The Anxious Child— Three Common Errors Parents Make, and How to Avoid Them!  Featuring Dr. Taylor Chesney Today we interview Dr. Taylor Chesney who is the Director of the New York office of the Feeling Good Institute. She specializes in the treatment of children and teens, and today will tell us about the three biggest errors parents make in dealing with anxious kids. Dr. Chesney has been a guest on several of our podcasts in the past (episodes 107 and 263, and Corona Casts 4 and 6) and is a terrific teacher and therapist. She recently taught a 12 week course for therapists working with teens and children (ages 6 to 18) and their parents and brings us some of the highlights today. She always begins treatment by interviewing the child and the parents and pinpoints what they want help with. Then she assesses how hard they are willing to work to bring about that change. The goals may be quite different for the child and the parents. It’s crucial to develop a meaningful therapeutic contract with the children, as well as the parents, as opposed to thinking your role is to “fix” the child for the parents. If the child is less than 11 years old, she meets with the parents first. If the child is 12 and up, she meets with the child first. Either way, she empathizes with the child and encourage them to tell their side of the problem. During or after empathizing, she does Positive Reframing, to show the child what their negative feelings, like depression and anxiety, show about them that’s positive and awesome. For example, if you’re sad about not being invited to a birthday party, it shows that you value friendships, and that you care a lot about other people. If the child is anxious, she will teach them how their anxiety can be helpful. For example, if the child is a good athlete or student, anxiety can be an important motivating force in their success. But sometimes we might get too anxious and feel intensely anxious about something that is not actually dangerous. Then you might experience your anxiety as trouble eating, a belly ache, trouble sleeping, or some other symptom that gets in the way of your optimal functioning. The most important question with parents and children is usually: “Do you want to learn some tools and skills to help you change the way you feel?” She also teaches children and teens what different kinds of emotions are, and the kinds of thoughts that trigger them. For example, if you feel anxious, you’re probably telling yourself that you’re in danger and that something bad is about to happen. If you feel guilty, you’re probably telling yourself that you’ve done something bad, or that you hurt someone you love; and if you’re feeling angry you may be telling yourself that someone is trying to hurt you or take advantage of you. Taylor brings the core cognitive therapy ideas to life with examples that children can understand.  Here’s how she explains the idea, taught by Epictetus nearly 2,000 years ago, that our feelings do not result from what happens to us, but from our thoughts about what’s happening. Let’s say that you got a 90 on a test. How would you feel? You might feel overjoyed if you studied hard and felt like you did a good job and got a wonderful grade. However, if you felt like you had to get a 95 to raise your semester grade in the class to an A, and you even skipped going to the prom to study extra hard, you might feel sad, ashamed, frustrated, angry, and disappointed, telling yourself that you “failed.” Same grade, but two radically different emotional reactions, depending on how you think about your grade. Conclusion: it’s not what happens, but what you tell yourself, that triggers all of your positive and negative feelings. Taylor said that anxiety is incredibly common in her clinic population and that surveys indicate that a whopping 25% of children have an anxiety disorder. She teaches her patients that anxiety in children, teens, and adults results from giving in to the urge to escape from a frightening or uncomfortable situation instead of facing your fears and discovering that the monster has no teeth. For example, Taylor was in the ocean with her 9 year old son, and there were jellyfish in the ocean. Her son was terrified and wanted to get out of the water and back to the shore. Taylor asked him what he was telling himself, and he said he was thinking that the jellyfish were bad. She also told him, “It’s okay to be afraid and to be careful and avoid the jelly fish, but you can also choose to stay in the ocean. Then we can have some fun together playing in the water.” He decided to stay and have fun and felt proud of himself! She described Three Common Mistakes parents make in dealing with an anxious child. Error #1: The Quiet Out Trap She explained that we love our children, and don’t want them to suffer, so we may give them an easy way out. For example, if your child is afraid to go to the party when you are dropping them off, you might say, “If you don’t want to go to the party, we can go home.” This seems like a kind and loving thing to do, protecting your child. However, you’re teaching the child that he or she can escape from anxiety through avoidance, so the child’s fear of social interactions actually increases. It also teaches the child that