Background
Summary of council decision:
Two issues were investigated, both of which were Upheld.
Ad description
A website for Brainworking Recursive Therapy organisation The Terence Watts BWRT Institute, seen on 4 November 2018.
On the website’s home page, there were links to six pages beneath the site map bar. One of the links titled “Total Professionals” led to text that stated “Every professional practitioner listed on this site has completed the 'official' BWRT training process and has completed a professional assessment to ensure their skills and suitability to practice as a BWRT Professional Practitioner. The skills they have trained in allow them to work competently and confidently with a huge number of psychological issues, including Weight management… Stress and Anxiety, Social Phobia, Fears, Generalised Anxiety Disorder (G.A.D.), PTSD (Post Traumatic Stress Disorder), Depression. In addition, those qualified as Level 2 - Psychology of Identity and Behaviour can also work with complex issues such as alcohol dependence, addictions of all types, eating disorders, self-harming, suicidal thoughts and more. And those qualified as Level 3 - Psychobiology - can work effectively with many physical conditions, including Fibromyalgia, CFS/ME, I.B.S., Chrone's [sic] disease; Colitis, Autoimmune disorders and more”.
Along the site map at the top of the page was a subsection of the website “Testimonials” which led to another page “Testimonials from Clients” in which text stated “The BWRT sessions that Mary has done with me have been extremely effective in helping me cope better with my Attention Deficit Disorder and associated anxiety” and “after 6 days of therapy… I stopped skin picking, PMS was much smoother this time”.
Under another subsection of the website titled “BWRT Training” text stated “As you might expect, the training is thorough and provides a rapid method to work with, among many other issues: Phobic response patterns, Habits, Eating Disorders, Depression, Anger, Generalised Anxiety Disorder (G.A.D.), Social Phobia, PTSD, OCD.” The “Training” subsection led to another page for “Brainworking Recursive Therapy - Level 3 ” text stated “The course material itself covers protocols and specific worksheets where necessary for: “Adrenal Problems, Thyroid Problems, Chronic Fatigue Syndrome, Fibromyalgia, I.B.S., Pain Management… Diabetes.” Another subsection titled “Two New Protocols” stated in text “Banishing Fertitlity [sic] Problems… Here, you will learn how to explain exactly why stress and anxiety causes difficulties with fertiility [sic]. It allows you to introduce your client to some of the major issues affecting the ability to conceive, and how to sort them out… This class gives you an easy-to-understand process you can use with your clients, both males and females, to help them achieve their dearest wish - a child”.
Issue
The complainant challenged whether:
1. the claims that Brain Working Recursive Therapy could treat and/or diagnose adrenal problems, anxiety, Chronic Fatigue Syndrome, diabetes, fibromyalgia, infertility, irritable bowel syndrome, pain management, phobias and skin problems (stress related) were misleading and could be substantiated; and
2. the ad discouraged essential treatment for addiction, Attention Deficit Hyperactivity Disorder, autoimmune disorders, colitis, Crohn’s disease, Generalised Anxiety Disorder, Obsessive Compulsive Disorder, Post-Traumatic Stress Disorder and thyroid problems for which medical supervision should be sought.
Response
1. & 2. BWRT Ltd t/a The Terence Watts BWRT Institute said they did not diagnose any of the conditions listed and only worked in conjunction with a client’s medical consultant/GP. They said when their clients approached them with any medical condition a prior medical consultation was necessary. They said they did not diagnose or assume any medical cause of infertility. The Terence Watts BWRT Institute said that all testimonials on their website were genuine and verifiable with the practitioner and clients. They said that BWRT was considered a valid healthcare practice in South Africa where it was used by medical clinics, the police and the military and was regulated by the Health Professions Council of South Africa.
The Terence Watts BWRT Institute said there were no controlled trials of the treatment but that it was in use by an NHS Trust and had been the subject of a research PhD awarded in late 2018, for which they provided details. They said the research assessed the efficacy of BWRT with non-complex trauma and had been published online.
The Terence Watts BWRT Institute said they added information to the website that stated they did not diagnose any medical condition other than in conjunction with a client’s GP or other medical consultant. They said they also made it clear they worked only with the psychological component of the conditions listed. The Terence Watts BWRT Institute said that all of its practitioners were required to contact their clients’ GP or other medical consultant before working with any condition that might be of medical origin. They said that if a client refused, or claimed not to have a GP, then a practitioner would not provide therapy. They said that since they had many practitioners worldwide it was not feasible that each would have a medical specialist in attendance; they said it was normal for psychotherapy practitioners to work in their own practice but to contact their client’s medical team or GP as necessary.
