APIRE Practice Research Network: Accomplishments, challenges, and lessons learned

Abstract

The Practice Research Network (PRN) was established in 1993 to bridge the gap between the science base and the clinical practice of psychiatry by expanding the generalizability of findings and involving clinicians in the development and conduct of research. It began as a nationwide network of psychiatrists and has evolved to conduct large-scale, clinical and policy research studies using randomly selected samples of psychiatrists from the AMA Physician Masterfile. This paper provides an overview of major PRN initiatives and the impact of these studies. It describes the benefits to clinicians of participating in PRN research, as well as strategies developed to address key challenges.

Building clinicians-researchers partnerships: Lessons from diverse natural settings and practice-oriented initiatives

“…For example, in addition to the training involved in the proper use of a particular measurement system, outcome monitoring requires time to administer and interpret the questionnaire, provide feedback to clients, and keep track of assessment points (Boswell et al, 2014;Holmqvist et al, 2014;McAleavey et al, 2014;Strauss et al, 2014). The more and/or bigger tasks required by a research project, the more its preparation and implementation may compete with the daily demands of all participants involved (Koerner & Castonguay, 2014;Szapocznik et al, 2014;West et al, 2014). As a case in point, the design of a study on helpful and hindering events in therapy required practitioners to meet regularly with researchers for a year.…”

“…In addition, diverse POR programs have conducted process studies, focusing on topics such as the use of (or adherence/fidelity to) interventions associated with empirically supported treatments, consistency of routine care with evidence-based practice guidelines, helpful events, therapeutic alliance, and principles of change (Adelman et al, 2014;Fernández-Álvarez et al, 2014;Garland & Brookman-Frazee, 2014;Holmqvist et al, 2014;Koerner & Castonguay, 2014;Strauss et al, 2014;Szapocznik et al, 2014;West et al, 2014). POR studies have also involved the evaluation of assessment measures and DSM-5 diagnostic criteria West et al, 2014).…”

“…POR studies have also involved the evaluation of assessment measures and DSM-5 diagnostic criteria West et al, 2014). The development of tools for supervision of evidence-based interventions has also been a focus of a collaborative initiative (Garland & Brookman-Frazee, 2014).…”

“…Also investigated are a number of characteristics related to the client, such as sociodemographic factors, treatment history, diagnostic variables, pretreatment severity and family functioning, and attachment (Adelman et al, 2014;Holmqvist et al, 2014;McAleavey et al, 2014;Szapocznik et al, 2014;West et al, 2014); therapist, such as hours per week of direct care and personal style (see Fernández-Álvarez et al, 2014;West et al, 2014); treatment, such as practice settings, referral process, access to, utilization and provision of different types of services (psychotherapy and/or pharmacotherapy), sources of payment and management of care, as well as societal beliefs toward psychotherapy (Fernández-Álvarez et al, 2014;McAleavey et al, 2014;West et al, 2014); and the relationship between some of these variables, such as the congruence between client and therapist's perceptions of symptoms, as well as differences in diagnosis and treatment provided across patients' race and ethnicity (Holmqvist et al, 2014;West et al, 2014).…”

“…A common focus is the assessment of change using standardized outcome monitoring. This involves tracking or predicting the progress of individual, large groups, or specific types of clients (Adelman, Castonguay, Kraus, & Zack, 2014;Boswell, Kraus, Miller, & Lambert, 2014;Castonguay, Pincus, & McAleavey, 2014;Fernández-Álvarez, Gómez, & García, 2014;Holmqvist, Philips, & Barkham, 2014;Koerner & Castonguay, 2014;McAleavey, Lockard, Castonguay, Hayes, & Locke, 2014;Strauss et al, 2014;West et al, 2014). The use of outcome monitoring in day-to-day practice has allowed some of these programs to investigate a number of issues related to specific patterns of change (such as dose-effect and good enough models, predictors of differential response patterns, sudden changes, deterioration, and therapist-client responsiveness), as well as the impact of providing feedback and clinical tools to therapists based on client change.…”