Engaging with research as a clinician

How to become more research active

Dr Eleanor Chatburn's brief guide for Early Career Practitioner Psychologists

Are you an early career practitioner psychologist with a keen interest in research? Want to know how to become more research active but unsure where to start? Then this article is for you!

In this short guide, I share some top tips and resources that you can use to make your next steps into research. I have drawn on my own experiences of starting out on a clinical academic career pathway since I qualified as a clinical psychologist one year ago as well as the reflections of several research active practitioner psychologists who kindly shared their advice with me.

Why become more research active?

Becoming more research active in your role as a practitioner psychologist can have multiple benefits. For the individual practitioner, "being research active helps you to be the most effective therapist you can, and it also helps retain curiosity and enthusiasm in the work", Professor Barney Dunn, a research clinical psychologist at the University of Exeter, told me. "But equally importantly, practitioners bring a fresh, clinically grounded perspective", he added", "which helps ensure that the research that is being done in the field genuinely reflects the needs of the clients we serve and the services that are delivering care, closing the research practice gap."

Did you know that the value of clinical research is actually written into The NHS Constitution? It emphasises that one aspect of providing high quality care is "through the promotion, conduct and use of research to improve the current and future health and care of the population" (Department of Health, 2015). So far, so good. A big problem until fairly recently has been a scarcity of funding opportunities for allied health professionals or psychological practitioners to engage in research activity; many funding schemes prioritised medics which effectively shut out other practitioners from research (Newington et al., 2021).

But there is good news for practitioner psychologists. "There has been a real shift in the last few years", one research active Cognitive Behaviour Therapy (CBT) therapist* told me. "Both the academic side and the clinical lead side now recognise that there is a pool of talented, willing and interested clinicians in the field who could make a meaningful and patient-focussed contribution to research."

We now have a greater range of resources and funding streams available to practitioners who want to become research active such as the National Institute for Health and Care Research (NIHR) Integrated Clinical and Practitioner Academic (ICA) scheme. I have collated a list of useful resources and weblinks where you can explore these opportunities further (see Box).

What are the challenges?

Although we have made some great progress in supporting practitioners to become more research active, there is still space for improvement. The literature documents that the common barriers to becoming more research active include funding issues, interference with work/life balance, a lack of clarity for the career path, and insufficient support for clinical academics (Deane & Clunie, 2021; Newington et al., 2021).

I decided to ask a small group of practitioner psychologists with a passion for research to tell me more about the barriers they had experienced to see what we could learn from their experience. Back in 2019, a group of us wrote an article for CBT Today about some of these challenges after we participated in a research workshop led by Professors Barney Dunn and Shirley Reynolds at the BABCP annual conference. At the time, many workshop participants reported a lack of knowledge about how to get started and limited time, money, or support for research activity (Dunn et al., 2019).

I followed up with some of my co-authors to check in on their progress three years later. One person had been awarded an NIHR fellowship, another had worked as a therapist on two research trials, and a third person was running their own small-scale research projects, but others told me they had struggled to make much progress. All the practitioners I spoke to were very clear how tough it can be to get involved in research. As one CBT therapist put it, "I must admit [the progress I have made] has predominantly been through perseverance".

Some specific barriers to research activity that practitioners described include:

• Lack of protected time or resources for research activity within a clinical role. Newly qualified practitioners in particular can be under considerable pressure to focus on clinical appointments, leaving no time (or headspace) within the working day to shift gear and work on any kind of research.
• Research not prioritised by senior leaders or service managers. One CBT therapist* told me that "the service just want me to get through the waiting list". Another therapist described a "lack of support by management structures with some research topics being discouraged".
• Limited specific clinical-academic roles and career structures within the NHS. Once a fixed-term research fellowship or trial therapist job ends, it can be a real challenge to maintain both your research and your practice unless you can get more funding.
• Isolation and difficulty making contacts. It can feel lonely trying to pursue research on your own in a service that is not supportive of this activity. Practitioners are also unlikely to have an extensive network of research contacts and may not know of a suitable supervisor within their chosen topic. "I had difficulties making links with academic research departments who did not respond to emails", one CBT therapist explained, and another told me that the researchers they contacted "were not willing to engage" with practitioners.
• Personal impact. Several practitioners reported they ended up having to work on their research passions in their evenings/weekends as realistically they were otherwise unable to make any progress. Some people even chose to drop some of their contracted hours to collaborate on research projects in an unpaid capacity which they described as not financially sustainable.   

