What role can the arts play in recovery? And how can realist approaches help us understand the deeper processes behind healing, identity, and lived experience?

In this creative and thought-provoking conversation, Alejandro is joined by Dr Louisa Peters, a researcher who brings together psychology, community arts, and realist thinking. Louisa’s work draws on her background in musicology, community arts practice, and her PhD research exploring recovery in serious mental illness.

Louisa shares how realist approaches allowed her to movebeyond asking “does it work?” to exploring how and why arts-based interventions support recovery. She highlights how community arts create safe, trusting spaces that promote coping, acceptance, and positive emotional engagement, while also acknowledging the complexity and non-linear nature of recovery.

Drawing on her research, Louisa discusses innovative methods such as arts elicitation interviews, poetry, and visual approaches, showing how creative expression can uncover mechanisms that are difficult to articulate. She also reflects on navigating complexity in realist research through mapping,causal loop diagrams, and embracing a flexible, adaptive approach.

Whether you’re a researcher, clinician, or interested in theintersection of arts and health, this episode offers rich insights into embracing complexity, valuing lived experience, and using realist thinking to explore meaningful change.

What makes physiotherapy such a complex, context-dependent practice, and how can realist approaches help us better understand what works, for whom, and why?

In this insightful and grounded conversation, Alejandro isjoined by Dr Leah Morris, a physiotherapist, senior lecturer, and realist researcher working at the University of the West of England. Leah’s work spans academia, teaching and supporting realist research across healthcare settings.

Leah shares her journey into realist evaluation, reflectingon how it helped her make sense of complex roles such as first contact physiotherapy and why realist thinking aligns so naturally with physiotherapy’s core principles of individualised care and clinical reasoning. Drawing on projects like FREEHAB and her work in supporting colleagues, she highlights how realist approaches can uncover the mechanisms behind tailored interventions and explain variation in outcomes across contexts.

From applying realist thinking in non-realist projects to navigating methodological challenges, limited guidance, and misconceptions about “realist light,” Leah offers practical insights grounded in both clinical and research experience.

Whether you’re a clinician, researcher, or educator, thisepisode provides valuable lessons on embracing complexity and applying realist approaches to physiotherapy and beyond.

What makes medication management in older people with dementia such a complex challenge, and how can realist approaches help us make sense of it?

Alejandro is joined by Professor Ian Maidment, whose career spans over two decades in pharmacy practice, mental health, and dementia care, alongside leading NIHR-funded realist research.

Ian shares his journey from NHS pharmacist to realist researcher, explaining how he discovered realist evaluation and why it became essential for unpacking the complexity of medication safety in older populations. Drawing on flagship projects like MEMORABLE, he reflects on what realist synthesis and evaluation reveal about hidden burdens, particularly for family carers, and why understanding “what works, for whom, and why” is critical in this field.

From the power of realist interviews and stakeholder engagement to navigating limited literature and co-producing meaningful findings, Ian offers practical insights grounded in both clinical experience and methodological expertise.

Whether you’re a clinician, researcher, or policymaker, thisepisode provides valuable lessons on embracing complexity, translating findings into practice, and using realist approaches to improve care for vulnerable populations.

What makes realist evaluation so valuable in global health, and what does it take to apply it meaningfully?

In this rich and reflective conversation, Alejandro is joined by Assistant Professor Brynne Gilmore, whose career has taken her from community health programmes in East Africa to leading realist research and mentoring PhD students at University College Dublin.

Brynne shares how she first discovered realist approaches, why they’re so suited to the complexity of global health systems, and what it really means to work ethically, relationally, and with cultural awareness in contexts far from where the approach was born.

From navigating power dynamics and co-producing knowledge to adapting interviews and focus groups so they resonate locally, Brynne offers practical insights grounded in years of fieldwork and methodological reflection.

Whether you’re stepping into global health evaluation for the first time, refining your approach to stakeholder engagement, or looking for ways to close the capacity gap in realist research worldwide, this episode will give you both inspiration and practical tools.

In this episode of The Realist Lens, Alejandro is joined by Dr Robert Sandler, medical doctor and recent PhD graduate from the University of Sheffield, to explore how realist evaluation can help make sense of major changes in healthcare.

Rob shares his doctoral research examining the impact of ETI for people with cystic fibrosis in the UK, a treatment that has rapidly transformed health outcomes and, in turn, reshaped clinical care, patient experiences, and treatment decision-making. The conversation explores what it means to conduct realist research in a fast-moving and uncertain context. Rob reflects on how the introduction of ETI, alongside the wider disruption of COVID-19 and the shift toward virtual care, created a dynamic environment that required continual theory development and adaptation.

Rob discusses how he developed and refined programme theory using multiple methods, including multi-centre interviews with clinicians, targeted single-site interviews, a national patient survey, focus groups, and secondary quantitative analysis. He explains how realist logic guided the sequencing of these methods and how each contributed to theory refinement. The episode also explores keyfindings from the study, including tensions between clinicians and patients in how health and treatment decisions are understood, what Rob describes as “epistemological dissonance.” He reflects on the role of habit formation intreatment adherence, the challenges of maintaining intervention fidelity in changing contexts, and the importance of reflexivity as a clinician-researcher.

Rob concludes by sharing practical advice for clinicians and researchers working with realist approaches, including the value of formal training, building supportive networks, and staying grounded in real-world complexity.

