Dasha: [00:00:00] Welcome to the Biomedical Frontiers Podcast, where we explore pivotal research projects and disruptive innovations aimed at translating scientific advancements into tangible healthcare solutions. I'm your host, Dasha Tyshlek.

Is it a true statement that depression and anxiety are on the rise in our society? 
Bethany: While it is a difficult situation that we're in, and it is heartbreaking to see the number of particularly young people that are struggling, we are having a national conversation about youth mental health and mental health in general,
so much more than we used to. This conversation was long overdue, and so this gives me hope that people are recognizing that we need to deal with this. 
Dasha: You mentioned digital interventions. Could you tell us a little bit about what that whole program is?
Bethany: So MindTrails is a suite of web and app-based digital programs that we've tailored to different communities to meet [00:01:00] their needs.
What the programs share in common is that we are helping people to develop more flexible thinking and develop, to develop this ability to generate different perspectives and not assume the worst. Are there any other emerging and exciting technologies in digital health? One of the trends that I'm really excited about is the role of what's called non-specialist providers.
So recognizing that we can also increase access to care by really shifting our models of who provides care.

I'm Dr. Teachman and I study digital tools to detect and treat anxiety and emotion dysregulation along with my collaborators in engineering.
And in this episode, I'm excited to talk about the rise in anxiety and why we can't solve it with therapy alone. The journey from problem identification to building digital solutions to address those problems. How mobile sensing and AI can help [00:02:00] us to detect mental health struggles in real time and what we've been learning from physiological, social and environmental cues to help detect anxiety and struggles with emotion in daily life.
And I'll talk about what it means to be doing this as both a researcher and a clinician, and how that helps to broaden my perspective. 

Dasha: Well, welcome back to the show, everybody. Today we're tackling one topic that's actually been voted by you, our listeners, and this is Mental Health. And our guest today is Dr. Bethany Teachman, professor, a psychology and director of clinical training at University of Virginia, author of three books and hundreds of articles on clinical psychology. She leads the NIH Funded MindTrails program, which combines free anxiety reduction training with research and Bethany's from Canada and used to be part of an Egyptian dance company.
Welcome to the show, Dr. Teachman. 
Bethany: Thanks so much for having me, and please call me Bethany.
Dasha: Excellent. Well mental health I think is on everybody's minds. It's also part of a huge [00:03:00] national discussion.
I was just listening to the welcome address from RFK to HHS, and it's a pretty short address and pretty much three things were being talked about, chronic diseases, mental health and the cost of healthcare. And, , I wanted to start with this quote
rFK said, "if we're really going to end the chronic disease epidemic, we need to recognize the connection between the physical decrepitude that now plagues our citizenry and the pervasive spiritual malaise that has left so many young people feeling alienated, dispossessed, disconnected, purposeless, and hopeless. Spiritual and physical maladies thrive on one another, they feed one another."
, I feel like this is true in an intuitive sense, but I don't know anything about how mental and physical health, is actually connected. Can you help us understand that relationship and what you're learning from your research? 
Sure, absolutely. Mental and physical health are closely connected.
We used to have lots of ideas that were sort of dualism as though what happened in the body and what happened in the mind. We're [00:04:00] gonna be totally disconnected and we know that that's false now. So our different types of health naturally coincide in one person. And so we have to take a holistic view to understanding people's experiences and recognize that when we feel challenged physically, it's also going to deplete us mentally.
It's gonna take a toll on us. And so we have to be watchful for impacts on anxiety and depression and all of those challenges when someone is dealing with a physical health issue. And also recognize that, depression anxiety are also associated with changes in our physical state. So for example, with depression, we see people having lower levels of motivation and arousal, and it can literally feel harder to do physical things than it normally does.
So this idea that they are separate really is just understood now to no longer be the case. And most of our, you know, major physical health challenges we know are also affected by emotional health. So the [00:05:00] trajectories for people, for example, who are dealing with cardiovascular disease are different if they're also anxious and depressed versus if they are not.
And so if we want to help with those physical health outcomes, we also absolutely need to help with the mental health outcomes. 
Is it true that mental health challenges, and particularly depression and anxiety are on the rise in our society? It's a great 
Bethany: question. So it does seem to be the case that we are seeing rising rates, particularly among young adults and youth who are girls.
But we do see that these challenges are occurring. There's a lot of debate about exactly how much of the rise is due to a range of different factors. So I'm not gonna say to you, we know that it's up X percent because we don't know how much of the rise that we're seeing is due to some positive factors, namely that we do a better job of screening for these problems now, so are more likely to identify them.
And stigma may be starting to reduce [00:06:00] somewhat, so people are more likely to come forward and talk about these problems. Those are two very positive trends that would lead us to see rises in the prevalence rates, even though that's actually not a sign of things getting worse. It's a sign of people being more comfortable talking about these important topics, but we also have very good reasons to believe.
That there are also actual rises in these problem areas. So for example, among certain groups we see more frequent visits to the emergency room because of concerns about self-harm and suicide. That indicates to us that this is not simply a change in reporting because those kinds of challenges when they get to that level of severity would've been observable regardless of the screening that we were doing.
So it seems to be simultaneously the case that we have a serious rise in these problem areas that we need to address and we don't entirely know how much of it is a rise versus problems that are, have been ex in existence for a long time, [00:07:00] but are more apparent now. I do think it's important though, to highlight that regardless of the degree of the rise, the fact that these problems are so pervasive.
Has always been an enormous problem. So it's fantastic that we're having these conversations now and really working to try to address them, but regardless of how much they are new or were in existence before, they're enormous problems that need to be addressed. 
Dasha: Yeah, I, I do love that we can have the discussion.
We can also reunite the physical and mental health. I feel like the idea that we're like a brain in a kind of vat of a head is it's, no, it's not, it's not very scientific to be honest. Right. But we're talking about two different things here. Primarily. You mentioned depression and anxiety. What is the difference between the two and how do you track them so that you can make that distinction?
'cause to me it's all just like bad feelings. You raise a 
Bethany: good point. For a lot of people, it feels just like bad [00:08:00] feelings. And so actually one of the things that we do in treatment is help people to get more specificity and clarity on their emotional experiences to help them to recognize the difference between sadness and anxiety.
So a person who is feeling anxious is feeling some. Fear or sense of threat, sense of vulnerability, that they are not up to the task of the dangers that they are facing. And it can play out in a number of different domains. So we talk to people who have social anxiety where they fear negative evaluation from other people and feel like their social performance is not gonna be good enough.
