From the APA Science Student Council

How Science Informs Clinical Practice and Vice Versa

In psychology there tends to be a rift between the “scientists” and the “practitioners."

The Science Student Council is a group of nine graduate students who spend a couple of weekends a year with the Science staff, advising on programs and activities that would benefit graduate students in psychological science. In this column, the students will present useful information that other graduate students need to know! Visit the Science Student Council to learn more about the activities of the SSC.

How Science Informs Clinical Practice and Vice Versa
by Marc Berman 
 

In psychology there tends to be a rift between the “scientists” and the “practitioners.” This rift is unfortunate given how important both science and practice are to improving mental health. Luckily, however, there has been a recent trend to bridge the two orientations. This trend has led to some very interesting and important research, as each orientation informs the other.

There are many examples of how science and practice can be mutually beneficial to the advancement of psychology. One example of science impacting practice comes from Posner and Rothbart’s recent Annual Review of Psychology paper (2007). The authors discuss how differences in attention, assessed with cognitive measures, are predictive of differences in temperamental and effortful control in children. Other researchers have shown that children exhibit better school success and behavior when they are trained to improve basic attentional processes (Diamond et al., 2007). In addition, differences in attentional performance are related to differences in dopamine transporter genes (Rueda et al., 2005). Therefore, it is possible that genetic markers could predict which people will have attention difficulties, thereby allowing therapies aimed at improving attention to be initiated early in life. This is not only true of attention, but may also be true for susceptibilities to depression, OCD, and anxiety. In these circumstances, effective therapy is enhanced by findings from basic psychological science.

By the same token, clinical practice has helped shape and inform psychological science. For example, practitioners often find and report individual tendencies in patients who suffer from various mental illnesses. These tendencies can be very helpful in elucidating more general behaviors in the greater population. In the case of depression, for example, patients commonly show ruminative tendencies, where they perseverate on negative thoughts and thus worsen their mood. Recent research has shown that depressive rumination is associated with an inability to inhibit prior mental sets. However, other forms of rumination, such as angry and intellectual rumination, are associated with difficulties in task-switching, not with difficulties in inhibiting prior mental sets (Whitmer and Banich, 2007). Here, clinical practice, which identified different ruminative styles, informed science of meaningful differences among the ruminative styles.

In other research, Mayberg (2003) shows that practice and science can inform each other simultaneously. Two successful treatments for depression are cognitive behavioral therapy (CBT) and drug administration, and both treatments are about equally effective in treating depression. However, brain imaging indicated that drug treatments affected a more sub-cortical brain network, while CBT affected higher-order networks involved in attention and voluntary control. These data suggest that while the outcomes of both treatments are similar, the mediating variables are quite different. These neural markers may identify which treatments would be most effective for which people, an important milestone in both practice and science.

In summary, both science and practice enhance our understanding of psychology from the theoretical and applied perspectives. There is a growing interest in collaboration between these fields, and this interest may yield innovative research and therapies that would not have come to fruition if each field had worked independently.