Shaping Psychologically Informed Community Mental Health Teams: A Grounded Theory of How Clinical Psychologists Influence Practice

This thesis explores how clinical psychologists grow psychological thinking within multidisciplinary teams (MDTs), offering both a novel contribution to the field and a synthesis of existing knowledge. It seeks to deepen understanding of how this process unfolds in practice, so that future efforts to embed psychological knowledge within teams can be better supported.
The first paper systematically reviews and critically examines existing research on how MDT members experience the indirect work carried out by clinical psychologists, such as consultation, supervision, reflective practice, and training. Drawing together insights from nine qualitative studies, it highlights that indirect work can strengthen team cohesion, build clinical understanding, and deepen empathy toward service users. It also identifies organisational barriers, such as limited time and resource constraints, that hinder the embedding of psychological approaches. Gaps in the evidence base are outlined, with a call for future research into the longer-term impact of indirect work, the inclusion of more diverse service contexts, and the exploration of wider systemic conditions. 
The second paper contributes original knowledge by exploring how clinical psychologists influence Community Mental Health Teams (CMHTs) to become more psychologically informed. Using a Critical Constructivist Grounded Theory (CCGT) approach, interviews with twelve clinical psychologists were analysed to develop a conceptual model of influence. Relational security emerged as central to the process, with influence found to be most effective when adapted to the emotional and developmental readiness of individuals, teams, and systems, working within their Zone of Proximal Development (ZPD). The study offers new insights into how influence unfolds relationally and adaptively, within the realities of systemic pressures and constraints.
The third paper presents the research in an accessible executive summary, sharing key findings and practical recommendations. It aims to help clinical psychologists, service managers, trainees, and policymakers recognise, understand, and strengthen the contributions clinical psychologists make within CMHTs.