Miscellaneous Completed Studies

 
Short- and Long-Term Treatment Study
Principal Investigator: Dr. Jonathon Rabinowitz (formerly JBFCS)
Consultant: Irving Lukoff, PhD (CUSSW)
 
This investigation was an exploratory study of some characteristics of clients, workers and problem areas that influence the decision-making of clinicians at JBFCS.  The design consisted of a series of vignettes with three different descriptions.  For each symptom configuration clients were differentiated by age, sex, and ethnicity.  The three symptom pictures that were chosen reflect commonly noted ones in outpatient therapy, closely modeled to reflect DSM-III descriptions: Adjustment Disorder, Dysthymic Disorder, and Borderline Personality Disorder.  Additional information was also obtained in the clinician's training, years since graduation, tenure at JBFCS, job-title and demographics.  There was substantial agreement on when it was appropriate to use planned short-term therapy (PST; defined as up to 12 sessions) or to prefer long-term therapy (LT).
Doubled-Up Homeless Study  Under direction of  Dr. Ruth Fangmeier   A study of the formerly doubled up, or persons who had joined another household and then subsequently became homeless, was conducted by Dr. Ruth Fangmeier.  One hundred forty-seven cases of formerly doubled up were identified among clients served by JBFCS homeless projects, and 45 of these clients participated in in-depth interviews on their experiences.
This exploration of doubling up from both the interviews and from case records showed the predominance of young, poorly educated females.  Doubling up prior to homelessness is a reflection of economic instability.  Many of the doubled-up arrangements were brief in duration.  Family members, often parents, and generally females, hosted most arrangements although nearly one-third were doubled up with friends.  Most arrangements were based on an agreement between guest and host, although many ended in conflict.  Despite the breakdown and subsequent failure of the doubled-up arrangement, most guests continued to receive some type of support from their hosts after they moved out.
The findings suggest that the length of the double up was related to the guest's contribution to the household, with the doubled-up arrangement being a transfer of money and services from guest to host in return for shelter.  Regardless of why those interviewed doubled up, all became homeless, and a sizeable portion were homeless one year after service contact ended. Doubling up was a stressor to guest and host.  It disrupted the environment in the household as indicated by the places where guests slept, and the concern about its effect on the entitlement benefits of household members.
Social service providers should recognize the entire doubled-up household as the 'client.'  The management of the stress caused by doubling up is an area for clinical intervention.  Attention to the difficulties faced by hosts as well as guests might make the doubled-up arrangements less stressful.  Enhancements might include financial incentives for hosts such as tax credits, rent credits, monies to purchase needed household goods, utility and goods vouchers, and space modification.
This study was funded by the New York State Department of Social Services, Local Initiative Grant to JBFCS.
Cult Membership Study  Under direction of  Carol Marcus, PhD (JBFCS) and Bruce Grellong, PhD (JBFCS)
Based upon previous research finds, the investigators undertook to explore, among three groups of young adults, age 22-32, the family environment, adolescent history, depression, stressful life issues and the personal view of how one's self and one's life pursuits fit together, i.e., a purpose in life.  The first group, not in therapy and never involved in a cult, found adjustment to adult life changes easier while development continued in their need to define a sense of meaning and purpose in their lives.  The success of these young adults was due in part to the support of their families that allowed for their independence and growth.  
Clinic and ex-cult subjects were both found to be different from this first group.  Young adults using clinic services, the second group, expressed the greatest amount of distress over life events in the year prior to treatment and reported a decrease in stress over the course of treatments.  However, the clinic group came from backgrounds of greater family conflict, experienced more difficulties in adolescence and felt more depressed in young adulthood.  Ex-cult members, the third group can be characterized by difficulties, particularly feelings of depression specifically related to identity formation.  They also had the most difficulty developing a sense of purpose in life.  Difficulties with identity formation appeared to have made this group more vulnerable to cult recruitment techniques that offer clear cut identities and prescriptions for living.  
The Marjorie Dammann Research Fund was the project's major funding source.   
 
