
Discover U Podcast with JD Kalmenson
Discover U Podcast with JD Kalmenson
Clinical Virtual Reality and Associated Technologies, Albert "Skip Rizzo, PhD
Welcome to Discover U! On this episode, straight from the Emerging Themes Behavioral Health Conference, host JD Kalmenson (CEO of Montclair Behavioral Health) talks with the one-and-only Dr. Skip Rizzo. He's the brains behind Medical Virtual Reality at USC's Institute for Creative Technologies, and he’s got some mind-blowing stuff to share.
Dr. Rizzo breaks down how VR is becoming a total game-changer for mental well-being. You'll hear about:
(00:01:13) The awesome "Game Boy story" that first sparked his ideas for VR in brain injury rehab.
(00:03:05) What makes VR tick for therapy? Think super-controlled, immersive worlds designed for healing and growth.
(00:06:16) VR's rollercoaster history: From 90s sci-fi movies to today's powerful headsets (and how the gaming world accidentally helped fund it!).
(00:09:28) Using VR to help veterans face PTSD, new ways to support military sexual trauma survivors, and even inspiring global efforts in places like Ukraine and Israel.
(00:15:12) What therapists actually need to know to use VR – and how it can make the connection with their patients even stronger.
(00:18:00) Could VR help us build resilience and maybe even head off some mental health struggles before they start?
(00:20:07) Where can you actually find VR therapy today? (Hint: The VA is already a big believer!)
(00:26:02) The great news: VR is here to boost therapists and the crucial human connection in healing, not replace it.
If you're curious about how tech is making a real difference for people dealing with PTSD, autism, ADHD, Alzheimer's, pain, and so much more.
Follow JD at JDKalmenson.com
00;00;00;29 - 00;00;27;21
JD Kalmenson
Welcome to another episode of Discover U, our podcast exploring innovative and effective solutions to issues in mental health. I'm JD Kalmenson, CEO of Montclair Behavioral Health, a family of dynamic and comprehensive mental health centers in Southern California. We are here at Emerging Themes, the Behavioral Health Conference, catching up with some amazing innovators who are reshaping the treatment space with fresh breakthroughs and new approaches.
00;00;27;23 - 00;00;52;14
JD Kalmenson
Today, I'm thrilled to have a conversation with one of our speakers. Skip Rizzo, PhD, a leading expert in the use of virtual reality and technology in mental health treatment. Doctor Rizzo is a clinical psychologist. He's the director of medical virtual reality at the USC Institute for Creative Technologies and a research professor in USC's Department of Psychiatry and in the USC Davis School.
00;00;52;17 - 00;01;10;16
JD Kalmenson
His work focuses on developing virtual reality systems for clinical assessment, treatment and rehabilitation in areas like PTSD, autism, ADHD, Alzheimer's. And so this is something that is so cutting edge and so new. First of all, thank you for being with us, doctor.
00;01;10;19 - 00;01;13;05
Skip Rizzo
So thanks for having me.
00;01;13;07 - 00;01;21;10
JD Kalmenson
Before we even begin, what sparked your interest in virtual reality? When was it. And maybe it's actually older than some people even think.
00;01;21;12 - 00;01;52;00
Skip Rizzo
Yeah, yeah. Well, the light bulb moment was when I was doing work in brain injury rehab as a psychologist and neuropsychologist. And this was from 85 to 94. And during that time we didn't have much technology. It was, you know, a lot of paper and pencil, assessments and workbook exercises and so on. And one day, one of my clients came bursting into my office, 22 year old frontal lobe injury, from a car accident.
00;01;52;02 - 00;02;13;09
Skip Rizzo
Hard to maintain motivation, in any of the rehab activities that we that we had that we offered. And he comes, bursts in and he goes, Skip, you got to see this. It's a new thing. I go, what? He goes, it's called a Game Boy watch. And I saw him. He bent over and he's playing Tetris. And he was like a Tetris warlord.
00;02;13;11 - 00;02;38;27
Skip Rizzo
But not just that 20 minutes. I just sat there and watched him in awe. Because this was a kid you couldn't motivate for more than 5 or 10 minutes at the most, to do traditional rehab. But here he was, glued to this thing. So I thought if we could bottle that, you know, if we could translate rehab into to an activity that was that engaging, maybe we'd go somewhere.
