1. Professor Andrew Gumley Dr Suzy Clark Dr Heather Laithwaite
Translating Practice to Research and Research to Practice in Psychological Therapies NES Psychological Interventions: Hitting the Targets 17th March Heriot Watt Conference Centre Edinburgh
Professor Andrew Gumley
Dr Suzy Clark
Dr Heather Laithwaite

2. Overview of Workshop
Research evidence derived from randomised controlled trials of psychological therapies has been central to underpinning the Widening Access to Psychological Therapies agenda in Scotland.
There remain real challenges in developing close partnership between research and practice in mental health services.
The workshop will provide an opportunity to explore tensions between scientific, health service and political drivers on research in the NHS in Scotland.

3. Intended Learning Outcomes
Specifically the workshop will address the following Intended Learning Outcomes:

1.      Develop an overview of current initiatives to increase capacity for mental health research in the NHS in Scotland and the UK.
2.      To identify barriers to research in relation to psychological
therapies
3.      Identify priorities for research in in psychological therapies.

It is hoped that the workshop will facilitate an orientation to exploring increasing partnerships between clinicians, services and researchers to address priorities for the further development and availability of evidence based psychological therapies.

4. Workshop Presenters
Professor Andrew Gumley, Chair of Psychological Therapy, Consultant Clinical Psychologist, West of Scotland Clinical Lead for Scottish Mental Health Research Network and BPS representative on Psychological Therapies NOS National Reference Group.
Dr Suzy Clark, Consultant Clinical Psychologist and lead for psychological therapies in ESTEEM North Glasgow Early Psychosis Service.
Dr Heather Laithwaite, Consultant Clinical Psychologist in Rowanbank Forensic Mental Health Services.

5. Competence Framework for Psychological Therapies
Driven initially by IAPT and SfH NOS the framework determined the core competences required to deliver CBT by:
Identifying those therapeutic approaches with the strongest claims for evidence of efficacy, based on the outcome of therapies in clinical controlled trials.
Competences derived from the manuals by which therapists were evaluated for fidelity and competence.
Basis for model of Systemic, Humanistic and Psychodynamic / Psychoanalytical psychotherapy competences.

6. Hierarchical organisation of competences
Competences organised to reflect complex, dynamic non-linear nature of competences required in psychological therapies.
Reducing psychological therapies to a series of rote operations makes little sense since competent practitioners need to be able to make higher order links between theory and practice.
Note the key terms here:
Randomised Clinical Trials
Fidelity
Competence
Theory
Practice
Reflect the close relationship between theory, research and practice in meeting strategic NHS priorities!

7. Commitment 4 in ‘Delivering for Mental Health’ (DfMH) (Scottish Executive 2006) stated that:-  ‘We will increase the availability of evidence-based psychological therapies (PTs) for all age groups in a range of settings and through a range of providers."
Summarising the most up-to-date advice on evidence-based interventions; Providing information and advice on strategic planning issues in the delivery of efficient and effective Psychological Therapies services; Explaining the levels of training and supervision necessary for staff to deliver Psychological Therapies safely and effectively.
Mental Health in Scotland
A Guide to delivering evidence-based Psychological
Therapies in Scotland
“The Matrix”

8. Delivering Evidence Based Psychological therapies: Research to practice and practice into research.
The concept of delivering ‘evidence-based ‘interventions have a number of implications for any service. The evidence base is derived from the results of key therapeutic research trials, and to deliver an ‘evidence-based’ therapy we must be able to demonstrate that we are replicating the conditions operating within those trials as closely as possible.
In practice this means having therapists:
trained to recognise standards, and having the competences necessary to deliver psychological interventions effectively to the tier of service within which they work;
delivering well-articulated therapy, and adhering to the appropriate model; and
operating within a well-governed system which offers regular high quality, model-specific clinical supervision, support and relevant CPD.

