Contrary to popular discourse, social media holds real promise to *support* adolescent mental health—especially for teens facing barriers to accessing treatment.
My take in
@statnews
today!
Just learned that I received a grant for which my cat accidentally clicked 'submit' while I was out walking the dog
Mochi now has a higher grant hit-rate than I do and will be submitting all of my applications until further notice
Here she is looking unimpressed:
Framing mental health problems as chronic illnesses that have flare-ups (as all chronic illnesses do) would save so many patients from self-criticism over lapses. The idea/goal of 'full recovery' is still common in treatment settings, and it puts so much undue pressure on people.
I ❤️ writing intros to papers/grants. If you don't, here's my approach, which (for me!) makes intros more fun to write:
1. What's the problem/why do we care?
2. What do we know re: solving the problem?
3. What don't we know? Why not?
4. We tested X to fill the gaps from '3'
🧵
Here is a 🧵 of terms related to money/funding in academia that no one explained to me until I was applying for faculty jobs (or after I'd started), that I pretended to understand until then, and that would’ve been very helpful to learn earlier than I did.
1/a whole bunch
Hi grad programs! If your letter of recommendation portal requires me to rate a student's "emotional stability" or similar, I will endorse everyone's "stability" as "once-in-a-decade" until you remove this stigmatizing and frankly embarrassing (for clinical psych programs) item!
Hi academia,
If you took the weekend to rest: Good job! You needed it.
If you're frustrated because you still feel burnt out after taking the weekend to rest: Please be gentle with yourself. Normalcy evaporated nine months ago. Four days can't fix that & that is not your fault.
While you're all here...
The grant will fund a 2-yr project testing whether single-session, online interventions can help bridge pediatric primary care-based depression screening with treatment access in teens (currently, <50% teens who screen positive access tx!)
THANKS MOCHI!
These words have lived in a document on my computer since grad school, save the first sentence and my job title. Nervous to share but it seems maybe helpful. Reserving the right to delete.
I hope this helps someone, even if I'm not sure who or how. ❤️
It's real!! There is officially a ready-to-apply, evidence-based, comprehensive resource on brief and low-intensity youth mental health interventions! Grateful for the chance to help bring this book to life, and for the many authors' 🔥 contributions 🥳
Also, I think empowering folks to know that change is always possible (and indeed constant!) is very compatible with the 'mental illness as chronic' idea! Flare ups may happen, but they're not personal failings, & there are always things you can do to manage & cope w them.
If you're a PhD student feeling guilty enjoying TV, stop by and talk to me about the show, because I've probably seen it.
The only things I'm reading post 7pm on a weekday are Netflix subtitles, mainly because I'm tired & my brain needs the extra layer of processing support
Overheard report of a senior academic telling a PhD student “you should be reading papers in the evening instead of watching TV.” This is all that is wrong with
#academic
culture.
#phdchat
#phdvoice
#WorkLIFEbalance
Mistakes in academia can feel awful. They're also inevitable. And even if they're unfixable, things can be OK long-term.
Mine include
-Shared results—then learned I cleaned data wrong
-Forgot survey items
-Wrote "Harvard" in my PhD app to Yale
Share yours to prove my point! 👇
My department just voted to support my promotion to Associate Professor with Tenure 🥹
There are more steps to go, but this was a big hurdle and I'm so relieved
Quote-tweeting my birthday-post from last year, because that message is hitting me especially strongly today...
These words have lived in a document on my computer since grad school, save the first sentence and my job title. Nervous to share but it seems maybe helpful. Reserving the right to delete.
I hope this helps someone, even if I'm not sure who or how. ❤️
Not to disclose academic trade secrets, but your "availability for meetings" does not equal "all open hours in your work calendar." If your day has 4-5 hours of meetings & "nothing else," your day is full, because "nothing else" is when you do the work discussed in the meetings.
Happy day-before-birthday to me…
I’m beyond excited to share that the Lab for Scalable Mental Health is moving to Chicago!
In September 2023, I'll begin as Associate Professor of Medical Social Sciences at
@NorthwesternU
@NUFeinbergMed
!!