you don’t think they can handle the situation. An alternate response would be to say, “Let’s go in and sit down together!” She advised against cheerleading or trying to convince your child that they have nothing to be afraid of (e.g. “it’s not that scary” “there’s nothing to be afraid of.”) Instead, you can tell them that it’s okay to feel the fear but do it anyway, and you can often model that together with them. Error #2: The Escalation Trap In this trap, you let your fearful and avoidant child become more and more anxious and demanding, until they freak out and throw a temper tantrum, and then you give in to them. This, again, provides immediate relief, but in the long run you are training them to escalate and throw a tantrum to escape from having to face their fears, and on a broader scale, any time they want to get what they want. Error #3: The Mental Filtering Trap Mental Filtering is one of the ten original cognitive distortions, and it means focusing on the negatives in any situation and ignoring, or discounting the positives. It’s a common cause of depression, but can also be a communication error if you focus excessively on what your child is doing wrong. Instead of pointing out your child’s errors, you might say, “Johnny, I love how you stayed calm when X happened. You’re really getting good at that.” In other words, you can comment on what they are doing right. She said that showing kids how to be successful is more effective than berating them for what they’re doing wrong. This is an effective and low-stress way of reshaping their self-defeating behaviors. David mentioned that this positive style of communicating can also be highly effective in a work environment, and that he uses it a great deal in his interactions with colleagues on the app team. If done in a genuine way, it can quickly reduce conflict and enhance morale and mutual respect. How to Teach Parents David asked Taylor if many parents resist implementing these kinds of changes. Taylor said that if she calmly and clearly teaches the parents what they’re doing that isn’t working, using the Five Secrets of Effective Communication, most parents quickly become motivated to grasp their mistakes and change their strategies in dealing with their children. Taylor also “Sits with Open Hands” when making suggestions to parents. She explains it like this: This means that if what the parents are doing works for them, and they aren’t willing to work hard to make changes, I accept this. But if they’re willing to work hard and change, we can work together to help them implement more effective parenting strategies. Getting parents to work together as a team can be very important, but some parents may fight over the best way to discipline and raise their kids. These conflicts between mom and dad are one of the major causes of the unhappiness in the kids and get in the way of change. Taylor emphasizes “Little Steps for Big Feets,” and might set small attainable goals for the parents who are at odds. For example, can they just sit next to each other and perhaps even “fake” a unified front for one conversation? Parents do not have to commit to making these changes “for the rest of their lives,” but make experimental small changes instead, for a small discrete period of time, and then check in and see if the change makes a difference. If it does, they may be motivated to continue to try to implement more changes. Taylor typically works with children and their parents for 12 to 16 sessions and gives them a tool set to change some specific problem they came to therapy to solve. She has worked virtually for the most part since the start of the pandemic, but is now starting to see some people in person again. She offers classes for mental health professionals and also runs a monthly case consultation group on the last Wednesday of every month from 12:30 – 2 pm EST. For more information, you can reach Dr. Chesney at Taylor@FeelingGoodInstitute.com. Every fall, Taylor teaches a 12-week training course for therapists on TEAM-CBT for children and adolescents. You can also check the www.FeelingGoodInstitute.com website for more information on TEAM-CBT training for children and adults. Thanks for listening today! Rhonda, Taylor, and David

Personal Work with Dr. Tom Gedman-- Overcoming Performance Anxiety The Triumphant Conclusion Last week you heard Part 2 of our personal work with Dr. Tom Gedman, which included T = Testing and E = Empathy. This week you will hear the dramatic and inspiring conclusion of the session, including A = Assessment of Resistance and M = Methods. Dr. Tom's beloved pal   Start of Part 2 A = Assessment of Resistance We began with the Invitation Step, asking Dr. Gedman what he hoped to accomplish in today’s session. His list included: Develop some clarity on the direction of my business. Become more authentic in my video recordings promoting my clinical work. Increase in self-confidence. Feel accepted by David and Rhonda. My ability to push ahead during recordings instead of stopping and backing down because it isn’t “good enough.” Dr. Gedman said that he’d gladly push the Magic Button to make his negative thoughts and feelings instantly disappear, but agreed to look at some of the positives in them first by