We have talked to people who have panic disorder and they experience these intense rise in anxiety symptoms and they have a sense of dread and feel like something terrible is gonna happen to them. They're gonna die, they're gonna pass out things that aren't really gonna happen to them, but they feel intense fear in that moment.
And there's a whole range of different anxiety disorders that express in different ways. [00:09:00] For people with depression, they tend to have a lot of difficulties with low self-esteem, low self-worth a lot of sadness or irritability, and find it very difficult to find pleasure in things that they used to enjoy.
And so one of the differences that we see is that anxiety tends to be associated with more of that high arousal state of like something bad's gonna happen. Whereas with depression, we tend to actually see the lower arousal because it's hard to be motivated. A person feels a lot of fatigue. So there are important differences in those expressions.
At the same time, there's a lot that they share. So they have an underlying vulnerability of sort of this neuroticism that feeling bad, that emotional volatility that is common to both problem areas. And they are highly comorbid. And what that means is that many, many people who have anxiety will also have depression.
Vice versa. Many people who have depression will also have [00:10:00] anxiety. So in fact, the norm is that if people have one problem area, they are likely to have a second problem area, whether that be two anxiety disorders or anxiety and depression. And some of that is likely tied to it being hard to have these disorders, right?
So if you have an anxiety disorder, it leads to lots of avoidance and your world is getting smaller, and that's kind of depressing. And so when you are no longer engaging, you're no longer getting reinforcement from your environment that is gonna breed those depressive thoughts, those depressive feelings.
And so we start to see them being very closely connected and feeding into one another. 
Dasha: When people discuss online the causes of mental health epidemic, you see all kinds of theories: social media contributing to it, or maybe that people don't have enough challenges in their lives anymore .
But for you actually [00:11:00] treating and seeing this what are, what's driving these trends and what seems to be the causes of anxiety and depression in people? 
Bethany: I appreciate you using causes plural, because I don't believe it is one answer. So I worry a lot when I see headlines that really try to oversimplify these challenges.
These are complex difficulties and it's unlikely that they're caused by one thing. So the reality is we don't have the full answers. I expect it is a combination of the economic anxiety, climate anxiety, extreme polarization. Social media may play some role, but I think the headlines that suggest that it is the answer are way oversimplified.
And the data really don't line up with that. In fact, the relationships between social media time, you know, that you spend online and these mental health issues, those relationships are really small. They're inconsistent. Some studies actually show that what happens is you experience anxiety or depression and then [00:12:00] as you withdraw, you're spending more time online rather than the other direction.
So I don't think we have the simple answer. I think we have a lot of challenges that we're facing as we have become more individualistic and sort of not spending as much time in community with other people. And we know that that lack of social connection, that withdrawal, for whatever reasons that it's happening, is problematic and likely to be feeding into these problems.
But we need to really avoid these kind of simplistic one line claims about the causes because it means we're not actually working on developing the complex solutions that are needed for these problems. We also know that we can't ignore social context and factors that we know make people vulnerable.
So if you are growing up in poverty, if you are experiencing abuse, if you are in a situation where you are experiencing adverse [00:13:00] outcomes and don't have the resources or supports you need to thrive, you are more likely to develop anxiety and depression. And so we need to really be watchful of this tendency to say: "hey, if we just took away cell phones, we're gonna solve this problem" because, I don't believe that's going to be what gets us there.
These are complex problems and they're gonna require complex solutions and recognition that it's not the same path for each person. There are many different ways that someone can end up depressed or anxious. They do often have a component of withdrawal or avoidance that leads people to no longer be engaging in the world in a way that makes them feel connected, that makes them feel reinforced, that makes them feel like they can meet their goals.
So all of the factors that make it difficult to do those things are likely to be causal factors, but that's gonna differ for you [00:14:00] and for me. Hmm. 
Dasha: So it sounds like there's many different potential causes and really for each person it's an individual set of experiences, and that to me sounds like each treatment has to be also individualized, and then you pair that with kind of a rise in anxiety, rise of depression.
Also paired with there's a doctor shortages and therapist shortages. So how do we solve that when each person's causes are so individualized? 
Bethany: Yeah, it's a great question. 
So, part of how I think about it is that we know the principles of change. In other words, we know the mechanisms that tend to maintain anxiety and depression, and so we want our treatments to be effective at targeting those mechanisms.
But how you bring that to life is something that we're gonna personalize for the needs of each individual. So for example, I talked about the idea that if you are withdrawing, avoiding escaping, no longer [00:15:00] engaging in activities that give you meeting, help you meet your goals, you're very likely to be experiencing depression.
But it's up to us as therapists working with individuals to figure out. What are each individual's values and goals? What does it look like for them? What would they need to engage in in a new way in order to get that meaning, to get that purpose, to feel like they are living a valued life? So the principle or mechanism is the same across individuals of we're gonna help you to reengage in ways that allow you to have those connections and meet your goals.
But what those connections look like and what goal-driven behaviors you should engage in has to be really similar. Another example is we know that negative thought patterns, which is something that my group studies, make people more likely to have anxiety and depression. So in anxiety, we see lots and lots of catastrophic thinking where people in situations that are kind of uncertain, [00:16:00] assume the worst is gonna happen, right?
So they go to the most catastrophic, most threatening, most vulnerable, dangerous version of understanding the event that's occurring. We know that in depression, people focus on thoughts of low self-worth, feelings that of hopelessness and that things are going to turn out badly. So we know we wanna help people to catch that thinking, to identify when they're falling into those kind of thought traps and work on shifting it so that they don't assume the worst in those situations.
And that's a skill that can be learned. But for the person with social anxiety, those thoughts that they might need to challenge are probably gonna be about, this person thinks I'm stupid, I sound like an idiot, they're bored, they don't like what I'm saying, they don't wanna be with me. Whereas for the person with panic disorder, their catastrophic thoughts are gonna be:
this is never gonna end, I'm having a heart attack, I gotta make this stop, it's, you know, never gonna end. All of those kinds of [00:17:00] things. So the thoughts might be different, but they share in common a tendency to assume the worst in a situation. And so what we have to do is give people the skills to then apply, to the types of thoughts and the types of avoidance patterns that come up for them.
Dasha: Now this is very interesting because it's almost a philosophical point you bring up, which is, there's a requirement to sort of change how you think. And I think, a lot of people think that what their mind thinks and how they think is like set in stone and once they've grown up, they're not really changeable.
How do you deal with that resistance to change but desire to, to solve a problem? And are people able to so significantly change how their mind actually interprets the world around them?