This episode will be valuable for anyone conducting realist evaluation, working with mixed methods, researching complex interventions, or navigating research in rapidly changing healthcare environments.

In this episode of The Realist Lens, Alejandro is joined by Michele Wood, art psychotherapist in palliative care and part-time PhD researcher at Lancaster University, to explore what it really means to undertake a realist PhD alongside work, life, and personal commitments.

Michele shares her journey into doctoral research after more than 30 years in clinical practice, where her interest in the role of technology in palliative care, particularly following the rapid changes during COVID-19, led her to investigate how and why new practices are adopted (or resisted) in complex healthcare settings.

The conversation focuses on the realities of doing realist research part-time, including managing competing demands, navigating the iterative nature of realist thinking, and sustaining momentum over what Michele describes as a marathon rather than a sprint. She reflects candidly on the personal and professional contexts that shaped her journey, and how realist philosophy helped her make sense of complexity across different levels of experience.

Michele also shares practical strategies that have supported her along the way, including reflective journaling, memoing, “deep work” practices, and what she calls leaving “pebbles through the forest” to stay connected to evolving ideas.

This is an episode for anyone considering or undertaking a part-time PhD, working with realist approaches in practice-based settings, or trying to balance rigorous research with the realities of everyday life.

In this episode of The Realist Lens, Alejandro is joined by Dr Gareth Wiltshire, sociologist and critical realist scholar at Loughborough University, to unpack realist thematic analysis, a method designed to move qualitative analysis beyondsurface-level patterns and into causal explanation.

Gareth shares his intellectual journey into critical realism and explains how realist thematic analysis emerged as a response to longstanding binaries in qualitative research, between positivist and interpretivist approaches, and between descriptive coding and explanatory theory-building.

The conversation explores how experiential, inferential, and dispositional themes work together to support generative causal explanation, helping researchers move from what participants say, to what can be inferred, and ultimately to what must exist for those experiences to occur.

Drawing on examples from sport, volunteering, and qualitative interviewing, Gareth explains how realist thematic analysis supports methodological coherence, interpretive rigour, and transparency while remaining flexible and usable for applied researchers.

This episode is essential listening for anyone grappling with qualitative analysis in realist, critical realist, or complexity informed research particularly PhD students and early career researchers navigating how to analyse data without losing ontological depth.

In this episode of The Realist Lens, Alejandro is joined by Sebastian Lemire, evaluator and methodological pluralist, to explore one of the most contested questions in contemporary realist inquiry: Is the realist trial a methodological impossibility, or a rare but viable unicorn?

Drawing on his extensive experience in theory-based evaluation and a review of published realist trials, Sebastian shares his pragmatic view on the long-standing debate between realist evaluation and randomised controlled trials (RCTs). Rather than taking sides in ontological disputes, Sebastian invites listeners to focus on what different forms of evidence can do and how they can be meaningfully integrated.

The conversation traces Sebastian’s journey from theory driven evaluation into realist-informed work and unpacks how the debate around realist trials reflects deeper divides about causation, evidence, and credibility in evaluation. Together, Alejandro and Sebastian examine why the topic remains so divisive, what distinguishes the rare “unicorn” realist trials, and how integration can occur at the level of evidence and analysis rather than philosophical purity.

This episode does not seek to close the debate. Instead, it keeps the conversation open, offering a thoughtful, empirically grounded perspective on how evaluators might navigate complexity, pragmatism, and explanation without becoming trapped by methodological dogma.

In this episode of The Realist Lens, Alejandro is joined by Dr Kerryn O’Rourke, public health researcher, realist evaluator, and Co-Lead of the Realist Research, Evaluation and Learning Initiative at Charles Darwin University, to explore what it really means to do realist work across cultures ethically, methodologically, and epistemologically.

Kerryn shares her journey from nursing and frontline public health practice into realist research, shaped by a long-standing commitment to health equity and social justice. Drawing on her PhD and subsequent evaluation work, she reflects on how realist methodology offered a way to make sense of complex social programmes, particularly those involving vulnerability, power, language, and cultural difference.

The conversation centres on cross-cultural realist interviewing: what happens when theory-testing conversations move across languages, worldviews, and livedrealities. Kerryn unpacks how bicultural collaboration became central to her work, not as a technical add-on, but as a core part of realist inquiry and knowledge co-creation.

Kerryn also shares practical lessons from evaluating maternity and social support programmes with culturally diverse communities, as well as her current work with First Nations communities in Australia.

This is an episode for anyone conducting realist evaluation or research in diverse, multilingual, or inequitable contexts, and for those grappling with how to remain philosophically coherent while working ethically across difference.

In this episode, Alejandro is joined by Dr Pragati Hebbar, dentist, public health researcher, realist evaluator, and Assistant Director at the Institute of Public Health, Bangalore to explore what it looks like to transition from clinical practice into policy, embrace complexity, and use realist approaches to make sense of real-world implementation.

Pragati walks us through the journey that led her from treating precancer cases in dentistry to questioning the systemic forces shaping tobacco use in India — andeventually into realist research. She shares how realist evaluation helped her unpack why one national tobacco control programme produces vastly different outcomes across states, and how she combined quantitative proxies, qualitative interviews, and field observations to build and refine programme theories.

We talk openly about unlearning linear clinical thinking, navigating contextual variation, realist interviewing, and the challenges of matching policymaker expectations with the nuanced findings that realism often provides. Pragati also highlights the importance of accessible training, communities of practice, and the growing momentum for realist work across India and the Global South.