Introduction to the Special Issue: Integration of Practice,Advocacy,and Research in Counseling Psychology

Where Is the Practice Focus? The History of TCP and Practice Research

As counseling psychology’s flagship journal, TCP represents the innovative nature of the practice, advocacy, and research of counseling psychology. For over 50 years, TCP has published a variety of articles and served as a vehicle for critical analysis and deep commentary on matters of importance to the discipline and profession. Although matters related to practice and advocacy have been included throughout the years, there has been recognition that more attention is needed. The number of practice focused articles in TCP and the Journal of Counseling Psychology declined over an almost 30-year time frame (Scheel et al., 2011).

Notably, there were efforts made to address this. Beginning in 2000, Drs. O’Leary Wiley (then SCP vice president for practice) and Ruth Fassinger (then SCP vice president for science) created an initiative for TCP to have a “Practice-Science Integration Section of the Scientific Forum” (2003–2007). Dr. Robert Carter was editor when this section began and noted his vision for TCP to emphasize this new forum; he called for the submission of articles that represented a true integration of research and practice, and that would highlight best practices for the clinical treatment of mental health disorders and concerns (Carter, 2003). Likewise, Drs. Nadya Fouad (2008–2013 TCP Editor) and Jeffrey Prince (2008–2013 TCP Practice Forum Editor) continued to focus on using research to inform practice with specific attention on the “critical issues facing clients and therapists” (Fouad, 2008, p. 6). Both efforts produced quality scholarship that benefited counseling psychologists. Both efforts also struggled to identify their practice-focused contributions, specifically, to label them as being within the Practice Forum section, and ultimately, unlike other forums that began around the same time (e.g., the International Forum), the Practice Forum did not continue.

Goals of the Special Issue

Dr. Moore-Lobban began her Leadership Collaborative project focused on practice from a point of the practitioner–scholar model that is foundational to counseling psychology. As the three authors began the collaborative process of working on this special issue, we immediately noted the important role of advocacy in our discipline. Scholars have long called for the integration of practice, research, and advocacy in counseling psychology. For instance, Fassinger and O’Brien (2000) encouraged the use of “scientist–advocate–practitioner” to designate the overlapping roles in these important domains within counseling psychology. In addition, the inextricable link between practice, advocacy, and research has been noted across a broad range of TCP special issues on topics such as Whiteness, social justice pedagogy, and trans and nonbinary research in counseling psychology—and each have noted the inextricable link between practice, advocacy, and research.

As we crafted a call for proposals for this special issue, we fielded questions about what submissions might be “appropriate” for submission. As we responded, we noticed that to wrestle with the order of these important roles in counseling psychology and to explicate their interrelatedness was an ongoing issue for not only us as special editors, but also for the authors in this special issue. We highlight and share this history within our field and our own process to uplift the importance throughout counseling psychology of continuously asking ourselves how all of us in the field are engaging these three roles no matter what type of setting in which we work.

Ultimately, the goals of this special issue were aligned with previous attempts to expand the focus of TCP in calling for articles that represent a true integration of practice-informed research, practice-informed advocacy, research-informed practice, research-informed advocacy, and advocacy-informed practice, as well as a true integration of all three roles. Counseling psychologists integrate practice, advocacy, and research in everything that we do. In actuality, each area is strongest when influenced by and integrated with the other areas. These types of integrations highlight the best practices for the clinical treatment of mental health disorders and concerns, and that can be used to best approach clinical practice on micro and macro levels.

This current special issue was proposed to highlight a variety of practice and advocacy efforts that are grounded in research and applicable to the daily work of counseling psychologists. As guest editors, we were intentional about providing a space for the voices of practitioners to be amplified. For example, collaborative manuscript submissions were encouraged in which there was a clear coauthorship by at least one identified practitioner who may have been a practicing psychologist or psychologist-in-training (e.g., graduate student, predoctoral intern, postdoctoral fellow). Importantly, each article emphasizes the application of counseling psychologists’ work above and beyond the standard “Implications for Practice” section of an article.