Bethany:  A hundred percent. People are able to do it. So cognitive behavioral therapies and the range of treatments that try to shift cognitive patterns have been highly successful.
So they have helped, you know, millions of people to make these kinds of shifts. It's a [00:18:00] practice thing and one of the things that we do with people is kind of make them mini scientists. So what we want them to do is start to view their thoughts as hypotheses and they get to decide which thoughts they think are important, which thoughts they think are meaningful, and whether they sort of accept those thoughts as gospel or not.
So to your listeners, I suspect that while they've been listening so far, they have probably had their mind wander 25 times. They thought about what they were gonna have for lunch. They thought about that they needed to pick up something from the store on their way home. They thought about whether they were gonna call their friend that night.
But then they brought their mind back to this discussion, hopefully, right? They decided those thoughts are probably not the most important ones for me to focus on right now. So we are constantly actually deciding which of our thoughts are important and meaningful, which we wanna think are accurate, which we wanna shift.
So we form initial impressions [00:19:00] of people and then get to know them and say, oh wait, I thought you were this way and you know, maybe I had a negative judgment, but as I got to know you, I realized, oh, that was wrong. You're actually this way. So we in our lives are constantly rethinking situations, reevaluating, and so it is literally a skill you can learn to not just assume that the first thought you have is the be all, end all. But to say, is this a thought I wanna put a lot of weight on? Or do I kind of wanna move on from it? And, is this a thought that I wanna kind of question a little bit and say, what's the evidence for and against this thought? Is there an alternative way that I can think about this?
So one of the things that we do in the exercises we do with our digital interventions is give people practice in generating different ways of thinking about situations so that they're not just assuming the one worst outcome. So for example, if you go on a [00:20:00] date and the person you're talking to is quiet, if you're socially anxious, you're probably gonna jump to the conclusion that this person, you know, is bored, wishes they weren't here, doesn't wanna be talking to me.
But we could imagine lots of different explanations. We could imagine that the person had a tough day and is really tired. We could imagine that the person wants to make sure they're doing a good job of listening and getting to know you. We could imagine that the restaurant is noisy that you're in, and so they're finding a little bit hard to talk.
There's all kinds of things that could explain that behavior. And so as people practice realizing that, oh, in most situations there's a whole bunch of possible meanings, and then figure out how would I find out what my date thinks? How would I actually figure this out? They're going to have a new way of approaching the world, and instead of themselves withdrawing in that situation, not going on another date, not talking back, you know, all of those things, they're gonna engage in a really different way.
And so [00:21:00] that's what it means to be a mini scientist yourself, is to view this as trial and error and to recognize that you can gather information instead of treating things as though there's only one way to view the world. So treat your ideas as hypotheses to be evaluated, not as immediately right or wrong.
Dasha: I love that. Well, you mentioned digital interventions and the thing that you described sounds to me like the MindTrails program. Could you tell us a little bit about what that whole program is and then the app within that that you just described? 
Bethany: Yeah, absolutely. So MindTrails is a suite of web and app-based digital programs that we've tailored to different communities to meet their needs.
What the programs share in common is that we are helping people to develop more flexible thinking and to develop, to develop this ability to generate different perspectives and not assume the worst. So one of the challenges for individuals with anxiety disorders [00:22:00] is that they tend to have a pattern of very rigid negative thinking.
So they sort of immediately default to that worst possible understanding of a situation. It turns out that most of our encounters have some aspect of ambiguity. When you're talking to somebody, you don't know what they're thinking about you, right? We're constantly having to assign meanings as we go throughout the world.
And so what we do in MindTrails is introduce people to lots and lots of different situations that bring up possible concerns that could generate anxiety. Like that date situation that I imagined that I described to you earlier. There's a million of those types of situations that can arise for people.
And so we introduce brief stories that describe these: huh? I wonder what's happening and how I'm being evaluated or how this situation is gonna turn out. And then we give people practice in assigning less threatening meanings or assigning different [00:23:00] types of meanings. We have different exercises that we do.
In some cases, we are giving people the answer by saying, I want you to practice thinking about this in this less threatening, more benign way. In other cases, we say, how might you think about this situation? I want you to generate a whole bunch of answers about ways you might envision this situation. We try to personalize them in a few different ways.
So for example. On our app-based versions people indicate the main type of stressor they're encountering in that moment. So is it tied to financial stress? Is it tied to a social stress? Is it tied to a family concern, a health concern, an academic or work concern, et cetera. So they can indicate the domain that's causing them the most stress, and then we introduce brief stories that can raise anxiety tied to that particular stressor.
Right. So the health domain is gonna be people going to the doctor's office and waiting for [00:24:00] test results. The social domain is gonna be people wondering whether or not they're gonna get likes when they do a social media post, or the romantic domain is gonna be that going on a date example. So we have lots and lots of different examples depending on the domain.
The other thing we do is do a lot of work with our prospective users to understand their needs. So for example, we're launching a new version of the app. This is with my nursing collaborator, Jesse Gibson with individuals who have Huntington's disease in Parkinson's disease and experience anxiety because we know there are hard, high rates of anxiety in that population.
That version's called MindTrails Movement, and we've added in lots of these stories that are particularly common to individuals who have neurodegenerative movement disorders. With my student, Emma Wolf and former postdoc Alex Werntz, we have a version that's MindTrails Teen that's particularly focused to the kinds of stressors that teens are gonna encounter.
With my collaborators, [00:25:00] Taylor and Emmy and Valentino, we have MindTrail Spanish. So we have all different versions that are trying to get at the particular community needs. And I should say all of this work is done in collaboration with my close engineering collaborators, Laura Barnes. 
Dasha: Well this is so cool that there's multiple versions and I kind of, I went through the app and I tried it a couple times, the intro sessions, and I have one question.
I'm gonna kind of describe a little bit of what I experienced as a user. The things that vividly stand out, I'm asked to visualize a set of scenarios in detail, but it starts with this lemon exercise . So I'm asked to like, be really detailed about this lemon and then to try to be detailed about a setup, short stories, what I'm doing, the short stories,
there's also this fill in the blank piece, like you have to fill in the blank for the word, but there's only one correct answer for the word. And that one really stumped me. I was like, what is this doing with my brain? What am I supposed to be getting from that? So I'd love to learn a little bit about that.
And then of [00:26:00] course, like you mentioned, then there's a follow up question and it kind of, is about trying to figure out if you have a more negative or more positive perspective. Sometimes it's all aimed at more positive perspectives and sometimes there's kind of surprise negative answers.
