Healthily Psyched at Guy's

King's College London Health Psychology blog

Modifying measures: How to get the most out of your questionnaires for your PhD. An example using the Revised Illness Perception Questionnaire (IPQ-R).

A key stage to writing your PhD proposal, after coming up with your main research questions and hypotheses, is deciding how exactly you’re going to measure these factors. It may seem like the obvious choice is to pick the most widely used, validated questionnaire, but it’s important to spend some time considering whether that questionnaire will be relevant to your population, able to capture the unique experiences of your patient-group, and whether it fits in with the wider theory. Using a pre-validated generic questionnaire can save time but may lead to important idiosyncratic experiences of your target population being missed.

In this article, we briefly describe how we modified the Revised Illness Perception Questionnaire (IPQ-R; Moss-Morris et al., 2002) in two different patient populations: 1) patients with atrial fibrillation (AF), an irregular heart rhythm predisposing patients to a five-fold increased risk of stroke (Taylor, O’Neill, Hughes & Moss-Morris, 2017) and breast-cancer survivors (BCS; Moon, Moss-Morris, Hunter & Hughes, 2017), who have completed active treatment for breast cancer but who may require continued therapy and monitoring.

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A brief background of the questionnaire

The IPQ-R measures patients’ cognitive representations of illness (illness representations) which are developed based on abstract (disease labels) and concrete (symptom-based) information sources. Illness representations consist of a number of different components including: identity (symptoms association with the illness), causes, consequences, timeline (acute, chronic or cyclic), controllability (treatment control/cure and personal control of illness) and illness coherence (whether the illness makes sense) (Moss-Morris et al., 2002). Emotional representations about illness (e.g. fear) are processed alongside these cognitive representations (Moss-Morris et al., 2002). Cognitive and emotional representations of illness can be understood within the context of the Common Sense Model (CSM; Leventhal, Meyer & Nerenz, 1980) which proposes that patients’ cognitive and emotional representations of illness guide coping behaviours, quality of life (QoL) and clinical outcomes, as supported by a wide range of research (Hagger, Koch, Chatzisarantis & Orbell, 2017). Whilst the scale was developed as a generic measure to assess illness representations across conditions, the authors recommend that it is modified to suit the specific needs of each illness population (Moss-Morris et al., 2002).

Step 1: Qualitative interviews

To understand the target population, we carried out interviews with our patient groups. Questions specifically related to components of the IPQ-R, outlined above. For instance, the following question related to the personal control component; ‘Is there anything you can do to control/prevent the risk of recurrence?’. Transcripts were analysed using deductive thematic analysis and key themes were identified which informed the modification of the IPQ-R.

In the AF study 30 participants were interviewed with a range of demographic characteristics including different treatment types and pre/post treatment status.  Key themes included unpredictability of AF and a struggle to gain control of symptoms. Patients reported engaging in targeted behaviours such as avoidance to try to control symptoms. Patients also believed certain events or behaviours could trigger AF symptoms. Patients expressed different concerns relating to treatment-type. (For separate qualitative study see Taylor, O’Neill, Hughes, Carroll & Moss-Morris, 2017).

In BCS, 18 women prescribed tamoxifen were interviewed about their perceptions of cancer and suvivorship. A key theme was that the majority of patients did not identify as currently having breast cancer. Instead, when asked about control, consequences and causes, patients tended to discuss their risk of recurrence. Patients attributed symptoms to tamoxifen, an adjuvant treatment, rather than to their breast cancer. Specific causes of recurrence and symptoms were also elicited during the interviews.

Step 2: Modification of questionnaire

Interviews led to questionnaire modification through 1) retention of items, 2) minor revisions 3) development of new items.

Examples of minor revisions included wording changes such as replacing ‘my illness’ with ‘my AF/BCS’ and inclusion of population-specific symptoms onto the identity scale. For instance, in AF patients this included items such as heart palpitations and in BCS this included items such as hot flushes and night sweats.

Development of new items in AF patients related to the unpredictability theme. Three new items related to personal control behaviours (slowing down and avoidance): ‘Avoiding certain activities will control my AF’, ‘Resting will prevent me from having symptoms’, ‘By doing less and slowing down I can control whether I have AF symptoms’. In addition, AF patients seldom mentioned the original cause of AF but reported triggering AF symptoms instead. This led to changing the causes scale into a triggers scale to reflect factors which patients believed triggered AF. Due to different treatments, the treatment control component was re-worded to relate to pharmacological (antiarrhythmic and anticoagulant) and procedural (cardioversion, catheter ablation and AV-node ablation) treatments.