00;02;39;03 - 00;03;05;06
Skip Rizzo
And so I started bringing games into the clinic. Computer games. SimCity was one of the early ones, son. My Nintendo NES system. That's how old I am. But, And they loved it. But the interface was clunky. Using a game pad for complex decisions and an act active executive function activity like that. So then I learned about VR, and that was it.
00;03;05;08 - 00;03;27;24
Skip Rizzo
When I learned about VR, the compelling element of if we could design simulations that we could immerse people in, and we could systematically do the kinds of drill and practice activities, but in a context relevant for the real world. And maybe we could gamify some of that. Give people feedback, you know, compare their performance with the day before.
00;03;27;24 - 00;03;47;14
Skip Rizzo
Well, that was a great vision. I wrote a paper on it. And we got a little bit that was 94, 94 and it got a little traction. And then I actually tried real VR at that time and it's like, oh my God, this is this isn't what I thought it would be, because the technology was very immature at the time.
00;03;47;16 - 00;04;16;26
Skip Rizzo
Very, cartoony graphics, small windows in a VR headset and so on. But you could see that that was where, one future, would lie ahead. So 95, I had an opportunity to take a post-doc at USC. I left my clinical work, were moved to the Alzheimer's Center, USC, which was it was strategic move because it was right across the street from computer science.
00;04;16;28 - 00;04;45;17
Skip Rizzo
So I would spend my afternoons going over to computer science and bugging people with these ideas. And when one day this guy said, I know somebody with equipment, that's an idea, that sound. It was a visual spatial assessment and training, idea. And he goes, and I've got a student programmer. And it was like, okay. And that was a started in the lab built from that, you know, originally targeting cognitive assessment and rehab.
00;04;45;20 - 00;04;58;08
Skip Rizzo
But then later branching out into other areas of, you know, exposure therapy for PTSD or role play training with folks on the autism spectrum, with virtual humans.
00;04;58;10 - 00;05;19;17
JD Kalmenson
So essentially, virtual reality in its clinical uses, the ability to control a setting, to engage in the stimulation or the exercising of whatever the particular intervention that you're seeking to do, and having it really just sort of mapped out, minus ING out all the other variables that might otherwise compromise that process.
00;05;19;19 - 00;05;56;09
Skip Rizzo
You said it in a nutshell. Just basically we're talking about the ultimate Skinner box, right? You know, a controlled stimulus environment that you can design around whatever the clinical need is, whether it's exposure, for anxiety disorders or distraction from painful, acutely painful procedural pain, procedures or game of fine rehab. And so you just build these worlds and then you can not only systematically control the stimuli that appear in those worlds, but you're also measuring performance in a more natural way.
00;05;56;09 - 00;06;16;24
Skip Rizzo
It's not just right or wrong, but it's body action. It's head turning, all these things that you get for free with VR because it's it's essential to track the user's body and head movement. To update the graphics in real time. Wow. To make the environment compelling. Make it realistic.
00;06;16;26 - 00;06;27;05
JD Kalmenson
Very interesting. When did virtual reality become a household term? And it's not only in the clinical sense, but just in society in Silicon Valley. How recent is that?
00;06;27;06 - 00;06;57;15
Skip Rizzo
Well, I think it's been a roller coaster of, of, you know, the high end starting in 92, probably after the movie The Lawnmower Man came out, Brett Leonard's classic, an adaptation of the Stephen King novel about VR and about trying to take somebody who had intellectual deficits in combination with drugs and VR experiences, you know, do rehab.
00;06;57;22 - 00;07;24;13
Skip Rizzo
And that actually kicked off the first hype cycle in the early to mid 90s. But then, as I found out when I first tried VR, the vision was a little bit ahead of the, capacity for the technology to deliver. And so we kind of had a nuclear winter in the late 90s. But the university labs, people, you know, that could build this stuff were doing it.
00;07;24;13 - 00;07;50;29
Skip Rizzo
And it was always the academic activity that continued. Then there was another, another little bump when the, when the Nintendo Wii came out and that was in VR so much as its natural interaction, even though it was kind of faked. But people it it showed us that people wanted to interact with games beyond what they could do with their thumbs.
00;07;50;29 - 00;08;21;21
Skip Rizzo
And so it was body action. Microsoft Kinect came out, but the next big jump was around 2014. With the formation of Oculus, a company that ended up getting purchased by meta. This guy Palmer Luckey, who had worked in our lab previously, realized that with the advances in cell phone screen technology, you could build low cost VR headsets with reasonably high fidelity.
