Though Fals-Stewart bears sole responsibility for his transgressions, his actions did not take place in isolation. Rather, Fals-Stewart’s actions represent the confluence of systemic factors that prevail upon those in higher education institutions, particularly junior, tenure-track faculty and those in “soft” money positions. While the rank and tenure process in academia is often singled out for its role in increasing the likelihood of ethical lapses, that process serves the same performance evaluation function that exists in many other non-academic professions that are similarly hierarchical and highly competitive. Thus, the pressures created by the rank and tenure process are not unique to academia.
However, what is unique is that responsibility for oversight of the key performance indicator for rank and tenure, publications, is left to a network of loosely affiliated journals that are not privy to inner-workings of a given author’s research laboratory. Consequently, the publication process can only reasonably rely on the assumption that articles are submitted in good faith, and that the peer review and replication processes will root out suspect research. However, the U.S. Office of Research Integrity (ORI) conservatively estimated the rate of research misconduct to be 60 × more than the number of cases opened by ORI annually (Gallup, 2008). Thus, colleges and universities have essentially abdicated responsibility for ensuring the integrity of the research productivity of their respective faculty to a publication process that was not intended to serve as the gate keeper for the rank and tenure process, especially as concerns abound from within the research community regarding the veracity of the fundamental assumption that scientific inquiry is inherently self-correcting. To this end, it is imperative to begin to explore strategies to address the most salient systemic obstacles that confound efforts to root out research misconduct.
Culpability for academic research misconduct is far more complex than often portrayed. Principal investigators bear primary responsibility for maintaining fidelity to their respective study protocols and abiding by established research ethics and are thus responsible for actions that breach these obligations. However, given the financial benefit for administering grant funding, termed an “indirect cost,” along with the contribution of each grant award towards an institution’s Carnegie classification, and the desire to avoid negative media attention, academic institutions often succumb to such pressures by working to protect their respective organizations at the expense of the integrity of scientific inquiry (Titus et al., 2008). Institutions are particularly vulnerable to the potential for inadequately addressing research misconduct when a researcher such as Fals-Stewart contributes disproportionately to the institution’s overall funding and publication productivity. From 2003–2004, of the 33 federally funded projects, totaling approximately $45 million awarded to UBRIA’s 22 principal investigators, Fals-Stewart was the PI or Co-PI on 21% (7) of the projects, totaling $12 million, or approximately 27% of UBRIA’s total funding during that fiscal year.
This is not to imply that institutions do not intervene, but institutional imperatives often emphasize minimizing and/or quietly moving past allegations or findings, potentially resulting in perfunctory or performative investigations and disciplinary actions. This, in turn, works against the goal of minimizing damage caused by fraudulent studies infecting the extant literature and knowledge base. It is worth noting that Fals-Stewart left UBRIA in 2005 due to allegations of research misconduct but held research positions at the Research Triangle Institute (RTI) in North Carolina, and then University of Rochester (UR) School of Nursing, until a few months before his death in 2010. A search for Fals-Stewart’s name on the RTI website yields three results, and the University of Rochester’s site yields four, but a search of UBRIA’s website, where the allegations originated, finds none.
Fals-Stewart’s exit from UBRIA illustrates the competing interests within academic institutions when they commodify and prioritize research productivity for the purposes of tenure decisions and national rankings (Csiszar, 2020). Ultimately, it is important to note that Fals-Stewart’s downfall was not brought about because of UBRIA’s oversight of his research activity, or the actions they took to protect the integrity of research science and the general public from Fals-Stewart’s misconduct. In fact, despite ongoing concerns and subsequent investigations regarding data falsification on federally funded grants that hung over Fals-Stewart for nearly 4 years, his quiet departure from UBRIA allowed him to continue to ply his craft elsewhere, earning a national award for his research and landing a faculty position at another R1 university while he was concurrently being investigated by SUNY. Though SUNY concluded in 2008 that there was insufficient evidence to warrant disciplinary action (Herbeck, 2010), Fals-Stewart would end up resigning from UR in 2009, having been denied tenure (Campus Times, 2010).
Unfortunately, the decision by UBRIA and UR to address Fals-Stewart’s actions as they did is not unique. DuBois et al. (2013) surveyed 194 research integrity officers from universities in the United States and found that 88% reported having conducted investigations in the prior two years, with more than 50% of those investigations triggered by credible accusations of research misconduct. However, federal guidelines do not require universities to report the results of these investigations. Instead, despite more than two-thirds of whistleblowers reporting at least one act of potential retribution for their actions, and nearly half reported being pressured to withdraw the allegations (Titus et al., 2008), ORI relies on institutions to investigate and take disciplinary action when deemed necessary.
Consequently, the responsibility that academic institutions owe to the field of science to establish and maintain a culture of integrity and accountability is too often sacrificed in favor of remedies that prioritize revenue and reputations. However, in the absence of a legal imperative to publicly disclose confirmed instances of research misconduct and take specific, substantive action to mitigate the dissemination of fraudulent data, there are an unknown number of researchers actively publishing in their field after having been allowed to quietly resign and take their grant money elsewhere, just as Fals-Stewart did at least twice.
