Margaret Wardle, PhD

[TT] Dr. Wardle, thank you so much for sitting with us today! We are excited to learn more about your career progress and research.

[MW] Thanks so much!

[TT] Can you tell is how did your career and journey in psychology begin?

[MW] I was always really interested in psychology and I was a dual psychology and art major in undergrad and I thought I was going to be an art therapist but I couldn’t register for a class that I wanted it was an advanced level class and I went to talk to the Professor to like beg her to let me in and she said, well, I can’t raise the cap on the class, but if you’re interested in this topic come to research in my lab.

I got like really hooked on research from that experience. Clinical psychology has that balance between research and clinical work that I was really interested in. I graduated with my PhD from our program here at UIC in 2009 and then I did a postdoc at University of Chicago, and I was faculty at University of Texas Health Science Center before I came back here. So yeah, mostly from missing class registration is how I got started in psychology.

[TT] What has been the defining moment for you in this field?

[MW] I think an interesting thing for me was I really kind of grew into being clinical psychologist. When I was in graduate school, I actually thought that I did not like or was not very good at doing therapy, so I had come in thinking I wanted this kind of balance, but then I got in a room with somebody, and it was like extremely stressful for me. So, I thought maybe I would do research, maybe I’ll be more of a social psychologist or maybe I’ll do something else. Then, I got my job in Texas, and I was working maybe one to two days a week in the psychiatric hospital there in Harris County, which is a big county you know, like Cook County sized, but in Texas.

And I think there, I really learned, you know it was all short-term therapy seeing different people every day, you know they would stay for seven to 14 days until they got stable on medication. Over and over again I had to figure out what I could do that would be helpful for this person within this hour, which may have been the only hour I had for them.

It really kind of opened my ideas about like being a therapist, so I think that made a big change in my career and I really kind of grew into being, like a clinical psychologist. It’s funny because it was in this fairly stressful, very fast paced like hospital consult service that I finally got destressed about doing it. I always tell students; some people are natural therapists and other people aren’t and it’s something that you can learn to do because it was just doing it over and over again.

[TT] You mentioned you are an Alumna of the program here at UIC, would you mind sharing what drew you back to the department?

[MW] Yeah! UIC is super special for me. One of the things I really love about it is that we are a world-class research institution that nevertheless is an accessible and affordable education. Our student body is wonderful and one of the most diverse in the country. I think it’ a great place to be if you care about impacting the pipeline problem for the PhD program.

My partner also completed his undergraduate and graduate program in Physical Therapy. He’s a first-generation student and fourth generation Chicagoan, really local. UIC is an engine of economic opportunity and educational opportunity in the Chicagoland area, and I feel very strongly about that. UIC has a way of reaching students who would never have considered research or graduate education and that’s much more fun.

I went to Carnegie Mellon for undergraduate, but when I came to UIC for graduate school it was such a culture shock. I got to really know the student-body and it gave me a sense of how UIC is a neighborhood school with all of these cool resources.

[TT] Would you mind sharing your research from the Clinical Trials you’re currently working on?

[MW] Of course! The clinical trial is wrapping up this April. The trial is looking at combinations of medications and talk therapy for helping people to quit using cocaine or crack cocaine. This is a really important area of work because so far, we have some medications to help people quit using opioids (i.e. heroin or pain pills), and we have some medications to help people quit using alcohol, but we have no medications that have been shown to be effective for helping people to quit using stimulants like cocaine or crack.

So, there’s this kind of huge hole in terms of our arsenal, so that’s part of what the study is looking at is testing this new medication. But we are also looking at it because, I am a psychologist and not a medical doctor, we are looking at it in combination with a talk therapy and behavioral therapy to see if we can come up with a combination that works better than either thing individually. This is a pilot trial and the first time these two treatments have been tried together, so it’s smaller and we will have about 60 people done when we finish up.

[TT] Can you tell us a little bit about the work you will be doing with the CCTS Grant?

[MW] Yeah, so we just got awarded the grant. It’s a different kind of study that we have not yet started. The CCTS grant is what’s called an implementation study, which is where we’re taking a treatment that we know works in that controlled clinical trial sense and we’re trying to make it work in the real world. The CCTS study was inspired by some clinical collaborators we have at the UI Health Mile Square. They are a federally qualified health Center, which means that part of their mission is to provide treatment to people, regardless of their ability to pay.

They have a very active program for medication treatment for opioid use. There are a couple of different medications we know can help people to quit using opioids like I mentioned before. The one we are focused on is called Suboxone or the generic name, for it is Buprenorphine. And the reason we’re focused on that is because it’s one of the ones that’s more easily accessible to people, it can be prescribed outpatient in a regular doctor’s office, whereas some of the other medications like methadone you can only get from especially licensed treatment Center. We know suboxone helps people quit and, in fact, we know it saves lives by helping people quit and cut down on their use, so people are less likely to overdose. However, up to a third of people quit taking their suboxone before it even has a chance to work, within the first month of when they get the prescription.

We were talking with one of our clinical collaborators at UI Health, Dr. Nicole Gastala, and she was interested in implementing this behavioral treatment, so a non-medication treatment, that can help people stick with their medication. In literature it’s called contingency management, but it’s effectively a rewards Program. People get small rewards like gift cards as they demonstrate sort of positive behaviors in their recovery, so one example, could be coming into their appointments with a doctor, taking their medication, and other times you can focus on things like having a urine sample that’s negative for opioids. This works great in clinical trials and works awesome in the lab, but very few providers in the real world do these kinds of rewards programs for lots of different reasons.

It can be hard to keep track of the rewards, there are legal requirements that regulate you know you can’t give a patient above a certain amount of money, because otherwise they consider that a kickback like you’re paying the patient to come to treatment with you. So, one way to keep people in treatment is to do these small positive rewards when they come in for appointments. Gift cards seems like kind of a tiny thing to put up against like you know heroin use, but the literature shows that it can really help just getting this little positive boost when you do something good for yourself and good for your recovery.

When we started talking with Dr. Gastala, we thought about my expertise on contingency management using rewards programs in clinical trials and her need for this to work in her clinic. We brought on a third collaborator, Dr. Brittany Rudd, an instructor of Psychology in the Psychiatry and the Director of the Implementation Science and System-Involved Youth Research Program. Dr. Rudd’s job is to take what works in the clinical trials and make it work in the real world in the clinic.

I’m really excited to do this work because one of the things with clinical trials that is so difficult is another very tightly designed for scientific integrity, and to get really clean sample, but they’re difficult for participants and for us. It’s really intensive treatment and people have to come in three days a week and have to do extra tests, and it can be tough to recruit people who want to quit using cocaine or crack, but we don’t have a lot of common medical issues that people use them. So, I’m excited to for the CCTS grant and to collaborate with UI Mile Square Health because this is a place where people are asking for this treatment. Our participants are volunteering their time and doing this with us.

One of the cool things about implementation work is it’s like we’re solving a problem basically that’s out in the real world like very immediately, so I think that’s going to be neat.

[TT] This is really amazing, and we are all looking forward to learning more about the work you are doing! Lastly, would you share a fun fact about yourself or things you enjoy doing in your spare time?

[MW] I enjoy doing Aerial Silks. I’m not very good at it, but I really like it.

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Thank you, Dr. Wardle for sitting with us today! It has been great learning more about your history with psychology, as well as your future! We are excited to learn more about your progress with future clinical trials and the CCTS grant.

The project described was supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR002003. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.