Since September 2003, our team of researchers has been successfully recruiting families and clinicians into the Practice & Research: Advancing Collaborative (PRAC) project in an effort to learn more about how psychotherapy is practiced in community-based clinics for children and families. In January 2007 we enrolled our final family into the study and closed participation at 218 families. The majority of our child participants are male (67%) with a mean age of 9 years (SD=2.7). The race/ethnicity is as follows: 44% Caucasian, 27% Latino, 13% Mixed, 10% African American, 3% Other.

Our recruitment of clinicians was also a success with 99 clinicians from the six participating clinics enrolling in the study. The majority are female (83%) and Caucasian (67%). 59% are staff or trainees in Marriage Family Therapy (MFT), 17% in Social Work, and 23% in Psychology.

To date, 450 teachers have participated in the study, with prior approval by parent participants and after providing written informed consent. They provide valuable information about the child participants in the school setting.

We are pleased that PRAC parent participants have found the study experience to be valuable and not overly burdensome. When participants were asked “Please tell me what you thought of the interview” and “Were there things you especially liked about the interview?” they had positive things to say:

“I was very impressed with the study and how it can help families.”

“It was an all around great experience and made me think about my child. I support your program. Somebody is checking on our children and they care, and that’s great.”

“The interview was helpful, good questions that brought up issues and got me thinking of other stuff to bring up in counseling.”

“I like that somebody wants to help and is taking an interest in understanding and studying children with these kinds of problems.”

“I like the idea of being able to help out other families. I really appreciated the opportunity.”

“I believe in research, and anything that helps the field is good. The more that people are involved in research, the better.”

Similarly, when asked “If one of your friends were asked to participate, would you recommend this experience?”, nearly 100% indicated that they would.

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The PRAC study has also fostered stronger collaborative partnerships between researchers and clinicians, facilitating better integration of research and practice and aiding in the identification of the most effective treatment practices for children and their families.

In keeping with the design of the study, we collected video-tape data of the participants’ therapy sessions for up to16 months (or until therapy ended). We have collected a total of 3,241 video-tapes for our 218 participants. Over 1200 these tapes were coded to identify therapeutic strategies used in therapy sessions. Analysis of these data is ongoing, however, preliminary analyses indicate that therapists are delivering many common elements of EBP frequently, but other elements infrequently. Therapists are uniformly rated highly on measures of “warmth and validation”.

We have also continued to collect outcome data every 4 months for 16 months via parent/youth interview with our participants. We have completed 162 - 2 month, 190 - 4 month, 146 - 6 month, 179 - 8 month, 169 - 12 month, 156 - 16 month interviews. The outcome data demonstrate that children do show improvement in behavior problems over time.

These processes have enabled us to systematically evaluate the goals set forth at the onset of the project, and draw conclusions based on these "real-world" data our participants have helped us collect. The Investigators of the project have begun doing some of this preliminary work, and published manuscripts on these early analyses are available.

The success of this project has relied upon an active, constructive partnership between the researchers and clinicians to identify the most effective methods for feasibility and sustainability of this community based longitudinal study. One of the ways in which this was accomplished was through monthly meetings of the Therapist Advisory Group (TAG), which began meeting regularly in January 2003 and continue to this day. The goals and motivations of the group have evolved over time, ranging from providing guidance on the relevance of our research in clinical settings to new grant development that addresses clinicians’ and researchers’ priorities, to the Collaborative Expo. Over time, the clinician and research partners voted to change the name of the group to Therapists and Researchers: Advancing Collaboration (TRAC), to reflect the highly collaborative, dynamic nature of the group.

An article describing the early stages of this unique process was developed and accepted for publication (Garland, Plemmons & Koontz, 2006: PDF) in the journal Administration and Policy in Mental Health and Mental Health Services Research. This article reports the perceptions of practitioners and researchers towards the research-practice partnerships developed in support of this study.

This study has attracted local and national attention as a rare effort to gather systematic data about "usual care" psychotherapy practice. The Principal Investigator, Ann Garland, Ph.D. has been invited to speak about the study at the International Society for Psychotherapy Research, as well as many state and local forums.

Our thanks to all the families, clinicians and support staff who continue to help us learn more about effective treatment practices for children and their families. We look forward to continued partnerships and opportunities to bridge the research-practice gap.

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