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Dr. Anne Marie Albano and Dr. Shannon Bennett are clinical psychologists whose work puts them in some unexpected situations. On any given day, you might catch Dr. Albano dancing under a disco ball at a fake prom, or handling a very real snake. You might find Dr. Bennett wearing Virtual Reality goggles, or posing as a hiring manager. And this all might not sound like it has much to do with psychology but it’s actually essential to their work as they tackle one of the most important crises in a generation: Anxiety and Depression in kids and young adults. 

I'm Catherine Price, and this is Advances in Care.

On today's episode, I sit down with Dr. Albano and Dr. Bennett, the Co-Clinical Directors of the Center for Youth Mental Health at NewYork-Presbyterian. We talk about their research, and the landmark standards their work has set, in treating mental health disorders in young people. As both a science journalist and a parent,

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 I found the conversation fascinating and I hope you will too. 

Catherine: Dr. Albano and Dr. Bennett, thank you so much for joining me today.

Bennett: Thank you so much for having us!

Albano: We're happy to be here and if we talk to each other like we usually do, we'll have a good time. Right, Shannon?!

Bennett: Absolutely. 

Catherine: Great! So I wanted to start by trying to get a sense of your personal backgrounds, because I’ve noticed there’s often a connection between, you know, what people are doing now and what they were like as kids. So is there anything in either of your personal backgrounds that led you to have an interest in anxiety and depression? Dr Albano, maybe you want to jump in first? 

Albano: Okay. In my personal background, truth be told, I was a very anxious kid... We moved from New York City down to South Florida as I started high school, which is a time of heightened social anxiety. And I was teased for my accent, all kinds of things, not only by the kids, but by the teachers.

Catherine: What?! 

Albano: Yeah, yeah. Wasn't good, right? Literally the first day, one of the teachers made me stand up and say words that kids from Staten Island pronounced 

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very differently from kids who were growing up in South Florida. And it was humiliation at a level I had never, ever experienced. It was really bad. I did not wanna stay in school. I was just like, get me the heck outta here. And so my parents… a little manipulation on my mom's part. ‘We'll find a place for you in the schools in New York. You could live with an aunt and uncle, but you gotta keep going while we figure this out.' And really what they were doing was validating my feelings, but also kept me in the game, didn't let me refuse and avoid school and then just exposure to the wider range of kids over time, I found my crew and found my voice. And then I could say that in college I worked with a behaviorist who did a lot of work and pioneered classroom management strategies- it was about helping the kids who were anxious, too reserved in the classroom to be benefiting from instruction, how to help them 

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to get again into the game, talk to the teacher, make friends. So all of that led to then my interest in working with youth who had anxiety and then depression, which is a very big comorbid condition that occurs with anxiety. 

Catherine: So that’s just amazing. I mean, it’s amazing that your parents’ natural instinct was what you ended up proving through your research actually is the most effective tool. 

Albano: That's exactly right.

Catherine: So you both work together now directing clinical research at the Center for Youth Mental Health. Um, how did you start working together? 

Albano: We're sisters in the field of psychology with our common mentor, Dave Barlow, so, you know, it's a small world when you get down to it, and I think any of the physicians listening to this recognize that within whatever specialties they're in. So it's really nice because you see the field seated and growing through your advisors and then through you and your own trainees that you bring up, but you develop colleagues all along the way, which is exciting 

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and culminating in the work that we're doing together and have been for the Center focused on, uh, the emergence of young adulthood, uh, for those kids who struggle with anxiety and depression. This has just been sort of our dream to come true. I mean, I'm ahead of Shannon in years in the field, but at the same time, it's like, ‘wow, it's so exciting that I know Shannon's gonna be taking it forward for the longer term.’ Not that I'm retiring tomorrow, let's say that. Um, but it is exciting and, and a very cool thing to be involved in.

Bennett: I was gonna use the same term that it has been a dream for the last 10 years to get to work side by side with Anne Marie through the Center as she leads the clinical program at Columbia and I lead the clinical program at Cornell and we closely collaborate on how we serve youth and educate the community and do collaborative research. Uh, so Anne Marie's been a tremendous mentor and leader in my career as well as so, so many others in the field. 

Albano: Oh, thank you. 

Catherine: So Dr. Bennett, how did you end up here? Do you–did you also have a personal connection to the research? 