The modification of items in BCS focussed mainly on replacing references to ‘my breast cancer’ with ‘risk of recurrence’. For example, treatment control items were modified to assess the extent to which patients felt their treatment could reduce their risk of recurrence. The timeline scales were amended to reflect the fact that patients did not have symptoms which come and go, and instead are at increased risk of a recurrence. The identity scale was modified to identify symptoms attributed to tamoxifen as well as breast cancer.

Step 3: Think-aloud

Think aloud techniques enable the researcher to establish whether items on the questionnaire are interpreted as intended (i.e. face validity). In our studies, a small subset of patients were given the modified questionnaire and asked to read each item aloud during telephone interviews and to verbalise their thought process on how they would answer questions (Ericsson & Simon, 1998).

Changes were made in both studies to improve the clarity of questions. For instance, in BCS items were revised to improve applicability of questions to all participants. Some items were deleted where possible to reduce repetitiveness. In AF patients, some items were expanded upon to provide further context and improve interpretation.

Step 4: Factor analysis

Confirmatory factor analysis (CFA) is used when testing a hypothesised model and to ensure the original factor structure is still relevant for the modified questionnaire. Exploratory factor analysis (EFA) may be used when more significant changes have been made to the questionnaire and when the factor-structure is not pre-specified. Both analyses were used in Moon et al. (2017) and Taylor et al. (2017).

In both studies a CFA was conducted in MPlus (version 7) on the main scale of the IPQ-R (i.e. timeline (chronic/cyclic), consequences, control (personal and treatment), illness coherence, emotional representations). Items were specified to load on these hypothesised components using syntax to test model fit. It is recommended that CFA is run with at least 200 participants (Brown, 2015). While there are various methods of assessing model fit, both studies used Comparative Fit Index (CFI), Tucker Lewis Index (TLI) and Root Mean Square Error of Approximation (RMSEA), as recommended by Jackson, Gillaspy & Purc-Stephenson (2009). RMSEA values of less than 0.08 indicate reasonable fit and CFI/TLI values of greater than 0.95 suggest acceptable model fit (Hu & Bentler, 1999). For further useful instructions on conducting CFA see Brown (2014).

EFA was conducted on the causal attribution scale in both studies, as recommended by Moss-Morris et al. (2002) and because substantial changes were made to both this scale in both studies. In AF patients, Taylor et al (2017) conducted the EFA in SPSS (V22) using maximum-likelihood extraction and oblique rotation as factors were expected to correlate. For a useful paper on conducting EFA in SPSS see Yong & Pearce (2013). In BCS, Moon et al. (2017) used SPSS with R-menu for ordinal factor analysis based on polychoric correlations, which has shown some benefits over using SPSS alone (Basto & Pereira, 2012). Preliminary interpretation of the data should examine any ceiling effects, which can be tested by examining/removing item frequencies in which >80% of participants disagreed with any specified items. You should also examine whether there is a patterned relationship amongst variables to see if any items should initially be removed. Kaiser-Meyer-Olkin Measure (KMO) of >0.50 will also indicate that the data is suitable for an EFA. The number of factors to be extracted are indicated by using Kaiser’s criterion (eigenvalues of 1.0 cut-off), visual inspection of scree plots or parallel analysis. Items which do not load onto any factors or cross-load onto multiple factors can be removed. Factors should be labelled based on the items contained. For example, in the EFA for AF patients, a factor was labelled as ‘emotional triggers’ which contained items related to stress, mental attitude and emotional state.

Step 5: Testing the psychometric properties of the modified questionnaire

Internal reliability measures how well a set of items measure a particular concept. High internal reliability suggests that all items are measuring the same concept. Cronbach’s alpha can be examined using SPSS. Acceptable alpha values range from 0.70 to 0.95, with 0.95 indicating excellent reliability, (Tavakol & Dennick, 2011) and values higher than this indicating redundancy across items

Test-retest validity examines whether patients’ responses are consistent over time, and the stability of the questionnaire. Participants were asked to complete the questionnaire at baseline and at two-weeks. Intra-class correlations (ICC) can vary between 0 and 1.0 whereby 1 indicates perfect reliability. To examine any potential outliers, Bland-Altman plots can be used (Bland & Altman, 1986).