Articles in the Current Special Issue

In this special issue, you will find six articles that span the breadth of what the integration of practice, research, and advocacy can “look like” if counseling psychologists center practice at the heart of these three roles. How do we integrate practice and research? And for that matter, what is the difference between research and science? Where does advocacy fit in? These are questions that have been previously explored (Fassinger & O’Brien, 2000; Scheel, et al., 2011), but also demand continued questioning.

In the first article of the special issue, “Call Me Back: Examining Provider Biases Through Callback Rates and Responsiveness,” Hwang et al. (2021 [this issue]) present an innovative phone-based field experiment that investigated callbacks from 903 psychologists in the Los Angeles area, selected from an health maintenance organization (HMO) panel. A recurring dilemma for therapists in independent practice is how much time to spend calling people back when they have no openings, and an important question is how implicit bias plays a role in which clients are called back and which are not. As our field begins to focus on the most effective ways to meet the mental health needs of all those who could benefit from effective psychological treatment, counseling psychologists must increase their awareness of those who seek treatment that providers do not serve. Participant-actors seeking mental health services left phone messages for psychologists, who, in relatively high percentages, did not call back. The authors assessed whether there were differential call back rates across race, gender, and self-disclosed diagnosis of the prospective client, as it has been found in previous research outside of psychology (e.g., employment research). Significant implications for cultural competence, implicit bias, ethical responsibility, and workforce development are clearly demonstrated, as well as the micro- and macro-level biases with further implications for the clients that psychologists serve and how these providers advocate for them. The authors challenge psychologists to consider new ways practitioners can advocate for clients who seek treatment, with special attention to Black, Indigenous, and People of Color (BIPOC) clients and clients with more challenging presenting issues and symptoms.

In the second article titled, “La Clinica In LaK’ech: Establishing a Practicum Site Integrating Practice, Advocacy, and Research With Latinx Clients” Delgado-Romero et al. (2021 [this issue]) describe how a collective group of counseling psychology faculty and trainees worked together over the past five years to develop a counseling psychology clinic that is bilingual and bicultural. In this clinic, this collective group reviews the interrelated roles and strategies of practice, advocacy, and research they used to develop a counseling environment that was responsive to Spanish-speaking Latinx immigrants and families. The authors review how the important geographical content—the Latino South—provided both sociopolitical (e.g., anti-immigrant sentiment) and cultural challenges and opportunities as they created the clinic. As they describe these elements of building the clinic, the authors assert the crucial importance of having Spanish-speaking and Latinx trainees who were true collaborators with faculty, rather than solely instruments of service delivery. In this article, the possibilities are apparent for liberation as a core psychology value (Singh, 2020) enacted between faculty and trainees, between service providers and clients, and between research and practice—all the while integrating advocacy as a barometer for the success of their work. This integration is a true exemplar for our field and the unique possibilities for systemic change in how practice, advocacy, and research can be engaged for faculty, trainees, and clients.

In the third article, Carney et al. (2021 [this issue]) present a study titled “Center Effects: Counseling Center Variables as Predictors of Psychotherapy Outcomes” examining the link between college counseling centers, their policies, and student psychotherapy outcomes using data from the practice–research network called the Center for Collegiate Mental Health. Data were analyzed from over 100 centers, 2,000 therapists, and nearly 60,000 clients. The authors investigate whether the structure of the counseling center has an impact on the service provided to clients by analyzing previous counseling center research on factors having an impact on client outcomes based on client, therapist, treatment, and process factors. Their findings suggest that clients themselves continue to be the strongest predictor of treatment success, and the contribution of this study includes the elegance of using big data to address big questions through a systemic treatment advocacy lens.

