We wanted to know what it means to be a lead clinician for the Healthy Brain Network, and what motivates someone to come to work here. So, we sat down for a chat with Dr. Charissa Andreotti, a New York State licensed neuropsychologist and clinical manager for the study.
Healthy Brain Network: Could you tell us a bit about what sparked your interest in child psychology?
Charissa Andreotti: I got a PhD in clinical psychology at Vanderbilt, which has a strong child development program. A couple years in I had the opportunity to do some work with kids. I worked at a summer program for kids with developmental disabilities to get experience and I really loved it. And then it came time to apply for an internship, and I got an internship that spanned teenage years to adulthood at a hospital at Yale. I was working with teenagers and adults who had psychiatric disorders that were causing cognitive impairment, so it was focused on neuropsychology and neuropsychological assessment. That was awesome.
“Ultimately, it is very rewarding when we get to the end of the evaluation, write up the feedback report, and meet with the parents … They feel we were able to understand their child, to make a few suggestions they have not heard before that might be helpful going forward.”
HBN: When you look at the field of child psychology today versus when you first entered it, what’s happening — how has it shifted for better or worse?
CA: We are going more and more in the direction of trying to understand how the brain and brain development influence the emergence of learning and emotional disorders. We also are looking more at brain-body interactions and overall health, and how they influence overall mental and emotional status. For example, Bruce McEwan has done really great work on stress and how it affects not only the brain and the body, but also brain development. It can impact whether you develop anxiety, depression, obesity. What we are doing is really important because we’re not only scanning the brain, but we’re getting blood and saliva to look at markers within the body. I like how the Healthy Brain Network continues to move in that direction in terms of examining contextual factors that impact the body system as a whole, factors that drive mental health.
“I was really taken with the scope of the project — a research project, but with heavy clinical involvement in the community.”
HBN: What drew you to the Healthy Brain Network?
CA: After my internship, I had the opportunity to work at Sloan-Kettering, which is a cancer hospital. Although it was really interesting and I got really good experience there, the intersection of cancer and mental health and cognition was profoundly depressing and not something I wanted to pursue forever. I saw this job posting for the Healthy Brain Network at the Child Mind Institute, and the Child Mind Institute has a great reputation in New York. It seemed like a really cool job. I was really taken with the scope of the project — a research project, but with heavy clinical involvement in the community. It spoke to my interests in research and clinical work and working with kids.
HBN: What do you think is one of the most important things for HBN clinicians to keep in mind?
CA: We’re a research study. We’re trying to create a big-data, open-share dataset for the scientific community to further understand how the brain develops. To collect that data, we provide a highly-needed service to the community. Unlike in other settings, our clinicians have to keep in mind that they not only provide the highest quality service possible, they do it within the context of research. That means making sure that the assessment is reliable, valid and standardized and that we are getting all the pieces of data we need for our research project.
“We understand that we’re asking for a lot. I think sometimes parents don’t think we know that.”
HBN: If you could tell a parent or a child who is considering enrolling in this study one thing, what would it be?
CA: We understand that we’re asking for a lot. I think sometimes parents don’t think we know that. We’re asking for a lot of their time, we’re asking them to travel to one of our offices, and we’re asking them to do a lot of things — a scan, blood and saliva samples. But kids really do enjoy a lot of the activities — we get that feedback quite a bit. We try to make it as much fun as possible.
HBN: When someone walks into your office for an appointment for the first time, what are your priorities?
CA: I think my first priority is understanding what brought them in. Everyone comes in with a problem, and in a private practice or a specialty clinic the evaluation would be focused on that problem. We, on the other hand, are providing a high-quality, comprehensive evaluation, regardless of the problem — everyone gets the same great broad evaluation. That being said, I think it is still helpful to understand exactly what the family’s concerns are. Although we are still going to give the full assessment, I can tailor how I’m going to direct my time and energy when I write the report so I make the best recommendations to help with what they’re most concerned about.
HBN: Could you talk a bit about your day-to-day schedule? What are some of the most stressful and some of the most rewarding parts?
CA: Working with the kids and the families is a little bit of both. Many families come to us because they tried lots of other things and they are at the end of their rope — they want answers or solutions or both. They are often in a pretty stressed out place, and that can make it a bit more difficult to connect with them or to get them to a place of comfort. Ultimately, it is very rewarding when we get to the end of the evaluation, write up the feedback report, and meet with the parents. We say, “This is what we saw…”, and the parent says, “Yeah, that’s my kid,” to which I always say, “I’m glad we got the right kid.” They feel we were able to understand their child, to make a few suggestions they have not heard before that might be helpful going forward.
“It’s important to me that we’re contributing to research and creating a dataset that is really important in the field.”
HBN: What do you think is the most rewarding part of working with children?
CA: There is so much hope. Everything can be framed in a positive light — making progress and helping a child reach their potential — whereas a lot of adult assessment and neuropsychological evaluations focus on making do with what is there. With kids I like to think in terms of the strengths and weaknesses model — assessing not only where a child has deficits, but where he or she has strengths, and determining how we can cater to those to make the child successful, because in most cases I think we can.
HBN: What are you most proud of when it comes to your work here?
CA: I think when it comes down to it, I’ve always been a researcher at heart. It’s important to me that we’re contributing to research and creating a dataset that is really important in the field. Day to day, it’s working with the individual families — they either found no other resources, or the service they are looking for has a long waitlist or costs an ungodly amount of money. We provide a service that gets a child the help he or she needs to be successful and to function like more typically developing peers. These services should be available to people who need them. Everyone is entitled to a free and appropriate education. It can be really difficult to get that for your child. In a lot of cases, parents with special needs children have a lot of trouble navigating the system or are denied services that their children absolutely need. Doing this evaluation that we have down to a science, that we do efficiently and smoothly, and that results in these reports means thousands of kids may get the services they are otherwise denied. It is always heartwarming to me when I hear that.