and Yours. The Advertising Standards Authortity (ASA) blog post came out of the blue though (it was available to journalists though).

Some astute readers may have noticed a link between what is written on this blog and various media reports. This blog has a limited audience and working with journalists and mainstream media outlets is a way to reach a much wider audience. To be frank, it often has the effect of getting regulators to act. Some regulators seem to believe that they can ignore concerns about CEASE therapy from members of the public.

These reports have nothing directly to do with this blog.

ASA action
The blogpost by ASA CEO Guy Parker is quite hard hitting and tells us -

As part of that, our team has referred several cases to Trading Standards for further investigation. Any breaches of criminal legislation could lead to prosecution. Others could well follow.

Elsewhere is said that there are five cases. One of them is almost certainly Alan Freestone but the identity of the others is unknown. The ASA recently changed to using Bucks and Surrey Trading Standards as their legal backstop.

Whether or not any of these cases will result in prosecution is not clear. 

It has been known for some time that the ASA conducted a compliance exercise but the ASA did not want this to be made public. The enforcement notice was sent to 150 homeopaths that the ASA knew of from a few websites that listed UK homeopaths with a "qualification" in CEASE back in May 2018. Why it has taken the ASA so long to make this public is unknown.

It is the advice given in the notice that is of note -

Although advertisers may provide information about the history of a therapy, care should be taken not to make unsupported claims for the treatment when describing its background. It is very likely that referring to the therapy by its full name will also be problematic given the implied efficacy claim within it (see below).

And

As noted in point 1 above, the ASA would be likely to regard a reference to the therapy’s full name, ‘Complete Elimination of Autism Spectrum Expression’, as an implied efficacy claim. Further, any text which links CEASE therapy to autism and / or other spectrum-related conditions could amount to an implied efficacy claim. As shown in the ASA’s ruling, this can include visible text within URLs (as actual website page names, and as URLs within that website linking to external websites). 

If a testimonial includes direct or indirect efficacy claims, then this will be subject to the same rules as any other claim. In other words, where efficacy has not been established, a testimonial should not be used to imply that it has. Patient testimonials alone are unlikely to substantiate objective claims about the efficacy of a product or therapy. Moreover, the use of a disclaimer is unlikely to be sufficient to counteract any misleading impression.

CAP and the ASA understand that the body’s liver and kidneys automatically detoxify and excrete many toxic materials, including metabolic wastes, and has not seen evidence to support the theory that toxins can be removed from the body by other means, so care should be taken to avoid claiming or implying otherwise.

The last point suggests that it may be worth looking again at the websites of CEASE practitioners for claims relating to "detox".

There is something missing from the notice though and that is the claim that vaccines cause autism. In the current climate, using anti-vaccination propaganda in marketing is an absolute no-no. 

Implication for the Society of Homeopaths
So, it is now known that the enforcement notice was sent to SoH members. It is also the case that if the SoH were not made aware of this by the ASA, they certainly were by others. The SoH's response to the BBC reporting is somewhat odd -

The Society of Homeopaths said the therapy may now be renamed.

Yes, renaming something is going to magically transform it from an bogus cure for autism that advocates medical neglect of children into something else? Hardly. As previously discussed the name "Complete Elimination of Autistic Spectrum Expression" is both misleading and deeply offensive to many autistic people.

The Society of Homeopaths said that some of the terminology surrounding Cease has been misleading and it would take steps to avoid unsubstantiated claims being made.

Again the focus on claims, not the practice. The SoH should have taken the guidance on board during their reviews of member websites. The ASA are very clear in the kind of claims that are unacceptable.

The SoH seem to have forgotten what the Professional Standards Authority (PSA) made of the practice. They saw risk written all over it.

The Society stated that undertaking CEASE training does not imply that a practitioner will claim to completely ‘eliminate autistic spectrum expression’, apply the entirety of CEASE methods within their practice, or undertake any action that would breach the Society’s Codes. However, there did not appear to be any supporting evidence for this, such as mitigating statements, on registrants’ websites or on the Society’s website or other public materials. The team suggests that the main sources of information for CEASE therapy would inform the public that its purpose is to treat autism (and other disorders and diseases) and to steer clients away from conventional medicine. 

The team suggested that from the information available, the Society would need to provide significant assurance to the Panel that it continues to meet the Standards for Accredited Registers. The Society committed to developing public guidance outlining the scope of CEASE therapy that is acceptable to incorporate into registrants’ practice. The Society would then develop a mechanism to assure that registrants who do apply aspects of CEASE in their practice do not contravene relevant standards. The team suggested that the Society had an opportunity to enhance public protection by publishing an industry-leading resource highlighting risks associated with CEASE therapy and appropriate standards and advertising guidance for practitioners.

And there's the rub. Although the SoH were subsequently re-accredited by the PSA, this was conditional on the implementation of a plan to deal with the PSA's concerns over CEASE. There is little evidence that much in the way of action has been taken. Does the SoH currently meet the Standards for Accredited Registers?

As things currently stand, this seems unlikely. Many members are still listed on the CEASE-therapy.com website. It is possible that some have requested removal and it hasn't happened but that might be a violation of General Data Protection Regulation. Some still link to the site and a few still make outrageous claims. All potentially face expulsion for the SoH. 

It would be difficult for the PSA to re-accredit the SoH for another reason. The Equality Act 2010 and Public Sector Equality Duty (PSED) were mentioned in a previous post. Autism is a protected characteristic - and it could be very strongly argued that accrediting a register whose members practice something that advocates neglect of autistic children would be PSED failure.

If they did re-accredit the SoH without the issue of CEASE therapy being resolved, that could be challenged by Judicial Review. The PSA are aware that an application for Judicial Review is very possible.

This is crunch time for the SoH. They must decide between dealing with members offering CEASE (which would have severe financial implications) or giving up accreditation (which would be humiliating and might cost CEO Mark Taylor his job). 

If they don't deal with CEASE, the PSA will have to remove accreditation.

This is a lose-lose situation for them. Media reporting is likely to be extremely hostile in any case.