Should clinical psychologists be conducting more research?

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sarahg
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Should clinical psychologists be conducting more research?

Post by sarahg » Fri Apr 04, 2014 11:52 am

I recently read an interesting article in Psypag regarding the research interests and output in clinical psychologists.
What surprised me was the modal publication rate in CP practitioners is 0 (Eke et al., 2012). I thought this may be due to the training courses being less research focused before it was a doctorate, and as such those CPs skewing the results. However data from 1988 showed a mean publication rate of 2.5, which has only marginally improved to 3.6 (2012).

The article I am discussing is here (page 7): http://www.psypag.co.uk/wp-content/uplo ... Pag-90.pdf

The article discusses the pros and cons of CPs being actively involved in research, however I was just wondering what peoples views on here were? Do you think that CPs should have a greater involvement in research? Why so/why not? Does being actively involved within research improve ones own clinical practice, or is it okay to have just 'researchers' who inform 'practitioners'?

I look forward to hearing your views :)

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blue86
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Re: Should clinical psychologists be conducting more researc

Post by blue86 » Fri Apr 04, 2014 12:41 pm

sarahg wrote:I recently read an interesting article in Psypag regarding the research interests and output in clinical psychologists.
What surprised me was the modal publication rate in CP practitioners is 0 (Eke et al., 2012). I thought this may be due to the training courses being less research focused before it was a doctorate, and as such those CPs skewing the results. However data from 1988 showed a mean publication rate of 2.5, which has only marginally improved to 3.6 (2012).

The article I am discussing is here (page 7): http://www.psypag.co.uk/wp-content/uplo ... Pag-90.pdf

The article discusses the pros and cons of CPs being actively involved in research, however I was just wondering what peoples views on here were? Do you think that CPs should have a greater involvement in research? Why so/why not? Does being actively involved within research improve ones own clinical practice, or is it okay to have just 'researchers' who inform 'practitioners'?

I look forward to hearing your views :)
Edit: I apologize in advance for the huge post. I just realized how big it is.

I think this is an interesting topic, but it is doubtful we will be able to form any kind of coherent conclusion.
As you saw from that article, US CP also don't publish as much. Although they get much more research training years, and usually end up with a PhD. So I don't think it's a question of the UK CPs being less research focused before it was a doctorate.
The way I saw it was that some CPs were so involved in clinical work, admin duties, and consultation for teams that they didn't have enough time to devote to research. The ones that were in research didn't have time or didn't want to do more clinical work over time. Clinical psychologists get academic tenure posts in the US, and while some keep some private practice or small number of clinical hours on the side, often times they focus on research. Clinical psychologists outside of academia have to deal with many practice related issues, that although they read journals and refer to research, they often said to me that they wouldn't be able to devote as much time to publish.
I am aware the situation is slightly different in the UK, but that's the whole point, that even in different conditions, CPs can't exactly do both in equal amounts. I may be wrong, but it seems such people are the exception.

On a personal note, I do see the value of seasoned clinicians contributing meaningfully to research projects. I also see how much research has brought to our field. For such an applied field, it might not make sense to separate the clinicians from the researchers. But at the same time, I was often asked myself how many other fields do this?
My research advisor kept telling me how in biology or other fields it is more acceptable for researchers to get in outside help with bigger projects - they would have stats consultant, or research methods consultants, and that would be seen as ok. Meanwhile, clinical psychologists are required to take stats modules (in the US it's about 4 modules, so two years) and to make sure that they know stats and research well enough to conduct everything by themselves. In one university there was an entire small department of stats people that only did consulting for all other fields - when they would apply for big grants, or had complex designs for a bigger project.
I saw the article mentioning how training in both research and practice is unique to our field. Maybe that's why it is more difficult to completely integrate the two, or maybe trying to do both is not feasible given outside constraints on a CP's time.The Netherlands example seems appropriate here, where they decided to specialize in one or the other.

But the question remains - why is so much research training needed when so many graduates end up on the clinical side of things? This is particularly relevant to the UK where the D Clin Psy is geared towards practice and not academia.
I agree with the article that research takes time and if you have other things going on (they mention family/children) then a CP will have even less time to do research. I also agree that intention is polarized - people who want to do research, and organize their careers in that direction, and people who don't want to/can't at that time.

I like their note on the fact that scientist-practitioner is a model for the profession, and not for individuals. I never thought about it that way, but it's starting to make sense :)
In many ways, research training should prepare CPs to be consumers of research. We should be able to think critically about new research, link it to practice, even contribute ideas if we can. Doing small scale audits to evaluate our own work also seems important. But only a part of CPs will be publishing consistently after their doctoral thesis.

I don't think that CPs should give up research altogether. That's why psychology is a science and maintains a certain standard. I think that there should be some realistic guidelines regarding research productivity for the field. If a certain posts allows for a even split in the CPs time to conduct a research project, then that's great. They will inform the field from an applied perspective. But expecting each CP to publish more than 0 after qualification might not be feasible or desirable. I'm exaggerating of course, but you get the idea.

I had a small problem with their insinuation that research is the only thing separating us from CBT nurses. Those are different fields with different ethos, and I don't understand why without research it's so easy for us to be lumped together with anyone doing talk therapy. How about assessment? Or comprehensive (bio-)psycho-social evaluation?
Also, I'm getting a little tired of having to justify why we are being paid "so much", considering the level of training.
Am I the only one a bit alarmed that nurses are doing neuro-psych assessments? I understand that any technician can conduct the evaluation, but what is their training in interpreting those results?
In any case, I'm going off on many tangents here.

