Research Stream: Stories/Lived Experience
Author: Sarah Hooney, Research Assistant, Integrated Advisory Services, Maynooth University Assisting Living and Learning (ALL) Institute.
During my undergraduate degree, I completed a three-month assistant clinical psychologist placement in the Mater Misercordiae University Hospital, working within the National Centre for Inherited Metabolic Disorders (NCIMD). This experience deepened my understanding of clinical psychology – not just as a tool for diagnosis and treatment, but as a form of advocacy and justice.
The NCIMD is a multidisciplinary team treating rare genetic metabolic disorders, such as phenylketonuria (PKU) and Hunter’s Syndrome. Metabolic disorders can have very complex symptoms, including both medical and psychological impacts. For example, severe symptoms of untreated PKU include behavioural problems, developmental delays, intellectual disabilities, and even seizures. In the NCIMD unit, I observed that the psychologist’s role involved assessing cognitive and behavioural challenges in clients and helped develop care plans. Additionally, I saw psychologists offering mental health support for those navigating life with chronic illness. This involved providing the appropriate therapeutic methods or referral to a psychiatrist if alternative testing is required.
Throughout my placement, I shadowed the team’s clinical psychologist, speaking with clients one-on-one and providing behavioural assessments where necessary. From the first week, it became immediately clear that the job description given to us prior to starting placement barely scratched the surface of what the job looked like day-to-day. I noticed how the psychologist often acted as a bridge between the client and the medical team—speaking up for them, supporting them beyond medical intervention, and helping their voice be heard. At times, while the consultants might be focused on what’s considered the best clinical option, the client may face negative psychological side effects that make treatment more burdensome than beneficial. In those cases, the psychologist seemed to advocate on the client’s behalf to help find a more balanced solution – one which improves the client’s quality of life but is also medically sound. In-clinic sessions appeared to allow clients to vent openly about the situational difficulties they are facing. In these sessions, the psychologist gains key insights and communicates with the rest of the team to help the development of collaborative, person-centred care plans.
Working with this group presented several ideas that I had the privilege of never having to consider before. The NCIMD is the only specialist centre in the country for metabolic disorders, meaning many clients travel long distances, face transport difficulties, or require disability accommodations to attend appointments. These issues can become significant barriers in both access to care and client wellbeing – and are central to whether a client can even engage with the services available to them. During my placement, I struck me how the psychologist often found themselves dealing with these concerns and ensuring that the care was as accessible as possible. Genetic conditions don’t account for geography, but these individuals still require the same level of care regardless of location. In these moments, the psychologist seemed to take on the advocacy role – not just offering emotional and cognitive support – but also helping ensure that no one is left behind due to where they live or the barriers they face within the system.
I had the opportunity to spend a brief time shadowing the senior clinical psychologist of the Renal Medicine Unit, which highlighted the nuanced differences in psychological work across medical specialties. In renal care, a multidisciplinary team – including consultant physicians, nurses, nutritionists, medical social workers, and psychologists – collaborate to support clients navigating the emotional challenges of chronic illness and managing mental health alongside physical symptoms. Psychologists contribute by assessing patients’ readiness for transplant by looking at treatment adherence, and by advocating for patients during major clinical decisions. Through building relationships with vulnerable individuals, psychologists provide insights that can influence outcomes, including decisions around eligibility for life-changing transplants.
Throughout my time at the Mater, I gained invaluable insights into the collaborative dynamics of patient care. I observed that, alongside assessments and therapeutic interventions, psychologists play a vital role in patient advocacy, ensuring that care plans are both clinically effective and personally meaningful. This experience underscored the importance of each team member’s contributions in delivering comprehensive and client-centred care. My main takeaway from the experience was that in clinical psychology, empathy, communication, and advocacy are just as crucial as clinical expertise. This experience strongly aligns with the mission of the ALL Institute, which is committed to interdisciplinary research that enhances the lived experiences of individuals with chronic illnesses. Just like in the ALL Institute, the clinical psychologist’s role involves advocating for systemic flexibility and finding creative solutions that make an inherently unfair situation as equitable as possible.
