Tuesday, April 29, 2008

Research Clinic as Meme

Entry for 25 April 2008:

One of Carl Rogers’ many contributions to psychotherapy research was his creation of the first psychotherapy research clinic at the University of Chicago in the 1940’s. (John McLeod, 2002, in a lovely article in the first issue of Person-Centered and Experiential Psychotherapies, wrote about Rogers’ research program in this research clinic, at the Chicago Counselling Center, attempting to characterize what made it so productive.)

This idea of the research clinic, which has been passed down from researcher to researcher since Rogers’ time, is a powerful one. As I have written previously, I encountered this firsthand in 1984-85, during the year we spent on sabbatical at the University of Sheffield, working with David Shapiro and his team in the Social and Applied Psychology Unit. Empowered by what I saw, I went back to Toledo afterwards and set up my own research clinic, which later evolved into the Center for the Study of Experiential Psychotherapy (CSEP). Les Greenberg at York University subsequently picked up the idea, as did John McLeod at the University of Abertay, etc. Eventually, two colleagues at Toledo set up their own competing CBT research clinic, modelled after CSEP. The point I am trying to make is that the idea of the research clinic is a meme, that is, a viral concept, i.e., a catchy idea.

What is the content of the Research Clinic meme? Essentially this: (1) It is possible and desirable to set up and run within one’s academic organization a clinic for delivering psychotherapy within one or more research protocols. (2) Such an internal clinic is serious about both its research and its psychotherapy provision and tries to balance these as much as possible, while putting client welfare first. (3) As Cook and Campbell (1979) noted, creating your own organization (i.e., research clinic) is often the only way to get the degree of control over data collection and assignment of clients to therapy (e.g., randomization) needed for addressing many scientific questions. (4) Although research clinics require resources of various kinds, the key steps are: (a) get the support of administrators; (b) collect a group of people around the idea of setting up and running it; (d) declare publicly that one is doing so; and (e) just do it.

Our research clinic here at Strathclyde opened last November, under the able coordination of Brian Rodgers. This has turned out to be somewhat more challenging to set up than the research clinic at Toledo was, because we didn’t have the infrastructure of a pre-existing training clinic to build on and rely upon. But the group of us were able eventually to pull the different pieces together, and we are continuing to build and fine tune.

Currently, we have 16 clients in therapy, four clients about to begin, and five clients on our waiting list (and expected to be picked up in the next couple of weeks). Brian has set up a useful system for scheduling rooms, tracking clients through the protocol, and monitoring their progress using the Personal Questionnaire as a signal alarm procedure (following Mike Lambert’s method developed for the Outcome Questionnaire).

Once up and running, a research clinic begins to produce its own energy. We have now reached the point where members of our research team are carrying out Change Interviews, and the excitement has begun to build, as it is becoming increasingly clear that powerful, useful data are emerging. We see our clients changing on our quantitative and qualitative instruments and we are starting to learn from them firsthand what it feels like to be met with a strong person-centred relationship. The Research Clinic is not just a catchy idea; it is also a place for helping clients and doing useful science at one and the same time, a place where science and practice truly come together!

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