It seems clear that there are some structural barriers to research activity for practitioner psychologists that are outside the control of individual practitioners, which require more action from our senior leaders and funders. I am keen to emphasise though that if you are passionate about research, there are some great resources and like-minded people out there who want to help you to navigate this challenging but hopefully rewarding journey. In the next sections, I have collated all the best advice that I could find for practical, doable ways that you can take that next step into research. 

Write up a case study. Prof. Dunn's top tip is to start by writing up some routine clinical work. "Add a little more methodological rigour to the routine outcome monitoring we typically do in therapy for example, by using a single case experimental design that tracks symptom change over time from a baseline to a treatment phase. This kind of paper can make a useful contribution to the literature in helping us to "characterise the individuals who present to routine services and how well their needs are met". You could submit your case study to a publication like The Cognitive Behaviour Therapist which also runs an excellent mentoring scheme for new authors.

Create opportunities within your current role. Looking for some "quick wins" can be a great starting point, advises Dr Tim Clarke, Principal Research Clinical Psychologist at Norfolk and Suffolk Foundation Trust. You could take a lead on an audit or service development project and disseminate the results for example, as a poster at a professional conference, or in a professional magazine or peer-reviewed publication.

Publish any existing work. If you completed a Masters or Professional Doctorate thesis, then now is a great time to revisit your previous work and turn it into a publishable paper or present your findings as a poster or short talk at a conference. Your previous supervisor should be able to help you. Demonstrating output from prior research is important for some fellowship applications. 

Work with a trainee. Supervise or co-supervise a trainee's case study, service development or main research project. This can be a great way to learn new research methods and to link with staff at the trainee's academic institution. You could then collaborate with the trainee on any dissemination activities and outputs.

Get a mentor. Clinical psychologist Dr Maria Loades is an NIHR Development & Skills Enhancement Award Holder at the University of Bath. Her best advice? "Get mentorship from and link into a university department who are interested in a similar topic and/or method to you". In my experience, getting the right mentor makes all the difference and it is worth spending time speaking to a range of people to get the right 'fit' for you. If you end up working with an academic/research supervisor from a different professional background to you, I highly recommend also finding a research active practitioner mentor (even if they work on a different topic or population) who can help you to negotiate the dual role of researcher and practitioner.

Contact your R&D team. Most NHS Trusts have an internal Research and Development team who are a great source of information about current research projects that the Trust is supporting such as opportunities to get involved in recruitment for large multi-site studies.

Train as a P.I. The NIHR runs an Associate Principal Investigator (PI) Scheme where you can shadow a PI to learn about the role. You may want to then become a site PI on a study, which is a great way to develop skills with clinical recruitment and research governance. Some regional NIHR Clinical Research Networks (CRNs) also run a "Greenshoots" scheme that offers extra funding for clinicians who are involved in recruitment for a study. Ask your R&D team for more information.

Network. "Linking with colleagues and like-minded individuals" is essential, as one CBT therapist told me. Dr Loades also advised, "look out for special interest groups of relevance to your topic area and conferences that will help you link up with others with similar interests." Clinical research is not done in isolation, and in my experience you need a team of collaborators and supervisors around you to make progress. Do reach out to others to learn about their research, explain why you are passionate about their topic, and explore any opportunities to collaborate.

Collaborate on an existing project. Getting your own new project idea off the ground can be challenging without buy-in from more established researchers. You may choose to build your research skills and ideas first by joining an existing project and research team. You could ask the lead researcher if they have any existing projects where you could make a defined contribution (e.g., screening studies for a systematic review). Working as part of a team on a larger project can be a great way to learn different research methods. Once you have these links, you may decide you want to apply for a fellowship to develop your own spin-off project (perhaps using the same data set or drawing on their methodology) so you can continue working with your new collaborators.