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Bennett: I, too, was a shy and, and somewhat reserved kid, and I have a, a very clear memory. My parents would take us to a bookstore at the end of every school year, our reward for a report card was getting a book. And I remember one year in high school buying a book on assertiveness, like stand up and speak out, which in retrospect, I realized like clearly I was socially anxious in high school and I would set goals for myself, like I'm gonna walk down the hall and say hi to three people from this class to that class. And was essentially exposing myself to get more comfortable saying hi to people and, and chatting with others and, and it was only sort of in looking back that I realized, um, you know, how I was accessing these tools on my own.

Catherine: Wow. I wanted to take a step back for a minute and get kind of a lay of the land about where things were in terms of youth depression and anxiety like 20 years ago. 

Albano: Yes. So I entered the field in 1990 and at that point, what you really had was 

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the psycho-pharmacology camp, which was taking on the development of SSRIs. Simultaneously, was the development of the cognitive and behavioral psychotherapy for anxiety and depression in kids. Monotherapies was the name of the game: one or the other. This is through the nineties. In the late nineties into the early two thousands, the CBTS were really blossoming. There were many NIMH trials from investigators around the country and also around the world showing that CBT was effective, uh, for treating anxiety. So the marriage through the NIMH of testing medication and CBT as monotherapies in the same study, plus their combination as compared with pill placebo started. That study was put together. I was one of the principal investigators of it. We had six sites, and that happened in 2002 when 

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that study started. Now both trials were really definitive for the field, and these were interesting: in the depression trial what we found was at immediate post-treatment of 12 weeks, the medication did better and the combination did better than CBT. But CBT alone at 12 weeks was no different than placebo. So it's not that it doesn't work, but it takes longer than medication does. Medication lifts the mood, gets the kids a bit more activated very quickly. But CBT needs longer, a longer time. This is different from what we found in the anxiety study. In the anxiety study, the combination of medication in CBT for kids with separation, social anxiety, and generalized anxiety, the combination got 80% of the youth better, but CBT and medication were equally effective. And all three were, uh, superior

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 to placebo.

Catherine: Huh, and just to clarify, this is the Treatment for Adolescents with Depression Study, or it’s like the TAD study, right?

Albano: Yes, exactly.

Catherine:  And I understand that study was really a huge game changer in the sense of integrating these two therapies: the medication and the CBT in treating kids specifically, right?

Albano: Yeah, this was the first time that the NIMH had a randomized controlled trial with independent evaluators at multiple centers around the country using the most stringent of methods for ensuring the reliability and the integrity of the study in its findings. So in both trials, it was the first time adolescents 12 to 17 with depression, kids, seven to 17 with the anxiety disorders, that they were seen in the same study over the long term for treatment and then follow up. 

Catherine: Can you give an overview, kind of a background sense of what 

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cognitive behavioral therapy looks like in this context? Like some examples of, of what it is and how it was being applied.

Bennett: We all have go-to thinking patterns, what we call thinking traps or distortions. With fear, it tends to be overestimating the probability of the feared outcome happening or believing that the worst is going to happen without acknowledging that there's other possibilities. We all recognize when we're at a 8, 9, or 10 out of 10 in any emotion it's gonna change the way that we're thinking about the world around us and the people in it and their intentions, that later on when we've calmed down, we might think about it in a slightly different way. So those emotional coping skills that help to bring us down to a 4, 5, or 6 out of 10, we can then recognize the role of emotions in influencing how we maybe come up with an alternative, more helpful, more accurate way of assessing the situation, assessing the potential threat in a feared situation. It's about living life

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 in line with what's most important to us, um, even when that feels scary or hard.

Albano: Yeah. It addresses the self-defeating negative fear-filled thoughts that you have about, ‘I can't, this is gonna harm me’ by teaching you a way of coaching yourself to be more open-minded, treat the things, uh, your thoughts as guesses and not facts. And it also encourages approach and taking things on as opposed to avoid and shirk away from things that might be challenging to you at the same time that it gives you skills for managing your emotions in the physical reactions. 

Catherine: Great. So at the same time that cognitive behavioral therapies are beginning to be applied in youth cases, Dr. Albano, you started working on a study of social phobias in teenagers, um, and I understand that this study in particular led to a pretty substantial ‘Aha’ moment for you that led you to establish what are now considered to be some of the best practices for treating youth. 

Albano: Yeah. That, so that study is so near and dear to my heart.