00;08;21;24 - 00;08;48;02
Skip Rizzo
I mean, these these screens previously would cost a couple thousand dollars per eye. So very expensive. But now, with mass production of cell phones, there were pennies. And so all of a sudden a head mount display became a practical tool. And that kicked off the the next great wave of VR, which we're still writing now because these companies have continued to evolve headsets.
00;08;48;04 - 00;09;01;11
Skip Rizzo
Apple's in the mix now with the Vision Pro augmented reality headset, where you can see through the real world, and I give a virtual version of you sitting in that chair right now. Or you could do.
00;09;01;11 - 00;09;28;06
JD Kalmenson
Holograms, right? I think it's, the first time I saw one, and it was about it was an artist who had passed away, one of my favorite. I got goosebumps. You know, it's it's just so authentic and fortunate. It's not always that you have gaming commercial for profit, actually inadvertently fueling and helping neurology and and and behavioral health.
00;09;28;06 - 00;09;56;17
JD Kalmenson
So this is like such a beautiful synergy even though it's not planned and it doesn't even have that. We lucked out. Yeah yeah yeah. It's really the most extraordinary, extraordinary innovators and programmers. It's really special. Let's talk about PTSD for a second. Sure. Because I know that a lot of the work that you're doing with virtual reality is really providing, an efficacious intervention for PTSD, which is so common.
00;09;56;20 - 00;10;18;11
JD Kalmenson
It's not going away. And despite all the talk about it, the actual, you know, sort of volume of evidence based interventions that are effective are not are not as many as people would think. So maybe give us a little bit of a high level overview of what current PTSD interventions are doing and how VR sort of changes the landscape.
00;10;18;13 - 00;10;42;05
Skip Rizzo
Well, I think what VR brings to the table here is a way to systematically create simulations of traumatic events that we can put a person in at a pace they can handle, to help them engage with their trauma narrative. Probably the best evidence based approach is, and there's only really three that fit this category is trauma focused therapy.
00;10;42;05 - 00;11;08;04
Skip Rizzo
And the key idea that you help a person to confront and reprocess difficult emotional memories rather than avoid. And so you see prolonged exposure. EMDR, cognitive processing therapy is really a trauma focused therapy, except you're writing about the trauma. And so what we do with VR is not a giant leap away from the evidence, but.
00;11;08;05 - 00;11;12;13
JD Kalmenson
The concepts, the philosophy. Yeah, it's just giving it more accuracy. Yep.
00;11;12;16 - 00;11;40;01
Skip Rizzo
And helping patients that would be difficult to engage in imagination, to try to conjure up the thing that they've been spending months, years, decades avoiding thinking about or avoiding going to places that helped trigger those memories. Now we can put them in gradually. So we've done work with veterans coming who've come back from Iraq and Afghanistan, and that that started in 2004.
00;11;40;01 - 00;12;16;12
Skip Rizzo
So we've got 20 years of research, randomized controlled trials. And one of the key findings is, you know, we get results in terms of efficacy, the equivalent across all people, equivalent to the best seven in space imaginal exposure up. But and this is where precision medicine, view comes in. We predicted in our last randomized control trial that VR would have better efficacy when a person had PTSD and co-morbid major depression, because those are people that are hard to activate and engage.
00;12;16;14 - 00;12;24;29
Skip Rizzo
But you could put them in a VR simulation and all of a sudden, you know, might not be an exact replica of where their trauma.
00;12;24;29 - 00;12;34;00
JD Kalmenson
I said I was going to ask you if talking about exact Replica, how sophisticated is it? Let's say somebody was abused by an individual. Do you take a picture of that person, put it into a you.
00;12;34;00 - 00;12;59;26
Skip Rizzo
Could do that. And we're doing things like that with sexual trauma, PTSD. You know, we've, completed a safety and feasibility trial where we had built out, this is a big issue in the military, military sexual trauma. Let's take out some of our military, context. But it turned out most people suffering from military sexual trauma, it happened stateside.
00;12;59;28 - 00;13;24;24
Skip Rizzo
And so we built our a bunch of civilian contexts, places, you know, bars, alleys, cars, motel rooms, barracks or, shipboard offices, as well as, army offices and so on. And we saw we can put people in those, those environments and help them at a pace they can handle.
00;13;24;24 - 00;13;25;17
JD Kalmenson
Right.
