Psychotherapy Bulletin

Psychotherapy Bulletin

More on Closing the Gap Between Research and Practice

As I end my term as president of Division 29, I would like to thank all those with whom I have worked—far too numerous to acknowledge individually.  Their dedication to further the division’s mission is both impressive and heartening, and it has been most gratifying to have been able to work with them. 

In this, my last column, I would like to offer my final thoughts about what has been happening lately in the attempts to close the gap between research and practice. Although this gap has existed for well over 50 years (see Lazarus & Davison, 1971), the need to close it is now more urgent than ever.  The important question with which we as therapists are currently confronted is how to respond to the growing pressures for accountability coming from professional organizations, governmental agencies and insurance companies. Who will respond to the challenge of determining which therapies work?  Will it be therapy researchers?  Practicing clinicians? Both working in collaboration? As both a researcher and clinician, I believe that effective therapy must be rooted in both clinical observation and empirical verification.  At the risk of being overly optimistic, I believe I detect the beginnings of a movement in several quarters that represent serious efforts to close this long-standing gap between research and practice.

What are the Recent Attempts to Close the Gap Between Research and Practice?

There have been a number of recent attempts that have been made to close the gap between research and practice, including the following:

  • The Division 12 and 29 initiative to create a two-way bridge between research and practice is based on the assumption that any difficulties associated with applying empirically supported treatments in clinical practice may provide us with important information about those variables that are in need of future research.  In essence, it provides a feedback mechanism from clinician to researcher, offering clinically relevant questions and issues in need of further investigation--giving the practicing clinician a voice in the research process. The first three surveys will be published next year from this initiative, dealing with surveys of clinical experiences in the use of empirically supported treatments for panic disorder, social anxiety, and general anxiety disorder. Two additional surveys have also just been completed, providing feedback on the clinical use of empirically supported treatments for posttraumatic stress disorder and obsessive compulsive disorder. 
  • Those involved in practice-research networks have pointed out that one of the benefits of these clinician-researcher collaborations is the ability to identify those factors that may make it difficult to implement empirically supported treatment in clinical practice, such as client, setting, therapist, and treatment variables (McMillen, Lenze, Hawley, & Osborne, 2009; Zarin, Pincus, West,& McIntye, 1997).  Thus, Castonguay and colleagues (2010) have collaborated with practicing therapists to survey their clinical experiences about what they have found to be  both helpful and hindering events in therapy. 
  • A chapter will be appearing in the forthcoming 6th edition of the classic Handbook of Psychotherapy and Behavior Change, written by Castonguay, Barkham, Lutz, & McAleavy (in press), that describes current paradigms where practicing clinicians are actively involved in therapy research.
  •  The Division 29 journal Psychotherapy has recently published a special section that focuses directly on possible ways we may be able to close the gap between research and practice.  The table of contents for this issue can be found at: http://www.jbo.com/jbo3/showtoc.cfm?volume=49&issue=2&journal=pst2
  •   The Journal of Psychotherapy Integration will be offering a regular section dealing with translational research, whereby basic researchers will review relevant research findings, written specifically for practicing clinicians to help them enhance their clinical effectiveness.  The first three articles to appear next year involve research findings on traumatic grief, person perception research on how people tend to distort their views of significant others, and clinically relevant research findings on close relationships.
  • Several forthcoming conferences will have the integration of research and practice as their theme. Thus the 2013 international conference of the Society for Psychotherapy Research (SPR) will have as its theme: “From Psychotherapy Research to Practice and Back.”  The Australian chapter of SPR, also to be held in 2013, will deal with: “A Dialogue between Psychotherapy Research and Practice: How best can we learn from each other?” And th forthcoming SEPI conference, to be held in Barcelona in June 2013, will have the theme: “Psychotherapy Integration: Researchers and Clinicians Working Together toward Convergence.” More can be learned about these conferences at the following two websites: www.psychotherapyresearch.org and www.sepiweb.org
  •  SEPI, which was founded close to 30 years ago, has had a presence in our division over the past several years, and members of SEPI’s Steering Committee have regularly written articles for the Psychotherapy Bulletin. SEPI was founded in response to a need that existed at the time--the desire for therapists to know more about how their approach was similar to and different from other orientations.  As a result of these efforts over the years, SEPI has played an important role in encouraging therapists to be more open to the possibility of integrating potentially helpful contributions from other orientations.  Some three decades later, another important need has arisen in the field, namely demands for the empirical accountability of our interventions. As suggested earlier, I would maintain that such important decisions need to be a collaborative effort of clinicians and researchers. After much discussion, the Steering Committee of SEPI has expanded its mission to facilitate these collaborative efforts in meeting this important challenge. Having had 30 years of experience of encouraging meaningful dialogues across theoretical orientations, SEPI is now committed to apply its efforts to facilitate collaborative interactions between clinicians and researchers. The goal is to enable clinicians to learn and utilize the findings of cutting-edge research, and for researchers to learn from the observations of clinicians working with the issues that arise in the actual practice of therapy.