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In my first or second month of being at Dr. Barlow's clinic as a postdoc, it must have been early on in the first month, boy came in, and the long story short here is this young man did not go into any school situation comfortably and in fact, he avoided almost everything. He ate lunch in the bathroom, in a bathroom stall each day. He never went to an extracurricular event or anything, and I asked him, I asked the typical question, we're we're trained to ask. ‘Well, where do you see yourself in the next five years?’ And he looked at me, and this was a, a lovely young man, easygoing and well mannered, and he looked at me with all seriousness and he said, ‘Dr. Albano, if these are supposed to be the best years of my life, I don't think I'm gonna be alive in five years.’ And, and so quite frankly, I was stunned and having had my own high school experiences the way that I had, it just 

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really hit me: the transference, counter transference reaction. I'm sure any analysts listening will understand that. I went running into Dr. Barlow's office and I, I said, you know, ‘what the heck? This is a kid who is like semi suicidal here over anxiety.’ And, and so we sat down and, you know, recognizing how significant social anxiety is, in youngsters, it wasn't really being studied well then. There was just a few things out there. We developed a program. Cognitive Behavioral Group Treatment for social anxiety in teenagers was based on an adult program. We tested it and published on it. It is the mainstay of the way we treat social anxiety and youth. We gave the kids ambiguous situations. You go into the cafeteria, we got this from this boy. You go into the cafeteria to find a place to sit. Kids are at a table, you sit with them. Some are popular. They're talking about getting together for the weekend. How are you feeling? What would you do?

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Catherine: I'm like, I'm feeling anxious. I'm feeling anxious just hearing you describe that situation. Go on. 

Albano: Right? We asked them for anxiety, their anxiety ratings and their plans, then we brought their parents in and we asked the parents to discuss with their teenager how to manage this. Long story short, before the parents came in and talked, most of the kids, their anxiety was high, but they gave us a plan for dealing with the situation,

Catherine: Uhhuh.

Albano: a plan of either asking the kids to join or something, right? After the discussion, their anxieties were higher, and their plans were avoidant. The kids then were saying, ‘I would leave. I'd find a way to get out, I'd go to another table,’ things like that. And the bottom line is like looking at everything. What we recognized is anxiety starts so early. Anxiety starts by 4, 5, 6 years of age.

Catherine: Wow.

Albano: What we recognized is that the kids' anxiety from early on 

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was shaping the parents' parenting behaviors. If you are constantly comforting, reassuring, calming down, um, encouraging and pushing, you know, a youth who was anxious and falling apart in front of other kids at parties, in school, at your family events, you start becoming overprotective. The parents were saying things like, ‘she said, there's popular kids there. Won't you feel funny?’ They were picking up on ambiguous cues. They were picking up on things that they thought would be harmful to their kid and helping them to avoid the discomfort. Shannon, did I miss anything?

Bennett: I think you covered it. One of the things that's so important in working with parents is to recognize and acknowledge that as parents, our deepest instinct is to protect your child and to try to stop them from feeling uncomfortable. But that we need to acknowledge that in order to develop the skills 

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to deal with stress and anxiety and solve problems, we have to experience stress and anxiety and problems. So if we avoid those situations where we might struggle or make a mistake, we're never gonna learn ‘How do we bounce back from that? How do we problem solve? What skills do I need to manage this situation?’ What we were recognizing 10 years ago as the center was being developed, that young adults were leaving high school to go on to their first job or to college or wherever they went next they didn't have the skills that they needed to succeed. And not only were they suffering from anxiety and depression, but they didn't have the life skills that they needed to make it wherever they were going. 

Catherine: So was that a new observation at the time? This observation that parents were playing a big role and needed to be included in the treatment?

Albano: This was an observation that several of us as investigators, friends, colleagues in Australia, others in the UK, others were having. And so it all coalesced with a number of studies from different labs.

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The issue of bringing parents into the treatment was still to be developed and, and we started by bringing them into 4 of the um, 16 sessions of that group program. We realized the parent involvement needed to be much more than giving them instructions in how to encourage and, you know, promote positives and stuff like that. But it really has to be about also addressing their own anxieties, their own belief systems, their expectations for their kids, and them learning how to let their kids be uncomfortable in these situations in order to learn how to grow and develop skills to manage. So these are keys to the way we treat youth now is understanding we have to address the parents' way of viewing the kids and their parenting, as well as helping the kids with the CBT that we know can be helpful and work for them. 

Catherine: I mean, that’s interesting to me on so many personal levels 

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because personally I’ve done so much CBT work for myself, um, starting when I was actually just out of college and it’s amazing to speak to someone, as in you, who actually pioneered using that technique for kids, but it’s also making me wonder as a parent myself, like, what strategies do you employ to help parents who are anxious themselves actually let go a bit, and allow their kids to experience this discomfort? 