00;13;25;20 - 00;13;49;00
Skip Rizzo
That's narrate and talk about it. And sometimes, you know, this stuff is so emotionally evocative that even if it's not an exact replica, the context is enough. And these folks are talking about things that they never talked to anyone about before. You know, a veteran doesn't want to burden his family or friends sometimes, they don't want to go see a therapist.
00;13;49;03 - 00;14;24;19
Skip Rizzo
The same thing with sexual trauma. There's a shame or stigma. But all of a sudden, all these years or however long start pouring out, and now the therapist is not just doing exposure here, you know, the exposure opens, takes the cork off the bottle, but the genie that comes out is where a lot of the traditional, you know, talk therapy, whatever your your perspective on talk therapy or, or discipline in that area, now you've got an active engaged very interesting.
00;14;24;19 - 00;14;45;18
Skip Rizzo
We're we've actually expanded the work now to Ukraine. We partner with Ukrainian developers that are building out the contexts that are culturally relevant. And we have a partnership with Ben-Gurion University in Israel to build out content that's kibbutz relevant, as well as Gaza relevant. Wow.
00;14;45;19 - 00;14;46;16
JD Kalmenson
So very.
00;14;46;16 - 00;15;12;07
Skip Rizzo
Interesting. You know, I would say a off the cuff estimate, probably 60% of people that engage in psychotherapy, the issues are addressing has some root in a past trauma, whether it's adverse childhood experiences or war time trauma or, you know, pathological grieving or whatever. There's you can always trace it in a good number of.
00;15;12;11 - 00;15;24;23
JD Kalmenson
Amazing couple of very technical questions for a therapist. Is engaging with the client, is using virtual reality going through that experience? Does that therapist need any type of special certification or training.
00;15;24;25 - 00;15;31;20
Skip Rizzo
With with our applications, you have to have certification and prolonged exposure so that.
00;15;31;23 - 00;15;36;12
JD Kalmenson
Prolonged exposure not necessarily VR general prolonged exposure, they could apply those principles.
00;15;36;15 - 00;15;38;23
Skip Rizzo
To VR. But we have a training program.
00;15;38;24 - 00;15;45;08
JD Kalmenson
But you got to be trained for prolonged exposure because a lot can come up. Yeah. That wouldn't ordinarily in a regular talk.
00;15;45;08 - 00;15;50;21
Skip Rizzo
And you got to know how to operate the equipment because right. The clinician is and you don't just put somebody in and.
00;15;50;25 - 00;15;52;06
JD Kalmenson
Know it's you're in there.
00;15;52;06 - 00;15;59;10
Skip Rizzo
Adjusting things in real time. The patient talks about. And then a guy came out from a corner in the distance with a gun.
00;15;59;15 - 00;16;01;22
JD Kalmenson
Click that guy. Does that make you feel.
00;16;01;24 - 00;16;02;04
Skip Rizzo
Yeah.
00;16;02;04 - 00;16;02;26
JD Kalmenson
Right. Okay.
00;16;02;26 - 00;16;11;29
Skip Rizzo
So they're controlling time of day. Number of people, explosions. Wow. Shady characters. All from the psych Wizard of Oz. Control.
00;16;11;29 - 00;16;12;23
JD Kalmenson
Very interesting.
00;16;12;25 - 00;16;32;09
Skip Rizzo
One of the the added benefits I think of that is when I was back in the day, I worked with Vietnam veterans on my VA internship, and I never served. And so I had no credibility to them anyway. I often say, well, I don't have to be schizophrenic to work with people that have schizophrenia, and I do that too.
00;16;32;12 - 00;16;53;18
Skip Rizzo
But what we hear from patients now is that I feel as if you understand my situation better because they don't use this term, but because we've co constructed the world, because the clinician is picking the world and changing things up and everything, and seeing it as the client is walking.
00;16;53;18 - 00;17;19;27
JD Kalmenson
Through a certain degree. The clinician is very with them in that moment. So that's that's extraordinary. I never even thought about that aspect of it. It was an added thing. Another technical question. So PTSD, it can come from violence can come from sexual trauma can come from other forms of trauma. Do you find that the VR is more effective in any specific domain or type of trauma than others, or is it more effective in a general way?
00;17;20;00 - 00;17;37;13
Skip Rizzo
I don't yeah, I would I would have to default to the generic, it's useful for activating the emotion. But especially with people that also have co-morbid depression. I don't think we've done enough research, to be able to say pinpoint.