I guess you can't live in rose colored glasses, but can we talk about the lemon and then what's 
Bethany: Sure. We go through each of those and I'll talk about the rationale behind them. These are great points to be raising. So the lemon exercise is literally just to give you practice in developing vivid, immersive images that use all of your senses.
The reason that we do that is that we don't want these stories to just be sort of hypothetical things that could happen to other people. We want you to really imagine yourself in the situation and imagine yourself thinking about and responding in that situation differently than your default negative response would be.
And so our hypothesis is that the more vivid that imagery is, the more you are immersing yourself in that [00:27:00] situation. So with my collaborator, Julie G, we're actually just launching a study right now where we are having people practice different styles of imagery with these stories to figure out, for example, if you do a first person perspective versus a third person perspective how does that change, the extent that you imagine yourself in that situation? And how does that change how much you relate to those stories? Because we think the more that you relate to those stories and really see yourself in them, the more effective this is gonna be. So the lemon exercise is really just to give you practice in a non-threatening domain initially to really be able to vividly bring on all of those senses to help you feel like you're really immersed.
Now, the filling in the blank, I think was your next one. So that just to explain to people who are listening we give people this brief story and it's meant to take you on kind of an arc. So the beginning of the [00:28:00] story is designed to set the context right, to give you a sense of this is the situation that you're in.
For example, you're walking down the street, your neighbor's walking not too far from you but doesn't say hello. So now we've introduced a potential threat. Why is the neighbor not saying hi? All kinds of things might be jumping to your mind, depending on your anxiety, your depression, all of those kinds of things.
So the first part is just you're walking down the street, no ambiguity there. The second part is you see the neighbor. The neighbor walks by without saying hello to you. Now we've introduced a potential threat. So for the person who experiences anxiety, they're going, wait a sec, what's going on? In the final sentence what we do is resolve the ambiguity by challenging the person to recognize that we don't have to jump to the conclusion that the neighbor doesn't wanna talk to you, the neighbor doesn't like you. And so what you'll see is a sentence along the lines of your neighbor [00:29:00] didn't see you because they were, and there's an open
word fragment, for example the word distracted, and you have to fill in the letters to fill in the idea that the reason the neighbor didn't respond is just 'cause they were distracted. And then, you know, it's not that the neighbor didn't like you. The reason we're having you in some cases, filling in a missing letter.
In some cases, coming up the word yourself. In other cases, we make you write the whole scenario yourself. So we have lots of different versions of this that get harder and harder as you go, is that we want people to practice themselves generating the resolutions to the emotional ambiguity that are less threat oriented.
Because if they do it themselves, they're more likely to be developing that skill versus just passively consuming it. So there was some research that was done by other colleagues in the field, Andrew Matthews and others, where they show that if you are [00:30:00] actively generating these new ways of thinking, you get more emotional change in your daily life.
It helps to reduce that emotional vulnerability. So that's why we have people go through and actually finish the words themselves, come up with a new ending themselves because we want them to own it. We don't want us to be the ones only providing these endings because of course we're not with people in their daily lives, right?
We are trying to give people the practice to develop the skill so that they can apply it in the situations that they're facing in daily life. So that's the reason we do that. It's the same reason that we can do that comprehension question you asked about. So after people read that story that if you took the example I gave with the neighbor walking by and not saying hi and finding out that they were just distracted, we would ask a comprehension question afterwards that says, did your neighbor not say hello?
Because they don't really like to [00:31:00] talk to you. And so we're asking a question where if you've read that story carefully, if you have internalized the resolution to the emotional ambiguity in a way that didn't assign threat, that assumed the benign outcome, instead that they were just distracted, you would say no.
And so it's a second chance for you to practice assigning that non-threatening meaning to the situation. So it serves, you know, a couple of functions. It makes sure you are actually reading the story and paying attention and all those kinds of things. But really what it's designed to do in terms of conceptually and its therapeutic value is it's helping you to reinforce the idea that, oh, that assumption I made, that the neighbor doesn't like me and doesn't wanna talk to me.
That didn't hold. There was another reason that I hadn't initially considered here. 
Dasha: Well, I want to kind of zoom out of the individual intervention and talk about your overall research and interest in digital [00:32:00] interventions. Why put time and effort into trying to create exercises that can be done on a mobile phone?
Is there evidence that this is gonna help and what kind of challenges it is solving that maybe don't get solved in a doctor's office? 
Bethany: So, I wanna start out by saying that I am a huge fan of in-person therapy. So I am the Director of Clinical Training in the Department of Psychology. I am a therapist myself.
I teach our graduate students to be therapists, and I provide clinical supervision to our graduate students. So everything I'm about to say is not knock in therapy. I think it's amazingly powerful and I love that it's a part of my career and what I'm able to do. However, we could literally double the number of providers in this country and still not be able to meet the mental health needs of our population.
So we are at a literal level, failing to address the burden of mental illness in our country. [00:33:00] And single providers, doing one-on-one in-person care, is an enormously important part of that solution, but on its own, it cannot solve the problems because the scope of the challenge, the level of need is too big.
And so I think it's really important that we keep doing that work. I think it's really important that we increase access to in-person care and think about having more providers and. We absolutely have to expand our toolbox and think about innovative delivery models that can allow us to get more care to people when and where they need it.
So one of the reasons we are doing digital mental health interventions is simply that we think it's really important to increase access to care to more people because wait lists ability to access in-person care is really challenging. It tends to be expensive, long wait lists. It [00:34:00] requires people to overcome all kinds of big challenges, whether that be stigma, ability to get the time off work to drive to the clinic.
So all of those things are huge barriers for many people, and they have resulted in the majority of people who need mental health care, not getting evidence-based care to help them. So most people are not getting the help that they need. So that's one of our big reasons for going to digital mental health care.
Another reason is that we work particularly with anxiety problems. The hallmark of anxiety is that it do a desire to avoid things that make you anxious. That's gonna include therapy a lot of the time. So we have wonderful therapies, but we have a sales pitch problem. When we talk to people about exposure therapy, which is our gold standard therapy, where we're gonna help people reenter situations that they've been avoiding because they scare them and help them to feel like they can tolerate those challenging [00:35:00] situations.
Those therapies work beautifully, but for many people, they're not interested in trying them and they won't come in. You take that rise in anxiety we started this conversation with, right? So we know that there's a rise, for example, in social anxiety among teenagers and young adults. I'm a parent of two teenagers.
Do you think if I go to my child and who's with social anxiety, this is my hypothetical child, right? So if I went to a child with social anxiety and said, Hey, why don't you come in and talk to a stranger about the things that scare you the most? And by the way, you're 15 and just trying to find the language for these emotional challenges.