Construct validity examines the extent to which a test measures what it claims to be measuring, and can be tested by looking at the relationships between the subscales of the modified questionnaire and other theoretically-related questionnaires. Correlations range from 0 to 1.0, with scores closer to 1.0 indicating high correlation.

In the AF study, the modified IPQ-R was examined with a measure of treatment beliefs; the Beliefs about Medicines Questionnaire (BMQ, Horne, Weinman & Hankin, 1999), and an AF-specific QoL measure (AFEQT; Spertus et al., 2010). The BCS study examined the modified IPQ-R with the BMQ and Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983).

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This blog post by Elaina Taylor and Zoe Moon has outlined how we modified and validated the IPQ-R specific to the patient populations we are studying. If you have any questions, please feel free to get in contact with us via the Healthily Psyched blog page. You can also check out the papers that we’ve written on this topic which are linked up to our profiles. In the meantime, we hope we’ve left you healthily psyched for more.

 

References

Basto, M., & Pereira, J. (2012). An SPSS R-menu for ordinal factor analysis. Journal of Statistical Software, 46, 1–29. https://doi.org/10.18637/jss.v046.i04

Bland, J.M., & Altman, D. G. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, 327(8476), 307-310. https://doi.org/10.1016/S0140-6736(86)90837-8

Brown, T.A. (2014). Confirmatory factor analysis for applied research. New York: Guilford Publications.

Ericsson, K. A., & Simon, H. A. (1998). How to study thinking aloud in everyday life: Contrasting think-aloud protocols with descriptions and explanations of thinking. Mind, Culture, and Activity, 5, 178-186. https://doi.org/10.1207/s15327884mca0503_3

Hu, L.T, & Bentler, P.M. (1999). Cut-off criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modelling: A Multidisciplinary Journal, 6(1), 1-55. https://doi.org/10.1080/10705519909540118

Hagger, S., Koch, S., Chatzisarantis, N. L. D., & Orbell, S. (2017). The common-sense model of self-regulation: Meta-analysis and test of a process model. Psychological Bulletin. https://doi.org/10.1037/bul0000118

Horne, R., Weinman, J., & Hankin, M. (1999). The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychology and Health, 14, 1-24. https://doi.org/10.1080/08870449908407311.

Jackson, D.L., Gillaspy, J.A., & Purc-Stephenson, R. (2009). Reporting practices in confirmatory factor analysis: an overview and some recommendations. Psychological Methods, 14(1), 6-23. https://doi.org/10.1037/a0014694

Leventhal, H., Meyer, D., & Nerenz, D. (1980). The common sense representation of illness danger. Contributions to Medical Psychology, 2, 7–30.

Moon, Z., Moss-Morris, R., Hunter, M.S., & Hughes, L. D. (2017). Measuring illness representations in breast cancer survivors (BCS) prescribed tamoxifen: Modification and validation of the Revised Illness Perceptions Questionnaire (IPQ-BCS). Psychology & Health, 1, 1-20. https://doi.org/10.1080/08870446.2016.1275629

Moss-Morris, R., Weinman, J., Petrie, K., Horne, R., Cameron, L., & Buick, D. (2002). The revised illness perception questionnaire (IPQ-R). Psychology and Health, 17(1), 1-16. https://doi.org/10.1080/08870440290001494

Spertus, J., Dorian, P., Bubien, R., Lewis, S., Godejohn, D., Reynolds. M. R., …& Burk, C. (2010). Development and validation of the atrial fibrillation effect on quality-of-life (AFEQT) questionnaire in patients with atrial fibrillation. Circulation: Arrhythmia and Electrophysiology, 10(5),15-25. https://doi.org/10.1161/CIRCEP.110.958033

Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s alpha. International Journal of Medical Education, 2, 53-55. https://doi.org/10.5116/ijme.4dfb.8dfd

Taylor, E. C., O’Neill, M., Hughes, L., & Moss-Morris, R. (2017). An illness-specific version of the Revised Illness Perception Questionnaire in patients with atrial fibrillation (AF-IPQ-R): Unpacking beliefs about treatment control, personal control and symptom triggers. Psychology and Health, 32, 1-19. http://dx.doi.org/10.1080/08870446.2017.1373113

