Dr Carol Lee is a clinical scientist with expertise in how people cope and thrive through stressful circumstances. She has experience working in mixed methods research design, analysis, and consultation related to mental health, thriving, wellness, and behavior change. She's also a clinical advisor to Bravely.

You can learn more about Dr Lee and her work here.

Here, our CEO Melissa Ng spoke to her about her story, passions and areas of research within her work.

M: Thanks for agreeing to this interview with us! To start off, can you describe your research background and education in psychology?

C: "Of course! So I have a PhD in clinical psychology and have been conducting research for over a decade now. My research has predominantly focused on mechanisms of change for traumatic stress and anxiety-related disorders and their interventions, and I am formally trained in cognitive, behavioral, and acceptance-based therapies (e.g. DBT, CBT, ACT, PE, CPT).

Previously, I focused on understanding these mechanisms in adults more broadly, but have recently shifted to understanding these mechanisms in software developers. This sounds random, but software developers are so frequently overlooked, despite the world as we know it (including healthcare!) depending on code!"

M: How did you become interested in your particular area of specialization within psychology?

C: "There is a way we talk about therapy at the undergraduate level that is like “if your client experiences xyz, then use abc treatment.” But if you dive into the research, it’s so much more complicated than that.

Different interventions work for different people depending on the therapist match, cultural background, their processing style, how ready they are for change, and whole host of other variables.

A good therapist knows that and develops an evidence-based sense of clinical decision making that allows them to decide what and when to target something. And so for me, it’s just way more interesting and useful to understand what those targets are across therapy modalities, and are how and why they work to create change - hence my focus on what we call mechanisms of change."

M: How do you ensure the research you conduct is informed by principles of social justice?

C: "I love this question so much. First, the important thing to remember is that all science, across fields, is biased because the questions we ask and the ways we choose ask and answer them are inherently biased by who we are as scientists.

"There is no such thing as bias-free research."

In that vein, there’s also no such thing as culture-free research because we are all cultural beings and culture is in everything. So the most important thing is to be aware of that and asking yourself “what biases do I bring to the table?”, followed by “who can this research hurt and how? What can I do to mitigate that?”

Research has consequences. There are, of course, the more obvious examples like the research done on conversion therapy, but there are more subtle ones too. For example, people still put out research with titles that essentially say “high rates of crime in urban neighborhoods with high rates of poverty/ immigration/ people of color/ whatever,” which leads to harmful stereotypes about minoritized and marginalized folx being violent.

All of this is, of course, ridiculous when you consider the common factor of population density - that is, if you have more people crammed into a space, of course there is a higher chance of crime compared to areas with few people who are all very spread apart. So a more accurate title would be “If there are many people stuck together, there is a higher likelihood of crime compared to a an area where people have to travel to see each other.”

I like to think that these authors aren’t doing this on purpose - they’re just simply failing to think about how their research can hurt people and feed into biases.

I could talk about this all day, but I also just want to mention that there are ways our methods and methodologies can create bias, inaccurately portray people, and yield biased findings. This is from the process of recruitment (who are you recruiting and how are you doing it), the measure you choose (many measures are biased - for example, the original SIAS, a measure of social anxiety has been shown to be heteronormative; the MMPI has been shown to be racially biased and conforms to gender norms in its scoring), the way you measure (who do you exclude by only using English language self-report measures, for example), your processes (who is interviewing and interacting with participants and how? Are the processes culturally inconsistent with certain groups? Do the materials exclude differently abled folx? How can you amplify instead of ignoring minoritized voices?), and your analysis (if you are comparing groups, who is the “control” group and what assumptions are you making about who/what is “normal?”)"

M: Brilliant answer, the tech and business world has seen more important discussions about inclusion and diversity, but it's vital that these conversations are had in the field of research. So, next question: What is your typical day like? Would you like to walk us through it?

C: "I am most definitely a morning person, so I wake up at 6, walk the dogs, make coffee and breakfast, then get to work! I usually like doing the higher cognitive load work in the morning - so things like writing, research design, and analysis, since that’s when I feel the most clear, creative, and energized. It also works out great for me because I’m on a different time zone than most of my team (I’m 2-3 hours ahead), so paired with my early start I get a good chunk of un-interrupted focus time, which is really important to me.

After that, I’ll usually eat lunch and take meetings, which is helpful for me in forcing myself to end my focus time. I have ADHD so that focus time can get intense!

