This article describes the development and implementation of the Pennsylvania Practice Research Network for facilitating psychotherapy research in the naturalistic setting. The methods and results from this phase I pilot project provide a basis for discussing the limitations that characterize effectiveness investigations, why they are insufficient for answering society's questions about therapy effectiveness, but why they are useful for establishing a preliminary infrastructure upon which to base subsequent, scientifically rigorous phase II investigations that can markedly increase our empirical and applied knowledge about psychotherapy. Finally, the problems and obstacles discovered in this pilot investigation and possible ways of overcoming such impediments are discussed.
This paper presents the findings of a psychotherapy process study conducted within the Pennsylvania Psychological Association Practice Research Network (PPA-PRN). The investigation was the product of a long-term collaborative effort, both in terms of the study design and implementation, between experienced clinicians of various theoretical orientations and full-time psychotherapy researchers. Based on a relatively large sample of clients seen in independent practice settings, close to 1,500 therapeutic events (described by clients and therapists as being particularly helpful or hindering) were collected. These events were coded by three independent observers using a therapy content analysis system. Among the findings, both clients and therapists perceived the fostering of self-awareness as being particularly helpful. The results also point to the importance of paying careful attention to the therapeutic alliance and other significant interpersonal relationships. The merits and difficulties of conducting scientifically rigorous and clinically relevant studies in naturalistic contexts are also discussed.
In this study, we examined the relationship between treatment outcome and variables from the Inventory of Interpersonal Problems Circumplex scales (IIP-C; Horowitz, Alden, Wiggins, & Pincus, 2000) in the Pennsylvania Psychological Association's Practice Research Network (PRN; Borkovec, Echemendia, Ragusea, & Ruiz, 2001). The PRN was a naturalistic observation treatment outcome study conducted with clinicians who were providing outpatient therapy. Assessment instruments, including the Compass Assessment System (Howard, Brill, Lueger, O'Mahoney, & Grissom, 1993; Sperry, Brill, Howard, & Grissom, 1996) and the IIP-C, were used to assess outcome at the 7th session (N=73) and at termination (N=42). Significant associations were identified between seventh-session outcome and most of the IIP variables. Only IIP elevation and amplitude were related to termination outcome. Elevation, amplitude, and hostile submissive problems were related to treatment length. Ad hoc analyses indicated that the IIP elevation fully mediated the relationships between interpersonal problems and seventh-session outcome but not the relationship between amplitude and outcome. We discuss the results in relation to the external validity of the IIP.
This paper describes the experiences of psychotherapists who, as part of a practice research network (PRN), collaborated with researchers in designing and conducting a psychotherapy study within their own clinical practices. A qualitative analysis of interviews conducted with these psychotherapists led to the delineation of several benefits (e.g., learning information that improved their work with clients and feeling that they were contributing to research that would be useful for psychotherapists) and difficulties for them and their clients (e.g., time and effort required to integrate research protocol into routine clinical practice) that psychotherapists associated with their participation in the PRN. Also identified were a number of strategies used by psychotherapists to address obstacles that they encountered, as well as general recommendations for future PRN studies. As a whole, the experiences of these psychotherapists are likely to provide valuable lessons for the survival and growth of what is viewed by many as a promising pathway for building a stronger bridge between practice and research.
This article describes the development and implementation of the Pennsylvania Practice Research Network for facilitating psychotherapy research in the naturalistic setting. The methods and results from this phase I pilot project provide a basis for discussing the limitations that characterize effectiveness investigations, why they are insufficient for answering society's questions about therapy effectiveness, but why they are useful for establishing a preliminary infrastructure upon which to base subsequent, scientifically rigorous phase II investigations that can markedly increase our empirical and applied knowledge about psychotherapy. Finally, the problems and obstacles discovered in this pilot investigation and possible ways of overcoming such impediments are discussed.
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