I get that this site is dying/dead, but I just got the page proofs for my book, and no dystopian internet horror show is gonna stop me from being publicly excited about it. [Out September 2023!!!]
Once I realized that rejections in academic research often have zero relation to the quality of my work/ideas, the deluge of No's got easier to manage. But WOW you have to believe in yourself to an absurd degree (or surround yourself with people who do) to make this path work
I feel like more youth mental health treatment research papers should start their method sections with "In a sample of children whose caregivers had the time, resources, understansing of mental health, and trust in research(ers) to enroll their kid in a clinical trial.."
It's amazing that I still have to say this but people's self-reports of emotional problems do not require justification by "objective" or "biological" assessments to carry meaning
If a biomarker tags someone as healthy, but they say they feel depressed, what would you believe?
Cancelled all my meetings today to decide which commitments to drop in order for work to stay sustainable/meaningful. Worrying I might let people down is hard, but burning out would guarantee it.
Feel free to use this as a nudge if you need to do something similar ❤️
@ProfessaJay
The dissonance between the pure truth in this and the total certainty that I will keep applying for grants, maybe forever, is stunning
I hope to be as wise as your 6yo someday
I just want everyone to understand for certain that lived mental illness experience and success as an academic and/or practicing clinical psychologist are NOT mutually exclusive.
Hi! If you tweet abt the truly amazing
#BlackHole
photo, pls give credit by name to *Katie Bouman,* who was a PhD student when she led the international team that made that image possible
Also: PhD students, you are amazing—and the reason science happens
New papers are showing null (or neg) effects for universal school-based mental health interventions, from mindfulness to multi-module eCBT.
IMO, an overlooked factor is that students *have* to do these interventions. They get no choice—as in most parts of their lives.
🧵 1/x
I cannot emphasize enough the importance of having people in your life who, when you're rejected/passed over for an important-feeling thing, reply without hesitation, "wow, how sad for them that they got it so wrong" and mean it.
@karlimarulli
sadly this tweet is already amplified & I hate to contribute. But to the many folks who'll see this & feel shame, despair, or self-blame: your struggle is serious. It is NOT your fault. You deserve compassion and care, full stop. I am so sorry you have to endure things like this.
I am so happy to share that my book is DONE!!
"LITTLE TREATMENTS, BIG EFFECTS: How Small Experiences with Meaningful Impacts Can Transform Your Mental Health" will be released ~Sept 2023 by
@LittleBrownUK
Will share updates and pre-order links when they become available 🥳🤯
We just got a NOA for a 3-year HRSA grant (led by Dr. Susmita Pati) that will allow us to establish a single-session mental health walk-in clinic for Stony Brook healthcare workers & trainees. I am so excited I'm crying. Also we're now hiring more than just one new postdoc! YAY
IT IS REAL!!! And I have zero chill about it. Wow. 😭🥹
Being gifted the opportunity to write this book has meant the whole entire world to me. I'm scared and excited for others to read it, and I sincerely hope you enjoy it.
[Out Sept 7 in the UK + int'l shipping; link below!]
At 22 I was ~1 year removed from taking leave from college to (re-)enter intensive treatment for anorexia. Now I'm a clinical psychology professor directing a research lab that builds barrier-free mental health supports. Change is life's only constant.
Question time ! I'm 22 and people like to tell me how young I am and how much time I've got to figure things out even if I don't feel like I do. So...what were you up to around 22 and how has your life changes since then?
Why do MD/PhD programs seem to support "bench-science" PhDs only?
Do we not want MDs with research expertise in public health, health services, or applied psychology? Are there MSTPs that do support this?
Asking for UG/postbacc mentees, but also me. I don't get it.
#MedTwitter
Dear fellow burnout battlers. I am displeased to report that four days of rest does NOT cure burnout that took many years to build, even if the whole situation is super inconvenient. It takes as long as it takes. Be as patient with yourself as you are with those you care about 💜
So close to activating this autoreply
"Hello,
I have over-committed to things. This autoreply is an intervention to help me stop, ensuring that my "sorry I can't!" reaches you before my "yes." Now, if I try to agree, it will feel awkward. Thank you for tolerating this message"
@reginegalanti
From your perspective, it makes perfect sense why you would want me to tell you I'm a psychologist without telling you I'm a psychologist, and I can imagine anyone else in your position asking the same.