So, here’s the commercial: I am asking that you support the efforts spearheaded by SEPI by becoming a member.  Its expanded mission is to work toward closing the gap between research and practice. The dues are very modest, and there is a special rate for students.  This can be done on line at the SEPI Web site (www.sepiweb.org).

I would like to conclude by saying that his effort is something that has been professionally important to me for many years--indeed, since graduate school.  Some 30 years ago, I expressed my belief—which still holds:

The experience and wisdom of the practicing clinician cannot be overlooked.  But because these observations are often not clearly articulated . . . [and] . . . may be unsystematic or at times idiosyncratic . . . it is less likely that these insights can add to a reliable body of knowledge.  The growing methodological sophistication of the researcher, on the other hand, is in need of significant and . . .  [clinically] . . . valid subject material.  [In short], our knowledge about what works in therapy must be rooted in clinical observations, but it must also have empirical verification. For the researcher and clinician to ignore the contributions that each has to make is to perpetuate a system in which no one wins (Goldfried & Padawer, 1982, p. 33).

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Cite This Article

Goldfried, M. R. (2012). More on closing the gap between research and practice. Psychotherapy Bulletin, 47(4), 2-4.

References

Castonguay, L. G., Barkham, M., Lutz, W. & McAleavy, A. (in press). Practice-oriented   research: Approaches and applications. In M. J. Lambert (Ed,) Bergin and Garfield’s   Handbook of Psychotherapy and Behavior Change (6th ed.).Hoboken, NJ: Wiley.

Castonguay, L. G., Boswell, J. F., Zack, S. E., Baker, S., Boutselis, M. A., Chiswick, N. R., Holtforth, M. G. (2010). Helpful and hindering events in psychotherapy: A practice research network study. Psychotherapy: Theory, Research, Practice and Training, 47, 327-345.

Goldfried, M.R., & Padawer, W. Current status and future directions in psychotherapy.  In M. R. Goldfried (Ed.), (1982).  Converging themes in psychotherapy: Trends in psychodynamic, humanistic, and behavioral practice (Pp. 3-49).   New York:  Springer.

Lazarus, A. A., & Davison, G. C. (1971). Clinical innovation in research and practice.  In A.E. Bergin and S.L. Garfield (Eds.), Handbook of psychotherapy and behavior change (pp. 196-213). New York:  Wiley.

McMillen, J.C., Lenze, S.L., Hawley, K.M., & Osbourne, V.A. (2009). Revisiting practice-based research networks as a platform for mental health services research. Administration and Policy in Mental Health, 36, 308-321.

Zarin, D.A., Pincus, H.A., West, J.C., & McIntyre, J.S. (1997).  Practice-based research in psychiatry.  American Journal of Psychiatry, 154, 1199-1208.

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