How many 15 year olds do you think are super excited to go in and do that? 
Dasha: Definitely not so many. There's no 15-year-old that wants to be in that office. 
Bethany: Right. And so, again, you know, bring your 15-year-old in because most of the time what happens is once they start, they actually end up getting so much out of it.
So I don't wanna, in any way discourage people from bringing their [00:36:00] 15-year-old in. What I wanna highlight is that we need additional tools to get care to people when and where they need it most. And so another reason we went into digital mental health interventions is because of the populations that we work with.
And we need to think about shifting the model away from us sitting in the clinic and waiting for people to come to us. We also can't keep waiting for people to come to us once a week for an hour on the timeline that works for us. That's not how emotional health difficulties actually work. And so I fell in love with the idea of thinking about can we instead get help to people when and where they need it most, putting it in their own hands so that they're empowered to access help at the time that works for them and the situation that works for them, and to match that help to their [00:37:00] particular needs in that situation.
So if you are about to go in to talk to your boss, to ask for a raise, and that makes you feel really anxious, I want you to have something you can do for the five minutes right before you go in, that makes it more likely that you overcome that anticipatory anxiety and actually go and make that ask. If you're about to go on that date, or let's say you went on the date and you're perseverating afterwards and thinking, oh, it went horribly.
They thought I was so stupid, they, they'll never wanna go out with me again. That you have an intervention to help you in that moment. It's probably 11:00 PM. There's no therapist who's there, right? So how can we match inter interventions to really meet individuals needs? 
Dasha: Well one other project that you are working on is researching not only into interventions, but detection of anxiety, kind of through various means.
And I wanna turn a little bit to that and first of [00:38:00] all, what are people able to recognize? We're gonna talk about anxiety here, I guess predominantly. And then what is the purpose of these tools? What can they help you do for your anxiety? 
Bethany: So let me start by doing a shout out to my amazing engineering collaborators 'cause they are the genius behind a lot of the sensors that we use in order to detect anxiety and emotion regulation and daily life.
So I particularly wanna shout out to Laura Barnes and Mark Rucker and their whole team. So we use a combination of signals because it's not that there's gonna be the one indicator, but we get, for example, samples of audio. Not so much the words. We don't record. Keep that because that can be invasive in terms of people's privacy, but we are looking for things like the tone, the pitch, all of those things that can show us shifts.
We look at heart rate and heart rate variability. We look at electrodermal activation and skin conductance and all of those different signals. We look at your accelerometer, your movement patterns. We look at your GPS to see where you're going. And [00:39:00] the reason that we're tracking all of those different signals and combining this is because we want to be able to detect two key things that can help us deliver these interventions more effectively.
One is we wanna detect periods of vulnerability. So we want to know when you're struggling so that we can help you overcome that avoidance and withdrawal draw pattern. And instead say, Hey, it seems like you might need a little help. Can we offer you something right now? So we wanna figure out when do you need help?
We wanna know, oh my gosh, you're about to have that thing come up where you go talk to your boss. You're about to be doing rumination about the date that you just went on. How can we help you when and where you need it in order to help you reengage, make the life choices that are gonna work for you? So that's a big piece of what we're doing.
The other piece that pairs with that vulnerability, in other words, when do you need help, is what's called receptivity. [00:40:00] So some of our signals we use to try to determine when do you want an intervention, when are you most open to getting help? And so that helps us to figure out what's called just-in-time adaptive interventions.
And so that's what a lot of our work is coming together to develop is to figure out how can we detect the right moment to say: hey, do you want a little help right now? And what should that help look like? So by detecting lots of things about the environment that a person is in their social context, are they alone?
Are they with other people? That's gonna give us really valuable information about what kind of help is gonna make sense for them. So let's say I detect a period of anxiety and I notice that you're at home. I might make a suggestion to you that you do one of our cognitive exercises, or I might make a suggestion to you that you do something that is relaxing and enjoyable to take a break.
Or I might, [00:41:00] you know, take a bubble bath, right? Or I might say, why don't you call a friend or a family member right now to get some social support and social connection? That all makes great sense. If it's 7:00 PM and you're at home. We can tell that with the monitoring that we do. Imagine instead we pick up that same state of vulnerability, that same anxiety, but we can tell that you're sitting in class.
Dasha: Mm-hmm. 
Bethany: It makes no sense to suggest that you take a bubble bath at that moment. It makes no sense to suggest that you call a friend at that moment. Right. So instead, what we need to do is recognize what are those contextual cues and how do we modify our intervention recommendations to match those cues so that we are doing a better job of actually getting you the help you need that matches your situation.
And the other piece, and a lot of this is in the works, we can't do all of these things yet, but we can do some of them. And we're putting together the [00:42:00] pieces to do more and more. We wanna learn, hey, when you were in class and we recommended you do exercise A, how much did it help you versus when we said try exercise B?
And so what now we learn that for , this individual, we should be recommending exercise A when these contextual cues line up. But for somebody else it's gonna be exercise B, right? So we can learn what's effective for that individual, in that situation at that, that, that time, in that social context, in order to really get better and better at making the matches for people. So that we can start to do a better job of moving from a one size fits all model to something that really is saying, hey, for you right now, this is something that might make a difference.
'Cause it's helped you a lot in the past when you were in these situations. 
Dasha: Well you mentioned, as you were describing kind of this passive sensing, anxiety sensing concept and research that you're doing, [00:43:00] that you're looking at a variety of different signals, including heart rate, maybe perspiration.
And you also mentioned you have engineering collaborators. So I wanna turn to, okay, you've you've got the clinical experience, you see what kind of treatments and personalization as needed, the hypotheses about ways to detect, but then it has to be turned into a technology. What has that process been like and what are some learnings from kind of turning what you know is medical knowledge and clinical experience into a scalable, digital tool?
Bethany: We are so lucky to work with an absolutely amazing interdisciplinary team. It is a lot of work. So we do big team science. It really is quite interdisciplinary. We meet every week with a team of engineers, our computer scientists and developers, as well as the psych psychology team. And we need to come together because it's really very synergistic.
So what we're saying in the meeting is, [00:44:00] you know, if we really wanna capture that moment of anticipatory anxiety and help people in the moment, here's what's happening clinically. From all of our years of experience of working with clients, we know that these are the kinds of things that are likely to be coming up for them.
And then the engineers say, oh, hey. I bet we could capture it in this way and then they can help to build the technology. So for example, the audio signal is a good example of that. It's a particularly challenging one to work on because it raises lots of privacy concerns and ethical concerns. And we believe very, very strongly in partnering with our users to make sure that they feel good about the ways that we are collecting data.