00;17;37;13 - 00;18;00;19
JD Kalmenson
Or this trauma is more of okay, got it. Yeah. Very, very well understood. Well, and another question is, in the future, when this becomes more widespread, do you anticipate or would you support an initiative similar to the way an antibiotic is actually a healthy injection of bacteria? So you can your body can build up its immune system.
00;18;00;21 - 00;18;13;14
JD Kalmenson
Would there ever be a thought process that people should actively engage in a VR version of some type of adversarial experience to actually give us a greater degree of resiliency, toughen us up, as it were?
00;18;13;21 - 00;18;43;14
Skip Rizzo
You know, there's two lines of evidence for that. Number one, we built out a pre-deployment system from our PTSD exposure therapy treatment, and this was designed for service members before they went to war to go through a mission and to have it all go bad. And then a virtual mentor walks out in the scene and walks him through various coping strategies, like if it's, you know, it gives people permission to have kind of freaked out.
00;18;43;14 - 00;19;06;21
Skip Rizzo
They're in a Humvee that gets blown up. And then the character says, okay, you survived this, and you know, you're very anxious. It doesn't mean it doesn't mean you're a wimp. It's acute stress now. The strategies for dealing with acute stress. Let me guide you through a breathing exercise. So we developed a series of these scenarios that the Army has used.
00;19;06;21 - 00;19;31;06
Skip Rizzo
But they haven't done the research to really show. But in another area, there was recently a study on cardiac surgery where patients before they went into surgery, they went into a VR world that showed what they would be going through, going into, you know, the pre care, room and then, you know, being moved into the operating room and all that.
00;19;31;08 - 00;19;51;27
Skip Rizzo
And you might think that might be frightening and might cause rumination, but actually patients reported it gave them an honest idea as to what to expect. And it reduced their anxiety. So, you know, is it you know, spoonful of medicine makes her go, I don't know, preventative.
00;19;51;27 - 00;20;07;26
JD Kalmenson
It sounds like a there's preventative opportunity here. I think there are preventative. That would be amazing. How widespread is this? Is it available on the market? If I'm a client, I'm a patient. I'm looking to avail myself to this. Where can I find virtual reality therapy?
00;20;08;02 - 00;20;40;23
Skip Rizzo
Well, as far as large medical systems implementing it, which I think is a major, a major step, we see the VA operating, you know, they've got something like 4400 VR units across 180 VA medical centers, dressing, pain management, pain distraction, physical therapy, cognitive rehabilitation, PTSD, of course anxiety disorders, substance use with Q exposure strategies and relapse prevention.
00;20;41;00 - 00;21;11;25
Skip Rizzo
So we're seeing that, as far as clinical practice, there are a number of companies that specifically license like if you're primary practice is exposure therapy for phobias. You can you can you can buy a $300 headset, meta quest that connects to the cloud, and you have a tablet and you can pick, okay, I want the agoraphobia seen or I want the fear of flying, seeing, being.
00;21;11;28 - 00;21;41;11
Skip Rizzo
And then you can systematically control if it's flying, you know, it's a nice smooth flight that you put a person on. Or as they get more comfortable you make turbulence. So there are companies that produce that kind of content. And probably the biggest area actually is in in physical therapy. Now, there is probably eight companies that are producing this kind of game based, highly interactive and measurable.
00;21;41;13 - 00;21;49;15
JD Kalmenson
So it is out there and in some of the look for you have to look for it, but only in some of the indications. For example, do you have it out there for PTSD?
00;21;49;18 - 00;21;59;08
Skip Rizzo
Not no, because we have it in the VA and in private practice, but we don't make that available for patients to download them.
00;21;59;14 - 00;22;14;21
JD Kalmenson
But, but, but if a clinician or a clinic wanted to see that, that would be possible. And if, let's say, a clinic was licensed that out, do they have the tools to customize the scenes to customize the VR for the patients? They do have.
00;22;14;21 - 00;22;25;09
Skip Rizzo
That. Yeah, that's that's part of the software package where you have a clinician interface that adjusts everything in the headset. And, you know who's part of the package.
00;22;25;09 - 00;22;36;09
JD Kalmenson
That's amazing. Is there some type of an FDA version of approval that it would have to get, or it's a or because it's done in conjunction with the therapist. It doesn't need to be FDA.