The better I've gotten at research the harder it's become.
I think 'mastery' in this line of work is just radical acceptance of how little is truly knowable—and trying earnestly to know things better anyway.
My new book—Little Treatments, Big Effects—is available for pre-order (pub date Sept 7)!!
Writing this book—which merges lived experience with science to argue for BIG change in mental health care—has been an unimaginable privilege. I hope you enjoy it.
Finally made a new lab-wide project board for my home workspace. Feels like my brain can breathe again.
10/10 recommend color-coded sticky notes for organizational therapy purposes, should that be your jam.
New scientific norm: No more apologizing for null effects in papers. Your study results are worth sharing PERIOD, not "in spite of" non-significant p-values.
Free advice! If someone declines a peer review invite with "sorry I'm going on vacation, but here's some other folks w related expertise" a good reply is "enjoy!" not "that's a shame"🙂
Anyway off to my first real >5 day vaca in 3 years! The only shame is that it took this long!
Hello from my recurring state of paralyzing alarm at the fact that nearly ALL of our evidence on youth mental health treatments hinges on a small, privileged subset of kids whose parents 1) noticed a problem, 2) helped them access care, & 3) signed them up for a clinical trial 🫠
Last year I gave myself a scary birthday gift: publicly sharing my experience with mental illness. I worried this might bring difficult career consequences, given my field (clinical psych).
Largely, I don't think it has. For birthday 32 (tomorrow!) I’d like to talk about why.
The clinical PhD application process is an uneven playing field. So much is opaque to folks w/o strong mentors or connections.
Hope this FAQ page pulls back the curtain for applicants to my lab this cycle. (Thx to my lab members for feedback!!)
🤯 Our lab is in
@WSJ
!!
Ft words from me, work by our team (incl a preprint led by
@jennaysung
!) & research from colleagues across the country on the power of brief interventions to promote mental health! TY
@drjennytaitz
for championing this work!
Hi to anyone else who's had people doubt their work, or ideas:
In the past ~5 years people in academia have called my single-session intervention work "fanciful," "dangerous," "insulting," & "wrong"
Now I sometimes see those people at talks I give.
Keep at what you believe in.
“Hard money” and “soft money” refer to whether your base salary is guaranteed by your institution (hard money) or supported by external (usually federal) grants (soft money). Some positions are a hybrid of both.
2/x
An unfortunate thing about imposter syndrome is that the people who should maybe have a little of it often don't, and the people who do, often shouldn't.
This is not a subtweet, I'm just sad about it
Scientific "objectivity" has always been a false premise. Arguments for "empiricism over activism" in social science research are dangerous, disingenuous, and rampant.
Please read and sit with this crucial piece by Dr. Steven Roberts on dealing with diversity in psychology.
“Fellowships” & “grants” are not the same. Fellowships usually support living expenses, esp for PhDs/postdocs; they variably support costs for carrying-out studies. Grants cover costs to *do* research. Sometimes (for faculty) they may be used to cover portions of salary.
4/x
.
@PsychScience
I was invited to share my expertise on single session interventions AND as a psychologist w lived mental illness experience. No tweet will capture now validating this is, nor how certain I once was that it couldn't happen. Hoping this signals change in our field.
It's wild spending 10+ years and getting a PhD studying/testing scalable mental health interventions, and still struggling to help anyone (even myself!) find in-network therapists with relevant expertise *and* openings for new clients. Deeply motivating, and equally sad.
The more interview-based work I do, the more it upsets me that qualitative data is often sidelined and devalued in building/testing mental health treatments.
Can any of us really argue that a mean 3 pt PHQ-9 drop says more about 'what works' than a personal account of recovery?
Gentle reminder that housing policy is education policy is economic policy is criminal justice policy is healthcare policy is mental healthcare policy
time for us to drop our self-perpetuated silos; in reality, there are none.