asking these types of questions of each negative thought or feeling. Is there some truth in this negative thought? Could this negative thought or feeling be appropriate or even healthy, given my circumstances? How might this negative thought or feeling be helping me? What does this negative thought or feeling show about me and my core values that’s positive and awesome? Could there be some negative consequences of giving up this negative thought or feeling? The Positives in My Negatives Negative thought: “I can’t be authentic on videos. I look like such s smug phony.” I want to be other-centered, and focused on how I might be able to relieve the emotional struggles and health problems of my patients. I value being authentic and genuine. I want to help people who resonate with my message. I don’t want to hide. I want to be open with my flaws. I value honesty and integrity. I value humility. I value compassion. Negative feeling: sadness I care a great deal about my dream. I don’t want to fail and let my family down. Negative feeling: shame Motivates me to work harder Shows my love for my family. I’m aware that I’m letting down the very people I want to help. Negative feeling: inferior, inadequate Show that I respect and admire the many people who have superior skills at talking live in front of a camera. Shows that I’m aware of what others have accomplished. Shows I don’t feel superior to others. The idea behind the Positive Reframing is to help the patients see that their negative thoughts and feelings are not the expression of what’s “wrong” with them, but what’s right with them. This paradoxically reduces the resistance to change and opens the door to the possibility of rapid recovery. You can see Dr. Gedman’s goals for each of the negative feelings on his Daily Mood Log if you click here. As you can see, instead of trying to eliminate his negative thoughts and feelings by pushing the Magic Button, he has decided to dial them down to lower levels with the Magic Dial. Of course, these are only goals. We will need methods to challenge and smash his negative thoughts so we can reduce his negative feelings. M = Methods Rhonda, Tom, and David used a variety of methods to work on several negative thoughts Tom wanted to work on first, including numbers 1, 2, and 4 from Tom’s Daily Mood Log.. I can’t be authentic. I look like a smug phony. 100% I waste so much time on my videos. I should be quicker. This should be easier. 100% David and Rhonda will judge me for what I’m doing. 80% We used several methods including Explain the Distortions, Survey Technique, Externalization of Voices (with Self-Defense, Acceptance Paradox, Counter-Attack Technique,) and more You can see Dr. Gedman’s end-of-session scores on his nine negative feelings on his Daily Mood Log if you click here. As you can see, eight of the feelings fell all the way to zero, and his feelings of inadequacy fell from 100 all the way to 5. Toward the end of the session, we discussed Tom’s medical and psychological philosophy, which might appeal to some of our podcast fans, especially if you live in England. First, he uses TEAM-CBT in individual two-hour sessions to help help people who are struggling with feelings of depression and anxiety. He finds this work thrilling because you can often see amazing changes within a single session, just like we saw in Tom’s work today. Dr. Gedman also hopes to develop TEAM-CBT groups as well. This can be difficult because you need many referrals, but in my experience, TEAM groups can be incredibly effective, and cost-effective as well. In addition, Tom also has a Functional Medical Practice which focuses on developing healthy nutritional and eating habits, consistent exercise, limiting the intake of toxins, developing loving relationships via the Five Secrets of Effective Communication, and enhancing spirituality. If you would like to contact Dr. Gedman and learn more about his clinical practice, he can be reached at www.DrTomGedman.com. Toward the beginning of these show notes, I reminded everyone of how anxious and insecure our beloved Rhonda felt at the start of our work together, when she took over for Fabrice. And now, she seems to be the poster child for charm, warmth, humor, and charisma. That doesn’t usually happen automatically. Rhonda, like Tom, did her hard personal work, using the Daily Mood Log and several TEAM-CBT methods. But one thing that has been especially helpful to her, after initially “beating” her insecurity, has been the constant exposure work, with hours of weekly podcast recordings. I, too, have had the chance to do constant, ongoing exposure for my own extreme feelings of inadequacy in front of live audiences or cameras, since I teach every week at my Stanford psychotherapy training class, as well as frequent  workshops, In addition, I have recorded almost daily for the Feeling Great App, which should be released in the first quarter of 2024. This exposure work has helped me cement and extend my gains in overcoming my own performance anxiety. I plan to contact Tom to recommend the same. Perhaps in England they have program similar to Toastmasters, where you can have the chance to speak in public frequently and get valuable feedback from peers and colleagues. I want to give a big hug and thanks to you, Tom, for sharing your intensely personal and real personal work with all of us today, and thanks, too, for reminding us of our own humanity and the magic of humility and the “Great Death” of the “Self.” Thanks for listening today! Tom, Rhonda, and David