So we do lots of interviews with them and try to understand their comfort level, their needs, how we can improve what we do. So that's an example where it turns out audio signals are better than a lot of our other signals at detecting when someone feels that they're under a evaluative threat. So we have socially anxious [00:45:00] folks who go through our studies and we manipulate whether they feel like they're being evaluated negatively by others or not, in order for us to understand what changes for a person in that moment that we might be able to detect.
And then of course we reassure them and make sure that they don't feel at the end of the study that there was any negative evaluation happening. But there's understandably a lot of concerns if we were just to record people's audio as they walk around daily life and then, you know, upload that to the cloud and have that sitting there and have recorded conversations.
So, okay, wait, we've got this signal that could be really valuable. But we've all these privacy and ethical concerns that we need to absolutely prioritize and needs to be our number one concern. So Sabir, one of the engineering graduate students on the team worked with our team to develop a special way of modifying the audio on a watch like a smart watch.
So that what they do is within literally a matter of seconds, they strip [00:46:00] out the signals that are not the actual audio words. So not the semantic meaning, but the pitch, the tone, all those kinds of things. They encrypt that data and then they transfer it. So we've now reduced all of that risk about we're recording your conversation in a way that could identify you,
all those kinds of things. But we can get the important pieces for us that can help us detect, oh gosh, this is where you're feeling nervous, 'cause you're about to go talk to your boss. So we get the pieces that we need, the signal that's important for us to detect. The moment of anxiety, the moment of threat, all of those kinds of things.
But we do it in a way that is safe, that is ethical, but that requires real technological expertise and innovation. And what's wonderful about doing it in this collaborative way is that we then write up two papers from that one research paper goes out that is led by the engineering [00:47:00] team that says, Hey, let's talk about how we did this really cool methodological advance in order to strip away this aspect of the data,
keep this data, do it fast in a way that doesn't run out all of your battery on your watch, allows you to transmit it safely. That's really cool. And honestly, not something I know a whole lot about, but I collaborate with people who are amazing at that stuff. And then we take the lead on writing a paper that goes to a psychology journal that says, oh my gosh, look at what we're learning about detecting fears of negative evaluation for socially anxious people so that we can personalize an intervention for them.
So that collaboration is absolutely essential. We also meet regularly with our development team. So the digital tech core at the University of Virginia, that Laura Barnes and Mark Rucker lead. They're constantly working with us to say, okay, how do we need to modify the programs? And so we really need to have that marriage happening.
Otherwise, what happens is the [00:48:00] technology is developed in a way that doesn't really keep the user at the center of it, right? So it's really important to me that I always spend lots of my time actually talking to people with anxiety disorders, actually talking to people who are depressed, and I constantly am asking them, try this out.
How does this feel for you? Is it meeting your needs? Is it not meeting your needs? So we have a large team of psychology research assistants and graduate students. Who always do a set of qualitative interviews as we're developing new materials to understand, hey, is this gonna effectively meet your needs?
And it's constantly trying to think about what do we need to do differently depending on the community. So my graduate student Noah French, for example, has a grant where they're trying to help individuals who identify as LGBTQ plus experiences of stress in daily life so that we can help bring. These kinds of programs to them.
Well, they might have a different set of [00:49:00] concerns about identifiable information or about whether they would be outed in a situation about all kinds of things that are different than the concerns for our individuals who have Huntington's disease or our teenagers or our individuals who identify as Hispanic and have anxiety and are dominant Spanish speakers.
So each of our communities requires us to do this important work where we sit down and really say, help us understand your needs. Help us understand your concerns. We bring all of that to those interdisciplinary team meetings, and we talk to the tech developers, so the computer scientists, and we say, Hey, when we interviewed our patients with Parkinson's disease because of the involuntary movements, they need a bigger back button on the screen because otherwise this is not an accessible program for them because it's too hard for them to be able to use this on their phone without this adjustment to the functionality.
We go to the engineers and we say: [00:50:00] Hey, we wanna do a better job of sharing information and ensuring these additional privacy protection for some of our users who identify as Latinx and may have particular concerns about who's gonna be accessing their information. So we have to go back and forth constantly and work collaboratively about who's gonna solve the different needs that are coming up.
Sometimes they're technical, sometimes they're psychological, sometimes they're, you know, in a totally other category. 
Dasha: I love how you have this iterative process and what in kind of the business sense in the, in the product development world would be like, customer discovery and UX UI design is so intricately woven.
You have this deep understanding that, you know, you have to, people have to be able to use it and understand it and want it. I have a question around the other side of the iterative process. Is there anything that you're learning because you're working with the engineering side or developing the signals and systems behind detection that's [00:51:00] actually informing like medical and clinical knowledge or maybe informing ways that you deliver treatment in person?
Bethany: Yeah, absolutely. So we've been learning a ton. So, for example, with some of our ecological momentary assessment studies. Those are studies where we use, we prompt people to answer surveys in daily life as they're going throughout the day. And sometimes they're randomly prompted and sometimes they're tied to different events that are going on in people's lives.
Some of our assumptions about the ways that people try to regulate their emotions in daily life when they encounter challenges are probably wrong. So we've been learning a lot about what it looks like, learning a lot about how often, for example, socially anxious individuals encounter stressors that aren't social in nature, but rate them really, really highly.
So we were making assumptions about what stress looks like in daily life that turn out to be wrong, both about what type of stressors are encountered and how people [00:52:00] wanna respond to those stressors. So for example we, in therapy, it is routine for us to spend lots and lots of time doing cognitive restructuring where we teach people to reappraise situations differently.
When we've been doing our naturalistic studies to sort of see like, Hey, what kinds of things are you doing in daily life to try to manage this situation? We were shocked at how rarely people said they were using that strategy in daily life. And so we need to better understand like what's working for you in daily life.
How do we find that right balance of saying, Hey, you might wanna try this other thing that could work more effectively, and how can we learn from you about what you've figured out that works for you in daily life? And bringing people into the clinic and simply doing the interventions we know how to do didn't allow us to see how that was actually playing out.
And so one of the reasons that I got drawn to this work is really some frustration. Not only that people weren't coming [00:53:00] in and all those kinds of things, but knowing that when I sit in the room with someone doing therapy, I am seeing them for one hour a week, usually, and I am missing so much of what's actually happening in their lives.