A million thank-yous to every human who's written a thoughtful, generous reference letter (without asking for the referee to draft it first) & then shared it with the person you wrote it for, unsolicited, just to give them a boost. The impact of this gift cannot be overstated 🥲
We set up our online single-session interventions such that teens can try them on their own, anonymously, w/o parent permission. We ask those who've been unable to access care: What got in the way?
The replies are heartbreaking. Teens deserve autonomy in getting needed support.
Hi clinical researchers: Once you've tested intervention materials & found them to be helpful, PLEASE share them publicly. Today I heard from teams on 3 continents using our lab's materials in practice/research. Sharing helps. Gatekeeping harms. This should not be controversial.
Happy mental health awareness month!
But awareness is not the end goal. Structural change is -- toward making treatment more accessible, more effective, and less harmful. Toward restoring agency and trust to people seeking help.
Awareness is Step 0. We've got long way to go.
We are overwhelmed with data, so I'll be recruiting for a 1-year postdoc. Start date flex, WFH possible.
MAIN TASKS: data analysis, writing papers & grants, collaborating w a great team.
Will 100% help you write an F/K if you'd like.
Official post soon—reach out if interested!
📢NEW PREPRINT w
@mcmullarkey
@kathrynrfox
@mallorydobias
, Shroff, Hart, & Roulston
In a nationwide RCT during COVID-19, 2 online single-session interventions both reduced 3-month depression symptoms in high-symptom teens (N=2,452) vs an active control
🧵
“9 month salary” = the annual academic-year-length salary for tenure-track faculty, which is 9 months long. Summer work is not automatically paid. Faculty may pay themselves up to 3 “summer ninths” (1/9 of the 9-mo salary) through external grants and/or extra teaching.
3/x
Happy Hanukkah twitter-verse! Here is Penny, setting a good example by celebrating indoors with her pup-safe menorah, cozy blanket, and immediate family members only. ❤️✡️
Clinical psych PhD students: Please grant yourself freedom to dream BIG about careers. Consider what you want to do, impacts you hope to make—independent of setting (in/out of academe).
Your ideal path may not exist yet, but don't assume you can't build it. Your skills are vast.
I seldom hear colleagues refer to mental illnesses as disabilities—even though they're defined as such by the ADA and can be very disabling.
I think this stems from ableism in psychology & psychiatry—an impulse to self-distance from "disability." We're long overdue to combat it.
Petition to just write how humans talk in scientific papers. Everyone would be happier! Non-scientists would know what we're saying! WE would know what we're saying! Such neat possibilities.
I'm set to drop performative "indeeds" and "heretofore's" if you are
Perhaps it has to do with the ways in which we are trained to write so as to sound “academic.” Thus, it is not that we like the word per se but that we like sounding how we think academics sound
R01 SUBMITTED. (!!!) Please send continuous positive vibes to me and Co-PI
@KathrynFoxR
over the next however-many months. No matter what NIH review turns around, I've rarely been this excited and hopeful for a potential study, which really is saying a whole lot. 🤞🤞🤞
ALSO. Soon-to-be FLOTUS
@DrBiden
is a social science PhD, college prof, & former classroom teacher to kiddos with emotional challenges ❤️
Here is her dissertation/my afternoon reading: "Student Retention at the Community College: Meeting Students' Needs"
📢 HELP! FB/Insta won’t let us advertise our free, IRB-approved, grant-funded single-session mental health support website, built for & with LGBTQ+ teens. Our ads were tagged as ‘abusive.’ Working on a fix, but until then: Please RT to help us reach 1000's of LGBTQ+ teens anyway.
Hi academia. Anyone else feeling drained by administrative/structural roadblocks over which you have no direct control today? This is me seeking social support and validation instead of just sitting defeatedly. Thanks! :)
I shouldn't by now, but I feel sad/baffled whenever I hear that there are still PhD mentors who react to students' nonacademic career plans with anything but joy (bc they found a path that excites them!) & instrumental support.
I'm preaching to the twitter choir here, but yeesh.
Last month I asked Twitter how one might, hypothetically, pitch a nonfiction book idea.
Last week I got an offer from a publisher to make my book idea real. I'm in disbelief and overwhelm of the best kind.
