By Aoife West
Last year, the Psychological Center at City College began the preliminary steps of what has come to be known informally as the Clinic Research Project.

The project received the blessing of the IRB last year and is titled, “The Effects of Patient Personal Qualities and Beliefs about Psychotherapy on the Outcomes of Psychotherapy.” It has been designed primarily by Jeff Rosen and Peter Fraenkel with input from Elliot Jurist, Dan Grady, and students from Quantitative and Qualitative Methods classes. As its title suggests, this project seeks to find out whether patients’ beliefs about psychotherapy influence outcomes such as the likelihood that the patients enter individual treatment, the quality of the therapeutic alliance, the longevity of treatment, and the success of the treatment. The project will also examine the mediating and moderating effects that personal qualities such as relationship styles, demographic factors, and self-reported symptoms of patients may have upon outcomes of therapy.

Once data collection begins, all new patients will be invited to give their consent to participate in the study upon presentation to the clinic. Clinic staff will administer the Relationship Styles Questionnaire (RSQ), the Brief Symptom Inventory (BSI), and a Demographic Information questionnaire prior to any intake appointment. During the intake process, members of the research team will administer the qualitative interview, a thirty-minute tape-recorded interview in which patients will be asked about their beliefs about psychotherapy. Together, all of these measures make up the baseline data that will be compared to the outcome measures. Additional process data will be collected at three- month, six-month, and twelve-month intervals, and it will include a re-administration of the BSI and the RSQ.

The research project has not gotten off its feet quite yet due to a host of minor procedural questions around when exactly to attain consent, administer baseline questionnaires, and approach the patient for a qualitative interview during intake, as well as the formalization of procedures for ongoing collection of data. Discussion of these and other questions is ongoing, and the research team looks forward to acquiring input from faculty at other clinical programs who have embarked on both successful and less successful research ventures at their respective program clinics.

In preparation for the clinic research project, Jeff Rosen has been looking at the vast archives of data that we have on patients who have come to the clinic over the past twenty years and whose cases have been long since closed. Dr. Rosen has been recording information such as age, gender, race and ethnicity, country of origin, first language, previous mental health history, and presenting problem. He is looking at how these factors correlate with the result of the intake process, the likelihood of referral, the likelihood that the patient engaged in individual therapy at our clinic, and for how many sessions. Although these data cannot be used for any formal publications due to the requirements of informed consent, it will aid in providing an overview of the clinic’s retention rates and provide some indications on the personal and demographic factors that may contribute to retention. Starting this spring, the clinic will provide demographic questionnaires to all patients who show up to the clinic, regardless of whether they are referred out, never return, or enter the formal intake process, in order to compile ongoing clinic statistics on who we are serving.

One of the many products of the retreat in September 2004 was the formation of the Research Working Group, a working group of clinical students who meet under the guidance of Jeff Rosen to discuss ongoing research projects at the Psychological Center. This group has begun to apply the same question that the Clinic Research Project asks of patients—i.e., how their beliefs influence the outcomes of therapy—to clinicians. The group has designed a semi-structured interview to be administered to therapists about the wishes and aspirations that therapists envision for their patients and about the markers of therapeutic progress. Students in the working group will pilot this interview on advanced graduate students who have volunteered to be interviewed. The interview will be refined over the pilot administrations, and it will then be administered to faculty members in the Clinical Psychology program at City College with the hopes that it may later be administered on a wider scale to supervising clinicians who agree to participate. This project is seen as a first step in the identification of the treatment goals and aspirations that are shared within this psychodynamic community. This will enhance our ability to create a set of outcome variables that both have meaning to this community and are a prerequisite to mounting our own investigation of treatment effectiveness.

Research at the Psychological Center is an up-and-coming reality that is sprouting buds in a number of interesting directions, from the formal Clinic Research Project to the informal collection of clinic statistics on the patients who screen for services at the front desk, to the Research Working Group’s survey of clinician’s beliefs about and goals for the therapy they provide. Opportunities abound for involvement at the level of overall project and procedural design, data collection, data entry, interview transcription, and both qualitative and quantitative coding and analyses. These projects promise a better understanding of who we are and are not serving at the Psychological Center, as well as what personal factors, beliefs, and attitudes about therapy make patients more likely to engage in and benefit from the therapeutic process at our clinic. The answers to some of these questions will not only lead to further questions, hypotheses, research, and dissertations, but will provide us with a lens for self-reflection that we have not had in the past.