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Memorandum of Understanding

This document outlines the terms for the oversight, governance, and activities of the Exposure Therapy Consortium (ETC).

1. Background

The ETC is an international research collaboration aimed at improving the effectiveness and implementation of exposure therapy. Emphasizing a team approach and collaboration to science, training, and implementation, the consortium is inclusive and invites members across disciplines and settings. Members will be expected to comply with and abide by the terms of this memorandum of understanding (MOU) throughout their membership in the ETC. 

2. Organization

The ETC has a research arm and a clinical arm. Both arms are managed by committees and overseen by a board of directors. Details for the organizational structure and committee responsibilities in each arm are described below.

2.1 Board of Directors

The board of directors oversees the direction of the ETC and provides oversight to the research and clinical arms. The board of directors is made up of 5 individuals, and includes a chair, vice chair(s), a representative from the research steering committee (research chair), a representative from the clinical steering committee (clinical chair), and a treasurer (optional). Board members have relevant expertise and a commitment to the ETC through continued attendance and engagement in board meetings and consortium activities. The board of directors meets on a bi-quarterly schedule and on an ad-hoc basis as needed. Quorum will be set to 60%. Responsibilities include the following:

  • Engage in transparent operation and open and timely communication;

  • Provide oversight and steering of consortium-wide goals and activities;

  • Create harmonization across research and clinical arms;

  • Providing support and resolution as necessary;

  • Modify organizational structure of the consortium as needed

2.2 Research Arm

2.2.1 Research Steering Committee (R-SC)

The R-SC is tasked with providing scientific leadership and oversight. R-SC membership includes 5 individuals who have relevant expertise and are involved in at least one working group. The R-SC meets on a bi-monthly schedule and on an ad-hoc basis as needed. Quorum is set at 60%. Responsibilities include the following: 

  • Direct scientific priorities and strategy;

  • Develop new research projects;

  • Review and approve investigator-initiated research project proposals (e.g., aims, design, analysis, publication plan);

  • Provide guidance on formation of working groups; 

  • Coordinate publication projects (e.g., review/develop proposals, track manuscripts)

  • Provide support (e.g., letters) to working groups to facilitate funding; 

  • Liaise with clinical arm leadership to guide the development of training activities and projects

2.2.2 Rigor and Reproducibility Committee (R-RC)

The RRC is tasked with providing guidance on intervention, assessment, and data analysis protocols for proposed research projects. This committee comprises members with relevant expertise. The RRC meets on a monthly schedule and on an ad-hoc basis as needed. Responsibilities include the following:

  • Develop research project guidelines (pre-registration, data sharing protocols, open access) to promote open science;  

  • Develop and share detailed “tools” that support measurement and treatment procedures, including clinician training/monitoring (e.g., rating manuals, standard operating procedures);

  • Provide guidance on the selection of data analytic strategies for proposed research projects; 

  • Consult on data analysis for research projects;

  • Establish and update data sharing policies;

  • Establish and maintain infrastructure to facilitate meta-analyses

2.2.3 Research Working Groups (R-WG)

R-WGs design and implement research projects (one or multiple). Any consortium member can submit a new R-WG proposal to be reviewed/approved by the SC. R-WGs include a chair and members with relevant expertise. R-WGs meet on an as needed basis.

Responsibilities include the following:

  • Develop and submit research project proposals (aims, hypotheses, analyses, procedures, publication strategy) to R-SC for review/approval;

  • Obtain IRB approval and establish reliance agreements; 

  • Register studies, hypotheses and analytic plans, and coordinate data management; 

  • Share data with consortium for follow-up analyses

2.3 Research Arm

2.3.1 Clinical Steering Committee (C-SC)

The C-SC is tasked with providing leadership and oversight of training and implementation efforts that have the potential to increase exposure therapy uptake and effectiveness. The C-SC membership includes 5 individuals who have relevant expertise. Well C-SC are expected to also engage in leadership other clinical committees or working groups, it is not required. The C-SC meets on a bi-monthly schedule and on an ad-hoc basis as needed. Quorum is set at 60%. Responsibilities include the following: 

  • Direct implementation priorities and strategy;

  • Establish and support membership and outreach subcommittees;

  • Provide guidance on the formation of new committees or clinical working groups; 

  • Develop new training and implementation projects;

  • Review and approve member-initiated clinical project proposals;

  • Liaise with research arm leadership to guide the development of training activities and projects

2.3.2 Membership & Outreach Committee (MOC)

The MOC is tasked with supporting consortium membership engagement among clinicians and supporting clinical outreach initiatives across the globe. MOC membership includes a chair, co-chair, and 1 representative from each of the MOC working groups. The MOC meets on a monthly schedule and on an ad-hoc basis as needed. Quorum is set at 30%. Responsibilities include the following:

  • Facilitate the development of MOC working groups; 

  • Develop clinical outreach projects to support the training, delivery, and implementation of exposure therapy; 

  • Develop and share “tools” that support exposure therapy delivery (e.g., worksheets, handouts, videos);

  • Create and maintain website;

  • Support engagement with the ETC in their region across the globe;

 

MOC Working Groups. The MOC is supported by a series of working groups, each made up of members from nearby regions (e.g., North America, South America, Europe, Asia, Australia). These regional working groups meet monthly and on an ad-hoc basis as needed. They provide input to the MOC and CSC regarding their particular region’s needs, facilitate clinical outreach projects and support MOC responsibilities. A representative from each MOC Working Group participates in MOC meetings.

2.3.3 Clinical Working Groups (C -WG)

C-WGs design and carry out clinical outreach and implementation projects (one or multiple). Any consortium member can submit a new C-WG proposal to be reviewed/approved by the C-SC. C-WGs include a chair and members with relevant expertise. C-WGs meet on a as needed basis. Responsibilities include the following:

  • Develop and submit project proposals (goals & implementation strategy) to C-SC for review/approval;

  • Carry out proposed project;

  • Update and share news with consortium

3. Publications and Authorship

3.1 Publication Planning

As part of the research plan proposal, R-WGs submit a publication plan to the R-SC for review/approval. This plan includes a working title, overall aims of the publication(s), and list of authors. The R-SC regularly reviews the number of manuscripts in circulation and acts as a publication committee. The R-SC keeps the membership informed on planned and ongoing publication projects and seeks their feedback. Each member has the right to independently publish the data and results collected by them (local project data taking into account the author's rights), provided that the questions and analytic strategy are not redundant with (e.g., focus on similar relationships in the data) and do not compromise a planned publication project.

3.2 Authorship

All authors meet standards for authorship (see ICMJE). Working groups will propose authorship positions as part of the publication plan. The R-SC mediates any concerns regarding authorship representation. Consortium authorship is recommended for all papers, considering the following options as stated by the JAMA Network:

  • Individual Authors “for” the Exposure Therapy Consortium
    (All Members of the Group Are Not Authors)

  • Individual Authors “and” the Exposure Therapy Consortium
    (All Members of the Group Are Authors)

  • The Exposure Therapy Consortium

        (All Members of the Research Group are Authors)

4. Membership

4.1 Affiliate Member

Affiliate members are individuals or organizations who have agreed to the MOU and have expressed interest in contributing to the ETC mission and aims in the future (e.g., when data/capacity permits).

4.2 Annual Meeting

To facilitate the exchange of ideas, formulation of research questions and projects, and active engagement in authorship and funding activities, the consortium will seek to hold annual meetings in the Spring of each year. Attendance is strongly recommended for all consortium members.

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