The Terence Watts BWRT Institute said that one of their senior mentors was medically qualified and available at short notice for any practitioner who needed advice, although that would happen where it was necessary to ascertain if there was a likelihood of a medical condition being the cause of a psychological symptom, after which the client’s GP would be consulted if necessary. They said that in practice they erred on the side of caution and required practitioners to advise their client’s GP if they could not be certain if the problem was purely psychological.
The Terence Watts BWRT Institute said that all BWRT practitioners had to be fully qualified as a psychologist, psychotherapist, counsellor, hypnotherapist or medical professional.
Assessment
1. Upheld
Rule 12.2 of the CAP Code stated that marketers must not discourage essential treatment for conditions for which medical supervision should be sought. Specifically that rule recognised that some medical conditions were sufficiently serious that consumers who had, or might have, such conditions should not be diverted by an ad from seeking suitably qualified medical advice. For that reason the rule required that ads must not offer specific advice on, diagnosis of or treatment for such conditions unless that advice, diagnosis or treatment was conducted under the supervision of a suitably qualified health professional. In circumstances where that requirement was met or when claims to treat those types of conditions were included in ads that were not addressed to consumers (and therefore not requiring of the protection provided by 12.2) the Code required advertisers to hold robust substantiation for their claims.
The ASA noted that the website included claims about the conditions which BWRT could treat. In some places those claims were featured on pages that were addressed to consumers and on other pages they were addressed to those who might be interested in training to be a BWRT practitioner. We noted that the web pages for “Two New Protocols”, “Brainworking Recursive Therapy - Level 3” and “BWRT Training” offered training on how to administer BWRT and were therefore addressed to those interested in learning how to be a BWRT practitioner rather than encouraging consumers to take-up the therapy. Those pages included claims that BWRT could treat infertility, adrenal problems and diabetes. We considered that those were conditions for which medical supervision should be sought. Had the claims appeared on pages directed to consumers we would have requested evidence that such supervision took place. However, because they appeared on pages intended for trainees, we assessed them as efficacy claims for which the advertiser would need to provide adequate substantiation.
In addition to those three conditions, we noted that the pages referenced above, other pages such as “Testimonials from Clients”, “Total Professionals” included claims that BWRT could treat or diagnose, anxiety, Chronic Fatigue Syndrome, fibromyalgia, irritable bowel syndrome, pain management, phobias and skin problems (stress related). We considered they were addressed to consumers both in tone and content. For example, on the page “Testimonials from Clients” one claim (provided by a former client) stated “… after 6 days of therapy … I stopped skin picking, PMS was much smoother this time”. We therefore considered that a suitable body of evidence would be required to also support each of those claims.
The Terence Watts Brain Reworking Institute provided us with a PhD research document. However, the document provided was only a research brief and, in any case, it did not meet the required standards of a sufficient clinical trial to substantiate the ad’s claims, such as a double-blinded randomised control trial method.
Because BWRT had not supplied sufficient evidence, we concluded that the claims had not been substantiated and were therefore misleading.
On that point, the ad breached CAP Code (Edition 12) rules 3.1 (Misleading advertising) 3.7 (Substantiation) and 12.1 (Medicines, medical devices, health-related products and beauty products).
2. Upheld
As mentioned above, the CAP Code stated that marketers must not discourage essential treatment for which medical supervision should be sought. We noted several pages addressed to consumers, for example “Testimonials from Clients”, which included claims such as “The BWRT sessions that Mary has done with me have been extremely effective in helping me cope better with my Attention Deficit Disorder and associated anxiety”. Those pages included conditions to treat addiction, Attention Deficit Hyperactivity Disorder, autoimmune disorders, colitis, Crohn’s disease, Generalised Anxiety Disorder, Obsessive Compulsive Disorder, and Post-Traumatic Stress Disorder; conditions for which such supervision should be sought. We noted that the site included an index of practitioners who provided BWRT. However, there was nothing in that index, nor had we received anything from the advertiser, which showed that those practitioners were suitably qualified to supervise the treatment of the above mentioned conditions.
We were concerned that in those areas where the conditions listed were addressed to consumers they were likely to encourage people to visit BWRT practitioners when that treatment was not necessarily provided with appropriate medical supervision and that the ad could therefore discourage essential medical treatment.
We therefore concluded that the claims breached the Code. On that point the ad breached CAP Code (Edition 12) rule 12.2 (Medicines, medical devices, health-related products and beauty products).
Action
The ad must not appear again in its current form. We told BWRT Ltd t/a The Terence Watts BWRT Institute not to claim or imply that BWRT could treat conditions unless they held adequate evidence to demonstrate that was the case. We also told them not to reference conditions for which medical supervision was necessary in advertising addressed to those seeking treatment.