Work on a trial. One newly qualified clinical psychologist* told me about their experience of working as a trial therapist. "As an early career psychologist this was a brilliant opportunity to continue to build on my developing therapeutic skills after training", they explained, and added "and it also gave me an insight into some of the 'behind the scenes' work on a trial". You may be able to take on some additional sessions within your current role or to apply for full-time trial therapist jobs when you see these advertised.  

Join a higher education institution (HEI). If you are passionate about teaching and supervising trainees, there are Teaching Fellow or teaching-track Lectureship roles on practitioner training programmes at many HEIs which often do not require much evidence of prior research activity. Once in post, you could then look for opportunities to supervise trainee research or to run small-scale projects. A good and supportive HEI should offer you career development support to apply for fellowships or to move across to a research-track position.  

Apply for your own funding. There are dedicated funding streams for clinicians and practitioners who want dedicated time for research (see Box). Be aware that completing an application for a fellowship is a time-consuming process! A full NIHR doctoral research fellowship could take up to one year to develop. Many fellowships schemes are also highly competitive, and you should be prepared to receive rejections or requests for extensive revisions. Funders have recognised some of these difficulties, and there are now predoctoral schemes that will give you funding to spend time with a supervisor to work up your initial project idea into a fully costed, detailed fellowship application.

I hope that this article has given you some ideas for practical ways in which you can take your interest in research to the next level. Good luck with your research endeavours!

Further reading

• The NIHR Incubator for Mental Health Research. A great resource for mental health professionals who want to explore opportunities in research. It includes career case studies and provides information on training, funding, and finding a mentor, plus it has a whole section with specific advice for practitioner psychologists. https://mentalhealthresearch.org.uk/advice-for-psychologists/
• NIHR Integrated Clinical Academic programme: https://www.nihr.ac.uk/explore-nihr/academy-programmes/hee-nihr-integrated-clinical-and-practitioner-academic-programme.htm
• NIHR Local Authority Academic Fellowship programme: https://www.nihr.ac.uk/explore-nihr/funding-programmes/nihr-local-authority-academic-fellowship-programme-and-associated-opportunities.htm
• Wellcome Trust PhD Fellowship for Health Professionals: https://wellcome.org/grant-funding/schemes/phd-fellowships-health-professionals
• Your regional NIHR Research Design Service (RDS). These services run useful careers and training events and offer one-to-one appointments with a research advisor to help practitioners who are drafting fellowship or grant applications. https://www.nihr.ac.uk/explore-nihr/support/research-design-service.htm
• Your regional NIHR Applied Research Collaboration (ARC). There are 15 ARCs across England which support applied health and care research. ARCs can be a great way of linking up with other researchers in your region, and some of them run an annual research fellowship programme for practitioners: https://www.nihr.ac.uk/explore-nihr/support/collaborating-in-applied-health-research.htm
• There are some Health Education England (HEE) regionally funded predoctoral and postdoctoral bridging schemes. These tend to be advertised locally, for example, see Clinical Academic Careers East of England: https://www.claceast.net/
• The Healthcare Professionals in Research Facebook group: a peer-run group for early to mid-stage allied health professionals and practitioner psychologists interested in clinical academic careers. You will need to apply to the group's administrators to join:. https://www.facebook.com/groups/351873385356662/
• The Council for Allied Health Professions Research (CAHPR) is a national organisation with regional hubs, it runs events and shares useful information: https://cahpr.csp.org.uk
• The Cognitive Behaviour Therapist, a peer-reviewed journal run by the British Association for Behavioural and Cognitive Psychotherapies (BABCP), offers a mentoring scheme for practitioners who are interested in publishing a paper but are unsure where to start. The journal is also recruiting experienced researchers to become volunteer mentors: https://www.cambridge.org/core/journals/the-cognitive-behaviour-therapist/tcbt-mentorship-scheme

About the author

Dr Eleanor Chatburn qualified as a Clinical Psychologist in 2021 from the University of Bath. She is a Lecturer at the Department of Clinical Psychology and Psychological Therapies, University of East Anglia and a Visiting Researcher at the Department of Psychiatry, University of Cambridge. Twitter: @eleanorchats

Key sources

Deane, J.A. & Clunie, G. (2021). Healthcare professionals in research (HPiR) Facebook community: a survey of UK doctoral and postdoctoral healthcare professionals outside of medicine. BMC medical Education, 21(1), 1-9.

