Exploring clinical leadership within the clinical psychology career pathway

Chapter 1. The first chapter of this thesis is a systematic literature review to explore the role of personality in the gender differences found in leadership. PRISMA guidelines were adhered to in order to structure the search and selection of papers. A total of 14 papers were included as meeting the criteria for the review. The quality of the papers was assessed using The Standard Quality Assessment Criteria of Evaluating Primary Research from a Variety of Fields (Kmet, Lee, & Cook, 2004). Findings from this review showed a complex and multi-faceted picture and methodological problems within the field of leadership research made drawing any robust conclusions difficult. In general terms, Role Congruity Theory provided a helpful framework to compare results. Many of the included studies supported this theory, indicating that pressures from adhering to social expectations regarding masculine and feminine behaviours impact on gender differences seen within leadership emergence, leadership style, leadership self-efficacy and others' perception of leadership effectiveness. Moderating factors to the general trend of gender differences are discussed. Chapter 2. The second chapter of this thesis is an empirical paper exploring clinical leadership within the clinical psychology career pathway. Within the NHS, good quality care for patients and their families, and staff wellbeing, is underpinned by good quality clinical leadership. Clinical psychologists enter into their profession at a fairly senior level once qualified. The British Psychological Society (BPS) recognised the importance of developing good clinical leadership skills within clinical psychologists during their doctoral training and adapted the competencies required to meet this (BPS, 2014). A study conducted by Channer, Ononaiye, Williams and Mason (2018) explored the clinical leadership experiences of Trainee Clinical Psychologists and Qualified Clinical Psychologists during training and upon qualification. They used the Leadership Framework Self Assessment Tool (LFSAT; NHS Leadership Academy, 2012) to quantitatively measure self-reported leadership skills. Data for Channer and colleagues' paper were collected prior to the BPS changes being rolled out to doctoral training programmes. They found that, whilst Qualified Clinical Psychologists reported clinical leadership as a key element of their role, the doctoral training did not necessarily build and develop Trainee Clinical Psychologists leadership skills. The present study replicated elements of the Channer and colleagues' paper, with the additional inclusion of Assistant Psychologists, in order to explore whether changes in training (following the BPS inclusion of leadership competencies) have impacted on experiences of leadership within their roles. Further, the present study used qualitative questions in order to gain a richer understanding of participants' leadership experiences. A total sample of 202 participants across the clinical psychology career pathway were recruited. Quantitative aspects were explored using group comparison and correlational methods. Qualitative aspects were explored using thematic analysis from a social constructionist perspective. Findings indicated a varied picture in leadership skills development throughout the clinical psychology career pathway since the BPS (2014) changes. Limitations regarding the LFSAT measure were discussed. However, the qualitative results of the present study provided helpful insights into leadership experience and development in the profession. They also highlighted areas that need further improvements. Assistant Psychologists would like earlier opportunities to develop and engage in leadership. Trainee Clinical Psychologists would like teaching on leadership to come earlier in the programme and for this to be supported by opportunities to practice leadership skills during placements. Qualified Clinical Psychologists reported a need for increased funding for training and development once qualified and a need for good quality, psychologically informed, training in leadership in order to support their continued professional development in this area.