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Psychotherapy research with chronic and difficult-to-treat populations such as those with co-occurring mental health and addictive disorders can employ flexible research designs, which allow for a systematic, yet non-linear relationship between efficacy and effectiveness designs. Outcomes research can bypass the efficacy-effectiveness dichotomy through use of a hybrid model (Carroll &amp; Rounsaville, 2003) conducted in the context of community treatment settings in collaboration with community providers. We present the case for using this methodological approach as a means of advancing psychotherapy research and practice, while translating and disseminating empirically supported treatments with more efficiency. A hybrid model study conducted within the National Institute on Drug Abuse's Clinical Trials Network illustrates the application. These findings inform new directions for future research.

professional psychology, research and practice

Methodological innovation to increase the utility and efficiency of psychotherapy research for patients with co-occurring mental health and substance use disorders.