Taylor, E. C., O’Neill, M., Hughes, L. D., Carroll, S., & Moss-Morris, R. (2017). ‘It’s like a frog leaping about in your chest': Illness and treatment perceptions of patients with persistent atrial fibrillation. British Journal of Health Psychology, 22, 1-19. https://doi.org/10.1111/bjhp.12267

Yong, A. G., & Pearce, S. (2013). A beginner’s guide to factor analysis: Focusing on exploratory factor analysis. Tutorials in Quantitative Methods for Psychology, 9(2), 79-94. https://doi.org/10.20982/tqmp.09.2.p079

Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

 

Early Career Paths into Health Psychology: Introducing the Healthily Psyched at Guy’s team

King’s College London Health Psychology Section in Guy’s Hospital is home to a number of PhD students, early career postdocs and trainees working in the field of health psychology. All of us share the research interest of working with individuals with long-term conditions, yet there is a lot of diversity in the particular areas in which we work. For our first post and the launch of our new Healthily Psyched at Guy’s blog, we thought it would be of interest to other early career researchers, trainees, clinicians and students to hear more about the different areas in which we work and the different entry pathways we have taken into a career in health psychology.

The majority of the Healthily Psyched team have completed a Masters in Health Psychology, which constitutes the Stage I part of training to become a health psychologist. When choosing a Masters programme in Health Psychology, you should be sure that the course is accredited by the British Psychological Society to constitute Stage I training. In order to become a qualified health psychologist you need to complete further training to constitute Stage II. There are different ways you can do this. Some universities run Professional Doctorates in health psychology, which grant you accreditation as a health psychologist and make you eligible for Health and Care Professional Council (HCPC) accreditation. You may also choose the British Psychological Society independent route, which is known as the Stage II Qualification in Health Psychology. We will provide subsequent posts about the alternative routes with more details on each. Individuals may also work in the field of health psychology without applying for accreditation as a health psychologist. Amongst us we have a physiotherapist, a clinical psychology trainee, an IAPT trained postdoc and PhD candidates and postdocs who are currently not planning on completing Stage II training.

Below we have collated a brief introduction to the Healthily Psyched team and the different areas of health psychology they have chosen to work in. You can find out more about the team here.

Federica Picarello- Full time PhD candidate developing and evaluating a biopsychosocial model of fatigue in End-Stage Kidney Disease.

Elaina Taylor- Part time PhD candidate examining illness and treatment beliefs in patients with persistent atrial fibrillation. Lecturer in Psychology at the University of Suffolk.

Katrin Hulme- Professional Doctorate in Health Psychology and researcher on fatigue.

Zoe Moon- Postdoctoral researcher on Breast Cancer Now grant.

Jo Hudson- Postdoctoral clinical health researcher.

David Herdman- Physiotherapist and part time PhD candidate developing an integrated rehabilitation programme for persistent dizziness.

Alicia Hughes- Postdoctoral clinical health researcher and Stage II trainee health psychologist.

Sula Windgassen- Part time PhD candidate exploring cognitive and behavioural factors in irritable bowel syndrome (IBS), part time researcher in IBS and Stage II trainee health psychologist.

Alice Sibelli- Part time PhD candidate studying the role of emotional factors in irritable bowel syndrome (IBS). Researcher in IBS and inflammatory bowel disease.

Pippa Davie- Full time PhD student investigating factors that contribute to successful breastfeeding and infant feeding practices among women who deliver large-for-gestational-age (LGA) infants.

Louise Sweeney- Full time PhD student investigating chronic pain in inflammatory bowel disease.

Susan Carroll- Full time PhD candidate and trainee health psychologist developing a biopsychosocial model and self-management treatment for fatigue in paediatric multiple sclerosis.

 

Federica Picarello

My background is purely in Psychology, having completed a Psychology BSc and a Health Psychology MSc. The Health Psychology module in the BSc sparked my interest in the role that psychology can play in physical health and that it is not purely confined to mental health. With the growing life expectancy, there is an increasing number of people who live with long-term physical conditions and psychological support is invaluable, yet to date this has been often overlooked and a stark separation persists between physical and mental health. This is both in the eyes of clinicians and patients.

I am currently completing my PhD funded by the NIHR through the BRC. The overarching aim of my PhD is to develop and evaluate a biopsychosocial model of fatigue in End-Stage Kidney Disease. What still astonishes me every day is that patients may have adequate blood test results, but this often has little bearing on their self-reported well-being, further highlighting the importance of beliefs and behaviours in physical health. In the future, I would like to combine research and clinical work to get the best of both worlds.