My personal opinion is that CPs should be allowed to be involved in research if they want or the posts includes it, etc. But that we shouldn't ask for more research productivity just because "it looks better". CP is doctoral level training and I don't see that changing any time soon. I think we just need to be more realistic about what CPs can accomplish after qualification, and instill in trainees a sense of at least critical consumers of research, if nothing else.

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enid
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Re: Should clinical psychologists be conducting more researc

Post by enid » Fri Apr 04, 2014 2:45 pm

I definitely do. It would be great to have more research out there, on therapies for example. There hasn't been a huge number of recent RCTs on CBT for different conditions for example. And I think CPs are best placed to research what works and what doesn't. In my field there is a massive dominance of psychiatry, and of course this gives a particular focus. It means that all the research being done in this area is by psychiatrists (and they do a lot) and this becomes the kind of 'norm'. Whereas I think my field is screaming for more psychology. In my Trust they have created a newish process of linking clinical work with research through clinical academic groups, but once again psychiatry tends to be at the top of these groups in terms of director positions, etc.

I also observe that a lot of the psychologists I meet, whether AP, TCP or CP, seem absolutely terrified of research and stats, and hence probably contributing to the fact that psychiatry dominates what research is commissioned and comes out, or research academics I often meet and can't actually believe they ever did a psychology degree (all those years ago), as they have such a medicalised view of everything now and have no ability whatsoever to think psychologically. I think my opinions are a product of my Trust and School though, which is particularly this way and other places may be a lot different. I do observe though that post CP doctoral level where TCPs are forced to do a thesis, they tend to stop there, as far as research goes.

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blue86
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Re: Should clinical psychologists be conducting more researc

Post by blue86 » Fri Apr 04, 2014 4:33 pm

enid wrote: In my Trust they have created a newish process of linking clinical work with research through clinical academic groups, but once again psychiatry tends to be at the top of these groups in terms of director positions, etc.

I also observe that a lot of the psychologists I meet, whether AP, TCP or CP, seem absolutely terrified of research and stats, and hence probably contributing to the fact that psychiatry dominates what research is commissioned and comes out, or research academics I often meet and can't actually believe they ever did a psychology degree (all those years ago), as they have such a medicalised view of everything now and have no ability whatsoever to think psychologically. I think my opinions are a product of my Trust and School though, which is particularly this way and other places may be a lot different. I do observe though that post CP doctoral level where TCPs are forced to do a thesis, they tend to stop there, as far as research goes.
I really like this idea of clinical academic groups! I think it's great especially when it's encouraged in such a manner. How does it work? Do people get to talk about current published research or they can also bring up their own projects?
I've seen what you mean about psychiatry being at the top of these things. Sadly, it's not just your service. It might be because they are an older profession?

That's the thing - I've seen people terrified of stats and research as well. I think it's because so much pressure to be trained in both, when most people have a preference for one or the other. Lecturers and professors should encourage publishing of thesis and etc., but I think that they should also be accepting that some of the trainees will be mostly practitioners. That's why I think starting with a critical consumer of research is a good start, and then encouraging those who show a predilection, instead of just lumping them all together and pushing them through the research productivity track.

We do need to keep up research in our field, I completely agree. But I don't think that pushing trainees for more productivity is going to do the trick.
Programs like the ones you have described might work very nicely. Setting some time aside in a post description for research as well. Involving CPs in more of a group effort also sounds good. Too often CPs tend to see research as a lone experience - especially the initial ethics application, and then the stats part - and I think that keeps them away. Approaching it from another angle might make everyone more comfortable.

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maven
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Re: Should clinical psychologists be conducting more researc

Post by maven » Sat Apr 05, 2014 8:19 pm

I guess it depends on what they are being funded to do, as well as what they want to do!
Maven.

Wise men talk because they have something to say, fools because they have to say something - Plato
The fool thinks himself to be wise, but the wise man knows himself to be a fool - Shakespeare

lakeland
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Re: Should clinical psychologists be conducting more researc

Post by lakeland » Wed Apr 09, 2014 10:39 am

I think it's a shame that we don't do more, particularly given the large research focus on the doctorate. But Maven is right, it depends on what we are funded to do. In some services, money is generated based on the number of contacts a clinician can see, so research won't be on the agenda - client contacts are more important in those cases. Although given the pressures to income generate, perhaps research should be prioirtised, as a treatment programme with good evidence is potentially sellable (is that a word?), and a body of published work would mean that a CP could offer training or consultancy in certain areas, further generating income for a team.

In my experience, when there is the opportunity to do research, this is usually a service evaluation or audit, which may or may not be submitted to the Clinical Psychology Forum, and is probably a trainee project. I know some departments have pretty good academic links, or staff with split clinical and academic posts, but this doesn't seem to be the norm.

I'm not sure what doing 'proper' research (e.g. RCTs) would look like for a CP working full time in a clinical post. Unless external funding was available, I can't see a CP being allowed to give up a chunk of the duties they are paid for to work on a research project without the service being reimbursed in some way. And then how do you go about getting external funding anyway? I wouldn't have a clue where to start!

Sorry that this is a bit rambly - I don't think I've managed to articulate my thoughts particularly well today!

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