Dr. Jane Gilmour: Welcome to ‘Mind the Kids’. I'm Dr. Jane Gilmour, honorary consultant clinical psychologist and child development program director at UCL.

Professor Umar Toseeb: I'm Umar Toseeb Professor of Psychology with a focus on child and adolescent mental health and special educational needs. In each episode of Mind the Kids, we select a topic from the mental health literature and in conversation with invited authors, sift through the data, dilemmas and debates to leave you with our takeaways for academics and practitioners.

Dr. Jane Gilmour: So today we'll be talking about the nature of influence between psychopathology, peer relationships and friendships. This episode is called Mental Health, Best Mates and Classmates.

Professor Umar Toseeb: Let's get into it, Jane. So, friendships. It's really interesting because everyone likes friends, everyone has friends, and the nature of people's friendship changes through time. I know when I was younger in primary school, I moved schools a lot, so I didn't really have friends that I kept in touch with, and it was pre-social media, so you couldn't just add someone on Instagram or whatever. You left school and then you never spoke to that person again. And then in secondary school, think I spent like the first four or five years being a bit of a loner and that was absolutely fine. I got my work done. I went to school, did my work, went to class, had dinner at dinner time and then went back to class and then went home. And then I had a surge in popularity around GCSE years and sixth form.

Dr. Jane Gilmour: To what do you attribute that surge in popularity? What happened?

Professor Umar Toseeb: I don't know. I don't, I have literally got no idea. I actually think in year 10, so the age of 15, because you start your GCSEs, you then change classes and you're in different classes with different people. And I think I just ended up being in classes with people who just got me a bit more. Yeah. So then I was very popular in sixth form and then it all downhill after that, as in I have no friends now. The age of 37, zero friends. What about you?

Dr. Jane Gilmour: Well, I had a very easy going time, I think, throughout my childhood. have to say somebody very close to me called me perpetually cheery, which is not necessarily a compliment. But funnily enough, I think you're talking about ancient times and the times before social media. If we look right back to ancient times, in fact, in 1994, the first peer reviewed article I published was a review of sociometry, which, of course, is the methods of assessing popularity in a peer group. And in fact, that was in the excellent journal, the JCPP. So what was really interesting about reading this current paper was it was fascinating to see how the literature had evolved over the last 30 years. That's three zero. I don't want to talk about that. It was so it was a really interesting comparison to look at how things had or had not moved on.

Professor Umar Toseeb: Yeah, it's fascinating. And I think that the importance of friendships changes for children and young people as they grow older. you know, in your early years, in middle childhood, in primary school, early primary school, family is very important. You spend a lot of time with family. And then as children become adolescents, they navigate away from family and friends become much more important. And we see that in some of the work that I did on sibling bullying, like we find that bullying within the family decreases as children progress from childhood to adolescence. And part of that we attribute to the fact that just spending less time with their family and they're spending more time with their friends, so there's just less opportunity for bullying.

Dr. Jane Gilmour: So the orientation changes out of the family. And I think, Umar, you're absolutely right. The developmental issue is key here because of course, Tom's paper is looking at pre-adolescence and of course, post puberty social experiences in the peer group become increasingly salient. And that idea of, you know, whether we have that pull towards peer integration and we belong in a peer group and that implies an authentic connection as compared to a peer group where we just fit in which implies some awkwardness in the experience might be interesting. So I think that idea of using peers as a social space to test out what's socially acceptable is interesting. So Tom's paper is with pre-teens and explores this idea and we'll hear more about his findings in a moment, but I wonder if the picture and these findings would be different with an older group. And that's a question that I'll be asking Tom in a moment. So I'm looking forward to hearing about that.

Professor Umar Toseeb: Yeah, fascinating. I think we, from Tom's work, we're going to speak to in a second and also the wider literature, we know that having friendships, good quality friendships during adolescence is associated with better mental health. You know, the kids who have good friends, good quality friends have better mental health and also being popular as a child and adolescent is also associated with better mental health. And we're going to find out why. So let's do that. I'll introduce our guests. So we're joined by Dr. Tom Wu from the Department of Clinical Health and Educational Psychology from University College London. Tom is the lead author of the paper ‘Examining longitudinal associations between interpersonal outcomes and general psychopathology factors across pre-adolescence using random intersect cross-lagged panel model’ was published in the JCPP. Tom, welcome.

Dr. Tom Wu: Hello, hi. Thank you very much for having me.