Elaina Taylor

My interest in Psychology began at A-level where I was one of two students in a small class taught by an inspirational teacher who unconventionally welcomed us to class each morning with a cup of tea made with goat’s milk. At university I undertook a combined honours degree majoring in Psychology with English literature and Archaeology. During a stats-heavy MSc at Glasgow, I wrote a dissertation focussing on stress and coping strategies in postgraduate students- a topic I would later become rather familiar with. The MSc led me to become interested in pursuing a PhD in Health Psychology in two ways. Firstly, my dissertation topic led me to become interested in the way cognition and behaviours interacted with physical health. Secondly, I gained immense satisfaction in completing a piece of work I felt proud of.

After graduating with the MSc, I took up a teaching post in Suffolk. I applied to London on the basis that I could commute and undertake a PhD part-time, but also to work with top researchers in Health Psychology, and more specifically in the area of illness representations. Working part-time has enabled me to develop six years of higher education teaching while undertaking my PhD. After completing four out of six years, I’m encouraged by the achievement of small milestones (in the form of publications) and look forward to developing a career as a researcher and lecturer in Health Psychology.

Katrin Hulme

I’ve always been interested in the human body, sport, nutrition and health. Although I did not realise it at the time, the topic I chose to explore for my dissertation (quality of life in Irritable Bowel Syndrome) was my first taste of health psychology. This, coupled with my personal interests, led me to the Health Psychology MSc; a very exciting discovery as I had not realised previously that this route existed.

My undergraduate degree was at Durham University where I studied Natural Sciences, combining Psychology, Biology and Anthropology (accredited by the BPS). I studied Health Psychology MSc at Northumbria University and then enrolled on the Professional Doctorate at Staffordshire University for Stage II, whilst working full-time at King’s College London as a researcher on fatigue intervention projects.

I handed in my doctorate at the end of June and finished at King’s in July. Next steps are: viva in the Autumn and decide what I would like to do next, after enjoying some time off over the summer months. I enjoy the behaviour change aspect of health psychology, as well as translating research into practice, so I would like to find a role which draws upon these aspects, and challenges me to develop further.

Zoe Moon

I studied Psychology at undergraduate level and left the BSc feeling unsure as to what I wanted to do in the future. I was not exposed to Health Psychology during the BSc and it wasn’t until after my course that I saw a listing for an MSc in Health Psychology. This felt like a natural progression for me and a good way to apply my psychology background to real world settings. Throughout university I had a lot of exposure to the NHS, living with trainee doctors/nurses and with people who had significant health problems and frequent hospitalisations. When I found the MSc, I was excited at the prospect of using psychology to support people with long-term conditions or to help improve the healthcare system. After finishing the MSc at King’s College London, I completed a PhD, which investigated adherence to adjuvant treatment in breast cancer patients. The PhD was full time and was funded by Breast Cancer Now. As part of the PhD I conducted several studies including a qualitative study, a large longitudinal study and a feasibility study of a self-management intervention.  I am now extending this work as a postdoctoral researcher in the department.

Jo Hudson

When visiting my Nan this weekend I was thinking about this post. In fact, it is because of my Nan that I became interested in health psychology. With my Nan being a hoarder of anything Grandchildren-related (thankfully she only has three!); I can share my attempt in the 90s at deterring her from smoking below:

IntroductoryUntitled

In the end, it was taxation that altered my Nan’s and indeed many others’ smoking related behaviour. My lack of success with my Nan’s attempt to quit did not deter me from following a career in health psychology. Perhaps, the public health “side” of health psychology was not for me. There will be more on the different “sides” of health psychology in later blogs.

Now, I work as a post-doctoral clinical-health psychology researcher. I focus on developing psychological interventions that support individuals in adjusting to living with a physical long-term condition. After my Health Psychology MSc, I worked in a Primary Care Mental Health Service. Here I completed a post-graduate certificate in psychological therapies. The one-year training programme focused on evidence-based treatments for the management of depression and anxiety. When I applied these CBT treatments to people with physical health conditions, I felt frustrated at the lack of integration between mental and physical health care provision. I completed a PhD to research these challenges further. After my PhD, I worked at the Centre for Primary Care, University of Manchester before moving down to the big city of London!

