Dr Lisa Grech Interview

You completed the combined MPsych/PhD program in clinical neuropsychology a couple of years ago. What motivated you to combine clinical and research training?

You might say I want it all! I love being able to combine teaching, research and clinical work, and I have been incredibly lucky to have the opportunity to do so. It’s a privilege to be entrusted with the life struggles and emotional difficulties of the clients I see as a practicing psychologist. I enjoy research and I’m particularly passionate about translational research, which is why clinical training was (and still is) important to me. The combined course has enabled me to teach postgraduate psychology and medical students. It is an incredible honour knowing I am able to contribute to shaping (if only ever so slightly) our future clinicians.

Many of your recent research activities have examined coping, quality of life and neuropsychological factors in multiple sclerosis (MS). What are some of your key findings?

This research found that while the direct relationship between executive function and psychosocial adjustment (stress, depression, anxiety and quality of life) is limited, there is a relationship through some coping strategies. This is important because cognitive impairment and emotional difficulties are highly prevalent in people with MS. For example, 50% of people with MS experience depression and more than 50% of people with MS will experience cognitive deficits. There is also research suggesting a relationship between stress and disease progression. Coping is amenable to intervention, so an understanding of the role of coping strategies in mediating or moderating these relationships allows interventions to be developed to maximise functioning and quality of life for people with MS.

MS probably isn't on many psychologists' radar as a focus of study or professional practice. What do you think psychologists have to offer in this area, and do you think other professions involved in MS treatment and research fully appreciate those capabilities?

Psychologists play a very important role in disease management for people with MS. Although MS was historically considered a movement disorder, the cognitive and psychological consequences have gained more attention over the last 30 years and are now considered common outcomes of the disease. Psychologists have a role in the treatment of depression, anxiety and other emotional disorders in MS, as well as with assessment of cognition to provide strategies to maximise day-to-day functioning.

There is still much research in MS to be undertaken in by psychologists, especially in view of research suggesting a stress-disease progression relationship and many similarities in the biological processes that occur in depression and MS exacerbation. There is also a need for clinical trials assessing whether treatment of psychological symptoms impacts disease progression. Psychologists can contribute expertise in research design, interventions, participant monitoring and analysis for such trials.  This requires collaboration with our neurologist colleagues, who hold primary responsibility for medical management and research in MS. While our colleagues appreciate the seriousness of the psychological and cognitive consequences of MS and the important role of psychologists in the management of these, funding for psychological management and research is limited and remains a barrier to greater interdisciplinary management and research.

You teach across a few different areas for the School. What are some of your teaching responsibilities?

I teach into the third year capstone subject and the Master of Psychology (clinical neuropsychology), as well as coordinating and teaching psychology content for the first year of the Doctor of Medicine (MD) within the Department of Medical Education. I enjoy all of the teaching I do, but am particularly passionate about teaching into the clinical programs (medicine and psychology) because of the contribution this makes to patient care, as I am teaching our future clinicians!

As a former student of the Master of Psychology (clinical neuropsychology) it is great to be involved in the education of the current students and watch them develop as clinicians as they progress through the course. As psychology discipline coordinator for first year MD program I have had the opportunity to continually develop this teaching and to work with our wonderful team of dedicated lecturers and tutors who deliver it. Our School has the important role of putting psychology on the radar of future physicians.  The contribution psychological management makes to positive patient outcomes is well researched and provides patient, societal and economic benefits. I’m excited to be a part of that.