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

 

Portland Psychotherapy’s Clinical-Research Social Business Model Published in APA Journal – Psychology Research and Practice

Portland Psychotherapy’s Clinical-Research Social Business Model Published in APA Journal – Psychology Research and Practice

Many of those reading this blog probably already know that that in addition to providing science-based mental health services, Portland Psychotherapy is also a productive independent research center.

How we fund our research

What many of you may not know is how we go about funding that research. To our knowledge, we are the only organization of its kind to have set up a private mental health clinic and research center based on social business concepts in which the profits from the money-generating activities of the organization go back to serving the greater good (in this case, scientific research) rather than be used as profits for shareholders.

What we discuss in the article

We are very excited that the APA journal Psychology Research and Practice just published our article that outlines our model, which we call the clinical-research social business model. Among some of the things addressed in the article include:

  • An outline of our clinical-research social business model that is based on social enterprise concepts
  • How we overcame the barriers to conducting research outside of academia, including how we created an independent IRB and how to address infrastructure limitations such as assistants and access to journal articles
  • Benefits of conducting research outside of traditional academic settings
  • How we have shifted the contingencies around money in our model and structure our model such that intrinsic rewards such as mastery, autonomy, and purpose can serve as powerful motivators that advance more communal and creative goals.
  • Ideas about how our model might be applicable to other settings.

One thing we are very aware of at our center is that all our work depends upon a supportive community. If you are reading this, it is likely that YOU are a part of that community and we thank you for that. If you are interested in reading more about our model, how it came to be, and what your support of us has helped make happen, you can read the a pre-print of the article here.

Jenna LeJeune, Ph.D

Author: Jenna LeJeune, Ph.D

Jenna is a clinical psychologist who specializes in working with people who struggle with relationship and intimacy difficulties and with those who have a trauma history. Her research focuses on developing compassion-based interventions targeting stigma, shame, and chronic self-criticism.

UPCOMING TRAINING EVENTS


Using Acceptance and Commitment Therapy to Guide Exposure Therapy: The Basics

Brian Thompson, PhD, Brian Pilecki, PhD, and Joanne Chan, PsyD
September 17th, 2021 from 12-3pm

This is a beginner workshop intended to provide the foundations of exposure therapy including types of exposure interventions and design effective exposure exercises for various anxiety disorders and OCRDs. Participants will learn how to use ACT processes to guide the implementation of exposure techniques and how ACT processes may be enhanced by traditional exposure methods. This workshop will provide some background in theory and will emphasize applying exposure to clinical contexts using case studies, exposure demonstrations, and the practice of new skills by participants. Read More.


Overcoming Barriers to Effective ACT-Informed Exposure Therapy

Brian Thompson, PhD and Brian Pilecki, PhD
October 15th, 2021 from 12-3pm

This workshop will offer a brief introduction to Acceptance and Commitment Therapy-informed exposure and focus on practical ways to address common problems in implementation. Case examples will be provided to illustrate common client barriers such as lack of buy-in and difficulty grasping core ACT concepts. Strategies for overcoming these barriers will be offered and participants will have the opportunity to practice newly acquired skills through role-plays and break-out rooms.Read More.


Therapy and Research in Psychedelic Science (TRIPS) Seminar Series

Second Friday of each month from 12:00 PM – 1:00 PM (PT)

TRIPS is an online seminar series that hosts speakers discussing science-informed presentations and discussions about psychedelics to educate healthcare professionals. This series was created to guide healthcare providers and students preparing to be professionals towards the most relevant, pragmatic, and essential information about psychedelic-assisted therapy, changing legal statuses, and harm reduction approaches in order to better serve clients and communities. This seminar series is a fundraiser for our clinical trial of MDMA-assisted psychotherapy for social anxiety disorder that Portland Psychotherapy investigators are preparing for and starting in the Fall of 2021. All proceeds after presenter remuneration will go to fund this clinical trial. Read more.

September 10th, 2021 – Cultural Considerations in Outreach to and Assessment of Minoritized/Marginalized Individuals in Psychedelic-Assisted Psychotherapy with Terence Ching, Ph.D.

October 8th, 2021Presentation Title TBA – Dr. Elizabeth Nielson

November 12th, 2021Presentation Title TBA – Anthony Bossis, Ph.D.

December 10th, 2021Presentation Title TBA – Jamilah R. George

January 14th, 2022Presentation Title TBA – Jordan Sloshower, MD, MSc