Interview

The speaker stumbled into their research on psychosis while working in an animal research lab. They then worked as a full-time post-bac research assistant in an early psychosis program, where they fell in love with working with the clinical population. They decided to apply to graduate school and got their master's degree along the way to their PhD. They applied more broadly to schools in the US because there were more opportunities for research in psychosis. They faced challenges with the geography of their career path, but had highlights like working with amazing mentors and students. Their current projects focus on resilience and cognitive intervention in college students with psychosis. They hope to incorporate protective factors and promote recovery-oriented interventions in their future work. They do not have a private practice but provide clinical supervision. Okay, so mine is what was your journey like in graduate school and did you always want to pursue that particular thing or was there something else that you were looking to do? Yeah, that's a great question. So, the question of what was my journey like in graduate school. I feel like more of a general thing, like what was the process or like just the little ways of it. Yeah, okay. So, it might actually work better if I answer the second question first. So, how I got into psychosis research. Some people have this like really deep story of like how they sort of got involved in a research area. For me, it was really, I kind of stumbled into this work. It was through working in a lab as an undergrad, especially an animal research lab focused on the kind of work that Dr. Wasserman does, sort of comparative cognition and learning and memory in rats and pigeons. And through that work, just getting exposure to kind of preclinical models of different types of psychiatric conditions. You know, through going to department talks and things like that, just kind of broadening my horizons a little bit. And once I graduated from my undergrad program, a position opened up as a full-time post-bac research assistant working in an early psychosis program. So, I was learning how to do clinical interviews and cognitive testing and data entry and analysis and all that kind of stuff. And up to that point, my human subjects research experience was working in a depression lab and also a psychopathology lab, but nothing to do with psychosomia or psychosis. I went for the job interview, loved the people that I would be working with, had an amazing mentor, and just fell in love with working with the clinical population and just sort of went from there. So, through that work, it was a two-year post-bac position where I was working full-time. I was doing clinical interviews with young people who were experiencing early warning signs of psychosis and meeting with their families. There was also some work with young people who were having, who had remissive onset psychosis as a first step of the psychosis program. Just completely fell in love with the work. My mentor was amazing and had a ton of data sitting around that she needed people to work on and get some papers out. So, I had the opportunity to do some data analysis and academic writing and get some papers out and present at conferences. And from there, decided to apply to the graduate school. I saw that you had gotten your master's. Is that correct? Yes. How did you sort of make that decision? Was it more popular back then to look at your master's first? So, it's actually, it was a part of the PhD program. You get your master's along the way. So, similar to Tess, right? She got her master's after she finished her first year project. And there's sort of like certain coursework requirements and so on. And once you complete that, then you're eligible to then get your master's degree. And then you continue on towards the PhD. Is that like a specific path that Tess or you had to choose? That's a good question. I think it's going to vary across programs. But I think most programs will give you the option to, like, if you want to get your master's along the way, then you just sort of like complete some paperwork, essentially, and apply to get the degree. But the expectation with, like, PhD programs and clinical psych is that you're sort of going all the way through the program. It's not that it would be like a terminal master's. Gotcha. Gotcha. So, in terms of my journey to grad school, so I became really interested in schizophrenia and just sort of trying to understand what are the factors that contribute to the functioning and quality of life for people who are experiencing a psychiatric condition. And so I knew that I wanted to continue on with research and also, you know, develop clinical skills as well. So, you know, applying to PhD programs in clinical psych was sort of aligned with my training goals. And just sort of the way that it is, there's a ton of folks doing psych research in psychology departments. And so that kind of, like, limits the pool a little bit of different programs that you can apply to, which was actually kind of a nice thing. Because as Natalie, I'm sure you're learning, as you're applying now, it's like it's kind of endless, right? If you're interested in, like, anxiety or depression, there could be 30, 40 people, right? So I am from Canada. I did my undergrad at the University of Toronto. There are PhD programs in clinical psych back home in Canada. But there are a ton of folks working in psychosis, or at least back then. Now there's a few more. And so I knew I would need to apply more broadly. And so I applied to schools in the U.S. And had a really amazing mentor at Kent State, and I was with Nancy Daugherty. So the first time, so I applied for two cycles. The first cycle that I applied to, I wasn't, at that time, completely certain about my area of focus. And so it was