Albano: Yeah. A lot of times we use different analogies of, you know, how anxious might you have been, uh, the first time you went up on a ski lift or the first time you got behind the wheel of a car. And they’re natural and normal for that situation, as anxiety is. Imagine after the first lesson on a ski lift or on a car, on a bicycle, you never got on it again but you kept at it and now you do these things without thinking and you enjoy them… for the most part, you know? So that's the thing we want people to understand and help kids to understand. Of course, there are things that we get them to do 

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that they need to do, they're afraid of and they're not gonna be comfortable doing. Getting a shot is momentarily uncomfortable. We have to help kids tolerate the discomfort.

Catherine: Mm-hmm.

Albano: Tolerating the fear of the situation and learning that the fear needs to be proportional to the momentary discomfort or the brief hour of discomfort in that chair at the dentist's office, whatever it might be. And ultimately, it's better for you.

Bennett: And what Anne Marie is, uh, is also alluding to earlier with the ski lift example, when you leave a situation at the height of your fear or you avoid a situation because you're afraid you won't be able to handle it, what your brain then learns and remembers is only that heightened fear state. You never have the opportunity to learn ‘I can actually tolerate this feeling and my head won't pop off, or the worst thing I imagined actually isn't going to happen. Or actually

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 I started to feel better once I got there and I actually had a good time.’ But if we avoid, then we don't– we just remember it at the height of our worst possible feeling, and we don't have those corrective learning experiences.

Catherine: I'm laughing because this is as if you had like somehow surveilled my existence for the past couple months cuz we actually took our daughter skiing for the first time a month or so ago and had exactly that. She freaked out. We got all these calls from the ski school, she won't participate. And we, thankfully, I feel like good about myself as a parent right now ‘cause we did what you said. Like she, she did, she completed the day and by the end of the day she she went to sleep saying that she was dreaming about skiing black diamonds. We're like, okay, 

Albano: Okay.

Catherine: A little bit, you know, we're gonna have to meet in the middle somewhere here. But, um, next I’d love to talk to you about the adolescent age group specifically, by which I mean the late teens, early twenties because I know this is something both of you have been researching quite a bit and is the target patient group for the work that you both do at the Center at New York Presbyterian, so can you talk a bit about what makes adolescents special in terms of their anxiety and depression and 

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how they respond to certain therapeutic interventions? 

Bennett: Absolutely. There was a really interesting study that, that Anne Marie and I are both familiar with that was done by our colleague Francis Lee and, and many people in his lab at Weill Cornell. He and his group studied mice. And so we learned that you can separate mice into child mice, adolescent mice, and adult mice, and really conveniently, within a matter of days, so you can study the same mouse over a, like a two week span of time as it ages from from birth to adulthood. I might be slightly off in those numbers. Um, but what they learned in doing a fear conditioning paradigm with these mice, which involves pairing a shock that would create a feared response with a sound or a tone, and then disconnecting that pairing, and when the mouse hears that tone, it will react in fear as if it will receive that same shock. And then if you continue to play the tone without the shock, it will learn that it can hear the tone and, and that response will, will decondition or they'll habituate to hearing the tone and, and they won't have the same feared response.

Catherine: That's like mouse exposure therapy, in other words?

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Bennett: Yeah, that's exactly right. So with child mice, quote unquote child mice and adult mice, they followed that paradigm of having a feared reaction to the shock, paired with the tone, reacting to the tone, and then experiencing a decrease in that reaction over time when they didn't experience the aversive shock. However, with adolescent mice, they didn't follow that same pattern. Their ability to extinguish that fear, didn't follow the same course. They held onto that fear slightly longer, and there's a lot of interesting, sort of evolutionary perspectives about why this may be- adolescence is a time of exploration and separation, and so perhaps it is helpful for teens to have a heightened sense of, of, uh, you know, awareness or things that may be threatening so they can keep themselves safe and and survive. 

Catherine: And do we know the neurological mechanism of these differences?

Bennett: From a neurobiological perspective, we know that the emotion centers of the brain develop before the control centers of the brain. 

