The mechanisms that power a sailboat through the world of winds and currents toward the skipper’s goals are unpredictable as are the processes and context that drive clinical outcomes in mental health care. I post thoughts on current literature that may translate into how research results might be used in clinical practice. This includes snippets that remind me that science is also a motivated and very human art form that reaches towards a paradox. We are always working in the space between.
Saturday, July 14, 2012
The gap between research and practice
Barry Wolfe published a thought provoking piece in the July issue of Psychotherapy that attempted to find pathways to bridge the gap between research and practice (Healing the research practice split: Let’s start with me. 49. No.2, 101-108). Basically he attempted to break down the perception of all or nothing approaches on both sides of the equation with the suggestion that researchers believe that empirical evidence is the key and clinicians should just do it, and clinicians believing that randomized clinical trials are too simplistic and the resulting protocols just are not practical or applicable to the complications of practice in the real world. The gap is bridged in a faux dialogue that softens both sides of the argument and results in: a broadening of what’s considered clinically useful; increased and improved collaboration between researchers and practitioners; and, giving clinicians ready role-model access to video examples of how research results are applied in practice.
While all of this is good and I agree with Dr. Wolfe’s direction, again, in application, the devil is in the details and the ever shifting therapy outcome target remains unchanged. The alchemy in Dr. Wolfe’s thoughts lay with what I read as his suggestion that there be an ongoing sharing and reflection on the potential uses for research protocols, the blossoming of a thousand flowers in real therapy work, the sharing of case studies and examples of applications and again, reflection and application in an ongoing feedback loop. Short of a grand scheme, it strikes me that this process is and always has been our responsibility as clinicians; my guess is that some do it better than others. I also know researchers that are very interested in working with and getting feedback from clinicians; my guess again is that some do it better than others.
While all of this is good and I agree with Dr. Wolfe’s direction, again, in application, the devil is in the details and the ever shifting therapy outcome target remains unchanged. The alchemy in Dr. Wolfe’s thoughts lay with what I read as his suggestion that there be an ongoing sharing and reflection on the potential uses for research protocols, the blossoming of a thousand flowers in real therapy work, the sharing of case studies and examples of applications and again, reflection and application in an ongoing feedback loop. Short of a grand scheme, it strikes me that this process is and always has been our responsibility as clinicians; my guess is that some do it better than others. I also know researchers that are very interested in working with and getting feedback from clinicians; my guess again is that some do it better than others.