Lotte Haverman: at the forefront of protecting children’s mental wellbeing

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Dr Lotte Haverman wears many hats - clinician-scientist, child psychologist and researcher.

Based at Amsterdam’s Emma Children’s Hospital, Lotte plays a vital role in supporting children’s mental wellbeing as a child psychologist helping children and families to cope and accept medical diagnosis, as well as providing treatment for trauma, depression and anxiety related to their medical conditions. She’s also leading psychosocial research focusing on the effectiveness of the use of Patient Reported Outcomes Measures (questionnaires) completed by patients to assess the effects of disease or treatment on symptoms and psychosocial functioning from their perspective.

In addition, Lotte sits on the board of Training Upcoming Leaders in Pediatric Science (TULIPS for child health), a non-profit, independent organisation that aims to improve children’s health.

Advance caught up with the UNSW graduate to hear more about her work and her advice for Aussies who’d like to move to Amsterdam.

Interview by Tammy Lee, Marketing & Communications & Digital Manager, Advance.

What drew you to a career in pediatric psychology?

In a way, I grew into it. Upon receiving my psychology degree at the University of Amsterdam, I had an urge to spread my wings. I was eager to explore, see the world and study somewhere exciting. Sydney was my first choice. I made a decision to study a master’s degree in Forensic Psychology and Post Traumatic Stress Disorders at UNSW.

I returned home upon my graduation and realised it was not easy to get into a career as a clinical psychologist. I made a decision to begin a role as a researcher at Emma Children’s Hospital instead and it’s a role that I really enjoyed. I love being part of a research team and interacting with multiple specialties in a hospital setting. I completed my postgraduate training in 2015 as a specialized clinical child psychologist and I am now part of the multidisciplinary team caring for children with bleeding disorders and sickle cell disease.

Can you explain Patient Reported Outcomes research? What's the aim of this research? What has been the most unexpected outcome?

Patient Reported Outcomes are self-reported degrees of wellbeing (in terms of e.g. physical functioning, pain, symptoms, anxiety and depression) from the patient’s point of view, as opposed to the doctor’s point of view. For this purpose, patients are asked to fill out questionnaires (Patient Reported Outcome Measures; PROMS) with items related to their health conditions.

The main goal of our research is to find ways to use those measures in daily clinical practice, specifically in patient-doctor (or nurse) communication. In our pediatric hospital, children complete questionnaires before they visit the clinic, the health care providers then discuss the answers on the questionnaires with patients and parents.

With this intervention, problems are identified at an early stage and problems are discussed more broadly with children and parents. It is interesting to see that our PROM portal (KLIK portal) built especially for children has now been adapted for adult care. The portal is now implemented in care in over 20 hospitals in the Netherlands. The main aim of the KLIK portal is still improving patient care. Our current PhD projects are now mainly focusing on Parent Reported Outcome Measures, increasing Patient Engagement in Health care and improving the use of the questionnaires by the very new possibility of Computerized Adaptive Testing (CATs).

With CATs questionnaires can be much shorter, reliable and relevant to the patient. Computer Adaptive Tests (CATs) are a type of measure in which the questions a person answers are tailored to that person. Each response is used to further refine a person’s score. The most well-known CAT questionnaires are the PROMIS questionnaires. PROMIS is an initiative from the NHI, but with the Dutch Flemish PROMIS group we translated the questionnaires and collected Dutch norm data so that we can use them in daily clinical care. With the purpose of make completing questionnaire less burdensome to the patients.

What's the most common challenge you’ve faced working to improve children’s health?

For me, it is the difficulty of getting children on board from various backgrounds and with challenging family situations.   We have the ability to provide the expertise and interventions for families and children in need, but it’s not always easy to provide care to the families who needed the most as some families haven’t prioritized getting appropriate treatments for their children.

In terms of research, it can be quite a challenge to get adequate funding for children’s health research. Many medical conditions are unknown and the horrible consequences as well. But we need funding so hard to conduct research and to develop psychosocial interventions for children, parents and siblings.

Another challenge lies in the limited number of patients participating in pediatric research. It is therefore critical to work together nationally as well as internationally, especially in studies on rare diseases. In the Netherlands, we built a community (TULIPS for child health) to educate young researchers within pediatrics to facilitate networking and collaboration in the future, and it has been an honor to be a member of the board for the past five years.

How was your study experience in Australia? What's the best part? What do you miss most?

It was great and an absolute pleasure! Even though it was already 12 years ago, it still brings back fond memories. I met a lot of people from all over the world and friends for life from Amsterdam as well. I miss the outdoorsy lifestyle, beautiful weather, the great beaches, the beautiful landscapes and of course the barbies.

But I think that what I miss most was the friendliness, easy to get along with personality Australians have.

What's your advice to help new arrivals to settle in Amsterdam?

It is not easy to find a place to stay in Amsterdam, so reach out to friends and use your network. Restaurants and bars are popping up all over. But make sure to explore outside of the city center, the canals are great, butthere is so much more to see, go the surroundings, the beaches nearby, Amsterdam North, take a boat to see the city from the water. Go for a run in the Amsterdamse bos or the Vondelpark. Amsterdam is an open-minded city, very liberal and with a lot of different cultures. If you want to get to know people, ask Dutch people to explain what ‘gezelligheid’ and ‘borrelen’ means.

But the best advice is; buy a bike and a raincoat!