Editorial: Integrating Research and Practice: The Role of the Journal of Pediatric Psychology

Abstract

The integration of research and practice in the field of pediatric psychology remains an important but elusive goal, despite early precedents (Wright, 1967; Wright, Nunnery, Eichel, & Scott, 1968) and more recent developments in dissemination of empirically supported interventions (Spirito & Kazak, 2006) and evidence-based assessments (Cohen et al., 2008). Despite these developments, published research in pediatric psychology still does not emphasize intervention, clinical significance, or dissemination of valid interventions (Brown, 2007; Drotar, 2002; Kazak, 2000; LaGreca, 1997; Roberts, 1992). Moreover, published research on psychological interventions generally does not focus on clinical populations that are seen in pediatric practice-based settings (Drotar, 2002, 2006, 2009). Moreover, most practicing pediatric psychologists are not engaged in research that evaluates the effectiveness of their clinical practices. The net effect of these patterns is continuing isolation of research and practice in pediatric psychology that is also reflected in published work in the Journal of Pediatric Psychology (JPP). Powerful forces have sustained less than optimal integration of research and practice in pediatric psychology. For example, even in the most academically oriented medical settings, fiscal incentives for practitioners focus primarily on clinical care, especially billable hours, rather than on developing practice-based research. Moreover, research funded by the National Institutes of Health (NIH) is generally not conducted in clinical populations because of sampling (e.g., presence of comorbid conditions) and study design considerations as well as the considerable pragmatic obstacles involved in conducting research in practice settings (Drotar et al., 2000). For example, it is very difficult to conduct and sustain research in practice settings given limitations in space, time, and resources (e.g., research assistants, data analytic support, etc.). Heterogeneous clinical practice patterns also make it difficult to achieve the level of experimental control and treatment fidelity that are required for intervention studies. Moreover, NIH review places a premium on testing new intervention models rather than dissemination or clinical application of evidence-based interventions into practice. Based on the above constraints, and to the point of this editorial, research that is published in the JPP focuses on empirical descriptive or explicative research (Roberts, 1992) and randomized trials of intervention rather than case series and clinical effectiveness studies that evaluate the application of interventions conducted in clinical care settings. Such publication patterns reflect the content of manuscripts that are submitted to JPP. In order to shift these publication patterns, I am very interested in encouraging authors to submit clinically relevant research, case reports and series, and studies of clinical effectiveness to JPP. Such research can have important scientific and clinical impact on the field of pediatric psychology. For example, single subject designs and clinical case reports have heuristic value and scientific utility in suggesting new directions for research or clinical care by documenting success or failures of empirically supported interventions in clinical settings, describing the generalizability of research to practice, and evaluating new practice-based interventions (Drotar, 2009; Drotar, LaGreca, Lemanek, & Kazak, 1995). Studies designed to test psychological interventions that improve the power and effectiveness of those conducted in clinical settings will enhance the psychological and health outcomes of children who are seen by practicing pediatric psychologists. Moreover, studies of the comparative effectiveness of alternative interventions should have increased priority under Health Care Reform and for work funded by the Agency of Healthcare Research and Quality. Finally, it is also important to note that the need for greater clinical