This podcast discusses performance anxiety, specifically focusing on a British physician struggling with intense anxiety when speaking on camera. They explore the fear of sounding inauthentic and the pressure to entertain. The speaker shares their experience with anxiety and the importance of exposure to overcome it. They also discuss the power of rapid mindset change, group therapy, and the concept of empathy. The struggle with authenticity and self-doubt in creating video content is highlighted, along with feelings of guilt and remorse.

Rhonda Describes the GRIP Program and Interviews GRIP Graduate, Shakur Ross The Guiding Rage Into Power (GRIP) Training Institute serves incarcerated men and women in California.  Their mission is to create personal and systemic change to turn violence and suffering into opportunities for learning and healing. I (Rhonda) was introduced to the GRIP program when two of my dearest friends, Steve Zimmerman and Vicki Peet, invited me to a yearly celebration of the GRIP Training institute.  I was blown away by who I met and what I learned that I wanted to share it with the Feeling Good Podcast listeners.  Thank you, David, for letting me deviate from our typical subjects. The GRIP program is a different subject for the Feeling Good Podcast, because it is not about TEAM-CBT.  What the GRIP Program and TEAM-CBT have in common is that they are both evidence-based programs that incorporate CBT theory and methods into their treatment methodology.  But the main thing they have in common is that people who engage in these two therapies experience profound, enlightening changes in their lives. From their program: “The GRIP program is an evidence-based methodology developed over 25 years of work with 1000’s of incarcerated people and many victim/survivors. Rooted in Restorative Justice principles, the program’s trauma informed model integrates cutting-edge neuroscience research.  Students engage in a yearlong, in-depth journey to comprehend the origins of their violence and develop skills to track and manage strong impulses rather than acting out in harmful ways.  They transform destructive beliefs and behaviors into an attitude of emotional intelligence that prevents revictimization.” The GRIP Training Institute was started in 2011.  As of October 2020, nine years after running its first group, 915 students have graduated.  Of the 915 graduates, 369 were released from prison.  Only 1 graduate in nine years returned to prison, which is a recidivism rate of 0.3%, which is very impressive considering the recidivism rate for California is between 44-46%.  Many, if not all of the graduates, say that GRIP saved their lives.  Something many people who have benefitted from TEAM-CBT echo. At the GRIP celebration, I was standing in line waiting for the buffet.  A man got in line behind me.  It was confusing where the line ended, which was not directly behind me. In another circumstance I might have mentioned to him that the line ended somewhere else, but he was kind of scary looking, big, buff with obvious prison tattoos on his neck so I didn’t say anything.  But the line moved slowly and I was curious so I asked him what his connection to GRIP was.  He told me he was a graduate of the program and then politely asked me the same question. It has been my experience that often people love to talk about themselves more than they are interested in other people so I was immediately impressed that he was as interested in me as I was in him.  When I told him I was a therapist, he asked me what kind of therapy I practiced.  I explained TEAM-CBT, and he was super interested! He told me he loved CBT, and had learned a lot about himself through that kind of therapy because GRIP incorporated it in their program.  I asked him about his experience in GRIP and his tough exterior transformed right in front of me as he talked about how GRIP saved his life. I talked to several other men (so far only men have graduated from the GRIP program because the services have only recently been brought to a women’s prison), and had the same experience.  I met our guest on this podcast, Shakur Ross, who kindly agreed to share his journey of transformation with us. GRIP graduates continue to do the work and live as Peacemakers.  Shakur works for GRIP and returns to San Quentin and other prisons to provide the same lessons that he received. The podcast starts with an interview with Kim Moore, the Executive Director of the GRIP Training Institute, who explains some of the key concepts of the program. Thanks for listening today! Rhonda

In this podcast, Rhonda and the co-host work with Jessica, a mental health professional living with regrets. They explore techniques for overcoming regrets and finding peace and joy. They discuss cognitive distortions, blame, negative self-talk, and the importance of not settling in life. They also delve into the idea of embracing failure for personal growth, gratitude, and self-reflection.

