Clinician-Researchers in Psychotherapy

Careers Engaged in both Practice and Research

Jill D. Paquin

• Publisher: Routledge
• Year: 2020
• eBook ISBN: 9780429685378
• Edition: 1
• Topic: Psychology
• Subtopic: Evolutionary Psychology
• Index: Psychology

Clinical researchers who have an active clinical practice are rare. Therapists who conduct therapy research are rarer still. Why is this the case? And why is the study of the practice often so far from the actual practice? If the practice and research worlds of therapy are to be bridged, might clinician-researchers—professionals who do both—play an important role in this process? A career engaged both with providing therapy and researching therapy is unique.

This book combines original empirical work, theory, and first-person scholarly narratives authored by clinical mental health professionals in the early, middle, and later stages of their careers as they highlight the rewards, challenges, and potent areas of synergy they experience as clinician-researchers.

This book was originally published as a special issue of Counselling Psychology Quarterly.

Sharing wisdom: Challenges, benefits, and developmental path to becoming a successful therapist-researcher

Margit I. Berman, Norah Chapman, Brenda Nash, Dennis M. Kivlighan and Jill D. Paquin

The scientist-practitioner model encourages counseling psychologists to integrate research and psychotherapy practice professional roles, but knowledge about how professionals integrate clinical and research roles is limited. In addition, we know little about how counseling psychologists specifically integrate these roles. The current study utilizes a consensual qualitative research approach to analyze a discussion among prominent counseling psychologist therapist-researchers about how they have integrated these roles within their careers. Results revealed benefits and challenges faced by therapist-researchers. In addition, domains identified included the process and development of becoming a therapist-researcher, comparisons among each professional skill, and beliefs about being a therapist-researcher. General and typical themes articulated by the sample included: the idea that doing research iteratively informs clinical work and vice versa, that institutions can and should support integrating research and practice, and that doing research and being a clinician positively affect each other. Future directions for research and limitations of the data are included.

The scientist-practitioner model (Raimy, 1950) encourages counseling psychologists to integrate research and psychotherapy practice professional roles, but the challenges to integrating research and practice in psychotherapy have been well documented (Apostolopoulou & Skourteli, 2015; Beutler, 2009; Goldfried, 2010; Lampropoulos & Spengler, 2002). Over time, psychologists have observed that a research-practice gap exists, as well as developed innovative methods to support its integration (Castonguay, Youn, Xiao, Muran, & Barber, 2015; Goldfried, 2010; Teachman et al., 2012). Historical and current challenges include logistical barriers to doing both simultaneously as well as challenges posed by the fact that researchers often do not see clients and clinicians may not do research, and psychologists who engage in only one primary professional role may not value the contribution of the other role to their work or see it as relevant (Drabick & Goldfried, 2000; Yanos & Ziedonis, 2006). Research may be poorly generalizable to the work of clinicians in naturalistic settings. For example, clinicians report not using evidence-based practices because they find psychotherapy science is not generalizable to their clients (Hatfield & Ogles, 2007; Safran, Abreu, Ogilvie, & DeMaria, 2011). Instead, clinicians may find that their own clients are more helpful source of learning (Safran et al., 2011). Thus, clinicians may not always use approaches based on empirical work (e.g. Castonguay & Muran, 2015; Goldfried & Wolfe, 1996).

Despite inherent challenges to integrating science and practice, initiatives have been developed toward this end. For example, the scientist-practitioner model (SP; i.e. training in the application of clinical practice informed by scientific inquiry; Raimy, 1950) promoted training in the integration of research and practice in psychology graduate programs. However, implementing an integrated research-practice professional identity post-graduation is often difficult, suggesting the profession has not fully bridged the gap (Apostolopoulou & Skourteli, 2015; Castonguay et al., 2015; Goldfried, 2010; Teachman et al., 2012). Professionals continue to struggle to understand how to consistently apply the SP model in real-world settings, integrating both roles into their professional identities (McWilliams, 2016). In practice, one professional role typically predominates, with few psychologists engaging in both simultaneously (Drabick & Goldfried, 2000; Yanos & Ziedonis, 2006).