The fourth article, “Supervisors’ Perceptions of Their Integration of Strength-Based and Multicultural Approaches to Supervision,” is by Wiley et al. (2021 [this issue]). In this article, the authors explore the question of how counseling psychologists can integrate practice, advocacy, and research into clinical supervision using a grounded theory research tradition. Their findings include four major themes that address the integration of these three roles throughout the supervision process and relationship: (a) supervisory approaches currently used, (b) multicultural content/integration of multicultural approaches, (c) strength-based content/integration of strength-based approaches, and (d) supervisor power and supervisee empowerment. The contribution of this article to the practice, advocacy, and research integration is the understanding of how strength-based approaches and multicultural competence in the form of awareness, knowledge, and skills have the possibility to open up both supervisor and supervisee empowerment spaces. The authors note that this parallel empowerment is an important part of the value and experience of liberation.

The fifth article in the special issue is, “Building a Climate for Advocacy Training in Professional Psychology.” Alexander and Allo (2021 [this issue]) share the development of graduate training experiences in counseling psychology that address specific issues of advocacy, social justice, and public policy as they relate to research and practice in a doctoral training program. The authors highlight the opportunity counseling psychology has to view advocacy as a specific competency supported by sustained curriculum change. Aligning their social justice and advocacy courses with the timing of their state legislature assembly and integrating multiple opportunities for real-life advocacy, the faculty created assignments (e.g., Mock Legislative Testimony) related to some of the key issues the legislators are proposing in their current session. In doing so, both faculty and trainees can integrate research and practice as it relates to advocacy, public policy, and social justice education in one seamless course experience. The contribution of this article is to not only provide an exemplar for training in the lived experiences of advocacy but also to demonstrate that, when the training of counseling psychologists is specifically linked to advocacy competency training, there are future possibilities in the community and within the university to further advocate for important public interest initiatives.

Finally, in the sixth article of the special issue, “The Synergistic but Troubled Relationship Between Psychotherapy Science and Practice: Moving Forward,” Gelso et al. (2021 [this issue]) review the theoretical, conceptual, and ultimately practical difficulties of asking these questions regarding integration. The authors begin by emphasizing the difference between science and research, as well as the importance of not using the terms interchangeably, noting that science is much broader than data-based research; and they also reflect upon the different cognitive processes that counseling psychologists utilize as we think as practitioners and researchers. Most compelling, however, are their descriptions of ways that psychologists can truly integrate research and practice, which range from incorporating practitioners and practice into the planning and completion of studies, to publishing case studies and research with significant practice implications. Finally, they review practice-oriented research that focuses on real issues that therapists deal with in sessions with actual clients, as opposed to randomized clinical trials with brief practice protocols. In doing so, Gelso et al. encourage the field to consider new lenses of integrative thinking as it conceptualizes, assists, and advocates for clients.

Moving Forward With the Integration of Practice, Advocacy, and Research in Counseling Psychology

Collectively, the articles in this special issue have further shown the importance of integrating practice, advocacy, and research. Counseling psychologists hold a variety of roles including therapists, supervisors, educators, researchers, program developers, and advocates—roles that are impacted by practice and are at the heart of who counseling psychologists are and what they offer within and outside of their profession. The articles in this special issue provide an opportunity for practitioners to journey with people by considering their lived experiences and the implications of their practice on their clients’ lives. Such considerations naturally lead toward creating additional space for advocacy and liberation within practice and research. As such, we noted four themes in which the authors of the six articles challenge psychology as a field to consider moving forward by increasing the integration of practice, advocacy, and research across counseling psychology roles.

The first theme is that integrating practice, advocacy, and research is imperative in everything that counseling psychologists do. Across each of the articles, the authors assert that there are ample opportunities to center advocacy within practice and research (Delgado-Romero et al. (designing a bilingual, bicultural counseling clinic to address service gaps and inequities in the Latino South while simultaneously stimulating multiple studies to examine practice gaps and advocacy opportunities), to understand how research fuels better practice and advocacy (Hwang et al. demonstrating how callback rates can be influenced by implicit bias and advocacy to transform cultural competence in practice), and how practice can drive advocacy and research (Gelso et al. arguing that practice-oriented research should advocate for a focus on real-life therapist–counselor experiences as opposed to randomized clinical trials).

