The National Institute of Mental Health (NIMH) has published a seventy-six-page report, Translating Behavioral Science Into Action, that identifies and seeks to resolve a problem that might shed some light on why research findings are often treated within the psychoanalytic community as if they were clinically uninformative. A copy of the report may be downloaded from the NIH Web page at nimh.nih.gov.
The apparent disinterest in behavioral research findings is often regarded as a form of “resistance to research.” Its causes among psychoanalytic practitioners have not been well understood. The new NIMH report acknowledges that the results of decades of behavioral science investigations of cognition, emotion, motivation, personality development, and social interaction are underutilized.
Ideally, basic behavioral research studies in any of these domains would specify treatment and prevention implications. Investigations of sensation and perception, for example, would ultimately benefit our understanding of neurological and sensory disorders; motivational research could help in formulating innovations in treatment or prevention programs for most Axis I illnesses.
This issue has raised two related questions for NIMH and its advisory group on government policies and activities for mental health research, the National Advisory Mental Health Council (NAMHC). First, why were behavioral research insights into the nature of mental illness and its prevention and treatment not more widely appreciated and then transformed into viable clinical intervention strategies? Second, what could be done to remedy this conflicted state of affairs? Something about behavioral science research prevented its findings from becoming the evidential basis of the clinical research on which NIMH-supported mental health programs ultimately stand.
NIMH and NAMHC convened a behavioral science work group to study and formulate ways of improving the translation of behavioral science research into social action. The group spent several months in 1999 collecting information from other behavioral scientists as well as from clinical research workers, representatives from mental health providers and advocacy groups, and members of professional societies throughout the U.S. The work group specifically wanted to know how behavioral science could be used to better inform clinical research and practice. The work group also wanted to know how to overcome “barriers to the translation process.”
The group discovered that there is a rational basis for the widespread reluctance among clinicians to attend to even the most ostensibly relevant research data. Practitioners did not feel that their ideas about how services should be offered, or health-care policy fashioned, were properly represented by the research contributions in these areas. They objected to research-based treatment guidelines that did not fit the clinical settings or the patients they were designed to serve. They complained that research findings had little to offer in the diagnosis or treatment of complex cases in which multiple psychiatric and physical symptoms and troubled life circumstances were prevalent.
Some of the practitioners went on to say that these concerns could be addressed if (1) clinicians “had a larger role in developing and conducting generalizable research”; (2) clinicians could be assured of “the effectiveness of evidence-based treatment rules”; and particularly (3) NIMH worked to communicate more clearly and effectively the actual benefits of the research findings to increase practitioners' receptivity to recommended variations in treatment approaches.
What can we learn from Translating Behavioral Science Into Action? Perhaps the most important inference is that the cautious attitude of many psychoanalytic practitioners toward research data might change if the research programs were formulated and expressed in a manner that addresses their treatment concerns. Such an approach could strengthen the link between the methods of psychoanalytic science and those of psychoanalytic practice.
Stephen H. Portuges, Ph.D., writes a regular column for TAP on psychoanalytic science. To let him know of interesting research for this column, e-mail him at .