In this episode, Rhonda and David work with Jessica, a mental health professional haunted by a decision made at 17. They discuss regrets and the intense negative emotions associated. They explore Jessica's background as a ballet dancer and her struggle to pursue her passion. They also touch on therapy tools, empathy exercises, and the importance of understanding core values. Additionally, they delve into the benefits of anxiety, shame, and humility.

Today's special guest, Brittany. Podcast 375. I'm Struggling! Ask David Live: a New Podcast Twist We start today’s podcast with a visit from Dr. Jacob Towery. You might recall that one year ago he offered an amazing and (almost) totally free two-day workshop for shrinks and the general public on overcoming social anxiety. Roughly 90 people attended, and it was a huge success. The only “cost” was a $20 contribution to a charity of your choice, including Doctors Without Borders and several others. Dr. Jacob Towery This year, Dr. Towery will be repeating this incredible program on March 16 and 17, 2024, which will be on a Saturday and Sunday, in Palo Alto. Once again, the title will be “Finding Humans Less Scary.” Jacob and Michael Luo will lead the program and will be assisted by 10 - 20 expert therapists who will lead the break-out groups. Last year, people described the program as “transformative” and “life-changing.” Social anxiety can have a significant impact on your life, so you owe it to yourself to attend if you or a loved one has struggled with any of the five common forms of social anxiety:Shy Bladder Syndrome Shyness in social situations Public Speaking Anxiety Performance Anxiety Test Anxiety You’ll learn and practice tons of awesome anxiety-busting techniques, including Smile and Hello Practice, Flirting Training, Rejection Practice, Talk Show Host, Shame-Attacking Exercises, and much more. Social anxiety rarely exists alone, but is nearly always associated with other mood problems, such as loneliness, shame, depression, and substance misuse with alcohol and benzodiazepine pills to try to combat the symptoms, to name just a few. How do you sign up? It’s easy! Just go to FindingHumansLessScary.com If you attend, let us know how it worked out for you, what you learned, and how you grew. Thanks so much, Jacob, for making this kind of world-class experience available to everyone who’s looking for some help, and some wild, life-changing and zany fun in March! Brittany, an enthusiastic podcast fan, asked for help with a conflict with her husband. She wrote: Hi Dr. Burns, I’m struggling a bit. My husband reads a ton of articles and feels that the media has been portraying a lot of the current events incorrectly, especially the horrifying Israel/Palestine conflict. He is extremely frustrated by this and has become depressed because none of his friends or family seems to want to talk about it. He says he feels alone & isolated. I have never been much into politics, abd I don’t know enough to have a real opinion on things to say who is right. I try to be a good listener to whatever he says. For example, I may say “yeah, that sounds really frustrating,” and then I agree with what he says. But I’m obviously doing a bad job at the empathy because he says the support he gets from me is not satisfactory at all. Sometimes I feel like a parrot, just repeating back what he says. I think you had an example before on an Ask David where you showed how to empathize with someone who says how awful everyone is and how awful all the liberals are. Something like that. But I can’t find it. When I empathize my husband says I just don’t get it and nobody is doing anything to help these innocent people who are being attacked, and he says that I am not doing anything either. I’m at a loss on how to reply? Maybe you could do an example on an Ask David. Sorry for the long message. - Brittany Hi Brittany, Sorry you’re struggling, this is a common but important problem. Yes, we can and will do that. Can you give me an example of something he says to you, and exactly what you say next? You can use the attached Relationship Journal I you like. Try to complete steps 1 and 2 at least, and mail back to me ASAP. Lots of people with this problem