Luís Costa da Silva: International Network Supporting Psychotherapy Innovation and Research into Effectiveness (INSPIRE)
The INSPIRE work meeting took place on the 23rd and 24th of April, in Leiden, the Netherlands, and it was indeed truly inspiring. INSPIRE stands for International Network Supporting Psychotherapy Innovation and Research into Effectiveness, whose main goal is to inform themselves and others about the state of the art in psychotherapy outcome research. This objective and this research area align with the work we do at CORC, so we joined this diverse group of clinicians, researchers, practitioners and psychotherapists from all different backgrounds for a couple of incredibly enriching days. Outcome monitoring and feedback on psychotherapeutic progress has become popular and has been implemented by many mental health providers around the world. It is as an important feature of good clinical practice with great potential, whose study is not yet exhausted. More research is needed, and this is what inspired INSPIRE.
The sessions combined these voices in different talks, covering a good number of topics, including general updates on feedback research, implementation success, therapist effects in naturalistic settings, but also included workshops, discussion about statistical approaches to data and the chance to network with the leading researchers in the field. For me, the diversity of the research presented, as well as the passion of these researchers about the topics, made the whole experience captivating – and for someone relatively new to this topic, it was an amazing learning opportunity as well. Presentations also encouraged debate, whether about the latest findings or about how to potentially utilize the shared knowledge into new and exciting projects.
It was particularly interesting (and helpful) to have a glance at the update on feedback research, which suggests that despite the low number of studies looking at the effects of dropouts, research shows that feedback can reduce these. Overall, a new meta-analysis discussed also showed a small overall effect of feedback on outcomes but, perhaps more importantly, also alerted to the difficulty to interpret these results as the studies seem to be very heterogeneous in terms of methods, variables analysed, measures, blocks of moderators, etc.
A very animated discussion prompted about a more practical issue: some clinicians are not open to feedback, so what should be done? Some argued for the use of mandatory feedback, which was countered by some who claimed this could potentially lead to it being poorly done; others maintained that it could still offer research some more useful data. Nonetheless, there was a unanimous consensus that feedback should be more than just a way for organizations, such as insurance companies, to claim or justify reimbursement: it should truly assess the impact of psychotherapeutic interventions. Similarly, some other questions and points were raised: how do organizations that don’t use measuring systems make decisions? More pre-work is needed on this, as well as an encouragement for more multidisciplinary work with other healthcare fields, some of which have been using feedback outcomes for a longer time than mental health services.
Overall, these two days covered a vast range of topics, but raised even more questions for the future, feeding ideas to new studies and catalysing new approaches. We can expect new and exciting developments from this group and we at CORC will hopefully be joining them again next year in Braga, Portugal, where the next meeting should take place.
Luís Costa da Silva joined CORC in April 2018 as a Research Associate