Thus, it imperils the field of research to allow academic institutions to continue framing their role in scientific inquiry as that of neutral observers. Rather, academic institutions have repeatedly demonstrated that their interests, intentional or not, can often run counter to the needs of the scientific community. Compounding this dynamic is ORI’s choice to defer responsibility to colleges and universities for the investigation and adjudication of allegations of research misconduct. Consequently, higher education has established a research culture in which colleges and universities can reap significant financial and reputational rewards from a tenure process that compels feverish grant and publication activity, only to accept little to no responsibility for overseeing the actions of faculty in order to satisfy the conditions for continued employment.
As with any corrective action, the incentives for establishing and maintaining ethical standards must outweigh the benefits of acting otherwise. For many colleges and universities, the fear of negative public relations consequences that might result from calling attention to research misconduct have the potential for creating a greater imperative to ignore, stifle, or minimize acts of research misconduct than to report them and ensure that steps are taken to protect the integrity of the given researcher’s field of study. To this end, though the responsibility for fiscal oversight that institutions assume when administering grant funding is narrowly defined as ensuring the appropriate use and accurate tracking of grant expenditures, it is reasonable to extend that definition to include ensuring that the funding was not used in the support of fraudulent research activities.
Doing so would require that colleges and universities be compelled to realign institutional priorities from a traditional focus on grant procurement and management, to an organizational ethos that embraces its role in protecting the integrity of scientific inquiry. This is particularly important given that research productivity has become the principal mechanism by which higher educational institutions evaluate their faculty and distinguish themselves from peer institutions (Gingras, 2020).
Specifically, in cases in which fraudulent behavior is confirmed, the institution should bear responsibility for not only reimbursing the funding source for the grant and indirect funding received, but also risk a formal sanction if it is found that the college or university did not make a good faith effort to address concerns or allegations of fraud. For example, UB never followed up on the concerns this writer voiced to the IRB in 2003 regarding data collection on Fals-Stewart’s projects. Additionally, despite having been one of Fals-Stewart’s longest-serving project directors during his time at UB, this writer was not contacted as part of the 2004 or 2007 investigations.
Sanctions could include informing the institution’s accrediting body of the infractions, placing the college or university on probation requiring future grant applications to include additional procedures for monitoring grant activities, and ultimately barring the college or university from receiving federal funding for a period of time.
The foremost risk in allowing fraudulent data is to the populations for whom treatment and policy decisions are informed by such data. Given that Fals-Stewart was one of the most prolific researchers in the area of BCT and his work was, and to some extent still is, ubiquitous among articles on the subject of BCT, his influence on that field of research is vast and incalculable. With such a breadth and depth of influence, it is unknown whether empirical support for BCT with such couples would remain as robust in the absence of Fals-Stewart’s fraudulent contribution to the research. IPV carries a serious potential risks to victims and it is imperative that evidence for interventions be empirically sound. BCT methods were not considered appropriate for this population prior to Fals-Stewart’s research; however, his research played a significant role in establishing BCT as both effective and safe. Following discovery of data falsification, almost nothing has been done to draw attention to the consequences of Fals-Stewart’s actions, or to re-assess the accuracy of his findings. In fact, Fals-Stewart’s research has been cited more than 7,000 times since his death, which was 5 years after he left UB due to allegations of fraud.
As it stands, Fals-Stewart is dead. His actions while at UBRIA, RTI, and UR have largely been exorcised from their websites, and the author information page for the book that Fals-Stewart co-authored on the Guilford Press website, Behavioral Couples Therapy for Alcoholism and Drug Abuse (2006), only notes that Fals-Stewart died in 2010. Thus, any attempt at due diligence based on information provided by his former institutions and publisher would give no indication that there is reason to question the validity of his research.
Consequently, only those who worked with him or were privy to the investigations are aware of what took place, but that is no small number. Fals-Stewart worked with more than 50 co-authors, from academic institutions throughout the United States, and, to date, it does not appear that any of them have sought to have their publications with Fals-Stewart retracted. Consistent with the barriers presented heretofore, the pressures of academic publishing and grant procurement create significant disincentives for co-authors to seek retractions.
Specifically, a faculty member’s publishing record is used to determine continued employment during the tenure process, as well as serving as the basis for grant applications. As such, the secondary and tertiary consequences for a co-author to come forward, especially tenure-track faculty, are foreboding. For example, Mongeon and Larivière (2016) found that co-authors of articles retracted due to fraud experienced a significant decline in publication productivity in the subsequent years and, 28% of co-authors who were innocent of wrongdoing did not publish another article in the five years following the retraction. Consequently, given that publication productivity is the primary metric used in determining tenure decisions, an article retraction is potentially career-ending for junior faculty, even among those who are innocent of wrongdoing.