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So adolescence is a time of emotion expansion in the brain. The amygdala and other emotion centers of the brain are developing rapidly during adolescence. That's part of the reason why adolescents are really emotional and those frontal control centers of the brain that give us more ability to plan and, and attend and dampen down those emotional spikes, those don't finish developing till much later, right? Age 20, 22, 25, 27. So we see this sensitive period during adolescence when emotional reactions, including fear reactions are going to be stronger than they would be in childhood or when we don't quite have the control capabilities yet that we do in later adulthood. We know that there's a long walk between a mouse and, and an adult, but, um, in reanalyzing some data from human studies of social anxiety and exposure therapy in children, adolescents, and adults, 

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we found that there seemed to, again, a less response to exposure therapy in teens than there was in kids and adults. 

Catherine: Wow.

Bennett: But so then the last interesting step in the mouse study was that when those adolescent mice were put back into the exact same cage where they acquired that fear, they actually were able to extinguish the fear more readily than if they were doing the de the habituation or deconditioning in a different cage or a context. So this was actually supporting what exposure therapists knew all along that we can't do true exposure therapy in a small office. We need to be out in the world. We need to actually practice interacting with humans, going and asking for a job application. If a teen talks to me and practices having a conversation, that's absolutely not gonna be the same as when they're talking to their peers. I don't know any of the words or the slang or the things that they talk about. Um, I can do my best to role play,

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 but it's not gonna be the same as when they're actually practicing in those real world contexts.

Albano: Yeah. And so this study actually validated for us what we do in exposure therapy. I learned a long time ago in treating patients with, uh, specific phobia of snakes, rubber snakes only go so far. You actually need to bring real snakes in and have the person interact with real snakes. We have to have as realistic as possible exposure situations. That young man I talked about, the first patient when we developed our group around him, his first date was a girl asked him to the prom and he had never been on a date before. We literally decorated the clinic to look like with the, with the you know, swirly ball that you know with that, with lights and shimmers on it. 

Catherine: Disco ball. 

Albano: We had a prom. 

Catherine: Oh my goodness. 

Albano: We had a mock prom for him, and we had it go every way it could go. 

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We had girls dancing with him who stepped on his feet. We had girls like leave him at the dance, people not talk to him. We did all the good stuff as well as the things that could go wrong. And in actuality, he went to the prom with this girl. He came back to us to therapy afterwards the next week, and he told us she dumped him at the prom for another guy,

Catherine: Oh no.

Albano: But because we had prepared him, he asked other girls to dance and he said he had a good time. And he said, ‘if you hadn't done this the way that you did, I would not have come back to treatment.’ So we've known this for many the years that you have to be as realistic as possible, and that mice, um, uh, study with, uh, Francis Lee and colleagues confirm that. This is why we do as much as possible out of the office exposures, and why group therapy is so important because having, as Shannon said, other peers in the room to role play situations is critical,

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 and then it has allowed us also to develop virtual reality environments that we have. We have the virtual dormitory, the virtual classroom, the virtual professor, the virtual party. We can control the avatar's reactions to the student. So these virtual environments allow us to approximate and recreate environments that we can't actually go into with them, uh, without compromising their confidentiality. 

Catherine: So that’s so interesting, but it’s not just that you’re treating, um, adolescent anxiety and depression with CBT and exposure therapy, but I understand you’re treating a lot of other disorders too, so Dr. Bennett, can you tell me a bit more about how you apply CBT to treat Tourette’s and tic disorders? 

Bennett: Well, so Tourette's and tic disorders are a little bit different. One way of differentiating is that we, there's not really a cognitive process. So Tourette’s syndrome is the experience of a tic, which is an involuntary movement or vocalization that often, um, 

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may occur after some sort of uncomfortable internal experience or urge. So there's a phenomenon called a premonitory urge that people feel often right before they tic, and the tic alleviates that urge. And so we do use behavior therapy that if we can do something different to block the tic, so for example, if my tic is to scrunch my shoulders up, I may press my shoulders down using my muscles, maybe, you know, clasp my arms in to hold that position. And again, I'm gonna have to feel that uncomfortable sensation longer and more intensely than I'm used to until that urge passes. So there's not a lot of thought work or cognition, but it does follow a similar pattern of tolerating an urge, tolerating something that feels uncomfortable.

Catherine: Gotcha. So switching gears quickly, I actually wanted to ask you about social media impacts in particular, and if you can expand on some of the effects you've seen it have on adolescent development, because that obviously has been huge, 

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huge, huge change in the past 10 years.