Professor Umar Toseeb: So Tom, I know you can take this. So I'm going to say I was in two minds whether to say or not. That is a very, very descriptive title of a paper. You've explained everything that you've done in like about 20 words.

Dr. Tom Wu: I think I like your title better for the podcast. I should have gone with that.

Professor Umar Toseeb: So what was your motivation for writing this paper? Why this paper?

Dr. Tom Wu: So I think I didn't start out doing research in adolescent mental health and peer relationships. For me, it had always been temperament when I sort of my master's research in Taiwan and when I carried that over to my PhD studies at King's. But adolescent mental health has always been like a major theme in my investigation. But it wasn't until that I started working on my current project that I started looking at interpersonal relationships a bit more. So that's when it made sense to combine the two because peer relationships has been heavily implicated as a sort transdiagnostic risk factor for mental health problems.

Professor Umar Toseeb: And when you say peer relationships, we're about the positives and the negatives. So today we're going to be talking about the positive aspects of peer relationships. But they can also be negative, we talked about bullying as well.

Dr. Tom Wu: Yeah, of course, yes.

Professor Umar Toseeb: So what does, in your paper you talk about friendships and you talk about popularity. Let's just define those. What does quality friendships or good quality friendships look like in childhood?

Dr. Tom Wu: Yeah, and I think it can be quite personal. know, like people see quality friendships in different ways. It's probably different for us. But in research, for example, the friendship quality questionnaire that I use, it measures a few facets of it. For example, there's the companionship and recreation. So you spend time with your mates doing things that you both enjoy. There's conflict resolution, hopefully doesn't happen often, but when conflicts arise, you're able to resolve it peacefully. And then help and guidance, you know, you sort of provide a certain level of support and assistance to each other. And your friends should make you feel safe and secure. And there should be some level of sort of emotional connection and intimacy between you and your friends. And finally, there's the validation and caring. So you should feel validated by your friends and cared for.

Dr. Jane Gilmour: And that's a really well defined series of experiences, if you like, with these one to one friendships. But your paper also looked at peer status, so your sort of profile within a group, as well as these dyads, these one to one reciprocal relationships. Can you explore a little bit and explain how these are different and how perhaps touch on how these relate to your findings?

Dr. Tom Wu: Yeah, so friendship quality tends to be more intimate, I would say, especially in this study because we look at, you know, best friendship quality. So that one would be more intimate, whereas popularity in this study is perceived popularity. So whether or not, in this case, it's the teacher rating, but in general, could be, you know, whether or not your peers see you as being popular in your group, for example. And so some people would argue that popularity kind of sets the stage for friendship quality because, you know, with a wider social network, with more connections, you have more opportunities to establish friendships.

Professor Umar Toseeb: You said perceived popularity. feel like is that not... would say that popularity is the important measure there. It doesn't matter if you think you're popular, it matters if other people perceive you as being popular because it's a social thing. Is that right?

Dr. Tom Wu: Yeah, so it's usually separated into perceived popularity and sociometric popularity. So both are sort of sociometric measures, but perceived popularity is, you ask, for example, your classmates, who you think are popular in this class. Whereas, sociometric popularity is more like likability. So you would ask questions like, who do you like in your class? And that the student who gets nominated the most is the most sociometrically popular. Dr. Jane Gilmour: And that's interesting because you and raising these different methods of sociometry, I think is something that, course, having done this sort of study many, many years ago, really made me think about the experience of asking peers and asking teachers how other kids get along with one another. Now, in my experience, although the data is so valuable, the issue of popularity is such a sensitive topic and getting consent from teachers or parents for kids to be involved in sociometry sometimes has challenges. Have you got any workarounds? Because clearly you were developing this data from the study of early childcare and youth development data. Did you get any sense that there was controversy about gathering that sort of data or indeed any workarounds that might allow us to gather that data?

Dr. Tom Wu: Not too much from working with this data, although I do suspect that because perceived popularity in this study was teacher-rated, perhaps that was their workaround, you know, not having to chase down school children, asking them about popular kids. So maybe that's their workaround. The current project I'm working on, the RESET project, which is co-led by Professor Pasco Fearon and Professor Esie Bidding. So we also collect social network data and we ask questions like who are your best friends? Who you like in your year group? What are the popular students in your year group? So we do encounter some of these difficulties. Mostly, I would say it's not just teachers and parents, it's also the students as well. A lot of them will just be like, why am I doing this or? You know, this is so long. I don't want to do it. Yeah.