these days, so could be great ASK D question. Weren't you on the show live once a few years back? I know you’ve sent us some great questions. I'm thinking MAYBE you could join and practice with us, using your example. Do you have / have you read my book, Feeling Good Together? Best, david It turned out that Brittany was eager and willing to join us live on today’s podcast . This is kind of an experimental podcast where we not only respond to a great question by one of our fans, but actually invite that person to get our “expert” help in real time and live on a podcast. You can let us know if you like this format. To get us started, Brittany sent us an example of a Relationship Journal she had prepared. I thought this was really well done, and gave her revised version a grade of A-, which is way better than most people can do. I sent her an email saying that she could probably add more acknowledgement of his feelings and her feelings, like feeling alone and hurt and a bit lonely, and also a bit more Stroking, like "I want you to know how much I love you, and how special you are to me. And that's why it's so had for me to realize that I've really been letting you down." We practiced with Brittany using my Intimacy Drill, which you'll hear on the podcast. Essentially, one of us would play the role of Brittany's husband, and we would say something she wanted help responding to, and she used the Five Secrets to respond. Then Rhonda, Matt and David gave her an overall grade (from A to F), along with fine tuning suggestions, emphasizing what she did that was especially effective and if there were any changes that might make her excellent responses even better. Then we did role reversals so we could demonstrate ow we might respond, followed by additional role plays until she was satisfied with her response. Five Secrets of Effective Communication This approach is called "Deliberate Practice" and it is by FAR the best way to master the Five Secrets so you can use them successfully in real time. We also discussed her concern that at home she'd been feeling like "a parrot" when she tried the Five Secrets. That is always caused by the absence of "I Feel" Statements in your statements, and we modelled how to correct this error. One of the biggest problems in the way people communicate during a conflict or argument is defensiveness, and given in the urge to argue and defend your territory, so to speak. Matt explained that this nearly always results from thinking you have a "self" that you have to defend. Another common Five Secrets error is the failure to acknowledge the other person's anger. Therapists and the general public nearly always make this error, because of a mindset I call "anger phobia" or "conflict phobia." However, Brittany did really beautiful work during the podcast exercises, as you'll see when you listen. We (the so-called "experts") also practiced what we preached and took turns responding to criticisms, which is always fun and challenging, and often humbling when we goof up! Let us know what you think about this new format of having someone who asks a question actually appear live on the podcast so you can actually learn through practice while we answer your question. Thanks for listening today, and thank you Brittany for blazing new trails on our podcasting adventure! Brittany, Rhonda, Matt, and David

The podcast explores the concept of healthy anger and its role in improving relationships. They discuss cognitive distortions, expressing vulnerability and love, and the importance of empathy and assertiveness in building loving relationships.

Therapy failure is a common concern for both patients and therapists. The podcast discusses reasons behind therapeutic stuckness and ways to overcome it. Examples include misdiagnosis and the importance of not jumping from one problem to another. The hosts also share personal experiences with weight loss and attending bar classes. They address therapists' frustration and patients' expectations, emphasizing the need for open communication. Consistency and intensity in therapy sessions are explored, along with the importance of maintaining patience and seeking help. The podcast ends with an invitation to join therapy groups.

