What is a Practice Research Network (PRN)?
By Dr. Georges Tasca
There is a well documented gap between clinical science and clinical practice such that clinicians do not always use research to guide their practice decisions and researchers often do not rely on clinicians’ expertise when designing and testing interventions. Practice Research Networks (PRN) are a novel intervention to address the research-practice divide.
One can identify at least four barriers to translating psychotherapy research into clinical practice. First, clinicians may perceive that randomized controlled trials of psychotherapies are not representative of their clinical practice or relevant to the patients they treat (Westen et al., 2004). Second, there is a lack of communication between clinicians and researchers thus resulting in a two-way translational gap between clinical trials and clinical practice. Community-based clinicians may feel disconnected from research that is designed and implemented in health sciences centers, and distrust researchers’ intentions. Researchers may place a lower premium on information gleaned from clinicians, and may devalue clinical input (Beutler et al., 1995). A third barrier is related to the professional diversity of psychotherapy practitioners. Unlike many other areas of health care, psychotherapy is practiced by a broad array of professionals (e.g., psychologists, psychiatrists, GP psychotherapists, counsellors, social workers, among others) in a variety of settings (e.g., private offices, community clinics, rehabilitation centres, hospitals), and for a wide range of patient problems (e.g., addictions, anxiety disorders, depression, eating disorders, etc.). Training in clinical practice and research varies tremendously, as do the regulations of practice, training standards, and continuing education. Fourth, clinicians face economic and practical barriers when contemplating using theirs and clients’ time to participate in research design and implementation.
Overcoming barriers to translating psychotherapy research into clinical practice for the field of psychotherapy might involve conducting psychotherapy research in applied community and clinical settings in which clinicians inform research areas that are important to them and their clients. In a psychotherapy PRN, community-based practitioners actively collaborate with researchers to define research questions, design research protocols, and implement studies. This collaboration between practitioners and clinical researchers is devoted to the conduct of scientifically valid effectiveness research. To date, despite the development of PRN in the U.S. and the U.K., PRN are only just emerging in Canada.
Psychotherapy researchers and clinicians can and should get involved in PRN to reduce the translational gap. Researchers in particular should move beyond only disseminating their research in academic journals to engaging clinicians in knowledge translation. Psychotherapy researchers can: (a) incorporate clinicians within their research teams at the initial stages during which interventions are developed and study design is discussed; (b) develop and research interventions that clinicians can flexibly apply in real-world contexts; (c) engage in intervention studies within clinical practices with patients who have complex comorbidities; (d) foster collaborations to conduct practice-based research in clinical practices and in which clinicians are equal partners; and (e) find ways to provide financial, academic, and other incentives for clinicians to participate in practice-based research programs. Clinicians on the other hand must look to available examples in which research participation can complement and even augment clinical effectiveness and client outcomes (see Castonguay et al., 2013 for a review).
PRNs are an innovative way of improving clinical practice and of informing clinical research. PRN require that clinicians and researchers overcome attitudinal, economic, and practical barriers to form a truly collaborative relationship in which clients are the ultimate beneficiary. Better psychotherapy research that is informed by clinical practice will result in better clinical practice informed by psychotherapy research. This synergism created by a PRN will improve the health and mental health of our clients.
References
Beutler, L. E., Williams, R. E., Wakefield, P. J., & Entwistle, S. R. (1995). Bridging scientist and practitioner perspectives in clinical psychology. American Psychologist, 50(12), 984-994.
Castonguay, L.C., Barkham, M., Lutz, W., & McAleavey, A. (2013). Practice-oriented research: Approaches and applications. In M.J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behaviour change (6th ed, pp. 85_133). Hoboken, NJ: Wiley.
Westen, D., Novotny, C. M., & Thompson-Brenner, H. (2004). The empirical status of empirically supported psychotherapies: Assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin, 130(4), 631-663.
PRNs in Canada
Ontario
The Psychotherapy Practice Research Network (PPRNet) of the University of Ottawa and the Ottawa Hospital
- Contact: Dr. Georges Tasca, Ph.D. (GTASCA@Ottawahospital.on.ca)
- Team: Dr. Georges Tasca, Dr. Louise Balfour, Dr. Benjamin Fortin-Langelier, Dr. Kylie Francis, Dr. Jasmine Gandhi, Dr. Linda Huehn, Dr. John Hunsley, Dr. Anthony Joyce, Dr. Jackie Kinley, Dr. Diana Koszycki, Dr. Molyn Leszcz, Vanessa Lybanon-Daigle, Dr. Deanna Mercer, Dr. John Ogrodniczuk, Dr. Michelle Presniak, Dr. Paula Ravitz, Dr. Kerri Ritchie, Dr. John Sylvestre, Dr. Jeanne Talbot, Brian Wilson, MSW
- Institutions involved: The Ottawa Hospital, The University of Ottawa, QE II Health Sciences Centre, Mount Sinai Hospital (Toronto), University of Toronto, University of British Columbia
- Website: www.pprnet.ca
The Ontario Practitioner-Researcher Network (OPRN)
- Contact: Dr. Lynne Angus, Ph.D. (langus@york.ca)
- Team: Dr. Lynne Angus, Dr. Louise Hartley, Dr. Marilyn Fitzpatrick, Dr. Sandra Paivio, Dr. David Ross, Dr. Walter Middlestadt , Dr. Sandra Paivio, Dr. Annette Dufresne , Dr. Tayab Rashid , Dr. Adrienne Eastwood, Dr. Marnee Maros, Dr. Angel Pacheco , Dr. Sarah Thompson , Jennifer Robinson, & Dr. Anne Thériault
- Institutions involved: York University Psychology Clinic, University of Windsor Psychology Training Clinic, McGill Counselling, University of Toronto Counselling centres, University of Waterloo Psychology Training Clinic, Veteran Affairs Canada, Roy McMurtry Youth Centre, Primary Care private practice clinics, Ontario College of Art and Design University Counselling, Ryerson University Counselling, University of Ottawa Counselling Clinic.
- Website: www.yorku.ca/yupc