Bennett: Well, this is an, an area of active study. We know there's pros and cons to social media. We know that there's ways that it really helps us to connect and learn and socialize. And we also know that if it's used as, you know, as the only or primary mode of socialization, that's problematic, but what some studies have shown is that how we use social media is really important. So if we're using it as a tool for connecting with groups or peers that we are already actively engaged with, like planning a study session, that can be really positive for mood and anxiety, but for kids or adults, uh, if we're just sort of scrolling passively observing what everyone else is doing or what we believe everyone else is doing it cuz we know these are not fully accurate representations and comparing ourselves to everything that we see then that is really poor and, and heightens anxiety and depression. When kids are constantly connected to screens, they don't have any break from that, 

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they don't have any time to disconnect, to, you know, to use their imagination, to think creatively, to be bored. It's interrupting with our ability to, to just tolerate boredom. It interrupts youth sleep when they're using screens at all hours of the night. Um, and then finally, there's this sense of anonymity behind screens that contributes to cyberbullying that's really toxic, particularly for our most vulnerable youth, as well as the sexualized behaviors that kids aren't thinking through, and when kids aren't thinking this through or getting advice from their parents or other trusted adults on how to use these tools, it can really create very, very big problems.

Albano: One of the things that's happened is information is distilled in a certain way in sound bites now, and this is how kids are consuming a lot of information, this can heighten their misperceptions, their, their inaccurate beliefs about themselves and others. 

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So it's important to moderate and monitor the use of social media in a youth until a parent knows that they can be responsible with it, and a very important thing is that data show that all kids use social media, but it's the kids who have an outside life with face-to-face contacts are engaged in outside activities, be it sports, community service clubs, various things where they are actually doing socializing without screens, those kids are healthier on all kinds of measures. Anxiety, depression, um, optimism, various things like that. It's the kids whose lives are on screens that are the ones we have to worry a lot about.

Catherine: Gotcha. I wanted to close by asking you if you had any, anything you've learned over your careers and your research that you think would be useful for physicians in different disciplines to think about?

Albano: Yeah. I think physicians, uh, that I've worked with before in pediatrics, adolescent medicine, 

[31:00]

um, and such come across a lot is, uh, a request for sending in a letter of accommodation for a child, even all the way through the college age youth, some sort of accommodation for their anxiety. This is everything from, uh, they need their own room, not roommates because of maybe OCD or an emotional support animal, let's say. An accommodation for home tutoring because the anxiety is so overwhelming. Their tests to be in a private room at another time, um, not in the mornings. They have all different things that you know, they're asking for. What I always do with accommodation is assess the severity. How will an accommodation help this youth to overcome the anxiety or get to the highest level of functioning they can in a way that can be sustained as they move along? 

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And, you know, ultimately at the end of high school or the end of college, the work world does not accommodate the way schools do. So I always put in accommodation letters– if I do them– ‘this is temporary for the next four weeks while this student is working with me to address their anxiety concerns. And we will reevaluate the level of accommodation by the end of those four weeks. As we move forward, we're going to lessen the accommodation to help you be fully into the pool, whether it's, you know, maybe you're taking the test in the counselor's office, but now next time you're gonna take it in the hallway outside of the classroom, then you're gonna eventually get in the classroom.’ because the more we accommodate, the more we overprotect and not let the kids develop the skills to manage on their own. And we help the parents with this too.

Catherine: Great. And Dr. Bennett, any closing thoughts on your side?

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Bennett: Yeah. One of the things that, that Anne Marie and I have talked about previously and have both been involved in is, is patient-centered research, and this is true for clinical work as well. As doctors, as clinicians, as researchers, we get into, you know, a certain way of doing things, a certain track of study but we need to ask the people that we're working with what they think is most important in our clinical encounters as well as in our research. So patient-centered research centers the patients or the groups that you are wanting to help in asking the questions: ‘What's most important for them?’ This is particularly important for vulnerable populations and minoritized communities so that we know how our interventions can best serve them. It's not one size fits all, and, and we need more researchers and clinicians, people of color, and from the LGBTQ community to be part of this effort and leading this effort so that we make sure that our treatments are going to be as helpful as they possibly can be for every single person who may need them.

Catherine: Thank you both so much for making the time to speak with me today. I could keep talking to you for hours and it’s just so amazing to hear about your contributions to the treatment of youth mental health so thank you.

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Bennett: Thank you for your time. This was such a pleasure. This was a lot of fun.

Albano: Thank you for having us, and we're happy to come back anytime.

Catherine:  I’m Catherine Price; Advances in Care is a production of NewYork-Presbyterian hospital. The views shared on this podcast solely reflect the expertise and experience of our guests. To find more amazing stories about the pioneering physicians at NewYork-Presbyterian, go to nyp.org/advances.

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