Early psychosis detection, ‘geeking out’ and books

The winner of this year's BPS President's Award for Distinguished Contributions to Psychological Knowledge is Dr Lucia Valmaggia, Reader in Clinical Psychology and Digital Mental Health, and Head of the Virtual Reality Lab at the Institute of Psychiatry, Psychology and Neuroscience, King's College London [pictured above]. We spoke to her about her work, what she would like to see change in her field and her plans for the future.

Dr Valmaggia, also an Honorary Consultant Clinical Psychologist in the South London and Maudsley Trust, began her career in the Netherlands working clinically with people who had schizophrenia. Alongside this she conducted her PhD on the implementation of cognitive behavioural therapy for psychosis.

After her PhD she moved to King's College London (KCL) in 2003 to help set up a service for people at risk of developing psychosis. She and her colleagues received funding to set up the Outreach and Support in South London Service (OASIS) – a community mental health service for young people at high risk of developing psychosis. This was one of the first such services in the world. OASIS, which is still running, offers individual support for people across two years – including talking therapy, career support, practical advice and coping strategies.

Dr Valmaggia explained that research had found that those from less affluent backgrounds were less likely to seek help from OASIS before experiencing an episode of psychosis – with many ending up in the criminal justice system. As a result she helped to set up the London Early detection and Prevention Service in Prison (LEAP), working in London prisons to help identify people with an at-risk mental state for psychosis and offer them psychological interventions while in prison.

Later, she set up the Virtual Reality (VR) lab, which explores the use of VR in clinical settings – both in the assessment and treatment of mental health problems. The VR lab now has a dedicated VR developer and around 35 members from different departments in the university, conducting research into the mechanisms that trigger and/or maintain mental health problems, and exploring VR assisted therapy for a range of mental health problems including psychosis, depression, eating disorders, and autism. The VR lab is also involved in studies to target discrimination in health settings and is developing a training for family members of people who experience psychosis.  

When asked about what she would like to see change in her areas of work, Dr Valmaggia said early detection and intervention services were often a privilege of the few. 'This is not just in the UK – there are many places in the world where these services are still in development. In the UK it is not accessible to everybody, there are some areas where it's easier to get access and areas where it's much, much more patchy.

'We need more ways of engaging people who traditionally do not engage with services. Often they are called "hard to reach". I hate that term. I do not think they are hard to reach, I think we're not offering what they're looking for, or we're not offering it in a place where they can access it. So, we need more accessible services in the right place at the right time, which are culturally appropriate.'

She said highlights of her career included being elected President of IEPA (International Early Intervention in Mental Health Association), seeing the development of early career clinicians and researchers, and helping to make the process for selecting clinical psychology doctoral students more inclusive and representative as part of her role as Head of Selection and Senior Research Tutor for KCL's Doctorate in Clinical Psychology course. 'It's great to work with younger people, especially PhD students or clinical psychologist trainees, to see them learn, grow and feel more confident. Probably the nicest bit of my work is when, in a clinical context, you share the journey with somebody who trusts you enough to talk to you about their problems, and then to see that the work you're doing together helps them reach their goals – whether that's a better quality of life or a reduction in their symptoms.'

Dr Valmaggia concluded by highlighting the team effort that is behind all her work. 'These awards look like they go to one person, but you cannot do this on your own, you're a product of all the people you work with. Without all the colleagues I work with, the people who trusted me with their care, and the people who nominated me, I wouldn't ever be in the position of receiving this award. It's very much a team effort.'

Psychology technician Paige Metcalfe at the University of Salford has won this year's joint BPS and ATSiP (Association of Technical Staff in Psychology) award for technical support in psychological teaching. Metcalfe (whose preferred pronouns are they/them) has worked at the university since 2019 and is described as a 'considerate, knowledgeable, and reassuring presence' in their nomination.

Metcalfe said the nomination came as a complete surprise and that the best part of their job included 'geeking out' over the things they enjoy. 'I fondly remember working as a research assistant collecting data using EEG [electroencephalogram]. The EEG ending up not working and I tried to fix it which prompted my PI [principal investigator] to say, "remember you're a research assistant, not a technician". I believe this to be the moment that I realised that being a technician was for me.'

Metcalfe added that they felt remarkably proud each time their code ran without errors. 'I've still retained a will to live through the duration of the process – haha! Although more seriously, each year I feel immensely proud when our dissertation students go from their research being an idea to submitting – it's really nice to be a part of their journey. Finally, I have to say I have the pleasure of having absolutely cracking people around me. Their support, collaboration, and inspiration are most definitely appreciated.'

This year's BPS Book Award shortlist was chosen by the BPS Research Board and Practice Board, with the winner to be announced in November. The five books shortlisted are An Introduction to Mathematical Cognition by Camilla Gilmore, Silke Goebel and Matthew Inglis, From Talent Management to Talent Liberation: A Practical Guide for Professionals, Managers and Leaders by Maggi Evans, When It Is Darkest: Why People Die by Suicide and What We Can Do to Prevent It by Rory O'Connor, The Brink of Being: Talking About Miscarriage by Julia Bueno and Postfeminism and Health: Critical Psychology and Media Perspectives by Sarah Riley, Adrienne Evans and Martine Robson.