 

David Herdman

I am a physiotherapist specialising in the management of people with dizziness and balance disorders. My interest in health psychology is very much borne out of my clinical practice and experience of working with people with persistent physical symptoms. I have obtained an NIHR Clinical Doctoral Research Fellowship to develop an integrated (mind & body) rehabilitation programme for people with persistent dizziness that can be delivered by physiotherapists.

At the time I started my PhD I was also looking for some new challenges. However, I still enjoy my clinical work, which is why I chose to study for a PhD part-time. Although studying in a different field is challenging, it is also really inspiring and the opportunity to bring together experts from these fields is very exciting.

I hope to continue to combine research and clinical practice in the future. Clinical-academic roles for physiotherapists are in their infancy but again we have a lot to learn from clinical psychology in this regard.

Alicia Hughes

In the final year of my BSc, I had the horrible realisation that I still had no idea what career I wanted. Whilst my undergraduate experience had given me a passion for psychology, my interests were broad and with graduation looming I still didn’t know which interests I should pursue, let alone how to pursue them.

Then followed several years of gathering experience in different areas of psychology; working in low paid jobs, often for free and working all the tenuous connections I had, to shadow psychologists in different disciplines. After much debate and 8 months of finding myself in the outback, I was firmly fixed on the career of a health psychologist.

For me, the major draw to health psychology was that it is a broad church. Health and psychology are concepts applicable to everyone; from helping healthy people avoid ill health through changing their behaviours, to supporting people who have ill-health cope with and manage their condition. Since I had found my psychological niche, I applied to the MSc in Health Psychology at King’s College London and once there I began to learn more about the clinical application of health psychology. I became particularly interested in medically unexplained persistent physical symptoms, an area of research I subsequently pursued in my PhD.

I am now a postdoctoral researcher and Stage II trainee Health Psychologist. The first post involves research and the second provides training and supervision, which will (once complete!) allow me to work in an applied setting as a HCPC chartered health psychologist.

Sula Windgassen

My favourite module in my final year of my Psychology BSc at the University of Leeds was health psychology and I completed my undergraduate thesis in this area of research. However, after working in marketing for a year after graduating, it was personal circumstances that drew me back to pursuing a career in health psychology. I came to experience severe medically unexplained symptoms that caused me to seek professional help to manage them and the distress they were causing. A family member, who is a clinical health psychologist, introduced me to both cognitive behavioural therapy and mindfulness, and guided me through a formulation, which really empowered me allowing me to feel like I had some control and hope! Use of mindfulness and CBT techniques transformed my experience of the illness, which causes me very little trouble on an on-going basis these days. When I do get a flare up, I feel that I know how to manage it and therefore this causes very minimal disruption in my life. This is a stark contrast to when I first started experiencing problems. Both the CBT formulation and the experience of mindfulness very much inspired me and I have become passionate about working to improve the experience of individuals with long term conditions.

I completed an MSc in Health Psychology at King’s College and I am now finishing my part time PhD exploring cognitive and behavioural factors in irritable bowel syndrome whilst I work part time as a researcher on the ‘Assessing cognitive therapy in irritable bowel (ACTIB) trial. I have just handed in my Stage II portfolio to qualify as a health psychologist and hope to go on to train therapeutically whilst continuing my research in long-term conditions.

Alice Sibelli

I was born in Italy but I have lived abroad most of my life, enjoying the opportunity to study and work in unique countries with diverse cultural backgrounds. As I grew up, I was never sure of what type of professional path I wanted to follow but I was always fascinated by the different (and sometimes contrasting) ways we react to illness and the vulnerabilities of our human body.

Completing three years of medical training made me realise that many doctors and patients still hold a strong, dichotomised view of body and mind. This reality (which was hard to digest at first) provided me with a deep insight into the role I actually wanted to play in terms of patient care. I then decided to pursue a career in psychology.

After completing my MSc in Health Psychology at the University of Southampton, I realised that I had found exactly what I was looking for: the opportunity to blend my medical and psychological knowledge to contribute to the delivery of a holistic support for individuals with health problems.

I am currently completing a part-time PhD focused on the emotional processes of individuals with Irritable Bowel Syndrome (IBS) after receiving Cognitive Behavioural Therapy (CBT). Conducting a rigorous mixed methods PhD has allowed me to have close interactions with participants to explore in depth how they perceive their condition, the care they receive, their struggles and the way they feel in general. Learning from their own experiences and integrating them with current scientific knowledge has allowed me to propose novel ways to enhance existing evidence-based psychological treatments for IBS. I have also being in charge of delivering the modules focused on qualitative research methods to MSc and BSc students, which has been a fantastic opportunity to learn from each other’s perspectives.

