Jed

Age at interview: 44

Brief Outline:

Jed is employed as an art psychotherapist in two locations (a Mental Health Trust and in a hospice) and is in the process of completing his PhD. He feels that research in art psychotherapy is now growing and that the profession has much to offer.

Background:

Jed is an HCPC-registered art psychotherapist and clinical academic researcher. He is in a relationship and has two children (aged 16 and 15). His ethnic background is White British.

More about me...

In 2009, Jed retrained to become an art psychotherapist. He was keen for research to be part of his job even before he qualified. He practiced clinically for several years and waited for the “right thing to come along” in terms of research interests. Jed currently has three main roles: (1) as an art psychotherapist in a Mental Health Trust, (2) as an art psychotherapist in a hospice (which includes responsibilities for supporting research capacity-building), and (3) completing his PhD, which he is seconded to from the other two jobs. Jed works full-time on his PhD and splits six hours clinical time per week between the two art therapy posts. As this translated to a very small caseload, Jed proposed that instead he could develop research capacity in the two settings – for example, through supervision, developing research policies and procedures, and supporting other studies to take place. He felt this was a way of “bringing that knowledge back in” to the organisations. 

Before Jed started his PhD, he completed an NIHR-funded Master’s in Research where he met a number of other allied health professionals (AHPs), such as occupational therapists and physiotherapists, and nurses. He had previously completed a six month (30 days) Clinical Academic Internship Programme funded by NIHR. He felt the internship was a great opportunity to learn more about research in health and social care settings, and was an essential part of gaining a place on the NIHR MRes programme. It included Good Clinical Practice training and shadowing some clinical trial units. Initially, Jed felt the nurses on the internship had an advantage as many had worked as research nurses before, giving them “a general level of awareness of how a big NHS research project works”. However, when it came to thinking about leading research, he felt it was a “bigger step” for the nurses whereas it was a direction he (and some of the other AHPs) felt more capable of pursuing.

Jed’s PhD research brings together his interests from his two clinical posts and addresses an important research gap: end of life care for people with mental illnesses. It is important to Jed that his research brings benefits and reaches frontline staff: “[I knew that] just asking the question was going to lead to better care [… and] has made people have conversations about end of life care that they wouldn’t have had”. Although his PhD is “not a piece of art psychotherapy research on the surface”, his approach to research methodology and research dissemination is very much informed by his disciplinary background. Along the way, the process of undertaking research has shaped how he thinks about his professional identity: “I felt like I’d become a health researcher for a while, I feel a bit more like I’ve got the art psychotherapist back now [as I am coming to end of my PhD]” and the two are “becoming more integrated”.

Jed feels that art therapy, as a relatively small profession, has historically been quite “research shy”. This is now changing, although Jed tends to align himself with ‘AHPs in research’ as this is a bigger collective of people and experiences. Jed would like to see the research capacity in art therapy grow further. However, he describes structural barriers (such as middle management reluctance to second staff to pursue research). He encourages funders to support the full range of AHPs, which might require “open-mindedness” about the methods and research designs to suit the research questions of different professions. Compared to other professional groups (such as research nurses and nurse researchers), Jed feels clinical-academic career pathways for art psychotherapists remain very unclear – especially post-doctorally. He is preparing to develop a post with his line managers and other partners by adding a research element to his current post at the Mental Health Trust, although he anticipates this will be difficult to do in the hospice setting owing to funding arrangements, alongside retaining involvement with his university.

Jed is passionate about what art therapy can offer health research – in terms of research design, practice, analysis and dissemination. For example, Jed highlights that art psychotherapists are acutely aware that not everyone will feel comfortable expressing themselves through speech/text and that other visual forms of communication can be powerful. However, particularly with research involving ‘vulnerable’ groups, there can be risks for participants and art psychotherapists are highly skilled in assessing and addressing this issue in their clinical work – an ability which can be translated to research. Jed speaks about skills honed in art therapy which lend well to the world of research, such as a “personal resilience […] that you need as a psychotherapist and as a lone worker that you also need as a researcher”.

Jed thought differently about his professional identity at different times during his doctorate. He reflected on some of the things that art psychotherapists could bring to health research.

