Psychotherapy Leaders: Dr. Giorgio Tasca on Clinician-Informed Psychotherapy Research
Foreword by the Editor of the Psychotherapy Matters Blog:
Giorgio Tasca, Ph.D., C. Psych. is a compassionate believer in evidence-based and accessible psychotherapeutic care for all who need it. He is the Research Director of the Centre for Eating Disorders Research at University of Ottawa and the founder and director of the Psychotherapy Practice Research Network (PPRNet).
This interview is the first in a series that will introduce you to leaders in the field of psychotherapy across Ontario (and maybe beyond). It was both a pleasure and honour to interview Dr. Tasca for our blog.
PsychotherapyMatters.com (PM):
Tell us about the Psychotherapy Practice Research Network, PPRNet.
Dr. Giorgio Tasca (GT):
It developed from the Research Chair Funding that I have. It is intended as a way to bring clinicians and researchers together to do what we call “knowledge translation.” It is a collaboration between psychotherapy clinicians, educators, and researchers aimed at translating knowledge gained from psychotherapy research done within the practice context to improve patient outcomes.
PM:
How large is your network?
GT:
Currently we have about 800 members. Most of them are practicing clinicians, and most are in Canada. The majority of them are in Ontario. We have some international members as well. The advisory committee—we call it the Working Group—has 20 members who are a mix of researchers and clinicians. The vast majority of members practice psychotherapy.
PM:
How do members of PPRNet stay connected?
GT:
About once a month, I send out an E-Newsletter to the membership. The E-Newsletter includes a blog and other information about psychotherapy. The blog is a summary and review of two or three research articles, mainly meta-analyses of psychotherapy with practice implications. These blogs are written for clinicians. In between the monthly outreach by email, we have a couple of social network options for people. They could connect through our Facebook page, or Linkedin. We also have a Twitter feed where I post interesting items or news related to psychotherapy and psychotherapy research, about once a week. This keeps the membership connected.
The blog is pretty popular. We get a lot of comments from people who read the blog. Typically they reply by email or by our website at PPRNet.ca, where people can also join. We have a place on the website where they can respond but members usually respond by email, or on Facebook they will indicate a “like” to a specific post.
PM:
What strategies are you using to grow your network?
GT:
We had a nation-wide conference in 2012. We also posted various announcements on Listservs of a number of organizations in Ontario, in Canada, and in the US. We also ran a fairly large survey that was published in 2015 Psychotherapy entitled “What Clinicians Want from Psychotherapy Research,” and that helped to grow the network as well. More recently it has been by word-of-mouth, through the E-Newsletter, the blog, and social media like the Facebook page.
We are getting between 2-5 new members a week.
PM:
How can a clinician or psychotherapist join the network?
GT:
Joining is free. They can go to our website pprnet.ca and there is a tab to join on that page. Then it is fairly easy. They just have to give a couple of pieces of information. They can join as a “friend”, if they mainly want to receive information from us, like the E-Newsletter. They can join as a “member”, if they wish to participate in research in the future.
PM:
In what capacity will members be involved in research?
GT:
In a sense members will be participants but they will also have input into the research questions we pose and how we conduct the studies. That is all theoretical right now because we have not received funding yet to do research. Being a member is expressing a willingness to participate when research starts.
PM:
In your talks posted on Youtube, you emphasized “practice-based” research quite a bit. Can you tell us about it?
GT:
Practice-based research is research done within practitioners’ practices. It could involve therapists and patients, who are going through therapy. For example, right now, at the funding-proposal stage, we have a project in which therapist’s get trained to identify and repair therapeutic alliance ruptures. If funded, the therapist participant would recruit a few patients from their practice, assess patient outcomes and the therapeutic relationship. Then they would get trained and supervised and recruit another small group of clients from their practice. We would then look at whether the patient outcome and the therapeutic relationship improved after training within that particular therapist’s practice. This is one possibility.
When we have funding, we will contact friends and members of PPRNet and ask them to volunteer to participate in the study. We would tell them how much time it would take, what they would get out of it, what the procedure would be. In a study like the one I described, the therapist would have to approach a couple of patients in their practice, ask the patient if they want to participate, and fill out a few questionnaires. Then the therapist will get the training to help them to identify and repair alliance ruptures.
The therapists don’t have to have specific research skills or training. They just have to have a sense of curiosity about their practice and patients, interest in research, and a willingness to participate.
