FEATURED MEMBER - SKYE OSCHNER MARGOLIES PHD
I am a psychologist in the Department of Physical Medicine & Rehabilitation at Eastern Virginia Medical School working primarily with patients with chronic pain. While I initially imagined my career as a clinical health psychologist being focused primarily on sleep and behavioral medicine generally following my graduate training, working with patients grappling with chronic pain has been such an intriguing challenge that I have never looked back.
And it turns out that there are extensive (and almost unlimited) opportunities for implementing the proven techniques of behavioral sleep medicine in the context of chronic pain. Living life is not easy, and living it with chronic pain compounded by sleep problems makes the already not-easy seem to some like it might be impossible. I am confident that behavioral sleep medicine provides a means towards living a better life, and my current research and clinical work, and much of my energy is focused on facilitating that goal.
So instead of only focusing on sleep, I am fortunate to be part of a multi-disciplinary team helping patients to live fulfilling lives with chronic pain. I integrate behavioral sleep medicine as a critical component of each patient’s treatment plan so they can develop techniques to experience real change and benefits even with their chronic pain. This is sometimes a hard sell to patients conditioned to treat pain with drugs, which makes having an impact not just a success but even something akin to a personal triumph for the patients. I also endeavor to bring behavioral sleep medicine to the broader medical community at EVMS. I supervise clinical psychology interns and graduate students as well as medical students, residents, and fellows. I enjoy teaching them as well as introducing my medical colleagues to the integral role behavioral sleep medicine plays in successful and lasting patient care.
HOW DID YOU DECIDE TO SPECIALIZE IN BEHAVIORAL SLEEP MEDICINE?
I took the long route! Before going to graduate school, I spent ten years in broadcast journalism as an assistant producer at 60 Minutes, CBS News, and at New York Times Television, where I had the challenge and honor of helping others tell their stories. This was exhilarating work, especially as I explored a complex and diverse array of life trajectories. With time, I realized that I wanted to play more of an instrumental role in directly helping people to reshape their stories and reorient their trajectories on their own terms, rather than just narrate or observe them. The transition from a steady professional life in broadcast television to that of a graduate student learning an entirely new field carried its own set of risks and discomforts. (I had a lot to learn since I had majored in French in college!) This move has proven to be consequential and deeply rewarding.
While pursuing my doctorate at Virginia Commonwealth University, I studied with Bruce Rybarczyk, who introduced me to Behavioral Sleep Medicine and encouraged me to undertake an expansive dissertation examining CBT-I for Iraq and Afghanistan veterans with posttraumatic stress disorder. After graduating and completing a post-doctoral fellowship at EVMS in 2013, I have sought out as many additional opportunities to enhance my clinical technique as possible. I completed Michael Perlis and Donn Posner’s Basic and advanced CBT-I courses, which has had a big impact on my approach. I also participated in the University of Pennsylvania Mini-Fellowship in Behavioral Sleep Medicine, an excellent and comprehensive opportunity to live, eat, and breathe all aspects of BSM over one week! Over the past year, I have become more active with SBSM as a member of the Education Committee. This has been an exciting opportunity for networking and collaborating with other BSM specialists, at all stages of their careers, and contributing to the BSM field.
WHAT IS YOUR ADVICE TO EARLY CAREER INDIVIDUALS, OR THOSE RE-SPECIALIZING IN BEHAVIORAL SLEEP MEDICINE?
I would always urge people to be willing to be vulnerable, especially in pursuit of learning more. Some vulnerability, especially deliberate openness to the unknown and the unexpected, is required to work successfully with our patients and research participants. I believe people should seek out as many opportunities to learn what you don’t know and to grow with and alongside the colleagues in the field developing innovative approaches to BSM. The advantages of continued active learning have enormous benefits both for oneself professionally of course, but also for one’s patients, and research participants. Always placing myself in the position as a learner has been the engine that has allowed me to evolve both professionally and personally and to build on a strong graduate foundation with new work in a truly dynamic field. As we all know, personal or professional trajectories are almost never linear. They unfold in the context of the bumps, joys, and everyday fabric of living life. I have strived to develop a full appreciation of the often complicated relationship my patients have with sleep and pain and its impact on living both a healthy and meaningful life.
At this stage in my career, it feels both important and strange to be giving early career advice as I still have one foot in my early (second) career chapter and another foot just starting to land in the mid-career portion. I feel fortunate to be part of a community that fosters constant inquiry, mentorship, and excellence.
WHAT IS THE NEXT STEP THAT YOU PLAN ON TAKING EITHER IN YOUR RESEARCH PROGRAM OR CLINICAL PRACTICE?
I am currently most focused on creating more opportunities for EVMS patients with chronic pain to have access to BSM interventions. Following in the footsteps of those researchers and clinicians who are developing novel BSM approaches, I am studying internet-based CBT-I programs for patients with chronic pain for whom adding another in-person appointment is often more of a barrier. I have also implemented new insomnia research groups for patients with chronic pain that combine CBT-I and Acceptance and Commitment Therapy. With this group I plan to measure patient progress through a combined CBT-I/ACT program with respect to improved sleep as well as an eye on improved quality of life and increased functioning. Continuing to collaborate with medical providers and trainees across disciplines through patient care and educational opportunities is an on-going commitment in both my clinical work and research.