I think for a while I felt like I’d sort of stepped outside of my professional identity and gone into a new one. And so I felt very much like a fledgling health researcher, and that wasn’t my intention, it was because I’d, you know, I’d set off with my research question which was about what an art psychotherapist might offer this particular patient group. And then in my first literature review found such a lack of research that it was like ‘okay, well either I don’t do this, or I go, step, take some of the steps back and do some of that research that hasn’t been done’. Which is what I chose to do, and I'm glad because it’s made me much more sort of, you know, it’s put me in contact with a much broader range of colleagues and professions and people and, than if I’d stayed very much as an art psychotherapy researcher, that would have been quite narrow, for me. But as the study has progressed and I’ve thought more about how I’ve collected data, how I’m analysing data, how I might bring the study together, how I might disseminate it, and bring, even write up the thesis, you know, the art psychotherapy part of me has engaged more and more and more. From ethics onwards really. So from sort of going to that panel and having to sort of think-, sort of reassure about the patient group but also then defend the methodology choices, it feels like the art psychotherapy bit of me has kind of re-engaged. And my intention would be, you know, if I could have my wish, [laugh] if you like, would be that I could go back into a clinical-academic art psychotherapy post. And be part of helping the, the kind the health and social care research world understand what art therapists can offer, beyond-.

We are quite a misunderstood profession and we spend quite a lot of our careers, all of us, explaining what art therapy is and isn’t. And I think what I’d like to do is to kind of be able to explain, not only what art psychotherapy is and isn’t as a clinical intervention, but what the, what art therapists have as skills that are useful in their own research world. So how we could be helpful for research teams in facilitating workshops in a safe, ethical way, with vulnerable groups particularly. So I’ve been asked to, you know, get involved and support other people’s studies because they’ve wanted a bit of that. So, you know, where I’ve got a colleague who’s a nurse, and she said, “Will you co-facilitate,” because then I’m kind of almost covering that bit if you like, I’m covering that, that side of things that so that’s quite interesting ‘cos, you know, it’s not traditionally what we’ve done, but absolutely what we could do.

A part of what we could do.

Jed identified a number of potential challenges for NMAHPs wishing to undertake research qualifications. This included the level of funding available, the timing of applications, and being able to secure backfill.

If you don’t follow the, this pathway that I’ve followed then I don’t know how people do it. You know, cos either you leave your job and you take a stipend and then you go and almost start from scratch, which if you want people at a reasonable level of experience-, so if you want experienced clinicians, most people can’t afford to do that. So the clinical academic pathway I think is brilliant. They’ve made it a bit inaccessible at points, cos they’ve changed the time scales and it doesn’t quite butterfly to-, it doesn’t quite sort of, I don’t know, it doesn’t quite flow in the way that it could, ‘cos they moved the, the, the sort of time in the year that they advertise things. But it does give you the ability to follow a pathway and receive back-, backfill. So your organisation isn’t penalised. It’s hard if you do an unusual job, because you might not just have someone that can step into your role so I think, you know, that’s, that is an issue. But it does, so my sort of working arrangements for the last three years have been that I’ve taken-, I’ve got like a temporary reduction in my hours, and then, so I work these few hours that I’m allowed to work, and that keeps my pension going, and that sort of thing, although it’s reduced what I’m contributing. And then they, the organisations have got the backfill to employ someone to do the rest of my job. So that’s real-, that’s relied on them being very flexible, you know, and very accommodating of, of my sort of desire to do this piece of research. Many people wouldn’t be, you know, they wouldn’t, they wouldn’t have that flexibility. So the working environment I think is not always that supportive of people doing this kind of thing.

Jed described his experience of undertaking an internship and MRes (Master of Research) degree.

So the NIHR [National Institute for Health Research] pathway, there’s an internship before you do an MRes, and on that we did quite, we did things like Good Clinical Practice and other bits of, you know, training around NHS ethics. Around setting up studies and trials. We spent time in, in sort of the clinical trial unit’s around in hospitals. So, it was a bit like it was like a little mini apprenticeship, and it was really good, particularly if you’ve not been a research nurse, so I think the research nurses found it a bit boring, cos it was what they do, but for all of the rest of us it was really helpful. And then when I did the MRes at [city/university] cos they held the funding for that programme, their approach to the MRes was that you did a thesis but you also did a clinical portfolio, and that was a bit like a kind of enhanced version of what I’d done on the internship. So it had all these competencies that you had to meet as like a fledgling researcher. So it was really good actually, it was really, really helpful cos it meant that I had to go and do things that probably in my research career I won’t, so I probably won’t spend much time in a clinical trials unit because I’m a qualitative researcher and spending time with humans really rather than samples, but it was really helpful to get a sense of what that type of research is like. And you had, so you had to do all of these competencies as part of that MRes programme. I don’t think any of the other providers did that. But it was really, really good and it involved, you know, some of it was sort of taught seminars, there were some modules that you had to do. So quite a lot of research training, not just sort of academic writing.