Department of Health. (2015). NHS Constitution. https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england

Dunn B., Reynolds, S., Blacklock, J., et al. (2019). Turning research ideas into reality: How can we better support 'on the ground' clinicians to become research active?. CBT Today, 47(4), 18-20.

Newington, L., Wells, M., Adonis, A., et al. (2021). A qualitative systematic review and thematic synthesis exploring the impacts of clinical academic activity by healthcare professionals outside medicine. BMC Health Services Research, 21(1), 1-20.

Assistant Psychologists in clinical research delivery

Danae Palate with challenges and opportunities

Clinical research is essential for innovation in healthcare. The NHS is committed to promoting and conducting clinical research to provide the best patient care. Recent policy (The Future of UK Clinical Research Delivery: 2021 to 2022) has highlighted the need for more joined-up clinical research delivery across the NHS, including greater funding for academic institutions and third sector services, with the shared goal of better health outcomes for patients. This policy also details steps for more innovative clinical research, enabled by new digital data and tools.

One of the themes for the vision of UK clinical research implementation moving forward is a change in the culture of research within the NHS. Unfortunately, as pressures on the NHS have continued to increase, staff have needed to prioritise clinical contact over engagement with clinical research. Whilst this has been essential to make a dent in lengthy patient waiting lists, it means that research engagement has been neglected, even though clinical contact and research are both key to providing a good service and improving long term health outcomes.

Improving engagement with research

Assistant Psychologist roles are often undertaken by ECRs and include some level of clinical contact with patients as well as a research component. The job plan and experiences of Assistant Psychologists can vary enormously, and are dependent on both service pressures and the managing Clinical Psychologist.

Assistant Psychologists with primarily clinical roles can engage with the plan for clinical research delivery by being informed about the research relevant to the population(s) they are supporting. A searchable database of ongoing research has been developed by the National Institute for Health and Care Research (NIHR) (Be Part of Research) which ensures that staff can remain informed about current research in their area. Clinical staff can then signpost eligible people they are working with to get involved with ongoing research projects.

Disseminating research

The processes for gaining permission to disseminate clinical research are often confusing and can deter staff from disseminating research findings outside of their specific team or NHS Trust. This means that by the time research is disseminated, it might be less current, relevant and meaningful for both patients and staff.

Ensuring research has a meaningful impact means working to identify the target audience for dissemination in the early stages of research planning. Assistant Psychologist posts are often limited by fixed-term contracts. Therefore, planning dissemination early makes it more likely that Assistant Psychologists will have the time and resources to appropriately disseminate their work, so that their research can create maximum impact. Research and development teams are being transformed under new policy plans, and the hope is that Assistant Psychologists will be able to draw on increased resources to support and plan their research. 

Increasing diversity in clinical research

New policy outlines the development of data and digital services to improve the diversity of study participants to include those groups that are often under-represented in research. There are also ongoing investigations to better understand how to reach under-represented communities.                                     

Patient, Public and service user Involvement (PPI) is needed to better understand the challenges preventing under-represented populations from engaging with research. The value of service-user insight has been recognised as making research more effective and relevant, although the process for reimbursing service users for their time and expertise has been challenging to implement.

Successful PPI engagement requires shared expectations to be established between service users and professionals. Assistant Psychologists might support this process by informing service users of opportunities for research engagement, and by seeking to establish a shared understanding between service users and professionals about what research collaboration involves.

In conclusion, the plans for improving clinical research in the UK and the steps taken so far are exciting from the point of view of Assistant Psychologists wishing to increase their engagement with research. As policy documents often focus on long term changes, Assistant Psychologists may feel like proposed changes are less relevant to them, due to their fixed-term contracts. However, as I have demonstrated in this article, there are ways in which Assistant Psychologists can meaningfully engage with plans for research delivery in the context of the barriers and opportunities they face.

About the author

Danae Palate moved to the UK to study her undergraduate in psychology, now holds Graduate Basis for Chartered Membership with the BPS, and works as an Assistant Psychologist in the NHS alongside training as a psychological therapist at the Centre for Psychological Therapies at the University of Edinburgh.