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ADA recognizes diabetes psychologist
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Michael A. Harris, PhD, was honored with the Richard R. Rubin Award from the American Diabetes Association at the organization’s annual meeting.
The award recognizes a behavioral researcher who has made outstanding and/or innovative contributions in the study and understanding of the behavioral aspects of diabetes, given in memory of Richard R. Rubin, PhD, CDE.
Endocrine Today spoke with Harris, who is the chief of pediatric psychology in the Institute of Development and Disability at Oregon Health Sciences University (OHSU), and a staff psychologist in the Harold Schnitzer Diabetes Health Center at OHSU, about his pivotal work in behavioral interventions for youths with type 1 diabetes.
What was the defining moment that led you to your field?
Harris: When I began as a research assistant in graduate school I was assigned to work with Cindy Hanson, PhD, retired professor. Prior to working with Hanson, I knew nothing about type 1 diabetes. She told me she was diagnosed with type 1 diabetes at age 11 years. Throughout graduate school, I was able to watch Hanson in meeting the day-to-day challenges of her diabetes. She explained to me that most of the research on the psychosocial and behavioral factors in diabetes had been driven by “deficit model” thinking. In other words, the bias that we have about people with a chronic health condition like type 1 diabetes being worse off psychosocially. She impressed upon me the importance of taking a “strengths-based” approach. She pushed me to identify what works and how people meet the incredible challenge of successfully managing type 1 diabetes. Because psychology is more about identifying pathology and deficits within people, she told me, it will be a constant challenge not to view diabetes through that lens. Thus, working with and learning from Hanson was the defining moment that led me to my career as a behavioral scientist in type 1 diabetes in youth.
What area of your field most interests you right now and why?
Harris: Currently, my scholarly and clinical efforts in diabetes have involved examining the implementation of an innovative intervention for youth who evidence repeat diabetic ketoacidosis. I developed this program in response to the triple aim of health care reform: improved care, improved health and reduced costs targeting the most vulnerable youth with type 1 diabetes and other chronic health conditions (ie, those on public aid, non-English speaking, with single parents, food insecurity, trauma history, comorbid behavioral and psychosocial problems, etc). This intervention, called NICH (Novel Interventions in Children’s Healthcare), is truly a translational research effort in diabetes, taking an evidence-informed intervention and implementing it with a real-world, highly vulnerable clinical population. I am most interested in this effort because it brings together my clinical experience with young people with type 1 diabetes and their families, my research experience in type 1 diabetes, and my interest in bringing our best interventions to our most vulnerable and challenging youth with type 1 diabetes.
What has been the greatest challenge in your professional career thus far?
Harris: The greatest challenge I have faced in my career in type 1 diabetes has been moving the needle in getting institutions and insurers to financially support psychosocial and behavioral services for youths with type 1 diabetes. I have been fortunate to have worked with physician-colleagues such as the late Julio Santiago, MD, and Neil H. White, MD, CDE, both of Washington University School of Medicine, St. Louis, and Andrew Ahmann, MD, of Oregon Health and Science University, who are all psychosocially minded as well as strongly supportive of having a psychologist embedded in diabetes clinics. However, many times, there is a disconnect between providing the highest and most effective diabetes care and the financing and business of diabetes care. A dear friend, colleague and mentor, Barbara Anderson, MD, of Baylor College of Medicine and Texas Children’s Hospital, frequently tells people that “behavior is the most important drug in diabetes care.” I think that many scientists and clinicians working in diabetes would agree with her, but behavior in diabetes care is not financed like medicines are in diabetes care; thus, this represents my greatest professional challenge.
What are some of the most exciting advances that you have been a part of?
Harris: Besides NICH, one of the most exciting advances I have been a part of in type 1 diabetes has been my collaborative relationship with Tim Wysocki, PhD, ABPP, co-director of the
Center for Health Care Delivery Science at Nemours Children’s Health System in Jacksonville, Florida, on the adaptation, evaluation and implementation of behavioral family systems therapy (BFST) for adolescents with type 1 diabetes. Historically, adolescents have been viewed as a challenging population for people to work with, and as a result, most have avoided working with adolescents. Wysocki and I collaborated in a series of NIH- and ADA-funded studies on BFST implemented with adolescents with diabetes. Consistent with my focus on the most vulnerable with type 1 diabetes, my collaboration with Wysocki targeted adolescents with type 1 diabetes who had relatively poor glycemic control and were evidencing high levels of conflict with their parents. What was exciting about our work was that we were able to adapt a model of intervening with otherwise-healthy adolescents and their parents to meet the unique needs of adolescents with type 1 diabetes and their parents (BFST-D). In addition, we were able to demonstrate the value of BFST-D in not just decreasing the conflict experienced by many adolescents with type 1 diabetes and their parents, but we were also able to show how BFST-D can improve diabetes self-management and glycemic control.
What are your hobbies/interests outside of work?
Harris: When I am not working, I am either going somewhere with my wife of 28 years or attending one of my children’s activities or events. My oldest son is a baseball player, my middle son is active in theater, and my daughter is a dancer, so much of my free time involves watching and enjoying my children in their respective activities, even when it means being a “dance mom” for my daughter. When I do have time to myself, I love playing ice hockey. I play in two local “beer” leagues, which keeps me physically active, but more importantly, hockey is my personal therapy. – by Cassie Homer
Disclosure: Harris reports no relevant financial disclosures.