9. HISTORY: Why have a Mental Health Research Network?
The importance of Mental Health as a public health issue
Relatively under-developed research
Relatively under-funded

10. HISTORY: Imbalance of resources
Recent figures show that mental health research received 6.5% of the total research funding compared with 25% for research for cancer and 15% for neurological diseases.
(Fair deal for mental health campaign, Royal College of Psychiatrists)

11. (people, studies, regions)
Aims of the SMHRN
Key challenge :
To facilitate the development and successful completion of large, well-funded research studies across Scotland.
Key strategy :
Be more INCLUSIVE
(people, studies, regions)

12. SMHRN objectives: Primary goals:
To increase the amount of mental health research
To increase the number of people participating in mental health research studies
Broadening the scope:
Trials at various stages of development
Epidemiological, genetic and imaging studies
A broad view of health services research

13. The SMHRN team Chief Scientist Office
Management Group: Andrew Gumley, Jonathan Cavanagh, Alan Carson, Keith Matthews & Ross Hamilton
Network Director: Stephen Lawrie
Advisory Board
Associate Directors: Gordon Murray, Andrew McIntosh & Jeremy Hall
Manager
Research Assistants: Emma Witt, Anna Peel, Sarah Browne & Lisa Blacklaw
Research Nurses: Lewis Harpin & Jacqueline McTaggart
Study Co-ordinator: Laura Hodges
Administrator: Amy Lambert

14. SMHRN Services Adoptions Service Protocol Development Service
Protocol Development Groups

15. Why should you contact the Network: (1) Adoptions Service
Aim of the Adoptions Service is to support Study Set up and Completion
Recruitment
Data collection
Regulation
Site files / Master files
Study documentation
Statistical advice
User Involvement
SMHRN Adoptions Service
help with

16. Adoptions Service: Application process
Eligibility:
Relevant to the understanding, prevention or treatment of mental illness
Human participants
Type of study
Led from or include a site in Scotland
Funded or application with funder
Assessment:
Study quality, feasibility, added value & Network capacity

17. Adoption Service: Current Portfolio
Trials
Genetic / Imaging
Observational
ProCEED
COBALT
CEQUEL
SMaRT 2 & SMaRT 3
EDIE-2
Multiple Symptoms Study
iMANTRA
GCIT
ACTp
DOWNSLIT
MD-CAD
2 commercial studies
CBASP*
KANECT*
Bipolar Family Study
Scottish Family Genetic Collaboration
fNEMO
Generation Scotland: Scottish Family Health Study
TMRI GC Imaging Study
SPECT
PODS
1 commercial study

18. Mental Health Research Register
Led by Andrew McIntosh
Scotland-wide
Aim to establish a register for people who might be interested in taking part in mental health research

19. Why should you contact the Network: (2) Protocol Development Service
Aim of the PDS is to encourage a pipeline of research
Focussing and refining the study question
Development of the protocol
Planning practical aspects of study execution
Addressing regulatory requirements
Making a power calculation and analysis strategy
Identifying funding sources
SMHRN Protocol Development Service
help with

20. Why should you contact the Network: (3) Protocol Development Groups
Aim of PDGs is to bring together researchers with a shared interest in specific research questions
Funding to support PDG activity
Methodological support
Focus on producing high quality fundable research proposals
Call for Applications for Protocol Development Groups
Peer Review

21. Current PDGs Lead Research Area Kate Davidson
Borderline Personality Disorder
Jane Morris
Anorexia Nervosa
Alan Carson
Functional Neurological Symptoms
Andrew Gumley
Recovery after Psychosis

22. Call for new PDGs
2010 – 2011
Actively encourage the development of PDGs in key areas such as
- depression (primary / secondary care)
- substance misuse
- developmental disorders
- …..?

23. Group Discussion Point
Barriers to research can include individual, organisational, practical.
Need for whole team approach and collaboration between services, clinicians, service users and clinical academics.
What are your priorities research in psychological therapies?
Recovery focus
Competences for therapy and supervision
Outcomes of psychological
User Involvement
Widening access
ALSO CONSIDER ACTION POINTS BEFORE END OF DISCUSSION

24. Future directions for the Network
Consult with:
Clinicians and researchers
Psychologists, psychiatrists, nurses, counsellors, physiotherapists…
Patients, carers and the public
Industry
on how the Network can best engage and support them in research.