Anyways, Twitter is unimaginably helpful. Thanks everyone.
@jimgmiller
Yes, the medical model applied to mental illness often looks like what you describe, which harms/stigmatizes. That's not what I mean! To me 'chronic' doesn't mean drugs are required or that you'll always be ill. Just that recurrences happen, can be managed, and aren't your fault.
roses are red
violets are blue
evidence based treatments help
except when they don't
which is kind of a lot, so maybe we should fully rethink how we assess clinical improvement & what "effective" actually means for people in emotional pain UM HERE'S A CHOCOLATE DON'T BE MAD BYE❤️
File under "career things I was sure couldn't happen, part 94"
My viewpoint arguing that psychologists must stop excluding experts by experience from tx design, in which I self-identify as a person w/ lived experience, is in press at Journal of Consulting & Clinical Psychology🤯
🌟New preprint!🌟
Clinical intervention science has long deprioritized the views & voices of those our treatments aim to support—experts by experience (EBEs)—in the development of novel mental health supports. This has to end. My thoughts on why & how:
There are so many more, but I am sleepy. Please add others! There is no reason these terms should be kept secret until the moment you need to know them (or after).
‼️Just accepted paper in J. Adolescent Health, by
@vmoraringle
@jennaysung
@caroulston
& me:
In a mixed-methods study of 211 teens, parents were BY FAR the most common teen-reported barrier to accessing mental health care
Parent-centered consent processes can mask youth needs.
“Direct/Indirect costs.” Almost all grant budgets have both. Direct costs = $ to actually do your research, pay staff/yourself. Indirect costs (AKA overhead, facilities/admin costs) = costs of using the University’s resources during the grant period (i.e. $ you can’t use)
6/x
on the off-chance anybody besides me is experiencing impressively high levels of distress following objectively minor, normally-tolerable challenges:
you're not oversensitive, the world is melting.
Book release day!!
@mcmullarkey
@MalloryDobias
& my
@NewHarbinger
workbook for teens is order-able!
Also, I have 10 extra copies. If you'd like one, live in the US, and are a trainee in mental health, message me to let me know & I'll mail you one myself.
Declining work "opportunities" that do not spark joy, to leave breathing room for the ones that do, is the most life-giving skill I've ever suppressed excess guilt and anxiety to maintain. 11/10 recommend, preferably without the excess guilt/anxiety but also either way!
“Buyouts” = releases from teaching duties granted to faculty members by the Dept/Uni in exchange for funding (provided by the faculty member, usually through a grant they secured), which is used to pay for an alternate instructor. Not all faculty jobs allow buyouts.
5/x
A reminder that mental health care was *already* totally inaccessible before the pandemic, and it will stay that way unless and until options for support expand dramatically.
Teletherapy is a start, and it will not come close to solving the whole of the problem.
Despite what every podcast advertisement on the planet will recommend, please do not use BetterHelp or suggest it to friends.
There are other, safer app options—e.g. those rated by experts as credible, transparent, and user-friendly:
To my knowledge, I'm visible most days, but this piece isn't unless I share it. So on
#BiVisibilityDay
, remember that bi+ identities are 1) worth honoring, however feels best; 2) never 'unprofessional' to share; & 3) defined by your own self-knowledge, not others' preconceptions!
If you have to factor in/subtract indirect costs from the *total* budget for a grant of interest, that can make a VERY BIG difference when planning out your budget for each funding period.
7/x
Just dug up a cover letter from 2013 (I was a 2nd yr PhD student) & saw that my summary of my research included *nothing* on brief interventions.
So, here's a reminder to allow your interests to grow. Change can be scary—and, it can help you find the work that fulfills you most.
Truly, if this actually predicted grad school success, I would've failed out. But that "low emotional stability" (as some could call it) led to a lot of anger-turned-drive to help make mental health systems less awful. So, I dunno. Maybe we could all use a little less stability.
Hi all future conversation partners!
Single-session mental health interventions will NOT replace traditional therapy
They CAN complement & extend existing care systems—which cannot & will never address all mental health needs
(may get this tattooed on my forehead to save time)