And so these approaches are allowing us to like get a window into how things actually play out for somebody so we can see like, what's getting you in trouble? What are you trying, what's working, what's not working? And things we were making assumptions about turn out not to be correct in terms of how often challenges arise, what people wanna try to get help in those moments, what is actually effective or ineffective in the moment.
And we, when we strip away all the context and bring them into our world in the clinic, we don't get to actually find out how it works in their world, but that's where we want them to apply the skills. 
Dasha: Well, I wanna turn a little bit. With the MindTrails program, you have an NIH grant,
it's [00:54:00] free to use sort of what is the vision and the mission with that and how do you achieve that at such a scale? 
Bethany: Yeah, we have been very lucky to have been supported by multiple grants, and I wanna say this is part of why maintaining scientific funding at this time is so absolutely crucial and why the threats to scientific funding are really a very big concern to folks like me who do research and are really interested in using research to increase access to care, to making interventions that are scalable and can get help to people when and where they need it.
For our work, we're actually shifting away from the website versions of the work to more mobile versions. The reason we're doing that is that it allows us to do a couple of things more effectively. One is the personalization, so it becomes much easier to have multiple versions that are geared towards particular communities.
And what it allows us to do is integrate the mobile sensing pieces. So [00:55:00] when you're doing the web-based work, it's a lot harder to introduce, like, we're gonna monitor GPS or accelerometer movements, or connect the watch, all of those kinds of things to do the sensing work. So that's easier to do when we go to the sort of app-based work and can really put it into people's hands, and it allows us to move more and more towards this model of the intervention is with you for when you want it at your convenience versus this idea of like: log in, do a session kind of model that is a little bit different. So I think both models are great and in truth, I am a huge believer in the idea of what's called the digital apothecary. So Ricardo Munoz's termed this idea of sort of saying there's not gonna be a one size fits all model. You know, the ultimate vision is that we get really good at having a range of digital and other delivery models available for people.
And we get really good at determining what's a good fit for different people, [00:56:00] depending on their needs and their context. And then we can offer them what they need at that time. So the long-term vision, if you think of the apothecary model. When you go into a pharmacy, you don't go in once by one medication and assume that will meet all of your needs, right?
You go to CVS and you pick up Sudafed when you've got a sinus infection and then you go back two weeks later and you pick up Ibuprofen 'cause you have a headache. This time it would be silly to be taking one medication when what you have, you have a different need at a different time, right?
So the digital apothecary model moves us away from this idea of like a one size fits all solution to all problems and says, Hey, come and get what you need when you need it. It's not an expectation that you use one kind of care forever, but that you can, we can help you to detect, hey, this is what's going on for you.
This is the solution that might be helpful in this moment. And then we'll offer you something else next week when you [00:57:00] have a different need. So that's our hope with these just-in-time adaptive intervention development work that we're doing, that we can use these different mobile models to be able to sense what people need and get them the help they need that really matches their particular context and preferences.
Dasha: And is this work for these adaptive interventions? Is this all gonna be part of the MindTrails, I would say brand 'cause it's, it's a name that sticks. And how do you ensure it's longevity since grant funded, free intervention, obviously there, there's always a risk to something like that.
Bethany: No, absolutely. So that's a challenge that we deal with and so we're really trying to think about how we can we move towards models that allow for sustainability. And so we've considered different options. We've had companies approach us who've been interested in licensing this, and that's something that we're open to the conversation, but also wanna make sure it happens in a way that preserves the mission of what we're trying to do.
And so that's, you know, one pathway that we've considered. [00:58:00] We've been trying to think about how we can scale in different ways. And, and so one of the things that we're working on and is through this new infrastructure that the digital tech core is building, Digital Trails, it makes it much easier to develop new versions.
And we're really excited about that because the technical work is really, really challenging and takes a long time. And so having. It'd be easier to develop new versions is really important for us because we have a lot of communities reaching out saying, Hey, have you thought about developing a version for this particular need or that particular need?
And we would love to be able to say yes more often and be able to have it be easier to do that. There's a variety of ways we approach that. So we think about making it easier to do more technically by having the tech development work happen in ways that are more modifiable. So the same core elements can be modified to meet the needs of different interventions, and that [00:59:00] allows us to do a whole bunch of interventions instead of just one.
We're also experimenting with some unusual approaches. So for example, we're about to launch a new study that uses AI to personalize the training materials that we offer to people so that we can find out, are you a person who worries about your neighbor saying hi? Or are you the person who worries about your boss?
Are you in a romantic relationship or not? Because if you are married and we say you go on a first date with someone, that's not gonna be a very good fit for you, right? We can find out more about who you are, what your situations are, what your worries are, and then we use AI to modify the materials. And so we keep the concept the same.
So let's take fear of negative evaluation as an 
example we've been using. So again, people with social anxiety we know have that fear of negative evaluation. But what we can do is say [01:00:00] for person A, we wanna really help you with your public speaking fears. And we know that you work at a company where you do this kind of a presentation, and so we're gonna give you stories that match your particular situation. For person B,
we know you also have fear of negative evaluation, but really you're a college student. For you it comes up when you have to ask a question in class or go to a professor and ask for help. So let's give you training stories that are really, get the same fears and negative evaluation, but are modified to meet those needs.
Right now, we do a lot of that manually, and it is slow. So we have, I have about 30 research assistants working with us this semester. Undergraduates to, and you know, some of what they do is develop hundreds and hundreds of these stories to match different kinds of needs, right? And that's great, but that is slow and cumbersome and really labor intensive.
So we're looking at using programs like AI and other approaches to figure out if we [01:01:00] can do some of that personalization in real time for people so that we can much more effectively adapt and personalize what we offer. 
Dasha: And I noticed, you know, I was able to access MindTrails and so I'm guessing that you know, this, this program and the app is being used pretty widespread at this point.
Do you have anything to share, like in terms of how widespread? Is it just the US? Is it hundred thousands of people? A little bit of, of the data around the scaling of this? Yeah, 
Bethany: so we're getting ready to launch more of the mobile versions and then that will increase access. We had been prioritizing web for a number of years, and as I said, we're making that shift.
So right now we're pausing on the web in order to focus on the mobile. But with the web version, we were lucky. We have had it used in over 85 countries by thousands of people all around the world. And so that's been really nice in the sense of clearly people are finding it and using it, and that's been wonderful.
It's a little bit sad about what it indicates about the needs. Right [01:02:00] now. Right. But yeah, so we've had thousands and thousands of users all around the world. And it's highlighted to us why it's really important that we think about modifications for different communities, language modifications, cultural modifications, different types of adaptations.
