“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.
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