Fals-Stewart worked with several early-career researchers, many of whom co-authored several articles with him before pursuing their own grant funding and research careers. These co-authors began building their research portfolios, citing their own work with Fals-Stewart, along with his many other publications, otherwise unaware that their findings may have been the byproduct of research fraud. The net result is that, not only did Fals-Stewart’s falsified data gain ever greater credibility as it continued to be cited by a wider array of researchers across multiple institutions, but also, the sheer volume of citations allowed his research to propagate quickly and become embedded within the extant literature and knowledge base of BCT.
Responsibility for addressing the ongoing dissemination of fraudulent research findings must begin at the institution level, foremost by allowing co-authors to come forward when they are privy to information that calls into question the legitimacy of an article they have co-authored. That, however, is the easy part. The difficulty is in establishing policies that encourage, or at least do not punish, the ethically correct action of removing articles derived from questionable research methods from one’s curriculum vitae. For example, policies might allow un-tenured faculty to extend their “tenure clock,” which would grant them extra time to rebuild their publication record before they are evaluated for rank and tenure. Alternatively, assuming the junior faculty member, as co-author, contributed to the publication during the writing stages, rather than during the period in which data falsification took place, their contribution in terms of authorship leading to a publication would remain recognized towards publication requirements for tenure. However, regardless of the manner in which academic institutions work with junior faculty to remediate gaps in tenure progress caused by the loss of retracted articles, it is imperative, in all cases and at any rank, retracted publications must remain on one’s vitae.
Notably, irrespective of whether a researcher is applying for external funding or simply posting their publication record on their institutional faculty biographical webpage, it should become standard practice that all publications, including those retracted, must be included on all official records of publications. While it is understood that there is a great deal of stigma associated with a retraction, as misconduct is often assumed, academic research, and researchers themselves, must be transparent. Further, requiring that retracted publications be properly documented begins the process of normalizing ethical decision making in research publication practices. Simply put, allowing authors of retracted articles to expunge them from their official professional documentation so as to avoid the embarrassment of having to disclose such an incident undermines the integrity of academic research for the sake of protecting a given researcher’s reputation.
Meta-Analyses and Systematic Reviews
The persistence of Fals-Stewart’s impact on BCT research cannot be overstated, as his work has often been featured, sometimes disproportionately, in meta-analyses and systematic reviews of couples treatments for IPV and with other populations. For example, Karakurt et al.’s (2016) systematic review of six published clinical trials of BCT and IPV, three of which were authored by Fals-Stewart, found significant reductions in IPV compared to traditional IPV treatment modalities or no treatment control groups. Karakurt concluded, “there is certainly reason to reevaluate the role of couples therapy in IPV treatment and cautiously increase its application (p. 578).” Likewise, Fals-Stewart’s 2009 study of BCT with same sex couples was included in McGeough’s (2020) systematic review, which found continued support for the efficacy of BCT in substance abuse settings. Fals-Stewart’s study was one of two that were singled out for having “employed the strongest methods (p. 205).” Lastly, despite noting “awareness” of the arrest and allegations of fraud against Fals-Stewart in the Discussion section of their scoping review of family-based substance abuse interventions, Cassidy and Poon (2019) cited his work 55 times and highlighted BCT as having “the largest base of evidentiary support (p. 357).”
As such, consistent with the Committee on Publication Ethics’ (COPE) 2019Retraction Guidelines, once a retraction has been issued, the authors of any systemic reviews or meta-analyses that included the retracted article in their analyses must be notified and encouraged to correct or retract their publication accordingly. While onerous, this is a necessary step, as a retraction only focuses on the article in question, otherwise ignoring the cumulative impact that the article has had on a given field of study. For example, Powers et al’s (2008) meta-analysis of BCT for substance abuse, in which six of the twelve studies included were authored or co-authored by Fals-Stewart, concluded that there was “a clear overall advantage of including BCT compared to individual-based treatments (p.952).” This meta-analysis has since been cited more than 350 times.
Wray et al. (2016), included the following note in the Methods section of their systematic review of substance abuse interventions with male, same-sex couples, when noting selection criteria: “An additional study by FalsStewart (sic), O’Farrell and Lam (Journal of Substance Abuse Treatment. 2009 Dec; 37(4): 379–387) met the criteria for inclusion in the review but was excluded based on advice from the editor-in-chief of the Journal of Substance Abuse Treatment that the journal has a general policy of advising authors to exclude the study from reviews because of concerns about the study’s validity (p. 150).” Despite such a warning, Fals-Stewart et al. (2009) has not been retracted from Journal of Substance Abuse Treatment, and has been cited nearly 90 times since its publication, including the McGeough (2020) systematic review noted above. Additionally, none of Fals-Stewart’s other 10 articles published in the Journal of Substance Abuse Treatment have been retracted, or otherwise flagged as necessitating the type of caution offered Wray et al., either.