Blurring practice–research boundaries using progress monitoring: A personal introduction to this issue of Canadian Psychology.

Abstract

Progress monitoring (PM) consists of using standardized measure to follow client progress and give clinicians feedback about response to treatment. PM systems have shown great promise in helping therapists identify when clients are not progressing, which improves both retention and client outcomes, but only if therapists use them. This article traces the story of the author's halting and sceptical adoption of PM and the questions that were raised along the way. Beginning at the point of seeing PM as a good thing for others, the author presents a series of questions that centre around the issue of how PM fits with a therapeutic philosophy that values conversation over numbers. Case vignettes illustrate some of the challenges and things learned along the way. Rather than diminishing the importance of therapeutic conversation as a vehicle for change, PM data have opened up new conversations and presented opportunities to broaden and deepen therapy sessions. The author suggests that working with a new kind of data in practice has developed her identity as a scientist-practitioner and increased her appreciation of how practitioners can contribute to the development of knowledge in our field. Keywords: progress monitoring, patient-focused research, practice-based evidence, outcome measure, scientist-practitioner I recently read a study that assessed methods of transferring research knowledge into practice in which 742 practitioners were divided into three groups and given information about an empirically supported treatment for bulimia (Stewart & Chambless, 2010). The three different information packages included: a research review, a case study, or the research review plus the case study. After reading their package, each practitioner was asked how much time they were willing to devote to learning about the treatment. Perhaps not surprisingly, the practitioners were more compelled by the case study - the story - than the data. Those who read the case were willing to invest more time in learning about the treatment than those who only saw the research. More surprising perhaps was the fact that those who read both data and story were no more likely than those who just read the story to invest in learning. Clearly, stories are powerful to those of us who work with clients. They are our data - the things that we observe, assess, and interpret. They are also our tools. In helping clients revisit, reassess, reframe, and retell their stories in new ways, we help them to change. In deciding to organise this special issue, the awareness of how I struggled to begin progress monitoring (PM) - my personal story - has motivated me to undertake the project. I have framed my ideas within that story and highlighted the ideas of the other contributors to this special issue that have helped me to understand and contextualize it. It is the story of my gradual, sometimes hesitant, sceptical adoption of practice monitoring. I tell it in the hope that some of my experiences will resonate with practitioners and stimulate interest in what I have come to value as an important dimension of my practice. I was a clinician first and a researcher second. I obtained an MA in counselling psychology, practiced for several years as a counsellor, and returned to school to complete a PhD and do research in psychotherapy processes. After my doctoral training, I accepted an academic position. Today I am both an associate professor of counselling psychology in a research-intensive university and a psychologist in independent practice. That certainly sounds like a scientist-practitioner, the identity embraced by most psychology training programs today (Horn et al., 2007). I graduated from, and teach in, such a program. Yet in spite of my training and my experience, I have not found the blending of these identities to be very natural or seamless. Yes, there has always been some bleeding of the boundaries: when I talk to clients about how their struggle or change strategy is supported by research, when I do clinical supervision and offer students a research-based rationale for my suggestions, when I draw on clinical experience to write a discussion that makes sense of my data. …