Although the trend of few professionals conducting both research and practice simultaneously has been noted, it is less well documented how professionals who do engage in both professional roles develop successful careers, as well as what benefits and barriers exist that may influence the success or decline of an integrated research-practice career. Learning from a subset of professionals who find such a balance may provide guidance as to how to better navigate the interweaving of the SP model in real-world applications throughout one’s career development.

The Development of Therapist-Researchers

Drabick and Goldfried (2000) described the historical context and vision for how clinician-researchers might develop. They suggested that the need for clinician-researchers emerged from the demand for quality clinical care that could be documented as effective for accountability to third party payers, government agencies, and clients themselves. SP model implementation was expected to answer these demands by training students, first to be competent clinicians who are consumers of empirical research that would inform their clinical work, while also being researchers sensitive and responsive to clinical practice needs. Students receiving SP training were expected to move into the field with a strong skillset to implement evidence-based treatments while also methodically evaluating their outcomes with clients. However, there is little empirical data about how this process has been realized in practice and much has been written about its challenges (Apostolopoulou & Skourteli, 2015; Castonguay et al., 2015).

Challenges, Processes, and Benefits to Becoming a Therapist-Researcher

Professionals face several challenges in their roles working to integrate clinical practice and research. In a synthesis of a special issue of Psychotherapy Research focused on Practice-Oriented Research, Castonguay and colleagues (2015) identified some of the salient challenges (as well as benefits) inherent to integrating research with practice, including clinical and methodological concerns (e.g. the difficulty of translating research findings to practice, the limitations posed by using treatment manuals with clients, fears and obstacles related to using outcomes measures with patients, etc.), communication problems, time constraints, and lack of funding or reimbursement for research combined with practice.

Psychologists have made efforts to address these challenges and create opportunities for integrating research and practice. For example, one form of Practice-Oriented Research is to create Practice-Research Networks (PRNs; Borkovec, 2004), which can combine the forces of several therapist-researchers to develop projects with similar aims, goals, and processes. Several benefits offered by Practice-Oriented Research and PRNs have been identified including: improved professional development, improved client outcomes and enhanced therapeutic processes, the ability to advance science, contribute to healthcare systems, and enhance organizations (Castonguay et al., 2015). However, there are other ways that therapist-researchers can integrate these professional roles (e.g. by conducting and intervening in clinical trials or doing small N research and case studies). The challenges, benefits, and processes for becoming a therapist-researcher outside of the Practice-Oriented Research framework are not well-specified.

Besides the limited quantitative or qualitative data relevant to integrating research and practice careers in applied psychology as a whole, there is little information about how counseling psychologists specifically develop therapist-researcher careers, and whether their development, process of integrating, and the challenges or benefits to integrating roles are similar to or different from those of other applied psychologists or clinician-researchers in other fields (e.g. physicians). Little has been written about the individual and collective processes by which therapist-researchers successfully utilize SP training in their careers. Understanding the individual trajectories of developing a career as a therapist-researcher as well as understanding what mechanisms contribute to maintaining success in this area is needed for future training and career development efforts. Sharing wisdom and expertise from counseling psychologists who have successfully developed integrated therapist-researcher careers may assist psychologists who wish to integrate these two roles to do so more successfully.

Current Study

The aim of this study was to understand how counseling psychologists who both conduct research on counseling and also do therapy with clients integrate these two professional roles, including identifying both the challenges and opportunities in pursuing a therapist-researcher career in counseling psychology. We were interested both in investigating participants’ experiences of pursuing both research and practice during their careers, as well as how they integrated these two activities. We investigated the following research questions:

• (1) Why d...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• Citation Information
• Notes on Contributors
• Introduction: Clinician-Researchers - A career engaged in both therapy research and practice
• 1 Sharing wisdom: Challenges, benefits, and developmental path to becoming a successful therapist-researcher
• 2 "Research doesn't fit in a 50-minute hour": The phenomenology of therapists' involvement in research at a university counseling center
• 3 Reflexivity in science and practice: What do French verbs have to do with it?
• 4 The psychotherapy researcher-practice relationship: Through a clinical supervision lens
• 5 Clinicians' prediction and recall of therapeutic interventions: practice research network study
• 6 A funny thing happened when my scientist self and my practitioner self became an integrated scientist-practitioner: A tale of two couple therapists transformed
• Index