00;22;36;11 - 00;22;54;27
Skip Rizzo
See, that's the thing. It doesn't necessarily need that. It all depends on the claims you make. But also are you are you using the VR to deliver an already evidence based correct strategy? Correct. I'm do I'm getting reimbursed to do exposure therapy whether I'm doing it in imagination or VR. Right.
00;22;55;00 - 00;23;08;24
JD Kalmenson
Right. It's just enhancing it. It's not actually creating an alternative modality. Right. But it does get technical because if it was FDA approved, then insurance might add, you know, a certain, a certain reimbursement for this.
00;23;08;29 - 00;23;37;08
Skip Rizzo
And, and there are a lot of companies that are moving towards trying to get FDA approval so they can get reimbursed from. Yeah, Health and Human Services and, like we've developed a, an assessment tool for ad one, but it's a, it's an attention process assessment headset application, virtual classroom. And it's a product. It's got norms and everything in order to get reimbursed for that specific type of an assessment.
00;23;37;10 - 00;23;39;00
Skip Rizzo
We are going the FDA.
00;23;39;07 - 00;23;39;25
JD Kalmenson
Very, very.
00;23;39;25 - 00;23;40;23
Skip Rizzo
Interested us.
00;23;41;00 - 00;23;45;00
JD Kalmenson
Yeah. Are there downsides? Are there any side effects? Not really.
00;23;45;02 - 00;24;09;01
Skip Rizzo
With kids, actually kids are quite resilient. But you do see a certain percent of the population get this kind of motion sickness. And that typically resolves quickly or over time, as you do it in repeated sessions, you see less of that. And the technology's gotten so much better that you don't really see it as much as in the past.
00;24;09;01 - 00;24;18;14
Skip Rizzo
There's no lag when you move your head and so on. But you you just have to accept there's going to be ten, 15% that maybe this isn't.
00;24;18;14 - 00;24;24;16
JD Kalmenson
Right for them. Right? I mean, as of now, it's it's not yet in the mainstream. Do you anticipate that changing in the next few years?
00;24;24;16 - 00;24;25;04
Skip Rizzo
I think there are.
00;24;25;05 - 00;24;29;26
JD Kalmenson
A lot of research institutes that are are primarily focused on VR. Or is it more?
00;24;29;27 - 00;24;59;24
Skip Rizzo
I'm seeing more and more of it. The VA was a big, big mission that we had. It started with the PTSD work, but then now it's expanded and now the I mean, it's not so much that the VA, they got to a point where it wasn't about, well, do you have another randomized control trial? They saw that there was evidence for using these tools, and they saw that their veterans population liked it and they wanted that.
00;24;59;27 - 00;25;26;09
Skip Rizzo
And so the VA took this step saying, we want to bring all these in and we're going to do research ourself and pragmatic clinical trials and so on. But then the trouble they ran into was they had 4400 sites. They had 35 different types of software that each had different interfaces and had different head mounted displays that they were using.
00;25;26;12 - 00;25;53;22
Skip Rizzo
And so it became kind of overwhelming to manage it. So now the VA has an initiative called made for VA. And it's a set of requirements, they give in advance to developers that your system has to run this way. It's got to follow a generalized format for an interface to, you know, for the clinician. It's got to have training and so that's I think those have been the barriers to implementation.
00;25;53;24 - 00;26;02;29
Skip Rizzo
Is is not the the cool sexy stuff about building an app for, to address that idea, but how do you pragmatically get it out the door?
00;26;02;29 - 00;26;23;14
JD Kalmenson
How do you get rid of all the, all the bugs? Yeah, yeah, yeah, it makes a lot of sense. And what's really, interesting about everything that I'm hearing is that this is not going to really take away the human element in behavioral health. It's just enhancing and exponentially making the the efficacy more pinpoint, more accurate, more controlled.
00;26;23;14 - 00;26;47;00
JD Kalmenson
So it's it sounds like something that really is, a special gift. Thank you for the work that you're doing, doing it to as many people as possible. And this has been a very illuminating discussion, and I really hope that, whoever's watching and listening takes the time, researches how, this can be more helpful. And, maybe there's somebody in your life who can be who can benefit from such a thing.
00;26;47;02 - 00;26;54;05
JD Kalmenson
So thank you for joining us today. Scare Free know. We really appreciate you taking the time and God bless you and all the wonderful. Thank you.
00;26;54;05 - 00;26;54;23
Skip Rizzo
So much.
00;26;54;23 - 00;26;55;12
JD Kalmenson
Of course.