EDITORIAL: RESEARCH (AGAIN)

Journal of Marital and Family Therapy, Jan 2005 by Wampler, Karen S

Four-and-a-half years ago when I started on the editor path, I was more certain and clear about research and the field of marriage and family therapy (MFT) than I am today after serving my term as Editor. Like diet and exercise, research is one of the field's most visible items on our list of "ought to do," "need to do more," "heavy cost if we don't," and "ain't it awful," accompanied by the usual finger-pointing as to whom to blame. I think every reader of JMFT could recite the difficulties:

* Need for more evidence of effectiveness of MFT

* Importance of documentation for consumers, policy-makers, and third-party payers

* Need to close the gap between research and practice

* Need for MFTs to be informed consumers of research that is then incorporated into best practices

* Need for MFTs to be actively engaged in outcome research rather than depending on other fields

* Need for evidence that what works in well-controlled research studies also works in real-life practice

Just as in therapy, the problems are much clearer than the solutions. Happily, the set of research articles in this issue of JMFT points to both. Hawley and Gonzalez (this issue) could identify only 109 full-time faculty in research-oriented MFT programs, defined as all COAMFTE accredited doctoral programs and those master's programs that require a thesis. There are sparks of optimism in these data as well in the finding that the newer faculty are more active in research. One of my responsibilities as Editor is to identify new researchers to serve on the Editorial Advisory Board. I have witnessed a generational shift in our field in terms of the number of active researchers I could identify to serve as reviewers, the quality of their reviews, and the quality of their research submissions to the journal. This shift has been fueled in no small part by the series of research conferences sponsored by AAMFT with faculty at all levels recommitting to changes in curriculum and role assignments in order to produce more and better research, emphasize the integration of research and practice in clinical training, and train students to be better researchers.

The article by Hodgson, Johnson, Ketring, R. Wampler, and Lamson (this issue) is representative of this shift. Using four accredited MFT programs as case examples (two master's and two doctoral), they identify clear, feasible strategies that have already been implemented for integrating research into clinical training. While the other mental health professions have appeared to move in the direction of separating research from clinical training, our field is going in the opposite direction. I get a bird's eye view of this from the envy of my faculty colleagues from clinical programs in other fields who cannot believe how passionate our MFT students are about integrating research and practice. Their doctoral students do one project, the dissertation, and then go into full-time clinical practice. The MFT training model lends itself to research with built-in observation, videotaping, multiple observers, including colleagues and supervisors, and naturalistic settings. I have the privilege of teaching our advanced MFT research class and have done it long enough that I see dramatic improvement in the research training and commitment to research that students have coming into our doctoral program. I know which master's programs offer excellent research training (they all offer good clinical training), and can see how these students benefit from a close mentoring relationship with MFT faculty in their master's programs. I see our doctoral graduates move out and start the same process with their students. I become optimistic about our field when I can see the 19 students in my research class get excited about research, gain confidence, and develop feasible research proposals.

There are other basic issues that have confronted me as Editor. The more compelling research articles focus on process instead of outcome. The articles in the Special Section (this issue) edited by Dattilio and Epstein are a good example. They focus on important processes underlying cognitive-behavioral couple and family therapy, particularly those involving relationship schemas and how to change them. Even though the clinical implications of this interesting set of articles apply to both couple and family therapy, almost all of the research cited was done with couples. This parallels research submissions to the journal during my term as Editor, with almost all of the research submitted focused on couples, with very little on families.

Conceptually, family-level processes are more difficult to handle and submissions reflect this. Research labeled "family" is usually based on dyadic- (almost always mother-child), or, at most, triadic-level data. New methodologies allow us to handle family-level data more effectively, but the core problem of getting and keeping families in treatment needs addressing in order to produce better family-level clinical research. One of the great strengths of MFTs is the ability to move easily from one unit of treatment to another, always keeping the family as a whole as the context. Current research methodologies do not allow us to capitalize on this unique nature of MFT practice that involves a mix of individual, couple, family, subsystem, and broader system interventions with frequent shifts in who attends any one therapy session. The theme of the 2005 AAMFT conference is relational therapies. I would like to hear thoughtful discussions on the nature of relational therapy and avoid limiting the definition of relational therapy to therapy that is conjoint, that is, involving more than one person in the room. This narrow definition of relational therapy is used in research as well and severely limits the applicability of MFT research for clinicians who define their therapy as relational, regardless of who is in the room.