Thoughts on Future Directions for Translation of Psychological Treatment: Commentary on Bitterman et al.

Fostering a Paradigm Shift, Without Reinventing the Wheel

This article by Bittermann et al. (2025) states that one challenge to the progress of psychological treatments is that psychological “treatment research still lacks a comprehensive translational framework.” In (relatively) recent years, a number of system-level changes have been implemented to support and foster translational research more broadly. For example, the National Institutes of Health established the National Center for Advancing Translational Sciences (NCTS) in 2011. The NCTS is one of the 27 National Institutes of Health centers/institutes, and its mission is to support translational research by funding project grants and training programs, including Clinical and Translational Science Awards (CTSA) that are awarded to universities and research organizations. These broader changes have implications not only for the translation of “medical” research but also for the advancement of translational psychological research (although it should be noted that we believe that psychology is a critical cross-cutting component of medicine). For example, having a clinical and translational science institute (e.g., one that is CTSA funded) at an institution where psychological research and treatment are being implemented can support translational psychological research publications and collaborations. Indeed, Boston University and Harvard University, which were identified by Bitterman et al. as having a high number of translational psychological research collaborations and publications, both have CTSAs. Available funding and training support through NCTS and CTSAs can provide opportunities, resources, and guidance for translational psychology researchers and to those who are becoming more involved in translational psychological research. The CTSA at our institution, Northwestern University, for example, helps support (a) community research efforts, (b) shared research services and resources (e.g., labs to process and store biospecimens), (c) pilot projects, and (d) seminars/training in team science and trainee mentoring—all of which help advance translational efforts of psychological research.

Leveraging Available Translational Research Frameworks

The authors noted that “without a common terminology, researchers may not be aware of models and approaches already discussed in the literature and may ‘reinvent the wheel’” (Bittermann et al., 2025). In addition to “foster[ing] a paradigm shift towards translational psychological treatment” through consistent terminology (i.e., a common, shared language), the field should consider using evidence-based principles and guidelines from already established translational research frameworks (e.g., medicine and public health). Although there is no agreed upon translational research framework that has been adopted in any field, leveraging available knowledge and frameworks could facilitate the progress of translational psychological research. Stated another way: by leveraging available translational research frameworks, clinical psychology could make progress toward more effective psychological treatments more quickly by not “reinventing the wheel” and reducing the likelihood that resources will be devoted to duplicating work that is already available. Indeed, the field can learn from what has or has not worked in other fields and test whether general principles also apply to translational psychological research. For example, frameworks available from translational medical research include (a) the Biomedical Research Translation Continuum model, which outlines the process/steps of translation (Drolet & Lorenzi, 2011); (b) the Translational Science Benefits Model, which outlines ways to assess how translational approaches have improved health and patient outcomes (Luke et al., 2018); and (c) the Exploration, Preparation, Implementation, and Sustainability framework, which is a widely used implementation framework (Moullin et al., 2019). In addition to these frameworks, there are also a number of journals that are devoted to translational research and implementation science that can be consulted (e.g., Translational Research, Journal of Translational Medicine, Journal of Clinical and Translational Science, Implementation Science, and Translational Psychiatry).

Adopting Approaches That Facilitate Collaborations: Training in the “Science of Team Science”

Leveraging available frameworks and adopting empirically based principles of translation will help build bridges between different disciplines to move toward more interdisciplinary research, yielding teams of scientists who work to address complex and challenging problems through multiple lenses and skill sets. Historically, academic research has tended to be siloed, as individuals often work separately in different labs and different departments (a model that we believe is often reinforced by the incentive and promotion structure in many institutions, although that is a discussion for a different article). Medical and psychological translational research have also historically been separate from each other—notably, none of the journals listed above (e.g., Translational Research) were included as journals that frequently published basic translational psychological research identified in the bibliometric review by Bittermann et al. (2025).

Critically, however, the systems-level changes that have been implemented to facilitate translational research (e.g., the creation of the NCTS) have helped to create more opportunities for cross-disciplinary research. This has helped reduce the barriers to team science—even creating interest in the “science of team science.” Indeed, there are a number of articles outlining frameworks and structural and system-level approaches (e.g., policies and incentives) that can be adopted to support more effective team science (Hall et al., 2012; Vogel et al., 2021). Approaches discussed include how to build, manage, and utilize teams and nurture collaboration. Importantly, effective team science is more than the sum of its parts; managing and integrating the strengths and perspectives of multiple team members with different training backgrounds, scientific and discipline-specific culture, language, and epistemology are notable challenges. Working with teams also requires the management and consideration of dynamic relational processes, preexisting biases, and perspective taking that individuals may not have previously navigated; that is, the approaches that one uses within a system that emphasizes individual success may differ substantially from the approaches one uses within a system that emphasizes the success of a team.