a little bit more scattershot. And I was, at that time, I was mostly applying to schools in Canada as well. And so I'd gotten some interviews, but no sort of good matches with any of the mentors. And so the second time around, I feel like my application was much more focused. And it was really kind of thinking about the fit with the potential mentor. And, you know, because it's kind of like an apprenticeship model, it's a training. And it was really successful, the second application cycle. I got a bunch of interviews. I was also just more well-prepared, I think, for sort of entering into academia. So at that point, I kind of knew what the grind would be like. In grad school, I had a couple of publications under my belt that I presented at some conferences and so on. A little bit more solid foundation, I think, for applying. So you mentioned you're from Canada. So the first time you applied, it was more like kind of community-based. How did you make the decision, like, oh, I'm going to apply to the United States? I think what, you know, it was a long time ago. I don't remember exactly. But I think what it was was just having a clear vision of what my training goals and professional goals were and applying more broadly in terms of geography. But finding a really excellent fit with mentors is what sort of prompted that. Mine is what were your biggest challenges and biggest achievements? Biggest challenges? So sort of the geography associated with this career path. So, you know, moved to a different country for grad school and then moved across the continent basically for internship and postdoc, right? So I'm from the Toronto area, moved to Ohio for grad school for internship and postdoc. I moved to Los Angeles. And then from Los Angeles, I moved here. I'm a little closer to home now, but it's still kind of far. It's a 12-hour drive from where I was animated. So, yeah. I would say just the geography and the sort of being willing to accept that it's a little bit of a nomadic lifestyle early on in the training because you do need to sort of, especially with clinicals, the expectation is that you're going to have to move for internship and that you may go quite far away for your postdoc training and so on. So that was a challenge. Highlights has been a bunch. I would say I've had the opportunity to work with some really amazing mentors. That was a highlight. I think since coming here, working with students has been really fun. It's been really enriching. So that's a big highlight for me. It was really fun watching you guys do your poster presentations. But it's true. So some of your current projects, such as the Hawkeye Research Team here, seem to center around resilience in college students and more cognitive intervention. Could you elaborate on these projects and the impact you hope they'll have in the future? Yeah. So I think thinking about psychosis and schizophrenia, for a long time there's been a focus on identifying vulnerability factors, risk factors, and predictors of negative outcomes, trying to avert negative clinical outcomes, like hospitalizations or relapse of symptoms, trying to avert negative outcomes with regards to poor functioning or poor social relationships and so on. I think that was necessary for a long time, and it's gotten us so far. But an understudied area has been, number one, protective factors. So what are some of the factors that help someone maybe adapt to a challenge and predict positive outcomes? And also thinking about separation of these different types of outcomes, that somebody could have what may be a somewhat negative clinical outcome in that they may develop a severe mental illness, but they may thrive in other areas of their life and adapt successfully to that. So I think a lot of my more recent projects have been trying to incorporate thinking about protective factors and resilience. Well, I mean, I feel like you kind of dragged me into this. I don't know. It's like, do you have any plans or aspirations in the future that you specifically want to do? Good question. That's a really hard question. So aspirations. So I think there are some aspirations for thinking about the training and developing clinical science here at Iowa, so providing opportunities for trainees to learn recovery-oriented interventions for severe mental illness and sort of growing the services that are available in our community. So we've started that a little bit with offering like a specialty practicum in severe mental illness through our training program. So what I'd like to do is kind of grow and expand that and sort of make our program sort of a hub to attract new trainees. I have like an interesting question. What does your – because like you're a licensed clinical psychologist. So do you do any like therapy or like assessment on the fly? Or do you just do like objectives? Do you like just do PTSD? So I do not have a private practice. I am a clinical supervisor through our training clinic here. So we do assessments and interventions through the clinic. The students are trained clinicians, so they're administering the different measures or they're administering the interventions. And then the supervisors are sort of overseeing everything and providing training and guidance on that. So that's one piece. Another piece is I do some teaching through the Department of Psychiatry, getting psychiatry residents and social work interns at the medical college to learn about different types of interventions. So I provide some training in cognitive behavioral therapy for psychosis to those trainees. And then I sort of like kind of combine my research interests with clinical interests through the peer program. I provide assessments to young people who have concerns about changes in their mental health or their functioning. And we provide assessments through a research program that we were able