The role of services researchers in facilitating intervention research

Even when interventions are shown to be both clinically effective and cost-effective within a system of care, they are rarely sustained beyond the period of external funding. The reason may be that these interventions are often developed and introduced in a "top-down" manner, with little input from frontline clinicians. The purpose of this article is to describe a "bottom-up" approach in which services researchers assist frontline clinicians in testing interventions that clinicians themselves have devised. This approach is explored in the clinical partnership program developed by the Veterans Healthcare Administration's South Central Mental Illness Research, Education, and Clinical Center. The program is expected to expand the evaluation and research capacity of clinicians, enhance the collaborative skills of services researchers, and result in interventions that are more likely to be sustained over time.