How I’ve done occupational therapy research: early days

I have been following #OTalk Twitter discussions about research and reflecting on my own experiences. This blog is the first in a short series, reflecting on my story of being an occupational therapist and a researcher, starting with the early days of my career.

It’s over thirty years since I approached the hospital library and asked for help, to find publications to shape my practice. At that time I worked in a hospital where teaching and research were evident in the constant presence and promotion of students, seminars, short courses, lectures and conferences. My request for time to find relevant publications, and read them, was welcomed and encouraged. Our workload was so great we could not hope to cover it: it was recognised that we did what we could, paying careful attention to what we were doing, so our practice could develop in a way that was consistent and informed. We constantly made difficult decisions about who we worked with, being such a scarce resource, which had to be justified. Many people missed out, because there was just not enough money to fund enough occupational therapy or people to fill vacant posts. Sounds familiar? It’s hard to give research priority but the institutional environment was helpful in this setting.

From 1987-1990, my research took a form which might be considered unconventional now, as it emerged from my developing practice rather than a protocol subject to institutional approvals (Bryant 1991). Ethical approval was not a formalised process, because it was assumed that ethical conduct was part of everyday practices. This is, of course, a questionable assumption, especially in the context of inpatient mental health services for older people, which in those days included continuing care with very low staffing levels in old Victorian wards (Brindle 2013). As a researcher, I gathered and worked with varied data, or information: from my own professional practice; the research and practice of others reported in articles and books; and continuing reflections on what I did and what I read. In joint work with colleagues, the ideas evolved and started to synthesise. We presented them at conferences and workshops, which provided further information about possible applications elsewhere. I believe the research was as collaborative as our professional practice was: we worked together to try and understand the challenges faced in the hospital, sharing our different perspectives. Some of the questions that drove the inquiry and innovation reflected my own interests, while others were being explored by my colleagues.

The hardest part was the effort to publish the findings (Bryant 1991). A number of things helped. I had moved to another job in another setting, miles away, so the research had finished from my perspective and I could reflect on it. I really liked writing.  I knew people who had published in other fields, who encouraged and guided me. A colleague lent me her word processor. I went on maternity leave which gave me some time to get the final version refined, with more advice and guidance from experienced people including the reviewers of the first draft. Five years into my career as an occupational therapist, I was beginning to recognise my expertise which was a good and a bad thing. I had to work very hard to get into the right headspace where I could ask for advice and actually use it. Sometimes that was, and still is, just too much effort. That is why I really like collaborative research: it’s easier to exchange ideas and thoughts. I have learned how to get a balance between exploring my own ideas and working closely with others to take research forward.

So I was more organised with the next research project (Bryant 1995). I’d been involved in innovative practice from 1990-3 in a community mental health team: we developed sessional day services in places like arts centres, cafes and leisure centres. We could not find relevant literature to inform what we were doing, as the closure of the large asylums and the emergence of day services was ongoing. Later, for my PhD, I was able to find out more research articles relating to day services (Bryant 2011), but at the time we improvised, exploring community resources. After I left the team I wanted to explore what we had done. I created a simple multi method design and asked my boss if I could work some additional hours to do the research (I was part time). With an outline proposal and local ethical approval, I was given the go ahead and was even assigned a psychology student to help me. I implemented my research design, gathered the data and by my next maternity leave was once again refining a final version of an article publishing the findings (Bryant 1995). This makes it sound easy but it wasn’t. I was acutely aware of the limitations of my design and therefore the findings. For years afterwards I expected people to tell me their criticisms but it never happened. I assumed, probably wrongly, that the project was therefore irrelevant and forgotten. But I had enjoyed doing it and resolved that next time I did research, I’d make sure I got my MSc for my efforts.

Brindle D (2013) Why whistleblowers’ voices must continue to be heard. The Guardian. Wednesday 27th November 2013 https://www.theguardian.com/society/2013/nov/27/whistleblower-voices-heard-nhs-elderly-care-graham-pink (accessed 7th April 2017)

Bryant W (1991) Creative groupwork and the elderly mentally ill: a development of sensory integration therapy. British Journal of Occupational Therapy, 54(5): 187-192.

Bryant W (1995) The Social Contact Group: an example of long term group work in community mental health. British Journal of Occupational Therapy, 58(5): 214-18.

Bryant W (2011) Mental health day services in the UK from 1946 to 1995: an “untidy set of services”. British Journal of Occupational Therapy, 74 (12) 554-561