As an art psychotherapist, Jed had a number of skills which he could translate into supporting research participants.

As a psychotherapist you’re sitting with a lot, you know, you sit with a lot of processes and distress, and trauma and, you know, therapy is not always easy, it’s not always comfortable, and it doesn’t always make you feel better straightaway, you know. And so some of the skills that you need to sit with stuff rather than stepping in translate really well. So how you’re being with me now, you know, you’re not leading my questions, you’re listening, I'm sure that there are things that you could say that you’re not saying. And, and in a way I found that some of the skills that you learn when you train to be a therapist are really helpful when you’re learning to be a researcher, particularly if you’re doing interviews and qualitative-, if you’re doing work with people rather than samples, I can’t really speak for the world of quantitative research really, or, or sort of, you know, lab based research. But I think if you’re researching with people, [laughs] there is definitely something that, there’s a real overlap. 

The other time that it’s really come to the fore I guess is in the methodology side of things. So thinking in a different way about how you collect data. How you analyse data, how you look at data. What are the risks of asking people to produce things in a particular way? So there’s quite a, there’s quite a focus on using visual and creative methods now in qualitative research. There’s not always the same consideration to the risks of doing it. So I’m often the one putting my hand up saying, “Yeah but sometimes you might plunge somebody into a really difficult place by asking them to make that out of Lego, you know, Lego might trigger them off to somewhere, you know, you’ve got to be able to then support them”. So when I went to ethics and said what I was proposing to do, I didn’t get lots and lots of sort of concerns raised about what I was doing because I was a therapist. So I was able to kind of, I suppose reassure the committee that if people did become distressed (a) you know, I work with people with mental illness and who are dying every day, so it’s my normal. And it’s their normal cos it’s their experience, and so if they became distressed in an interview that I would be able to cope with that and support them, but also that I would know who to refer onto and at what point.

As he nears the end of his doctorate, Jed was thinking about ‘what next?’ He would like to develop posts for himself as an art psychotherapy researcher in the two settings where he works, but there are challenges.

But what I’m trying to kind of negotiate is to be able to kind of create a research element to those posts, and certainly in the Mental Health Trusts that’s more possible. It’s harder in a hospice because it’s the way that the funding works is different. Although, although there is a big kind of movement of research active hospices, so if there, if there was ever a time for me to do it, it’s now. And certainly, I’ve had a lot of interest from the hospice movement in my research, and Hospice UK have a head of research now who’s, you know, looking at sort of capacity building and what have you. So yeah, it’s, I think it’s possible, but it’s not, it wasn’t part of my post. I’ve had to kind of create it [laugh].

And if you want to keep a clinical and an academic role going, that’s harder than just going into the university. You know, that’s the, the pull already is to just go into the university full-time but then you lose that contact with clinical which sort of defeats the object of doing it in the first place. Or just going back to work and back into practice, and then you lose the contact with the university. So I’m just trying to sort of work out how I, you know, how I proceed post-doctorally really.

Jed was nearing the end of his doctorate and felt there were barriers in terms of the next steps.

‘Cos they talk about it as a career pathway, but if, if there are sort of significant barriers along that pathway-. So, for me the clinical lectureship would be the next sort of stage, so you need a year post-doc experience-, you know, you need to have a year of that. Now, if I go back to work, I’m not at the university, so how do I maintain that? There’s not really a sort of a way of being at the university a day a week, that’s what it needs. It needs something like that, so you go back to your practice but perhaps you have a day a week at the university to develop as a post-doctoral researcher, work on that application, maybe work on another study. But there’s not really a funding mechanism for that, so the danger is you go back and then you’re back in clinical practice and you’ve not got the space to develop that application. So, I mean I’ll do it and I’ll find a way, but, but the pathway, it doesn’t, it doesn’t, it’s got some gaps.

I think that could just, just need looking at.