Research Update at ERC Pathlight: A Q&A With Renee Rienecke, PhD, FAED
Eating disorder and mental health research
Research has significantly changed how we involve families in eating disorder and mental health treatment at higher levels of care. By studying treatment effectiveness, we adjust our treatment plans based on research findings.
Research is core to our practice — and for good reason. The more we learn, the more effective eating disorder treatment and mental health treatment will be. Our team of in-house researchers and clinicians help us deepen our understanding of these complex conditions so we can provide the highest quality treatment to our patients and their families.
Why is research so essential to our work and how does the literature impact patients? To find out, we sat down with clinical psychologist Renee D. Rienecke, PhD, FAED, our very own director of research, to talk about how her team approaches research. Find out how to talk with patients and families about clinical studies, and how ongoing research can have a positive impact on partners and patients for the long term.
Q: What influenced your decision to become a clinician-scientist?
A: I knew I wanted to be a psychologist when I took my first psychology class in middle school. But the scientist part of the scientist-practitioner model didn’t really take shape until I was in graduate school, where I learned the value of research and discovered how much I love doing it. Coming up with a question that needs to be answered, designing a study to accurately answer that question, carrying out that study and answering a question that’s important to the field is so satisfying. You know you’re contributing to the field in a way that can impact a lot of people.
Q: How do you use research in your clinical practice?
A: I use research in several ways, first and foremost to inform the modalities I use and the way I work. For example, for outpatient treatment of eating disorders, the best evidence-based treatment depends on the diagnosis and age of the patient. For adolescents with anorexia nervosa, the research supports the use of family-based treatment (FBT). For adults with bulimia nervosa, it’s cognitive behavioral therapy. I turn to the research when deciding on the approach I’ll use with a particular patient.
Q: Do you talk about the research literature with your patients? How do they benefit?
A: I do. For example, parents of adolescents are oftentimes concerned that their child will relapse at some point. When this comes up, I can turn to the research and show that patients who go through FBT have very low rates of eating disorder relapse four years later. I can also talk about rates of improvement and remission with the particular treatment approach I’m using, and reassure patients or families that if they put in the hard work required during the recovery process, the chances are good that those efforts will pay off.
Q: If you have a patient participating in one of your research studies, how much do you discuss with them about the study?
A: It depends on my role in the study. Much of my research experience has been as a study therapist in treatment trials. In those instances, I don’t spend much time talking about the study. Most patients just want to feel that they’re getting good treatment. We purposely try to separate out the treatment aspects of the study from the research aspects of the study. So, the therapist is not involved in handing out research questionnaires or doing research assessments. That is left to the research assistant.
From the perspective of principal investigator, it’s important that the study is discussed with patients in detail so they know what they are agreeing to and can make an informed choice about whether or not to participate. They should be satisfied that all their questions have been answered before they make a decision. As far as sharing results, it depends on the patient. If they’re interested, we can certainly share the study outcomes with them.
Q: What if you ask a patient to be in a study and they say no? Does this damage the relationship?
A: Not at all. It is really important that patients participate of their own free will, with the knowledge that the quality of their care will not be impacted by whether they participate in the study or not.
Q: How do you explain the importance of research to a patient and their family?
A: I explain that there are still many unknowns about eating disorders and that we have an opportunity to improve on what we do know. There is a surprising dearth of information on treatment at higher levels of care, so we can explain to patients and families that, here at Eating Recovery Center and Pathlight Mood and Anxiety Center (ERC Pathlight), we’re closing that gap in knowledge by studying how effective our treatments are, and then adjusting our treatment (if necessary) based on the results.
Q: Has research really made a significant impact on the treatment approach and standard of care here at ERC Pathlight? In what way?
A: Absolutely. Research has had a significant impact on how we involve family in treatment at ERC Pathlight. Because of the efficacy of FBT, we now incorporate FBT principles into many programs at higher levels of care. That would not have happened without the research to support it.
Q: What impact do you hope ERC Pathlight’s research has on other treatment programs?
A: By publishing our results, other treatment programs can learn from what we’re doing, so the research we do can help to improve knowledge and treatment for eating disorders in general, not just here at ERC Pathlight.
For example, we published a study on post-traumatic stress disorder (PTSD) symptoms among our adult patients, finding that over half had a probable PTSD diagnosis at admission and showed significant improvement over the course of treatment. At ERC Pathlight, we already carefully screen for trauma at admission, and our hope is that other programs reading that study might decide to do the same and incorporate trauma-informed care into their treatment, improving care for their patients.
Q: Research takes a long time. Is there a direct and immediate benefit for our patients now? Or is it all to inform future practice of patient care?
A: I think it depends on the type of study.
Some study results take years to become available but provide direct and immediate results for patients who are participating in the treatment trial. Others might provide results sooner but come with less direct benefits for patients. For example, conducting a study in which patients fill out questionnaires on a certain topic may be published quickly. There may be no direct benefit to those patients, but the findings will contribute to the greater knowledge about what is being studied.
I think there is a certain amount of altruism that goes into research. Sometimes the benefits can be seen fairly quickly, sometimes not for years. But the efforts we put into it now will pay off — sometimes sooner, sometimes later, but they will contribute to our knowledge about these disorders, and every bit is helpful and has the potential to make a big difference.
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As leaders in the clinical space, we conduct research to improve patient outcomes for all levels of care. To learn more about our services, call us at 1-866-543-6059.