to get them feedback about the assessment results and get them connected with resources that might be helpful for them. This is my last question. So what do you wish other people knew about like schizophrenia or mental disorders in general? I wish that people knew that there is a lot of variability in outcomes for people. I think that there's a lot of stigma associated with severe mental illness and people make assumptions about what the outcome is going to be like for a young person who's experiencing psychosis and what their people want, and I'd like to challenge that a little bit. So yeah, I think understanding that there is variability in outcomes and also that recovery is possible. I have two additional questions. In undergrad, why psychology? I actually started out as an undergrad. I wanted to go to medical school. I had this idea I was going to be like a forensic pathologist or something, and it turns out that I get really clunky around blood, and so I was not well suited for pre-med. So I took a lot of biology classes and got interested in zoology, and from there interested in animal behavior, and then from there got into psychology. So it was sort of like a roundabout way. So getting around to psychopathology, it took a while. For any students interested in pursuing this career, like getting a Ph.D. in clinical science, what's your general advice? General advice would be it's okay to take your time and to learn a little bit more about what's involved in a career in clinical science and to consider alternative pathways to the kind of career that you want as well. So I think just in my interactions with undergrads through teaching like a large intro class, I think that a lot of students think that if they want to provide psychotherapy services, that they need to get a Ph.D. in clinical psychology, and that's really not – if that's sort of their primary goal for their profession, that's not the only way to get there. So, you know, like learning about alternative pathways, different types of careers, I think is important. We're really lucky here at the university in that, you know, the Department of Social Work routinely puts on info sessions about their master's program and what career options look like. Here for the clinical science program, we have info weekends for prospective faculty as well, so you can learn a little bit more about what our program is all about and, you know, what it's like to be a graduate student in clinical science. But, yeah, I think just learning a little bit more about the different types of programs and the different types of career options that are available. I have like two more questions back to sort of research. Yeah. What challenges come specifically with doing schizophrenia research? Good question. I think, like, logistically, sometimes it can be challenging to work with clinical populations when you're not at a hospital. So even if your lab is in a hospital base, it can be a little challenging sometimes. Here we're really fortunate because, number one, this university has a really rich history in psychosis research. I haven't talked at length about Nancy Andreasen's program for your program. So the University of Iowa has made significant contributions to our understanding of schizophrenia. So there's this rich history of psychosis research that I was able to sort of tap into here when I started at my lab. And we have the medical college very nearby, and there's lots and lots of collaborations across departments, and it's truly encouraged. So that's made it feasible to do this type of work in a psychology department. All right. Looking ahead, Andrea kind of asked a question, but what is, like, one next big question or hypothesis that you hope to address in your research? You can pick one that you can answer right now, Anna. Well, I'm working on a grant proposal right now to try to drill down a little bit to better understand, you know, different types of information processing processes. So, you know, different ways that our brain processes information and how those processes might go awry in schizophrenia and how some of those processes might be relatively stable and might represent sort of the vulnerability factor for developing the illness in the first place. And other processes, these abnormalities might kind of wax and wane, right, depending on what's going on with the person clinically. And so I want to kind of drill down into those a little bit more. What I'm hoping is that we can identify biomarkers of these different processes and it will inform treatment targets. Hardest part about grad school? I say this to the grad students all the time. Grad school is, it's like a marathon and you're on a really, really long reinforcement schedule, right? So, you know, it's not a lot of cookies along the way. So I think making sure that you celebrate successes along the way is really important to sort of keep your motivation going. But it is a marathon. The research clinical psych program is typically you're spending five years on campus and then you're doing a one-year internship and then usually you need to do two years of postdoc research training. All of this before you're sort of eligible to get licensed at the end. So it's kind of a long haul. It comes at a time in people's lives where they kind of want to get on with their life, right, and settle down and so on. So it's just a lot of different tensions there to negotiate. Final question. If you could change one thing about sort of the path you took or the research you've done or anything at all, looking back, what would you change? To be honest, I've been really fortunate to have, I was able to identify really amazing mentors along the way. And yeah, I don't think I would change anything. From this? Yeah. I think that's all. Yeah. Okay. Okay. Okay. Hopefully you got something. Yeah. I know. I know.