A mental health researcher reflects on her academic journey

Ashley Radomski is one of five pediatric students that will receive graduate degrees this fall

Judith Chrystal - 06 November 2019

Twice a day, every day for five years, Ashley Radomski has crossed the North Saskatchewan River while riding on the LRT to the U of A campus. Although that 45-second contemplative view is something the newly-minted PhD is going to miss after convocation, the view from the stage of the Jubilee Auditorium on November 20 will also be pretty sweet.

Radomski is one of five students from the Department of Pediatrics that will receive graduate degrees this fall. She describes her academic journey as circuitous. "I had a sense of what I wanted, but didn't know how I would get there," she says. "I was very unsure, especially with navigating a formal training environment." Despite this, her hard-earned achievements appear to others as a clear path defined by surrounding herself with inspiring and supportive people, focusing on the goals at hand, developing skills, and identifying and taking advantage of opportunities that help her move in the direction of her interests.

After completing an undergraduate degree in psychology, with an internship at a rehabilitation centre and a research-focused independent study, Radomski further developed her mental health and academic skills with a master's degree in psychiatry. An interest in children and a mentor's influence led to a meeting with Amanda Newton in the Department of Pediatrics.

"As soon as I met Mandi, I felt an instant click with her," says Radomski. "I became so interested in her research and beginning the process to train with her flowed very easily from there."

Radomski has worked toward her PhD, with Newton as supervisor, in the field of child and adolescent mental health. Newton's lab focuses on how to make healthcare more efficient for kids whose first entry into the mental health care system is through the emergency department-admittedly not always the best place to receive the kind of care they are looking for. Radomski helped evaluate how internet-based cognitive therapy could help youth with anxiety reach the services and resources they need long before a crisis may bring them in.

"Cognitive behavioural therapy, CBT, is the recommended therapy or treatment for adolescents with anxiety," says Radomski. "The advantage of internet-based CBT is that we can leverage the use, availability and accessibility of technology and the internet to increase kids' access and use of this evidence-based treatment." Newton's team is exploring how these technological interventions lead to positive outcomes for children and adolescents with anxiety.

"Over all, my research is very exploratory," explains Radomski. She evaluates how youth report their experience with the Breathe program, an internet-based CBT program developed by Newton's research team. Radomski also examines how other internet-based CBT programs work, looking for important trends in their design and delivery, with a goal of optimizing future programs. "If we can figure out what the key activities and features of internet-based CBT are, and how they relate to the treatment effects we see, we can apply these insights to better develop new treatments to improve outcomes for youth," she says.

One of the results of the research shows that teens are not using the programs as often as would be optimal and so the team wants to learn more about how to increase their use.

Would features such as reminders, prompts or nudges help keep them on track? Would other types of support through in-person, telephone or email positively augment the online programs and help teens better understand the content? "Adolescents really like the use of progress reports, feedback and surveys and like to see how their symptoms have changed over time," reveals Radomski, so the researchers want to understand the value of that. Adolescents also like to know that they are not alone and seeing that others may experience something similar helps to normalize their situation. Creating an online social context means teens could also learn from peers to better self-manage anxiety by modelling the helpful coping strategies of others.

Radomski also knows that what adolescents think about the impact an internet-based CBT program has on them is important, too. While researchers and clinicians may use symptom questionnaires to evaluate the effectiveness of a program, there is very little research done on youths' experience of internet-based CBT programs and what effects (or changes in anxiety) are important to them.

Newton's research team is hopeful the results of their national Breathe studies will show that the internet-based treatment is effective and can be offered more widely to families across Canada.

Just as the Breathe research has moved toward an end goal of making a positive impact in the lives of others, so has Radomski's career. Her next step is a two-year postdoctoral fellowship as a CIHR health systems impact researcher, working in Ottawa with Mario Cappelli, clinical psychologist and director of the Children's Hospital of Eastern Ontario Research Institute, and Purnima Sundar, executive director at the Ontario Centre of Excellence for Child and Youth Mental Health.

The objective of the government-supported project is to improve how mental health care for children and adolescents can be more seamlessly delivered through primary care and community-based care organizations. The research looks to strengthen inter-provider communication by improving the screening and referral process for adolescents and also to improve awareness and coordination of available mental health services.

"I'm really looking forward to making an important provincial and national contribution with this work," says Radomski. "We'll be focusing on improving major processes at a healthcare system level to more efficient, appropriate and timely mental health care for children and adolescents." After her time with that project is completed, she will allow her circuitous tendencies to take her wherever the next opportunity may be.


Ashley Radomski's top tips for graduate students
* Develop your focus strategies and establish a daily routine.
* Find your team and support network, including both professional and personal supporters.
* Know when to ask for help. Hint: it is often sooner than you may think.
* Capitalize on the snowball effect and know that wins beget wins.
* Don't forget that you are a human being - be kind to yourself!