Creation of an Institutional Review Board (IRB) for Practice-Based Research

“Science and everyday life cannot and should not be separated.” — Rosalind Franklin

Research in Clinical Practice

Clinical psychologists typically pursue either research or practice. While researchers typically have minimal contact with clients, practitioners typically have minimal access to resources that make research possible. For clinicians who do conduct research, few do so in settings in which they treat clients (i.e. “practice settings”). Instead, clinical research typically occurs in academic institutions, hospitals and research agencies (e.g. the National Institutes of Health). Yet, research conducted in practice settings could have unique benefits. Researchers would have on-the-ground insights into mental health and wellness, and could incorporate this knowledge into their research interests, hypotheses and designs. Clinicians would have insights into state of the art approaches to therapy, grounded in science. Ideally this would allow clinical psychologists to be true “scientist-practitioners” knowledgeable about both the research and practice of evidence-based treatments.

Importance of Research Ethics Review

One of the research resources that people in clinical practice do not typically have access to is an institutional review board (IRB) which reviews the ethics of research projects. These review boards are typically only available to people in academic and medical settings. Even though not all research needs to be reviewed by an IRB, review by these independent, non-biased third parties is an important step in insuring that research protects the right of participants who kindly offer their time to these endeavors. This review process also shows journals that researchers have taken steps to ensure their research is ethical, thus increasing the chance the journals will accept paper submissions and allowing researchers to more easily share their findings through peer-reviewed publications. The dissemination of research through peer-reviewed publications is key in improving therapies, and the collective knowledge of the clinical psychology field, in the long-run.

Institutional Review Board Options

Team members at Portland Psychotherapy and the organizations listed below banded together to create a nonprofit called the Behavioral Health Research Collective (BHRC) to host an independent IRB to review our research. The options for clinicians seeking to conduct research with an ethics committee are limited. Clinicians can pay a private IRB to review their research (however, this option is expensive). Alternatively, clinicians can attempt to obtain a faculty position at a university to gain IRB access, however, access to these IRBs are not always granted. Finally, clinicians can collaborate with people who do have access to an IRB, but this can limit the independence of their own research ideas.

Founding members of the BHRC:

Center for Cognitive and Dialectical Behavior Therapy, New York, NY
Cognitive-Behavioral Therapy Center of Western North Carolina, PA, Asheville, NC
Evidence-Based Practice Institute (EBPI), Seattle, WA
Evidence Based Treatment Centers of Seattle (EBTCS), Seattle, WAOakland Cognitive Behavior Therapy Center, Oakland, CA

The Behavioral Health Research Collective IRB

The Behavioral Health Research Collective IRB provides an alternative. The board is hosted by a separate, non-profit entity and its members are familiar with so that they can behavioral research that provides expert reviews of the ethics of research and liability protection. Currently, the BHRC IRB provides guidance for seven evidence-based behavioral health care organizations located in six states (CA, NC, NY, OH, OR, and WA). These organizations pay the board a low annual fee to cover standard operating expenses.

Board members who review the research do so as volunteers. Over the past 6 years, they have reviewed 28 protocols submitted by psychologists working outside traditional research settings. More detailed information about the BHRC IRB can be found in our article, “Overcoming a Primary Barrier to Practice-Based Research: Access to Independent Ethics Review” and our new website.

We hope that by sharing this information, others will create similar IRBs. This type of ethics board helps remove a barrier to conducting research in practice settings by making it easier and more affordable to have research reviewed by an ethics board. We believe that clinical research and practice are intrinsically intertwined, and that practice-based researchers are in a unique position to tackle the challenges of developing and disseminating improved treatments.

Acknowledgments

Thanks to Dr. Travis Osborne for his huge contributions in getting this up and running and for serving as the BHRC IRB Chair, and to Dr. Brian Thompson for helping the whole three-and-a-half-year undertaking get started. The creation of the BHRC IRB wouldn’t be possible without their contributions and support!

By Christina Chwyl, B.A., Research Coordinator

 

UPCOMING TRAINING EVENTS

January 31, 2020, 8:30 am – 4:30 pm · Portland, OR · Details

This workshop is intended to be part 1 of a two day workshop, but can also be taken on its own. This workshop is useful for therapists who want an update on the current clinically applicable research on how shame functions, including an overview of how and when shame tends to be adaptive versus maladaptive. This day has two primary goals: 1. To provide an overview of research on shame and self-criticism that can guide clinical practice and 2. To allow therapists to experience the model from the inside-out so as to develop greater personal self-compassion and a deeper intuitive understanding of compassion-based intervention strategies. Read more

February 1, 2020, 8:30 am – 4:30 pm · Portland, OR · Details

This workshop is intended to be part 2 of a two day workshop, but can also be taken on its own. If you already have a thorough understanding of the functions of shame and a good understanding of Acceptance and Commitment Therapy, then it is you will probably be OK taking just the second day of this workshop. The workshop proceeds to discuss how ACT processes can be focused on addressing chronic and pervasive shame-based difficulties, with a particular focus on flexible perspective taking. Demonstrations of how to use perspective taking and compassion-fostering strategies with clients will be provided and attendees will also practice in small groups. An overview of chair work in the context of ACT will be provided. Read more

February 29, 2020, 9:00 am – 12:15 pm · Portland, OR · Details

Exposure is one of most the effective treatments for anxiety, trauma, and obsessive compulsive and related disorders (e.g., OCD, PTSD, panic disorder). A transdiagnostic intervention, exposure involves the repeated and systematic engagement with avoided stimuli that cause anxiety. Unfortunately, exposure remains underutilized by clinicians (e.g., Scherr, Herbert, & Forman, 2015), mostly due to misunderstandings of how exposure works and perceived difficulty of using it with clients. This half-day workshop will address these gaps by drawing from research on enhancing clinician understanding of and ways to overcome barriers to delivering exposure therapy (Farrell et al., 2016). Using didactics, role-play, and experiential exercises, participants will learn flexible application of exposure for a variety of clinical targets. Read more

April 17 and 18, 2020, 9:15 am – 5:00 pm · Portland, OR · Details

Do you ever “get stuck” as a therapist? Do some of your clients press your “hot buttons”? Do you ever find yourself struggling and thinking about “what do I do next” or feeling anxious, scared or stressed in therapy? In this workshop we will work on clarifying your therapist values and defining what is “difficult” about “difficult” clients. Through discussions, demonstrations and roleplays we will then work on these difficult clients and look at the processes from a compassionate ACT perspective. Read more