Magazine article Addiction Professional

Calm the Discord between Researchers and Practitioners

Magazine article Addiction Professional

Calm the Discord between Researchers and Practitioners

Article excerpt

For at least 20 years many efforts have been made to ensure that the findings of the latest addiction research are reflected in what our addiction treatment system offers. We have made great progress, despite sometimes heated disagreements between researchers and practitioners on the nature of the problem and the best possible solution.


Those of us with a foot in each group often have had to defend one or the other from unfair stereotypes. The ugliest of these include the idea that researchers live in ivory towers, totally disconnected from reality, and the notion that practitioners are uneducated ex-users with no qualifications other than their own individual experience. Each group also has some legitimate concerns that it is not fully understood by the other.

The collaboration between researchers and practitioners works best when a common vision motivates both groups. When practitioners and researchers are united by a focus on their shared goal of positive client outcomes, implementing research findings goes very well. This column is designed to help each group understand the other better and to bring the two together in that common focus.

Practitioners' perspective

Practitioners want researchers to know that they are not resistant to change, and that they truly value what research has to offer. Once convinced that a major benefit to clients can ensue, practitioners can and do move quickly. Practitioners value the expertise of those conducting the research, but also want researchers to know that practitioners have expertise of their own that deserves respect.

Practitioners want researchers to know that practitioners are not willing to abandon the treatment system they have spent a lifetime building and to start from scratch each time there seems to be some credible evidence to support a small change. Practitioners work hard to identify major developments that might benefit their clients, and integrate these in their treatment offerings. Practitioners work equally hard to protect their clients from the harm that could result from their jumping aboard the latest unproven fad.

Practitioners want researchers to know that practitioners design their services to be research-informed, rather than exact replicas of laboratory conditions. Practitioners understand the concept of fidelity and its usefulness in the context of research. Practitioners want researchers to understand that this concept is not as useful in the operation of treatment programs, for several reasons.

In the context of research, a typical goal is to create an experiment with only one variable, making it easier to attribute client improvements to a specific medication or technique. Fidelity is important in studies that are designed to build on previous research. Yet in operating a treatment program there are other considerations. Fidelity to one particular research-based treatment protocol often shortchanges clients in another area. For example, treatment programs might integrate what seems like the active ingredient in two different research-based treatment options, each with its own very specific treatment protocols. To use either protocol exclusively would improve a program's fidelity rating, bur not necessarily its treatment outcomes.

Practitioners want researchers to know that integrating the latest research constitutes a process and not an event. It takes time to identify and prioritize needed changes, to train staff and to measure performance. Because of the time lag from decision to full implementation, insisting on fidelity to a specific treatment protocol usually doesn't work. …

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