And then finally, I end the day by getting “ops” stuff done - things like documenting progress, checking emails/slack, which I find to be a nice way to wrap up the work day and set myself up for the next day. Then I’ll take the dogs on a nice long walk, then spend the evening doing whatever I feel like. Usually it’s running, climbing, reading, or knitting, followed by dinner, one last walk for the pups, then bedtime!"

M: Considering you have a background in designing evidence-based workshops, what are the major factors you keep in mind while developing and implementing them?

C: "Something I care very very deeply about is making science and evidence approachable because there is a lot of awesome science out there that is also really inaccessible to the people it applies to - whether it’s because it hides behind a lot of jargon, isn’t publicly available or known, or doesn’t present itself as easily applied.

"There is a lot of awesome science out there that is also really inaccessible to the people it applies to"

So a big thing for me is making sure that we talk about the science in a very accessible way. That means keeping the language and tone real and casual and introducing activities that people can implement in an engaging and realistic way.

I think this realistic piece is particularly important. I really really hate when people only give takeaways that involve a lot of time and effort because it’s just so unrealistic in our daily lives. Sometimes you have hours, and sometimes you have a minute. So giving a range of time and effort commitment takeaways is key for me.

And then finally, having people come up with their own is important because the best first step they can take is the one they are willing and able to take."

M: Amidst it all, how do you take care of your own mental health? Any advice you would like to give us for taking care of our mental health?

C: "I think an important mechanism I work to incorporate into my daily life is mindfulness.

And by this, I don’t mean that I am doing a formal mindfulness exercise every hour or something like that.

I really mean that I’ve worked hard to habitually check in with myself about my internal experiences, without judging them, to see what I need. And that may be spending time outdoors climbing, a good book and a quiet cup of tea, getting errands done, or digging into a complex research problem or piece of code - all things I know fulfill me in different ways, because I’ve mindfully attended to how they make me feel."

M: I love that! What advice would you give to early-career researchers in the field of clinical psychology and research?

C: "It’s funny - as clinical scientists and practitioners, we know that it’s important to take a values and process-based (vs. an outcome-based) approach to mental health, but we sometimes don’t think to apply it to our own careers.

And I think that’s a mistake, because focusing on outcomes creates a narrow path to a single objective that doesn’t allow us to flexibly adapt to changing interests, needs, and circumstances. But focusing on what processes fulfill us allows us to grow, change, and find opportunities in ways we may not have ever expected. So I tell people to think deeply about what processes interest them the most.

For example, I deeply value creating knowledge that can be applied to real-world settings, and one process I love is defining and measuring a messy construct in a multidisciplinary way.

For others, it might be the process of actually running participants, or the moment of case conceptualization, where you take in all of the information you have about a client to create a narrative of their presenting problem.

Whatever that is, once you know what processes you really love, you can more flexibly find ways to pursue paths that allow you to engage in them."

M: What is your vision for the future of clinical research and how do you see your work contributing to this future?

C: "You know, it’s really interesting to me that there is this surge in chatter about mental health and technology, as if the two used to be mutually exclusive or as if it will replace in-person care.

In reality, technology has been an integral part of health care for decades. We use videos for teaching, record sessions for training, utilize complex digital records systems for notes and billing, use computer-based programs that give assessments and/or risk alerts, use video conferencing to deliver care to folks who are unable to get care in person… I mean the list could go on.

We’ve even used mobile devices as a part of therapy for years - whether that was using them to schedule reminders, having clients jot down notes to themselves, playing a mindfulness meditation off a phone, etc. Really the only “new” thing is delivering care via mobile devices - which at this point, are essentially small pocket computers.

Do we still use things like pen and paper? Yes! Do we still see folks in person? Yes! So I don’t think about tech as always “replacing” things, but as being extremely useful tools that expand clinicians’ ability to disseminate care to folks who may not have had access before. That isn’t to say we shouldn’t empirically validate the use of new tech in effectively delivering care, of course.

As with any change or innovation (tech or not), we should always empirically validate its effectiveness and efficacy. So I see future research really diving into that. For me personally, I see my role as a clinical scientist working in tech as really bringing the two fields together to benefit both clinicians and the people creating that tech.

Something I’ve been really passionate about is the people behind all the tech that clinicians rely on. Software developers are facing their own mental health crisis and have essentially been the invisible supporters of clinicians so my current and future work really works to bring awareness of their experiences to the field so that we can better support them in supporting us."

M: Dr Lee, thank you so much for a thoughtful and illuminating interview. I've learned a lot and I hope that we start seeing more conversations around biases in research, and self-care in the field.