Clinician referral guide · Liz Allen · Australia · Updated 2025
Lightning Process: Clinician Referral Guide — Liz Allen, Australia
- 18 peer-reviewed published studies, including an NHS/University of Bristol RCT and a systematic review
- All quantitative outcome studies found significant benefits and no side effects or harms
- A 2025 audit concluded GPs "can refer patients with a high chance of benefit without fear of harm"
- Conditions studied: ME/CFS, Long COVID, post-cancer fatigue, fibromyalgia, chronic pain, anxiety, depression, MS, substance use
- Over 75,000 people have completed the LP since 1999
1. About the LP and Liz Allen
The Lightning Process is a brain-mind-body intervention developed by Dr Phil Parker (PhD psychologist, researcher, and lecturer at London Metropolitan University). It targets dysregulation of the autonomic nervous system using neuroplasticity principles. It is not a talking therapy or CBT — a published peer-reviewed comparison study (Anderson et al., 2021, DOI: 10.1080/21641846.2021.1935373) confirmed LP's distinct elements include its neurophysiological rationale, language-focused approach, and affective/physiological change techniques.
2. Key Evidence
| Study | Type | Condition | Key finding | Side effects |
|---|---|---|---|---|
| SMILE trial (Crawley et al., 2018) | RCT — NHS/Bristol | Paediatric CFS/ME | Significant improvements in physical function, fatigue, anxiety, depression. Maintained 12 months. | None |
| Systematic review (Explore) | Systematic review | Fatigue, pain, anxiety, depression | "Strong evidence LP helps many participants." All outcome studies found benefit. | None |
| Long COVID audit (2025) | Clinical audit | Long COVID | All 12 improved. >90% reported ≥85% recovery. "Safe to refer." | None |
| Cancer fatigue (MDPI Cancers, 2021) | Pilot study | Post-cancer fatigue | Statistically significant improvements in all PROMs. "Remarkable" fatigue reductions. | None |
| Substance use RCT | RCT | Alcohol and substance use | Reduced alcohol use and impulsivity, increased flourishing vs. treatment as usual. | None |
| Alpine Study (multi-country) | Outcome measures (n=96) | CFS/ME, fibromyalgia, pain, anxiety, depression | Decreased pain and fatigue, increased well-being at 1, 3, and 6 months across international participants. | None |
3. Clinical Questions
Is it safe to refer patients?
Yes. The 2025 Long COVID audit (Journal of Family Medicine and Primary Care) concluded: "Primary care clinicians can refer patients for treatment with a high chance of benefit without fear of harm." No study in the LP evidence base has found side effects or harms.
Can LP be used alongside standard medical care?
Yes. The SMILE RCT studied LP as an addition to NHS Specialist Medical Care — and found LP + SMC significantly outperformed SMC alone across all primary outcomes.
What about the 2021 NICE ME/CFS guideline?
The NICE 2021 ME/CFS guideline (NG206) is a UK-only advisory document and does not apply in Australia. It is also highly contested within the UK itself — criticised by over 50 international experts, The Lancet, and multiple Royal Colleges. It does not represent Australian or international medical consensus on the LP. The Royal College of GPs called the LP decision "particularly arbitrary" given the RCT evidence. Over 50 international experts published a formal critique identifying eight methodological flaws (White et al., 2023, DOI: 10.1136/jnnp-2022-330463). Four NICE committee members resigned.
4. References
- SMILE RCT — Crawley et al. (2018). BMJ Archives of Disease in Childhood. DOI: 10.1136/archdischild-2017-313375
- Systematic review. Explore. View paper
- Long COVID audit (2025). Journal of Family Medicine and Primary Care. View paper
- Cancer fatigue pilot. MDPI Cancers (2021). View paper
- LP vs. CBT — Anderson et al. (2021). DOI: 10.1080/21641846.2021.1935373
- NICE anomalies — White et al. (2023). JNNP. DOI: 10.1136/jnnp-2022-330463
- The Lancet NICE critique — Flottorp et al. (2022). DOI: 10.1016/S0140-6736(22)00183-0
- Full LP research: lightningprocess.com/research/