Professor Umar Toseeb: Let's get to the findings. So, you investigated the relationships between friendship and popularity with mental health. So why might the two things be related? So why might being popular be related to having good mental health? And why might having lots of good quality friendships be related to good mental health?

Dr. Tom Wu: Yeah, think it's you kind of answered it partly in the beginning because you mentioned something about, you know, children, adolescents, spend increasingly more time with their friends and less time with their family. So, yes, here relationships, they do play increasingly more important roles in their life. And naturally, it's it becomes one of their major determinants of mental health. For example, perceived popularity in adolescents is quite important to them. They would value it sometimes even more than say academic success, which we think should be quite important at that stage.

Professor Umar Toseeb: Yeah, and you definitely cite this paper in your paper. So there was a paper by Anne Laura Van Hanelen about early adversity and the impact on later mental health and the importance of friendships. One of the ways in which I learn about these topics sometimes is when you're asked to do a lecture because somebody's off or someone's off sick or you're covering a module or something, you use their slides and you're like, okay, so what's this? And one of the ways in which I learned that friendships might be helpful for offsetting the impacts of early adversity is because you have a source of social support. So when you're going through a tough time as a child, some of the people that you can turn to are your friends.

Dr Tom Wu: Yeah, exactly. So yeah, hopefully you have high quality friendships that you have a supportive network that kind of offsets these early adversities. That's one mechanism through which the two are linked. For popularity, it could also be just that because being popular is so important. Once you achieve this goal, it makes you feel better about yourself. You feel more confident, and so you would experience less emotional problems.

Dr. Jane Gilmour: And also you're getting the opportunity to be alongside lots of different social experiences. So if you're isolated, you don't have that social laboratory experience. You can't necessarily hear different problem solving techniques or, you know, get alongside or get the responses or the variety of responses. I think that's really interesting that popularity having a sort of Matthew effect is really interesting.

Dr. Tom Wu: Yeah, it does afford you with plenty more opportunities for different experiences.

Professor Umar Toseeb: And your paper's about bidirectional relationships, so from that, before you even do any analysis and look at the data, you would have to have some sort of reason for why you'd expect the opposite to be true. why might, we've talked about how friendships might be associated with better mental health, but why might kids who have good mental health have more friendships or better quality friendships or be more popular?

Dr. Tom Wu: Right, yeah. So in terms of let's say internalizing problems, you imagine a child who has more native mood, who's more withdrawn, then it's conceivable that they will have more difficulties establishing, building friendships with others. And so they're less likely to have higher quality friendships just because they have less opportunities. They also might have more negative outlook with their friendships, so they might expect more turbulence. And that could become a self-fulfilling prophecy where it actually does happen. And as for popularity, it's quite similar. If you're more withdrawn, then you're less likely to... to build relationship with others, then you're less likely to be perceived ⁓ as popular. So those are the sort of mechanisms. Although for externalizing problem, it's a bit different. So research has actually shown that perceived popularity could lead to increase sort of relational or overt aggression, especially relational, because they need to... Once you've achieved that status, you want to stay in power, you want to stay in the hierarchy. So relational aggression is one of the means people resort to.

Professor Umar Toseeb: I would have thought that the... I think this is what you're describing potentially, is that externalizing problems, so the other part of psychopathology is when you, you know, fighting a lot with others, bullying others, violence, stealing things, those kinds of things. I would have thought that that would make you less popular and have fewer friends. Because if you're the bully, or if you're constantly getting into fights with people, or breaking things, or you're known as the person who's... stealing from the shop and people might, other children might not associate with you, want to associate with you, that might make you less popular and have fewer friends.

Dr. Tom Wu: I think yeah, you're definitely right, but I think it kind of depends on the context. For example, a few things to consider. The amount of these rule-breaking behaviors you exhibit. If you exhibit like an appropriate amount, at a younger age it actually could be perceived as a desirable trait because you you're kind of... rebellious, you're not following the rules, you you play by your own rules and you're seen as dealing with what's called the maturity gap a bit better. But obviously, if you do too much of it, then that's when you might be less popular, of course. And also there's research that kind of suggests for younger younger children, the association might be negative between externalizing problems and popularity, whereas the association becomes more positive later in adolescence. This could be because also children, might lack the social skills to display these externalizing behaviors sort of appropriately for the gains.

