Research Fellow, Lauren Cox
Full name: Lauren Cox
Place of work: JUICE Youth Mental Health Research Unit
Job title: Clinical Doctoral Research Fellow/Trial Manager
Career Journey to date:
I completed my undergraduate degree in Mental Health Nursing in 2012, gaining a first class and thoroughly enjoying both the clinical and academic sides to my degree. I then worked in acute inpatient units, and within secondary community services. I loved my job, but always wanted to return to study whilst gaining skills to better care provided for service users. To this end, I completed an MSc in Cognitive Behavioural Therapy for Complex Cases and moved to Early Intervention in Psychosis services as a CBT Specialist in Psychosis. I was responsible for delivering care for those at risk of developing psychosis in line with new clinical guidelines in 2016. I found there were issues within the pathway and wanted to improve this, deciding to try to get in to research. I audited my service, publishing the results and presenting findings nationally and locally, then completed and published a systematic review in my area of interest.
I then completed a research internship (ARC Northwest Coast), Early Career Researcher Programme (NHS R&DNW), Pre-doctoral Clinical Academic Fellowship (NIHR) and am now completing a Clinical Doctoral Research Fellowship (NIHR) – these have involved relevant training and development, developing my supervisory team, leadership and coaching and writing and executing my project plan.
I now manage my studies with the support of supervisors. I am currently completing a qualitative project interviewing people who have disengaged from services for those at risk of psychosis. The study is in recruitment and is being undertaken across four sites across the UK. The overall aims of my three studies are to improve current services for the at-risk group in the NHS.
What inspired you to become a mental health nurse?
I had initially started a degree in philosophy and literature, however shortly afterwards my dad took his own life due to serious mental health problems. This made me reflect on how I could help people in distress and try to improve others experiences in mental health services. My experiences of family members mental health difficulties; a desire to help others; and the ability to work in a rewarding career with a variety of different career path options made it feel like my calling so I changed course and have never looked back!
What are you most passionate about in mental health nursing?
Personalising care, ensuring this is individualised and the person has full input into care planning and provisions: holistic care planning through collaboratively exploring strengths, areas the person wants to improve and planning how this could be achieved. Writing the plan out together and sharing this with those important to the person (with permission) who could help support the plan. Reviewing this regularly to check any progress or areas for change. Valuing user opinions and values and addressing concerns.
A humanistic empathic stance to distress and taking time and care to listen: carving out meaningful time to listen to individuals, formulating this together to make sense of things.
What I am most passionate about: seeing a person move from distress/crisis to agency and empowerment, regaining/reclaiming their lives. Working with people in therapy to understand problems and address these through various therapeutic interventions. Working with families and carers to enhance support and recovery.
About your role
I am a Clinical Doctoral Research Fellow based at the Youth Mental Health Research Unit (JUICE). I am responsible for managing my research trial which has involved; writing research papers; research protocols; applying for ethical approval for my studies; Public and Patient Involvement (PPI) work; completing my PhD; financial management of my award; setting up study sites; recruiting and interviewing service users.
I have moved from being a full time psychotherapist to completing my NIHR fellowship; primarily working on my research studies, training and development plan and some clinical work.
NIHR fellowships allow clinicians funding and support to complete innovative research and future clinical academic leadership careers. They allow professionals to remain embedded within clinical services whilst completing the fellowship to ensure meaningful change is reached within services.
Completing the fellowship looks to make meaningful changes within the NHS within five years through delivery of your personal research project and associated training and development plan. My studies are aiming to develop an ancillary user-led service model within the NHS to improve current provisions for those at risk of developing psychosis.
What are the key priorities for your role?
The role of completing a clinical academic fellowship is pretty unique, as it is you who has designed your research and your training and development plan (with help of supervisors). Each fellowship is unique to the person, place and project.
Priorities for my role include managing the research day to day, delivering on milestones set out in the research, training and development plan.
The role is a mixture of trial management, conducting research activity, public and patient involvement, academic and some clinical work.
Within my role the key priorities are ensure my studies are conducted to plan in order to develop user-centred services for those who are at risk of psychosis. Currently this involves regular liaison with study sites for recruitment, clinical research practitioners and undertaking qualitative interviews, in amongst the academic work expected of the PhD programme I am enrolled in.
What do you like most about your role?
I am learning every day, brand new things to me we don’t usually get to learn as clinicians. These are equipping me with an array of professional, leadership and management skills. I am embedded in a massively supportive, skilled, friendly and enthusiastic team, and my supervisors are brilliant. I have ownership of my own research projects, diary and progression (this can be really challenging at first but has been invaluable in developing my confidence). I love engaging with research participants and hearing their stories to try and make things better ultimately through research. I am learning every single day.
What have you achieved in your current role?
I have completed a qualitative systematic review and meta-synthesis, in preparation for publication (learnt lots of new skills through training and ‘just doing it’)!
I have applied for and gained ethical approval for an interview study, set up study sites and started recruitment, developed associated materials for the study (of which there are lots!)