At Last! An Outcome Study!  One of the wonderful things about TEAM-CBT is the dramatic and rapid changes we see in so many of our patients. But we've had a huge problem-no published outcome studies. And that has definitely limited the general acceptance and recognition of TEAM-CBT. Today, that era has come to an end, thanks to Dr. Elise Munoz, who joins our beloved Feeling Good Podcast to discuss a remarkable outcome study conducted at her Feeling Good Psychotherapy clinic in New York City. She wanted to evaluate the effectiveness of TEAM-CBT with teens and young adults. Dr. Munoz is the Founder and Lead Therapist at Feeling Good Psychotherapy and Adjunct Assistant Professor at New York University. She is also a Level 4 Certified TEAM-CBT Therapist & Trainer, and specializes in the treatment of anxiety, depression and life transitions. Elise conducted a “naturalistic” study of data from 116 teenagers and young adults aged 13 -24 years of age who were treated by 15 therapists between 2017 and 2022. In a “naturalistic” study, you simply analyze all the data from your patients to evaluate the effectiveness of  the treatment. This is in contrast to a “controlled outcome study” where patients are randomly assigned to two treatments to see which treatment delivers the best results. Elise conducted the research study as part of her work for a Doctorate in Clinical Social Work at the University of Pennsylvania in Philadelphia. "The results," she says, "were encouraging." That's perhaps a humble description of her findings. David and Rhonda might say that the results were pretty awesome! Elise told us that although the average number of treatment sessions was 27, most of the patients made maximal gains after just 10 weeks (2.5 months) of treatment, and many achieved maximal improvement by the 5th session.  Specifically, by the tenth session. 80% of the patients scored in the "subclinical" range on the depression scale of my Brief Mood Survey (with scores of 0 to 4) and 87% scored in the subclinical range on the anxiety scale (scores from 0 to 4) . These scales range from 0 (no symptoms) to 20 (extremely severe.) Prior to the study, only 30% were in the subclinical range. According to Elise, the rapid improvement suggested that most patients will not need long-term treatment, although some will need more time to incorporate their gains following their initial improvement, and many will want to remain in treatment to deal with other problems, such as relationship issues that are so important in this (or any) age range. Prior to the study, Elise trained the therapists in a weekend TEAM-CBT "boot camp," along with two hours per week of group training and 1 hour per week of individual consultation/supervision. My own view (David) is that learning TEAM-CBT is very challenging, requiring a minimum of one to two years of intensive training. However, the fact that therapists can get excellent results with a relatively small amount of training is encouraging. One of the key components of TEAM is T = Testing. We test every patient at the start and end of every therapy session, asking, "How are you feeling right now?" This provides the therapist with a kind of emotional X-ray machine that allows you to see the precise degree of improvement, or lack of improvement, at every session in multiple dimensions. Therapists can use the information to fine-tune the treatment on an ongoing basis. Many other research studies have demonstrated that session by session monitoring of symptoms, consisting of measurement and feedback, significantly improves outcomes in mental health treatment. (please contact Elise for a list of research studies you can look up online). Research indicates that roughly half of adolescents and young adults will suffer from some mental health problem. Therefore, it is essential to provide accessible, effective treatments to prevent the development of long-term mental health problems. We salute Elise for going the extra mile to evaluate the effectiveness of the treatment and to identify the therapists who get the best results. This requires courage and also allows our field to move forward based on real data rather than subjective impressions. Dr. Munoz’s fascinating work adds to the body of evidence supporting the effectiveness of TEAM-CBT. and also sets a commendable example of dedication to improving mental health outcomes through research and ongoing professional development in a private practice environment. The famous and idealistic “Boulder Model” of the “scientist / practitioner” is highly touted in graduate school graining programs for mental health practitioners, but is rarely practiced in real life. Dr. Munoz shows that the integration of science with clinical treatment in community settings is not only possible, but extremely important. Dr. Munoz’s research also indicates that the TEAM model offers an exciting path to improved mental health for teens and young adults!