Dr. Jane Gilmour: And that, mean, that's so well described, Tom, because it's a really complex data set because there's a developmental nuance throughout the data. But what you're describing there is a sort of difference or two different dimensions of social visibility and social acceptance. And those two variables can contribute to the popularity score, can't they? But you're describing how the visibility, for example, might have a different nuance in pre-adolescence as compared to... post-puberty kids.

Professor Umar Toseeb: So I'm going to get into, for me, the most exciting bit. So you did something called random intercept cross-like panel models. And my understanding of this model, this kind of statistical model, is that rather than looking at the associational correlation or the relationship between two variables, it still does that. So it tells you, is one thing related to another thing? But it allows you to understand in a bit more detail which way the things are related and why they are related. So my understanding of what you've found is that on the whole children who have better friendships and are more popular tend to have better mental health and that's what you call the between-person effects. But then the mental health difficulties appear to lead to poor friendships. And lower popularity rather than the other way around and that's what you call the within person effects. Is that right?

Dr. Tom Wu: Yes, and I think especially for the general psychopathology factor though, at the between person level, the results are a bit different for friendship quality and for popularity. But in general, in general, yes, better interpersonal relationships, better mental health.

Professor Umar Toseeb: Okay, so I think that brings me to the point that we were trying to make, which we were making earlier, which was we'd expect that having better friendships would protect against mental health difficulties, but it seems to me that what we are within Personal Effects show is that actually it might not be protective in the way that we thought it would be.

Dr. Tom Wu: Mm-hmm. I think yeah, the literature does suggest that that it should provide the protective it should act as a protective mechanism but one thing that I kind of alluded to earlier is that it does depend on the context and in this case because we have a relatively younger sample of pre-adolescents age 8 to 11 and so it could be that this protective mechanism kicks in a bit later in development. And we kind of see that in our results. So where at the later stages, you start seeing more concurrent associations and also more effects from the outcomes to mental health.

Professor Umar Toseeb: And just to pick up on context there, and this is a complete curveball, not what we're talking about, but I think it's important. Well, it is what we're talking about. Cultural context, you know, we've been, when I started this, said, you know, children and adolescents navigate towards peers and friendship groups as they progress from childhood to adolescence. But actually, in some cultures, family is very important and navigation towards friendships and peer groups might might happen a lot later or it might happen to a lesser extent altogether. What might that mean for some of the findings that we've talked about in this relationship between friendships and mental health?

Dr. Tom Wu: Yeah, think that's certainly true for some cultures. in that case, if we were to do this, replicate this with those samples, then yeah, we would see the effects kind of push back even more. So yeah, that's an excellent point. Yeah.

Dr. Jane Gilmour: But I guess then proportionately you're looking for an influence from family relationships. So in other words, where the salience is, whether it's the light is shining on family relationships as a protector or something that makes you vulnerable or it's friendships. So that transition between the focus from family to peers, it would be interesting to look at that. Umar, get onto it. Tom, you've got a job to do. Come on.

Professor Umar Toseeb: We need to find the longitudinal data. I'm sure it exists. It definitely does.

Dr. Tom Wu: 10 year plan.

Professor Umar Toseeb: Shall we talk about the implications of the findings? So we've talked about what friendships are, what popularity is, what mental health is, and we've talked about the relationship between those two things and the direction of those relationships. So for people listening who might be working with children and young people, but also other researchers who are listening, what are the implications of these findings?

Dr. Tom Wu: So I think one of the implications is that timing is very different. At least from our results, it kind of suggests that, or if you do an intervention, if you want to improve mental health or interpersonal relationships at this stage, it might be more effective to target mental health problems, which seems to have a... bigger effect on interpersonal relationships rather than the reverse. Although it is quite speculative, it's based on this data, this analysis, but that seems to be what it's suggesting.

Professor Umar Toseeb: Yeah, I that makes sense. Yeah, and I think it's also, it's interesting to look at it from a different point of view. So we're constantly trying to see how we can improve the lives of children and young people or just the population in general. And, you know, I think before I read this paper, I would have said if you want to improve children's, children, people's mental health difficulties into being in their friendship, potentially, and improve their friendship, these are the two things that we have in mind. But actually, it seems that from this particular paper or in this developmental stage, in this sample, intervening should be at the level of mental health difficulties. If you try to improve people's mental health difficulties with these kids, then it will improve their mental health difficulties, but it will also likely have a positive impact on their friendship and popularity.

