Featured Faculty: Eve K. Freidl, MD

Featured Faculty: Eve K. Freidl, MD

Dr. Eve Khlyavich Freidl is a board-certified child and adolescent psychiatrist at the Columbia University Clinic for Anxiety and Related Disorders (CUCARD) and Assistant Professor of Psychiatry within the Division of Child & Adolescent Psychiatry, Department of Psychiatry, at the Columbia University Medical Center (CUMC). She specializes in the evaluation and psychopharmacological and psychotherapy treatment of children, adolescents, and their families. She also has clinical expertise in the evaluation and treatment of eating disorders, including anorexia nervosa, bulimia nervosa, and avoidant/resistant food intake disorder.

Dr. Freidl completed both the NewYork-Presbyterian Child and Adolescent Residency and the T32 research fellowship at Columbia University Medical Center. As a NIMH T32 postdoctoral research fellow, Dr. Freidl pursued research into affective, anxiety, eating, and related disorders. While a T32, Dr. Freidl received an American Academy of Child and Adolescent Psychiatry Pilot Research Award to study genetic contributions to stimulant medication side effects of weight loss and growth suppression. In addition, Dr. Freidl has served as a treating clinician in a longitudinal research study of adolescents with bulimia nervosa, and has developed expertise in the cognitive behavioral therapy and psychopharmacological treatment of bulimia nervosa. Dr. Freidl also had the opportunity, starting in her child and adolescent residency and continuing into her T32 fellowship, to participate in the evaluation of adolescent bariatric surgery candidates and ongoing research and assessment.

We sat down with Dr. Freidl to discuss her training at CUMC, as well as her areas of interest and goals for the future.

Q: Could you tell us how you chose to come to CUMC as a fellow in the Child and Adolescent Psychiatry Residency Program, and how, as a fellow, you first became involved in research?   

When I was exploring which child and adolescent psychiatry fellowship I wanted to pursue, I always had in mind that I wanted more exposure to research At the time, I had a particular interest in learning more about obesity and, over time, that’s shifted into an overall interest in working in the eating disorder spectrum. In my third year of residency, before I came to Columbia, I started talking to Drs. Timothy Walsh and Michael Devlin in the Eating Disorders Research Group. At CUMC, it seemed like I’d be able to find a space where I’d be able to start doing research even when I was also doing my clinical training. I was really fortunate to have been able to establish this relationship from the outset. I worked with the Eating Disorders Research Group on a research study looking at school and cognitive functioning problems in adolescent bariatric surgery candidates. The fellowship is very busy—it has a lot of clinical demands—but because I had narrowed down to a specific research interest, and Dr. Elisabeth Guthrie had helped me establish the plan even before starting training, I was able to make a nearly weekly commitment to paricipating in bariatric surgery evaluations. The second year of the Child and Adolescent Residency Training Program has a little bit of space for research in the scholarly project requirement. So I was able to take my work from the first year of fellowship, examine and synthesize the research in my second year of fellowship, to produce a poster for my scholarly project, and, in my T32 fellowship, we were able to turn the poster into a publication. At Columbia, there’s a real advantage in the sense that there are senior faculty members who can serve as mentors. Dr. Walsh was really helpful in pushing me to think about applying for awards, such as the AACAP pilot award. He also introduced me to many faculty members who are leaders in their fields to help me develop projects, including Dr. Rudolph Leibel, a pediatric endocrinologist. 

Q: So, did it seem like a logical transition to pursue the T32 postdoctoral fellowship after this?

Yes and no. Unlike some of the MDs and PhDs who are in the program, I had very little of my own research to represent myself as a worthy candidate (chuckles), but I had my eye on it. And it was an incredible opportunity to grow, both professionally and personally.

Q: Who were your mentors during the T32 fellowship?

I had many! Dr. Timothy Walsh was my primary advisor, but Drs. Evelyn Attia and Moira Rynn were also great mentors and models as clinician-researchers who are extremely successful in their fields. And the Eating Disorders Research Group also has a lot of very senior psychiatrists, so I also got to work on a project with Drs. Michael Devlin and Laurel Mayer. And I’m not even mentioning the psychology mentors—such as Deborah Glasofer and Robin Sysko. That is a true asset of the T32 program—the opportunity to work with a variety of mentors across disciplines, each with their unique expertise and approach to research.

Really, my mentorship hasn’t ended. The mentors and peers who have helped me continue to provide really valuable support. And, now that I am part of the faculty, peer mentorship has also become an important part of how I continue to develop and find support and collaboration—at CUCARD, in the Division of Child & Adolescent Psychiatry, and throughout the department and medical center overall.

I am also trying to learn to be a mentor , by teaching didactics and helping with the supervision of trainees at CUCARD.

Q: How did your experience in research help you as a clinician?

Well, for one thing, it really helped me become a research-informed clinician. Being informed about the evidenced-based practices is a piece of that, but it helped me appreciate how research informs our clinical work: ask questions and interpret data. My research experience has helped me understand what questions need to be answered and, just as importantly, what questions aren’t answered.

My research background also helps me formulate questions about how treatment for eating disorders could be improved and to look critically at current and future research in the field.

Q: What are your future hopes—both for yourself professionally and also for the next steps in the field of eating disorders?

I am now able to do clinical work with a variety of eating-disorder patients (and, of course, those with other diagnoses). I feel well equipped to see where we need to continue to develop in the field of psychiatry and eating disorders. For instance, there are a lot of questions about ARFID (avoidant/ restrictive food intake disorder), and I am hoping, in the future, to be part of answering those questions. There is much more for us to learn, and, ultimately, more for us to learn about how to treat children with this disorder and how to help parents with children in this spectrum of picky eating . I look forward to being a part of that, with my research and clinical colleagues.

Because I still stay very connected to my mentors, patients, and what’s going on in the field overall, I see gaps in the clinical systems delivery perspective. The T32 program and other professional experiences have reinforced the value of working as a team toward goals that aren’t a one-person solution. I hope to be part of a team of research-informed clinicians involved with the effort in New York to provide more comprehensive care to adolescents, with eating disorders in particular, where I and others can see the gaps. That means treatment development, in terms of ARFID, but also evidence-based treatment facilities, certainly in terms of patients with anorexia and bulimia.

Q: What makes you hopeful in your field?

On the clinical side, working with patients with eating disorders can present a lot of challenges. But, luckily, I continue to have times when I can see that I’ve helped somebody. I’ve seen kids recover and I know how grateful their families are for this work. So, it’s helped me to feel hopeful and know that the work we do matters. On the research side, my mentors and colleagues have been successful in asking lots of exciting questions and pursuing lots of exciting grants. And so, even though we hear a lot about concerns about limited funding and all of the difficulties that researchers face, I feel privileged to know some of the researchers working on such exciting projects right now. So, I’m hopeful that there will be more and more answers to questions that can really make a difference in the lives of patients and families.