Aligned with the first theme, the second theme is recognizing that integrative practice is informed by research and advocacy, integrative research is informed by practice and advocacy, and integrative advocacy is informed by research and practice. Counseling psychologists can assist clients in challenging the status quo in their relationships and lives in ways that allow them to heal; they can create research that is informed by the questions of practitioners and the lived experience of clients; and they can infuse an advocacy lens to allow deeper insights and changes on the part of clients and deeper questions to be asked in research. The field has to better utilize an integrative approach to its work and training within counseling psychology and also across other disciplines of psychology.

A third theme of the special issue entails that counseling psychologists challenge the false debate of how and when to prioritize practice, advocacy, and research. The first themes are about integration, and this third is the understanding that one does not have a hierarchical order to integrate. Many TCP articles (Deblaere et al., 2019; Scheel et al., 2011) have called to transform the false debate about how and when to prioritize these three roles so that practitioners no longer continue to pretend that practice, advocacy, and research can be stand-alone roles as counseling psychologists. For instance, Ratts and Hutchins (2009) argued that counseling is advocacy and advocacy is counseling—that the two roles could only be separated if one is upholding the status quo in practice. This same sentiment is noted in the revision of the 1992 Multicultural Counseling Competencies (Sue et al.) to the Multicultural and Social Justice Counseling Competencies (Ratts et al., 2016) that connected multicultural awareness, knowledge, and skills to advocacy action and chance across multiple ecological levels. Alexander and Allo’s (2021) article in this special issue shows how psychologists move beyond the false debates between the three roles of research, practice, and advocacy. Alexander describes how faculty boldly integrated specific public interest and advocacy initiatives into counseling psychology training by developing a course that drew upon research on societal inequities to drive trainees’ understanding of the connection between advocacy and practice.

The fourth theme to address in counseling psychology is tending to counseling psychologists' own home and being bold in the leadership and collaborative conversations within and outside of SCP. Aligned with the current SCP strategic plan, counseling psychologists are encouraged to engage fellow practitioners in all aspects of their organization and integrate practice, research, and advocacy in all they do. Let us bear in mind that advocacy is prevention, which has been a hallmark of counseling psychology since its beginnings (Meara & Myers, 1998). We are reminded to be especially mindful to “draw the circle bigger” (Bingham, 2000) and strengthen inclusivity, diversity, and focus on becoming an antiracist organization through advocacy within psychology and beyond. In this issue, Wiley et al. (2021) describe ways that clinical supervisors integrate multicultural and strength-based perspectives in an integrative way by recognizing that strengths vary depending on the cultural context of the client and supervisee. Gelso et al. (2021) look at new ways of pendulating between research-oriented and practice-oriented ways of thinking to be truly integrative. Alexander and Allo (2021) describe ways of integrating social justice and legislative advocacy into training. Adding counseling psychology’s traditional focus on prevention as one lens of treatment broadens the view to one of advocacy at the individual, group, and system levels (Romano & Hage, 2000).

We are calling for this integration for all psychologists across our larger field, and across the APA as well. There have been attempts to integrate areas of importance within APA, such as the directorates of practice, science, education, and public interest. There is recognition of the overlapping importance of each area, and that no one area should be solely responsible for carrying the work nor is such a siloed approach helpful to the collective mission of change and impact that is desired. We are calling for mindful integration of our important areas within SCP and also for all psychologists. Journals commonly have implication sections for practice and research: A big step forward would be to integrate these sections and include advocacy as well.

Conclusion

A central purpose of this special issue was to expand past the implications for the practice section of our manuscripts as we think about what our work, as counseling psychologists, truly means. We challenge counseling psychologists, and all future TCP manuscripts to continue expanding past the “implications” section and integrate a true understanding of what our findings mean for practice, research, and advocacy. We challenge counseling psychologists to understand practice, advocacy, and research as many overlapping and integrated roles. Collectively, they are vital to the practice of counseling psychology.