In the future, I would like to continue doing research focused on long-term conditions from a person-centred approach. I would love to work not only with patients but also with health professionals to overcome the obstacles that seem to persistently obstruct the patient-doctor communication.

Pippa Davie

I started thinking about what I wanted to do when I grew up only after I’d finished my undergraduate Psychology degree. I knew I was interested in research, health and illness, that I enjoyed caring for people, and that I was fascinated with pregnancy health and well-being. I wasn’t interested in Clinical Psychology and at the time, I couldn’t see many other options in Psychology. After some discussion with my academic supervisors, I decided I’d apply for Medicine thinking it would be a good way to combine my interests. Knowing the odds of a successful first application were stacked against me, I remained on the lookout for other opportunities – which is when I read about Health Psychology at King’s. I had done an elective module in Health Psychology during my undergraduate degree and really enjoyed it, so I remember being really confused as to why I’d not thought of it before! I approached the department to ask if there was any way I could gain any insight or experience and was offered a research internship later that academic year I’ve not looked back since. I completed the Health Psychology MSc in 2016 where I started exploring my interest in pregnancy health and breastfeeding, and was awarded the IoPPN PhD Studentship Prize 2016/17, which has enabled me to research an area I hope to continue exploring throughout my academic career.

Louise Sweeney

After completing a BSc in Psychology, I worked as Behavioural Health Care Assistant in a hospital in Bristol, predominantly working one to one with patients with brain trauma or neurological conditions, including Parkinson’s and Dementia. This gave me an insight into patient’s experiences living with a long-term illness and the huge effects this has on their psychological well-being and that of their families. I then became aware of Health Psychology as a discipline after having been to a talk about the biological effects of poverty and stress on health, and the steep prevalence of long term conditions such as diabetes and cardiac problems in poor and deprived areas. I was struck by the huge impact that ‘wellness’ and social conditions had on people’s physical health and functioning. It was this that led me to pursue an MSc in Health Psychology.

I am now studying a PhD investigating chronic pain in inflammatory bowel disease, in the aim of developing an online self-management treatment program for patients. Since starting my PhD I have carried out a number of teaching jobs, and look forward to working with both patients and healthcare staff to develop an effective treatment program for patients. After the PhD, I aim to pursue a career working as a clinical academic, so I can keep up my interest in teaching and research alongside working with patients.

Susan Carroll

During my childhood and teenage years, I had my fair share of medical quirks, and so experienced a spectrum of wonderful, to not so wonderful, healthcare. Whilst experiences in hospitals were not always fun, they inspired my fascination with how people adjust to long term conditions (LTCs) and difficult medical diagnoses, the role of healthcare professionals in helping people to adjust, and how psychologists can contribute to improving adjustment and management of LTCs.

After my undergraduate degree at Trinity College Dublin, I fed my interests through voluntary work, taking on some patient advocacy roles and working as a part-time research assistant, part-time retail assistant. Alongside that, I spent a lot of time asking google how I could make my interests into my career. I came across the MSc Health Psychology at King’s College London, which attracted me because of its balance between research, teaching and clinical placement. I took a punt and applied, with somewhat low expectations. When the acceptance letter came through, I felt like Harry Potter getting into Hogwarts! Being a bit of a home bird, the big move to London was nerve-racking, but from day one in the Health Psychology Section at Guy’s, I never looked back.

During my MSc, the opportunity arose to do a PhD on fatigue in paediatric multiple sclerosis with a fantastic team of supervisors at KCL and Great Ormond Street Hospital for Children (GOSH). Doing a PhD has been a fruitful, challenging and rewarding experience, filled with opportunities to meet inspiring colleagues. While balancing my PhD with Stage 2 Health Psychology Training, I’ve decided that I want to balance research with clinical practice in my career. I will be starting the Doctorate in Clinical Psychology at the IoPPN in October, and look forward to a career in Clinical Health Psychology.


 

 

We hope you’ve enjoyed our first blog post introducing you to the Healthily Psyched at Guy’s team! Hopefully it has also highlighted the various different methods of entry into health psychology. More specific information regarding different health psychology career paths will be discussed in subsequent posts. In the meantime, we hope to leave you healthily psyched for more.

 

The Healthily Psyched team