Training researchers for team science-based approaches can help facilitate individuals’ ability to navigate and participate in team science more effectively. Training programs and experiences can expose individuals to multidisciplinary/transdisciplinary work and the vernacular and jargon of other fields and provide opportunities to navigate relational dynamics. Exposing individuals to this multidisciplinary approach earlier in their training may be particularly advantageous, as trainees may develop greater fluency in team science by accruing more first-hand experience while they are still developing a cognitive model of science and research. There are articles available that discuss how to implement training programs in translational research (Kurpinski et al., 2014; Rubio et al., 2010); however, these primarily focus on programs within medical schools. While postdoctoral training experiences will be invaluable for clinical psychologists and clinical scientists (e.g., through CTSA-funded programs), creating training opportunities for clinical psychology predoctoral students will require additional considerations—for example, (a) offering individualized training options that allow individuals to learn from and/or work with individuals across disciplines, (b) how these approaches intersect with existing curriculums and requirements for accreditation in clinical psychology, and perhaps most importantly, (c) how to train mentors and other faculty members who may be less familiar/comfortable with interdisciplinary approaches (note: there have been randomized controlled trials evaluating the efficacy of different mentor training models in translational science, Pfund et al., 2014). Although many clinical psychology programs require a minor or concentration and breadth-related training/courses outside of clinical psychology, most options fall under the umbrella of psychology and neuroscience (e.g., social psychology, developmental psychology, quantitative psychology, and cognitive psychology). Broadening training experiences and project-based learning to mathematics, engineering, linguistics, computer science, and other health disciplines (e.g., obstetrics and gynecology) may be beneficial in exposing students to other academic worldviews.

Not Reinventing, but Perhaps Reshaping the Wheel

Although leveraging and adopting approaches from the field of translational research will prevent translational psychological research from “starting from scratch” or “reinventing the wheel,” the vast majority of available translational research frameworks and team science articles have been developed in the context of medical research (note: psychiatry is also commonly underrepresented in available translational medicine studies). Whereas cardiovascular and pulmonary translational research may differ on the therapeutics tested, these subdisciplines may not require vastly different translational approaches from each other. However, it is unclear to what extent currently available translational principles can generalize to psychological research. Psychological phenomena may require additional, unique approaches. Hence, we are not suggesting that we should assimilate current approaches and apply frameworks without modification or that the goal should be to medicalize translational psychology research. Rather, we are simply arguing that it will be critical to determine which principles of translation apply and whether there are unique considerations for translational psychological research that require modifications or a different framework than other types of translational research.

If there are unique considerations that need to be taken into account for translational psychological research, an expanded summary of available translational psychological research could help to identify both generalizable (cross-field) and specific/unique frameworks and approaches. For example, it may be particularly critical for translational psychological efforts to include community stakeholders. Additionally, although physical health conditions can also carry stigma, mental health disorders are associated with stigma and shame more often—especially within many marginalized and vulnerable populations. Thus, the role of stigma/shame is likely to be a more important consideration for translating psychological research compared to, for example, cardiology translational efforts.

Given that medical and psychological translational research have been relatively separate from each other, it is also unclear to what extent psychological approaches and perspectives have been integrated into general translational frameworks. In 2007, former president of the Association for Psychological Science, John Cacioppo, famously pointed out that psychology is one of the “hubs” of all of science. Perhaps, bidirectional influence would be helpful for both psychological translation and broader translational efforts. Indeed, the expertise and perspectives of clinical psychologists could inform and/or transform broader translational frameworks. For example, studies may wish to explicitly consider psychological phenomena that affect treatment-related outcomes in many translational models, such as stages of change and motivation (e.g., techniques from motivational interviewing) and ways to include stakeholders (e.g., participatory action research).

Mechanisms-Based Translational Psychological Research

A final next direction that we would like to highlight relates to mechanisms-based translational research. An important step in translational medical research is to identify mechanisms of disease (sometimes referred to as the “T0 stage”), which is characterized by a large emphasis on nonhuman animal studies. It is notable that the mental health conditions that were examined most in the basic science studies identified by Bittermann et al. (2025) were fear and anxiety related. It is possible that these conditions have been studied more frequently, in part, because fear and anxiety-related disorders have been extensively studied in animals, are grounded in neuroscience-based animal models, and have emphasized mechanisms.

Given the emphasis on identifying mechanisms in translational research and fear and anxiety studies, it was surprising that “mechanism” was not a term that was identified as occurring frequently in the Bittermann et al. (2025) bibliometric analysis of the available basic science studies. Identifying mechanisms of psychopathology (i.e., processes that are responsible for a condition) and treatments (i.e., the processes of treatment that result in change/“mechanisms of change”) are important for moving the field toward developing and identifying more effective treatments, as well as improving prevention efforts. If we do not know the cause(s) of conditions (i.e., “what” to target) and how our treatments work (i.e., “how” to target), treatments will continue to be insufficient. As outlined by the National Institute of Health’s Research Domain Criteria framework, focusing on specific, smaller units of behavior (which often cut across clinical conditions) rather than on larger diagnostic categories could help to further bridge animal studies with mental health conditions, advance theoretical and animal models of psychopathology, and improve our identification of mechanisms (Zalta & Shankman, 2016). Critically, these efforts should take individual differences into account (another key contribution that psychology could have on broader translational efforts). Indeed, an individual may be unresponsive to treatment not because the treatment failed to target the right mechanism but because that individual required a different mechanistic target for the same condition (as certain psychopathologies could reflect a final common pathway from multiple mechanisms).

Summary: Reaffirming the Need for Translational Psychological Research

As noted by the authors, response rates for currently available psychological treatments are quite limited (e.g., “one-third to one-half of all patients in psychological treatment must be classified as non-responders,” Bittermann et al., 2025). Given that approximately half of individuals will meet criteria for a psychological disorder in their lifetime, many individuals who do not sufficiently respond to available treatments will experience psychological suffering. Although a portion of individuals are “nonresponders,” the article reminds us that there are opportunities to work toward meeting the need for effective treatments and that translational psychological research is critical for achieving this. While psychological conditions are complex phenomena, teams of scientists with varying expertise, skills, and perspectives have the potential to solve challenging, complex problems. Having evidence-based guidelines, frameworks, training, and shared language can increase the likelihood that the field will meet the need for developing and implementing more effective psychological treatments to improve patient outcomes.