PM:
What are the barriers to obtaining funding for this research?
GT:
We have written a couple of grant proposals to national funding agencies, but it is extremely competitive to get funding for mental health research in Canada. We have gotten good reviews but ratings were not high enough yet to be funded. Somewhere around 15 percent of all protocols get funded and there are thousands of them. This situation is unlikely to change unless government commits more funding to research and intervention in mental health. The government has not done that. In fact, the funding for mental health research and intervention has been reduced. Philanthropic foundations are the only places where there is new funding. But these are very few and very selective.
PM:
This is not the only research endeavour from PPRNet. PPRNet has successfully published the survey you mentioned. Can you tell us more about that study?
GT:
That was a national and international survey of psychotherapists published in 2015, earlier this year. We held a conference in 2012 where we invited psychotherapist and researchers to attend. We ran focus groups asking psychotherapist participants what they wanted from psychotherapy research and performed qualitative analyses of the focus group transcripts. We then created survey items from those focus groups. Forty-one items on the survey were related to what clinicians’ priorities were for psychotherapy research. Then we did a large survey of clinicians across Canada and around the world. A little over 1000 clinicians completed to the survey.
For the most part clinicians were mainly interested in a few areas of research, including: the therapeutic relationship, factors that were common to various therapeutic approaches, professional development, and patient factors that may contribute to good outcomes. They were not so much interested in research on treatment manuals, cost-effectiveness, or progress monitoring, which involves repeated assessment of patient outcomes. So the clinicians were pretty clear about what they wanted and what they did not want from research.
We used these results to direct the PPRNet’s research agenda.
PM:
Do you have a sense from the study why clinicians wanted some things from research and not others?
GT:
Yes, we did a couple of focus groups of clinicians after the survey. We did one in Toronto and one in Ottawa. We asked them that question. Mainly they felt that the highly ranked items were things that they could do themselves to make a difference for patients, for example, having a better therapeutic relationship with a patient, professional development (what they could learn to make a difference for patients), and understanding patient characteristics, and how to tailor the therapy to the patient to improve outcomes.
The focus groups reported that lower ranked research themes were perceived to be other peoples’ agenda, for example, learning a particular therapeutic approach with a manual, or assessing outcomes in a particular way. These were seen as externally imposed priorities, not their own.
PM:
Sounds like the therapists are used to adapting to each patient, and want to learn how to do it better.
GT:
Yes, yes, that is one way to look at it.
PM:
And you have listened and taken that to heart and it has become your agenda for PPRNet’s research activities. So you are really doing “practice-based” research and “knowledge translation.”
GT:
Yes, that is right. We try to practice what we preach.
The Psychotherapy Matters Blog thanks Dr. Tasca for making himself available for this interview. We are all grateful for the efforts he and his PPRNet team are making to bridge the gaps between psychotherapy research and practice. For additional information about Dr. Tasca, click this link: Centre for Eating Disorders Research.
We encourage Psychotherapy members and readers to visit PPRNet’s website at pprnet.ca, view the PPRNetBlog, and join PPRNet at no cost.
To access the manuscript on “What Clinicians Want From Psychotherapy Research: http://www.societyforpsychotherapy.org/what-clinicians-want-from-psychotherapy-research
To download other publications by PPRNet: http://www.med.uottawa.ca/pprnet/eng/news_events.html
To see Dr. Tasca’s talks on his Youtube Channel: https://www.youtube.com/channel/UCpCx4IiY0TB9XuEvnmzVyIQ
The views expressed in these blogs are the author’s own and not necessarily reflective of those of Psychotherapy Matters. Copyright © 2015 PsychotherapyMatters.com
Vicky Nguyen
Vicky is a psychiatrist and recent graduate from the Northern Ontario School of Medicine (NOSM). She completed her PhD and MD training at the University of Toronto. Her research interests are directed at promoting innovative practices and policies to address sub-optimal wait times, access, equity, and quality of health care services for disadvantaged populations in Ontario. She is certified to provide IPT and CBT. She is trained to provide other types of therapy including DBT, and Psychodynamic Psychotherapy.
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This is a great interview. As a member of the PPRNet working group I believe you have captured the network’s activities and the spirit of our director’s leadership very well.
Thank you, I am a member of PPRNet. I fully support the network’s activities and Dr. Tasca’s vision.