Dr. Tom Wu: Yeah, that seems to be the case. Yes, I'm just a bit worried that I don't want to make like a really big claim just based on this one research. Yeah, I think that's definitely the direction that it's pointing to. But I do think more work is needed. For example, we could look at how the two outcomes might. Right now I've analyzed them separately, right? So mental health problems and friendship quality, mental health problems and popularity. But I haven't really controlled for each other. But then that's because the model would be quite complex if I were to do that. Maybe there is a workaround and yeah, I do think more work would be needed.

Dr. Jane Gilmour: But Tom, also, I think the thing that really came out from your paper, if I'm thinking from a point of view as a clinician, was how heterogeneous the samples and the routes to social difficulties might be. So I think you're right to say, you know, this is an interesting finding, you know, and I absolutely applaud your caution in saying, you know, how that might change the way we think about young people who have mental health problems and social difficulties. But it also raises the idea that there are many routes to that, you know, that outcome and thinking about pulling apart those reasons really comes across in your paper. And I think that's one of the reasons it's so valuable from a clinical point of view. Dr. Tom Wu: Yeah, I think something that you alluded to earlier as well about loneliness and exclusion. So it could definitely be a mediating mechanism between actually it has been found as a mediating mechanism that explains how lower popularity could contribute to depression through loneliness.

Professor Umar Toseeb: Can I, before we let you go, Tom, I want to just, again, another side quest. So when you were saying about, you don't want to make big claims. So what's interesting is I think it's different people have different thresholds for when they want to say, well, my work now should be translated into practice. And I think you're being very scientist-like and being like, no, but like, the stuff that we haven't controlled for, which is absolutely correct. Like we shouldn't, and that's my view as well. We shouldn't change policy and we shouldn't change practice based on one paper. But what I learned quite recently actually is that not everyone shares that view. And there are some people where I'm like, wow, you've done a, at best, good piece of work, at worst, questionable piece of work. And you are now trying to advocate for policy change and you are doing it shamelessly and you are shouting at the top of your voice and I'm like, what are you doing? But like, there's people on the spectrum and I think we're on the same end of the spectrum where we're like, I don't want people to change their practice based on one of my papers. But maybe at some point in the future when we're further on along our careers, we'll be like, I can shout the loudest, so I'm gonna do it and change practice.

Dr. Jane Gilmour: But I think Tom, that's a sign of a true expert to take that cautious approach and you know, and it adds, right? It's made us think differently and you can't ask for more from an academic paper.

Dr. Tom Wu: Yeah, no, thank you for bringing up that point. Or maybe it's just my imposter syndrome kicking in.

Professor Umar Toseeb: We're all there. We're all still there. We all feel like monsters. So let's call it a day. Thank you so much, Tom. That's been a fascinating conversation. I've learned a lot and hopefully it's been a fantastic experience for you too.

Dr. Tom Wu: It's been a great experience for me. Thank you very much.

Professor Umar Toseeb: Thank you That was really interesting. I really enjoyed that chat with Tom. I think he's, ⁓ very informed about the topic. ⁓ and I learned definitely a lot from that. What do think, Jane?

Dr. Jane Gilmour: Yeah, I really enjoyed it. I thought the idea of holding in mind both the mental health issues and perhaps potentially addressing those first as Tom's results suggest, but also the value of thinking about social experience. So when I'm in clinic, I want to know about one-to-one friendships. I want to know the names of your friends, what you like to do with your friends. But I also want to know about peer group experiences. So I would ask a class to describe, you know, if I see here a young person in the room, I will say, you know, how would your class describe you? When was the last time you went to a birthday party? But most important, perhaps, is asking teachers, because if you can get hold of a teacher and they're so busy, they absolutely are. But if you can ask them to describe what they see in dynamic or unstructured situations like playtime or drama lessons or whatever, they have this extraordinary, unique perspective on the world. So I think that was, you know, one really important part. And the idea that Tom used teacher report, which is absolutely valid, of course, was interesting. I think the second thing is about intervention. And of course, as we discussed, the paper highlights the idea that there's many reasons why a young person might struggle socially, you know, and that could range from unidentified social communication difficulties to impulsivity. And that heterogeneous nature of the population means that our interventions are going to be bespoke and different for individuals. So the universal peer group interventions are relevant, but in a therapeutic setting, you might be thinking about social skills training, which might include modeling or cognitive reappraisal. So testing out how young person interprets ambiguous social situations and helping them reconsider pro-social ones. So that is one aspect of intervention. So thinking specifically about why that young person might need support in their social skill set. But the other is about peer group interventions. And this takes a different approach. It's the kind of rising tide raises all boats approach. And usually these interventions are facilitated by teachers. And there are some good evidence based, including some RCTs for whole school interventions, which support emotional literacy. So there's a lot to think about, know, there's the zoom in and zoom out sort of individual skill, social skills training, as well as peer group interventions.