Nearly completed the first year of my PhD; relevant training milestones, continuation report and viva.
Learnt the day to day management skills and techniques to manage a research trial; budgeting, finance, people management, managing sites and recruitment, all the legalities and frameworks involved.
Set up a PPI group to inform all stages of the research cycle.
Completed study interviews which are revealing really interesting points we can take forward to plan to incorporate into services in the future.
Completed various academic, research and clinical training programmes.
What do you hope to achieve in your current role?
To complete my fellowship to the best of my ability! Achieve the aims of the project and enhance the current services I am researching. Develop a model which can be tested through applying for further funding/fellowship in clinical practice to improve outcomes for service users.
To develop my leadership and management skills to effectively support junior researchers/clinicians.
Inspiring others
Why should mental health nursing be considered as a career option?
Firstly, you get the chance to make a meaningful change to others lives and support recovery from often debilitating problems. There are so many pathways within the role; multiple clinical areas to specialise in and opportunities for career progression and growth. The role is exciting, fast paced and no two days are the same.
What advice would you offer mental health nurses at the start of their career?
Make the most of your preceptorship and the support you have early on – ask lots of questions, work with lots of different professionals and service users.
Try to keep an open, enquiring mind about the users you are working with – keep up to date with literature (rather than relying on old ways of working).
It can be easy to get overwhelmed and stressed – make proper use of supervision; prepare, be open, and work on areas you think you need to strengthen. Peer psychological supervision and psychological formulation meetings can offer varied perspectives from other professionals on how to think about complex issues in a supportive space.
How do you maintain your health and wellbeing, achieve a good work life balance, and develop resilience?
Admittedly, I am probably a terrible poster woman when it comes to this, although a programme I was involved in taught me how rest and recharge and creativity can boost your productivity in the long run (rather than going full pelt till you burn out!).
I think time outside or away from a work station/environment works wonders for removing focus when things are challenging, you invariably come back with a fresh focus.
I am forever being told to plan leave before you need it!
Do one thing for you each day (10 min meditation, a good book)
Resilience wise, I think having a supportive professional network (supervisors, managers) to regularly be able to discuss any concerns and your practice can boost your confidence and help you feel less overwhelmed.
What advice you would give to someone thinking of taking a similar career path as you?
If mental health nurses are interested in a clinical academic career, I would recommend trying to find an important area you are interested in and gaining managerial support regarding your research interests; what is a key issue you feel needs addressing in your service?
Produce something within your service; be it a service evaluation, an audit, or some public and patient involvement work (there are resources out there for help with this) to understand the issue and show you are committed to undertaking the groundwork.
Link in with your Trusts research department to discuss any ideas you might have, and the local research design services available.
Seek out guidance and support from the wide range of available networks out there to get you up and running with your ideas i.e., potential supervisors who may be experienced in the field you are interested in, local Applied Research Collaborations (ARC’s), the NIHR who fund health and care research.
Are there any useful websites/books/podcasts/videos that you would advise mental health nurses to refer to?
More broadly, and speaking from a clinical viewpoint, my interests and career are related to cognitive behavioural psychotherapy for psychosis. There is a fantastic e-learning programme available via Programmes - elearning for healthcare (e-lfh.org.uk) which involves tips on assessment and change strategies. The site has other relevant mental health programmes you can register for with an account.
If you are interested in applying for a clinical academic fellowship or any other relevant research grant/funding stream check out National Institute for Health and Care Research | NIHR
These guys can support you to develop your research ideas into a funding application Research Design Service | NIHR
ARC’s support applied health research and research on implementation of health and care evidence into day-to-day practice Collaborating in applied health research | NIHR
What is your favourite quote and how does this relate to you as a mental health nurse?
“Because in the end, you won’t remember the time you spent working in the office or mowing your lawn. Climb that goddamn mountain” (Jack Kerouac) – kind of my philosophy towards work (although I do work in an office a lot!); but for me it means stick your neck out there – if you want to achieve something you can do it!
Have you been nominated for or won any awards?
In my undergrad I was nominated for the Eleanor Coulter award for commitment to client-centred care in mental health nursing, and award for consistent academic excellence.
I have won a poster competition at an NMHAP event presenting results of a service audit and won a place to present my poster at the NIHR Academy Members Conference on PPI work for my research project.
I have been awarded a research internship, place on an early career researcher programme, awarded a pre-doctoral and now doctoral clinical academic fellowship.
Supporting Information:
Publications
Using cognitive behaviour therapy techniques with people who hold delusional beliefs (rcni.com)
Use of individual formulation in mental health practice (rcni.com)
My Experience of EIT (and beyond) (rcpsych.ac.uk) (a workshop presentation I ran with a service user on her experience of therapy for the Royal College of Psychiatrists Early Intervention in Psychosis Network Forum)
Research studies
hEARD – JUICE (juicementalhealth.com)
ARC piece
“Once one door opens, ten more doors open,” Lauren Cox - NIHR