Five years after the youth mental health crisis was officially declared a national emergency, severely elevated rates of anxiety and depression among adolescents have not returned to pre-pandemic levels.
Anya Griffin, PhD, Co-Director of the Behavioral Health Institute and Director of Psychology at Children’s Hospital Los Angeles leads a team of 80 psychologists embedded throughout the hospital. The number of children and adolescents coming to them with complex mental health needs is significant. Often, families don’t know to seek care until symptoms are severe.
Shepherding youth through this crisis, Dr. Griffin asserts, means empowering them with the positive coping skills and tools for resilience they can apply to everyday life—which would require integrating behavioral healthcare more broadly across medical, educational, and community settings.
Dr. Griffin shares her perspective on the future of pediatric psychology, and the interventions and care approaches she’s most passionate about.
What led you to pediatric psychology?
My master’s degree is in dance and movement therapy. After working as a creative arts therapist in inpatient psychiatric care for many years, I went back to graduate school to begin my PhD in clinical psychology.
I completed my doctoral training at CHLA as a practicum student and then a pediatric psychology intern embedded in a variety of subspecialties. I was trained in the Biobehavioral Pain Lab, conducting research on pediatric pain. These early experiences allowed me to see where my passions for creative arts therapy and clinical psychology could merge.
I spent several years helping grow behavioral health programs at medical centers around the country working in hematology/oncology and later returned to pain medicine. My research explored integrative interventions to help children cope with medical conditions.
I directed a chronic pain rehabilitation program at Stanford for eight years before returning to CHLA. Part of what drew me back here was wanting to give back to psychologists—these real-life superheroes who help children nurture their own resilience through the most challenging medical situations.
What integrative approaches do you find most helpful in managing pain, anxiety, and depression in children?
One technique that CHLA has explored for many years is virtual reality (VR). Specially designed for clinical use, immersive VR games help redirect attention, particularly during painful procedures in medical settings. Evidence shows these interventions can be effective in easing anxiety and pain, and can even reduce the need for medications during procedures.
Giving children and adolescents agency over their ability to cope more effectively is incredibly powerful, whether it’s achieved through innovative tools like VR or by helping them develop their own innate resilience.
A modality that may help kids tap into that resiliency is clinical hypnosis. I utilize self-hypnosis as a tool to enhance cognitive behavioral therapy interventions as a way to empower them throughout medical treatment. Kids learn to use their imagination to shift awareness, focus, and even change their experience of pain to increase comfort.
It’s remarkable to see what’s possible when kids learn to utilize self-hypnosis as a coping tool; it can be incredibly effective for even the most severe chronic pain conditions. Clinically, I’ve seen promising improvements in symptom management with the use of hypnosis for many complex medical conditions such as sickle cell disease, GI conditions, oncology care, and rheumatology treatment.
How can child psychologists prepare to address the ongoing youth mental health crisis?
First, as a society, we need to recognize the “new normal.” The reality is that life for many young people hasn't improved post-pandemic. They’ve experienced crisis after crisis. They may have witnessed or lived through multiple scary events at key points in their development.
That stress has traveled with them as they grow. Now, incorporating positive coping strategies into daily life is no longer optional; it’s imperative to their wellbeing. It needs to become part of our collective operating system.
To make this a reality in all our communities, and to ensure kids aren’t slipping through the cracks, we must approach behavioral health needs through a broader population health lens that prioritizes prevention and early intervention across settings. Youth and their families need access to tools for resilience in multiple aspects of their lives, from primary care, to schools, sports, and extracurricular activities.
At CHLA, we have psychologists embedded in almost every area of care across the hospital, and I’m proud of that. But I envision a future where preventive care for behavioral health is as common as seeing a pediatrician, dentist, or eye doctor.
What is the Collaborative Care Model?
It’s an approach that integrates behavioral health services directly into the primary care setting. It essentially creates a “triangle of care” around the patient with a physician, a psychiatrist, and a behavioral health provider such as a psychologist, psychotherapist, or clinical social worker.
We think of this care team approach as transdisciplinary, empowering collaborators to share knowledge, skills, and responsibility to support the patient by bringing together each provider’s unique goals. The collaborative care model ensures that concerns are identified earlier, treatment is adjusted based on outcomes, and patients are less likely to fall through cracks.
We have already piloted this model in several key areas of care at CHLA. In my experience, it shifts the team’s focus to a more proactive approach to address whole child health needs more broadly.
Collaborative care benefits everyone across the care continuum: It provides physicians a more balanced picture of their patient as they are making treatment decisions; it empowers behavioral health professionals to help families access care that historically was difficult to procure; and it leads to more timely treatment and better outcomes for patients.
We’ve seen success in some of our ambulatory clinics, as well as specialties like Neurology and Hematology, and we continue to expand into other areas. I look forward to sharing more about the collaborative care model and the outcomes of our pilot.