Cascading effects, ‘bottom up’ research cultures, and contextually responsive implementation science

A fundamental aim of supporting clinicians to engage in research and the development of research labs for practitioners is to foster cascading effects, where skills and ambitions for a ‘bottom up’ research culture help professionals to embed research-minded practice in services (Fouché, Reference Fouché2015; Austin & Carnochan, Reference Austin and Carnochan2020). This process should support opportunities for creative work at the intersections between the delivery of care, qualitative research, and clinical audit and quality improvement activity. Clinical audit and quality improvement’s value at a local level resides not just in enhancing care delivery but engaging early career professionals in using research-based techniques and methodologies to build research capacity and capability (Harvey et al. Reference Harvey, Plummer, Nielsen, Adams and Pain2016; Welfare-Wilson & Scrivener, Reference Welfare-Wilson and Scrivener2015). Moreover, practitioners lacking formal research roles frequently face barriers to undertake research, including limited protected time, scarce funding opportunities, and resistance to change in working cultures within organisations. Consequently, strategies to embed research activity within routine clinical practice and leverage collaborative grants can help mitigate these obstacles, supporting sustainable engagement in research (Fouché, Reference Fouché2015). Research ambitions realised through collaboration with practitioners also have potential for translation into improved local practice efficiently as findings are disseminated and implemented in practice within and across teams (O’Reilly et al. Reference O’Reilly, Archard and Kiyimba2025). Simultaneously, such endeavours may extend the reach of more substantive evaluative research in local settings, thus supporting an anti-quick fix, more contextually responsive implementation science (Epstein, Reference Epstein2002, Reference Epstein2009).

Practice-near thinking

Practice experience can serve as a fount of ideas for ‘practice near’ empirical endeavours (Cooper, Reference Cooper2009), with practising clinicians identifying matters otherwise obscure to researchers who may lack proximity to the social and emotional complexity of real-world care delivery. For example, two of the authors have been supporting a doctoral student who, as a counsellor by training and a foster carer, is pursuing research into the lived experiences of Black African Caribbean foster carers. This student’s background as an African Caribbean woman and foster carer afforded them certain advantages, including a closer appreciation of this community’s experiences and access to prospective participants. Crucially, though, it was their experience as a foster carer that motivated them to pursue this focus, which they found to be a neglected research topic.

As well as neglected areas of research, clinical practitioners are also better placed to recognise as yet unidentified blind-spots in research areas already subject to greater empirical attention. An example of this is the negotiation of professional self-disclosure in digital care delivery during the COVID-19 pandemic. A range of research was undertaken regarding digital remote mental health care delivery methods during this time, including research addressing the experiences of child-welfare involved populations and professionals supporting them (Ådnanes et al. Reference Ådnanes, Kaasbøll, Kaspersen and Krane2024). However, aspects of relational engagement in remote appointments were not examined in-depth. We found an absence of attention to how professionals navigated questions from children and families about their own lives. Yet our clinical experience was that professionals revealed more about themselves than they would have otherwise during these appointments, typically as a strategy to maintain trust with families in an unpredictable working environment (Archard et al. Reference Archard, Awhangansi, Moore, Majumder, Lewis, O’Reilly, Giles and Adkins2023 a, Reference Archard, Moore, O’Reilly, Majumder, Warrender, Adkins and Tilbury2023 b).

Clinician researcher reflexivity and methodological reflexivity

From the perspective of academic disciplines, practitioner engagement in qualitative research can also be viewed as an object of study in investigating how clinicians approach and think about research. Practitioners bring to research endeavours principles they learn and are socialised into through their training, practice and occupational cultures (Hay-Smith et al. Reference Hay-Smith, Brown, Anderson and Treharne2016). Their professional experience equips them with certain advantages in research praxis. For example, psychotherapeutic experience may be beneficial for learning how to undertake narrative, in-depth qualitative interviews. At the same time, to avoid research interviews turning into therapy, reflexivity is necessary for the integration of researcher and practitioner identities, clarity with role expectations and to ensure the ethicality of exploring participant experiences using psychotherapeutic ‘tools’ (Long & Eagle, Reference Long and Eagle2009; Archard & O’Reilly, Reference Archard and O’Reilly2022).

Methodological investigation of links between practice-based and research-based production of knowledge through labs for practice-near research also generates opportunities for conceptual enquiry. Specifically, ideas can be examined as they are resituated and reframed across contexts and disciplinary boundaries, supporting critical awareness of the socially and historically contingent quality of methods and practices, and re-engagement with relevant ideas forgotten or overlooked in evolving disciplinary paradigms (see Everitt et al. Reference Everitt, Hardiker, Littlewood and Mullender1992; Lapping, Reference Lapping2011; Duschinsky, Reference Duschinsky2019)

Next steps

The assumptions set out in this editorial are initial ideas for developing a practice research lab, which will evolve as the lab does, in its activity, purpose and ethos. As we have articulated them, these assumptions highlight two main points regarding the imbrication of practice and research in qualitative enquiry in child and adolescent mental health. First, connecting qualitative research with a current concern for a clinical academic focus in this area means determining how practitioner investment in qualitative research may be linked with the cultivation of research cultures within service environments. Second, a reason to encourage interdisciplinary collaboration between researchers and clinical practitioners is to orientate pluralistic discussion of qualitative enquiry to account for the situated nature and practical realities of clinical practice. The lab’s work, we hope, will help advance discussion regarding practice-near research, support practitioner investment in qualitative research, and shape the above assumptions further.