And so now what we're doing is, as I said, shifting to those mobile models because it's much easier for us to do the personalization that we think will help with engagement. And so that comes through Digital Trails, through the digital tech core, and we expect to be launching new versions of those very shortly for people to use.
So right now we're in that kind of transition period and looking to grow those different mobile options that we can offer people. 
Dasha: Yeah, that's super exciting. Well, as a final question so many things we dug into, but we talked about digital apothecary, role of AI, mobile sensing. Are there any other emerging and exciting technologies in digital health or in psychological health in general that you would want people to go and research and find out more about?[01:03:00] 
Bethany: Absolutely. 
I'm really interested in this idea of innovative delivery models more broadly, and so digital is sort of where we've put a lot of our attention, but it is not the only one that I would encourage people to pay attention to. One of the trends that I'm really excited about is the role of what's called non-specialist providers.
So recognizing that we can also increase access to care by really shifting our models of who provides care. So if we want to work with a community where there's a lot of stigma, for example, about seeking care, then we want to get creative about thinking about how we make it easier for people to access help.
So we know that having trusted members of the community, people who are part of the same faith institution, your hairdresser, your you know, person who you encounter at the store, the person who leads your PTO meetings, having those individuals play a role in getting [01:04:00] mental health information out is turning out to be really, really valuable.
It can also come together with the digital interventions. So for example, we've been doing work where we look at if you have a navigator, who plays a small role in helping you to get engaged with the digital intervention, and doesn't serve as a therapist, but supports you in doing that? In using it, can we get better outcome?
So for example, Emma Wolf, one of my graduate students just finished an initial trial with our MindTrails Teen new app version, and we actually administered that through mentorship programs like Big Brothers, Big Sisters. Because what
 we learned is that teens who are going through those programs often have high mental health needs and they have a mentor already there, but the mentor doesn't have training in supporting their mental health.
And that puts the mentor in a really difficult position 'cause they're there, 'cause they wanna support the person, but they don't know how. And [01:05:00] so what Emma and Alex and our collaborators on that study did was: give a very brief training session to the mentors on how the MindTrails Teen program worked and had them integrate that in their check-ins with their teen that they were already doing as part of the mentorship program.
Then the teen used the app and one of the things that's really cool is not only do we see like reductions in anxiety when people use the program, the thing that we're hoping for. But what we also saw was improvements in the mentor team relationship by virtue of having this ability to engage in this way and actually having a good way to support them on their mental health.
So that's another example of these non-specialist providers. So we need to start thinking about leveraging relationships people have in their lives, leveraging where they already feel trust with someone to help them get the supports that they need. Now, I'm not saying that's the be all, end all, it's one of many that we're gonna need to [01:06:00] use in order to be effective.
We can't assume one approach is gonna work for all people, but we've gotta get creative because there's so many ways to get people help and we have not been using enough of them. And that's put us in the situation that we're in right now and it has to change. 
Dasha: We started with a bit of a dire message at the beginning of the show, but what I hear you say is, while one of the challenges we have societally has been this kind of maybe community breakdown and the people who end up with anxiety depression tend to kind of isolate themselves from community.
But I also hear you say, community can be a way that you can spread opportunities and people don't have to face all of their anxieties right, right away. They might be able to ease in and get a little bit of help and then get a little bit more. And by the way, what you just described with the mentorship programs, Big Sister, Big Brother, I'm sure that when somebody gives you real help and offers you a solution that works for you, that bond of community and [01:07:00] trust and having community relation also comes back together.
So it's like stitching things back together even when things have maybe kind of fallen apart a little bit. So I really like that. 
Bethany: I do have hope at this time. I mean, while it is a difficult situation that we're in, and it is heartbreaking to see the number of, particularly young people, that are struggling.
And you know, I co-direct with Nancy Deutch, Thriving Youth in a Digital Environment where we're really focused on youth mental health. While it is heartbreaking to see those rates, we are having a national conversation about youth mental health, and mental health in general, so much more than we used to.
And as I said at the outset, these problems have been with us for a long time. Yes, some things have gotten worse, but it was really bad before too. So it's not that there was this glorious time before where mental health wasn't a challenge. Now we're finally talking about it and trying to think about how we can get people help.
That gives me a lot of hope because I've been working in this field for decades. I've been deeply concerned [01:08:00] about the needs for a very long time. This conversation was long overdue, and so this gives me hope that people are recognizing that we need to deal with this. 
Dasha: . So where what can people do to get involved and, and where can they find more information about MindTrails and other projects that you're working on?
Bethany: Sure. I encourage people to reach out to me at bat5x@virginia.edu. If they wanna get more information, they can go to teachman.org to our lab website and read more about what they're doing. We are fortunate to have an amazing team of graduate students and research assistants who work with us, and we are always thrilled to have people who are joining us.
They bring so much talent and creativity. And then, as I said we hope to be launching soon and, you know, the App Store and Google Play and all those kinds of things to give people more opportunities to get involved as we make this transition to the mobile apps. And of course we're always looking for people to partner as well.
You asked an important question about [01:09:00] sustainability and we're trying to figure out what are the right ways to make sure that we can continue to get these programs to people that need them. So we have been fortunate to have been the recipient of a number of grants that have allowed us to sustain this work.
And we're nervous right now about, you know, what that looks like in the current climate. And so we are eager to partner with folks who share our mission so that we can continue to make sure people can access the help that they need. 
Dasha: Yeah, and I'll mention also for anyone who wants to kind of dive deep into the technology and the research.
We're gonna link the papers to both the sensing using mobile digital tools, as well as how some research on how digital interventions have been used for treatment of anxiety. So you guys can check it out, read it yourself, dig into the science and the engineering concepts. Lastly, I just wanna say thank you Dr.
Teachman. Thank you Bethany, for being here on the show. 

Thank you also to the Glenn W Bailey Foundation, [01:10:00] which has provided a grant to sponsor this season. And we are available now on Instagram. So if you want to read mini lessons, learn while you scroll, you can go on Instagram.
We also post on LinkedIn, so please follow us across social media platforms to get new updates on podcast episodes. Bethany, thank you so much. 
Thank you for the fabulous questions. It was wonderful talking with you.


David: Thank you for listening to Biomedical Frontiers Stories with Innovators in Healthcare. My name is David Chen and I'm the managing director of the Wallace H Culture Center for Translational Research at the University of Virginia. Our mission is to help bring promising new biomedical research and technology into the hands of the provider and the patient.
If you found this episode valuable, please let us know by subscribing, following, or sharing. You can learn more about our promising translational research projects on our website. See links in the show [01:11:00] notes.