Professor Umar Toseeb: Just to pick up on something you said, when you said you have children in the clinic and you asked them about their friendships. And in the conversation with Tom and now you've mentioned it again, that talking to someone about their friendships and their social relationships might also be a very good way to understand their wellbeing and where they are in terms of their wellbeing. And I have a story about a boss who I used to work with like 10, 15 years ago. He was a very hands off person, like never, like he just let you get on with your job and that was it. And I remember one time he called me into his office. And we sat down and he was a psychiatrist and he said to me, how are you? And I was like, I'm fine. And he was like, so how's your family? And I was like, my family's fine. And he was like, do you have like a girlfriend or like, and I was like, no. And I was thinking, why is he asking me these questions? And then anyways, that conversation went on a bit like that. And I was thinking, this is the weirdest conversation I've had with like someone at work who's my superior. Like what's going on? Anyways, I went back to the office and I spoke to one of my friends at work and she was like, yeah, that's his way of checking in if you're okay. Like I was like, what asking me if I've got a girlfriend? Like what's that? And she was, and I know, I mean, it makes sense because he's asking me about my social circle. He's asking me about whether I have good social relationships with the people around me to get an indication of whether. I'm doing okay and to feed into that.

Dr. Jane Gilmour: Yeah, your social support, yeah, your five shoulders to cry on, as they say. ⁓ You know, if you've got five people around you that can help you if you had a real problem, that's a good sign. And I guess that's a strategy for a newcomer into your office. But I guess if you're thinking what on earth?

Professor Umar Toseeb: Yeah, it just seems a bit like, yeah, I think there could have been like bit of like softening of that. But anyway, just looping back to this, think the takeaway for me, well, the takeaway for academics for me is that a lot of the time we look at the relationship between two variables, and we say how is one thing related to another thing? And the analysis method that Tom's used here allows us to figure out, A, the direction of some of those effects. like, know, what is it that is subsequently associated with the other thing and which way around is that happening? But I think the key thing is the ability to distinguish between people who tend to have good friendships, tend to have good levels of mental health as we're looking at the population as a whole. But then at an individual level, if your friendships change from what would be expected, what would the impact be on your mental health? And I think this is not the first paper that I've seen where they've used this method to disentangle those nuance and you don't, you find something that you wouldn't expect. Like you'd find the relationships are in a different way around, or they're not as strong as you hope for. So I think there's definitely the takeaway for me from this paper is that the method that Tom's used, the random insect cross-back panel models, we should be using them more often, or methods like that more often, to disentangle the direction of some of these effects because it might not be, those relationships might not be in the direction that we'd expect them to be, and they might not be as strong as we expect them to be.

Dr. Jane Gilmour: Well, interestingly, the clinical takeaway is a relationship between two variables as well. Because I think increasingly the education and clinical worlds are connected. And there's lots of new programs, for example, as a mental health and wellbeing in education MSc at the Institute of psychiatry that shows the level of relationship there needs to be between these two worlds. And we know that school teachers have such a valuable place in clinical workup of any child. And in turn, we know that emotional literacy and relationship skills are teachable. So I guess my takeaway would be to see some evidence based emotional literacy programs given equal billing to the three Rs in the national curriculum, because young people and children with psychopathology will benefit and so will those without. So everybody would be a winner. That's my takeaway.

Dr. Jane Gilmour: Now then, producer Matt has asked me to remind you that the ACAMH website has many training webinars, including one that's timely given the recent Supreme Court ruling. So on July 15th, Sabra Katz-Wise from Harvard Medical School is leading a webinar which will leave you with practical evidence-based strategies for clinicians, educators, or indeed any adult supporting transgender and non-binary young people.

Professor Umar Toseeb: And finally, join us again next week for Mind the Kids, where we'll be talking to Dr. Rob Eves, who will be speaking to us about the relationship between infant characteristics and parenting factors and how they relate to children's outcomes. Hopefully we'll see you all next week.