Childhood Bereavement Study
Principal Investigator: Robert Schilling, PhD (CUSSW)
Co-Investigators: Robert Abramovitz, MD (JBFCS),  Nina Koh, MD (JBFCS)  Principal Investigator, continuing data analysis: Dr. Priyadarshi Datta
 
This study is testing an innovative group service for New York City African-American and Hispanic children affected by the untimely death of a parent figure.  In the first phase of the study, over forty bereaved children, aged 6-12,  participated in a series of twelve, 90 minute group sessions.  This phase of the study determined that participating children showed significant improvements in realistic attitudes about death, and also made small gains on measures of depression.  The research continues to evaluate this group service.  The Principal Investigator for the completed first phase evaluation was Dr. Robert Schilling and the Co-Investigators are Dr. Nina Koh and Dr. Robert Abramovitz.  For the continuing data analysis phase the Principal Investigator is Dr. Priyadarshi Datta.  This study is being funded by the Center's Research Development Program.
Services for the Homeless  Under direction of  Dr. Ruth Fangmeier
A study of the short-term effectiveness of services for homeless individuals and families was completed, under the direction of Ruth Fangmeier, M.S.W.  These were clients of JBFCS Services to the Homeless program under the direction of Pinches Berger, A.C.S.W., Director of Special Programs.
Caseworkers established service goals for clients at intake, and the researcher conducted follow- up interviews with 85 clients three months later to determine their level of service goal attainment.  The sample showed the characteristic heterogeneity of the homeless population with respect to personal and historical variables.  These factors, however, were not found to be significantly related to goal attainment.  Instead, addressing psychiatric/emotional service needs was found to be an important means of effectively engaging clients to the extent that clients were more likely to return for follow-up and maintain contact with the service provider.
The findings of this study have direct application to providing social services to homeless persons.  Workers who develop initial service plans for persons who are homeless need to review cases after housing has been secured to assess needs and establish goals other than housing.  It is incorrect to assume that clients who have been periodically or chronically homeless are already known to social service providers.
The differential assessment strategies on which the comprehensive service plan is based must include the history of homelessness and the composition of the case, referring to individual or family.  These two variables influence the range and type of service needs among homeless clients.  Adjustment following a period of homelessness requires long-term, periodic contact with social service providers.  However, many clients are lost to follow-up because the client's primary connection was to the provider of the housing per se.  In order to provide long-term services and to assess the effectiveness of the service plan, homeless clients need to be tracked at the site of their housing.
This study was funded by the New York State Department of Social Services, Local Initiative Grant.
  Patient Profile Study  Principal Clinical Investigators: Robert Abramovitz, MD (JBFCS);  Bruce Grellong, PhD  (JBFCS)  Principal Research Investigator: Mark Mattaini, PhD, (CUSSW)
The robust database gathered in the Center's Patient Profile Study provides opportunities to examine many critical practice issues.  In this study, agency clinicians completed comprehensive instruments describing a random sample of 876 adults, children and youth seen as outpatients by the Madeleine Borg Community Services of JBFCS.  Among the important questions examined in the study were the extent, and predictors of, aggression and violence among the patient population.   The study also identified risk and protective factors associated with aggression and violence.  Important intergenerational patterns were discovered.  
 
 Hawthorne Patient Profile Study  Principal Clinical Investigators: Robert Abramovitz, MD (JBFCS);  Bruce Grellong, PhD  (JBFCS)  Principal Research Investigator: Mark Mattaini, PhD, (CUSSW)
The population of youth seen at Hawthorne Cedar Knolls School, while almost universally experiencing serious psychosocial difficulties is not homogenous, according to preliminary results of a HCKS Patient Profile Study released by Drs. Robert Abramovitz, Bruce Grellong, and Mark Mattaini.  This study identified five relatively distinct clusters of patients receiving services at HCKS.
While every cluster is characterized by a high level of problems in relationships with parents, one group is characterized by a particularly high level of violent and anti-social behavior.  A second cluster have a particularly high level of substance abuse problems at admission, accompanied by severe depression and school problems.  A third small cluster appears to be suffering from the results of parental loss.  The largest cluster is a group with particularly severe school problems including learning disabilities, conduct disorders, problems with peers and emotional difficulties.  For the final cluster, the primary difficulties revolve around severe family problems.  
Five distinct clusters of families, based on dimensions of family functioning like communication and affective involvement, as well as on positives and negatives exchanged with the environment, were also identified.  Substance abuse has been present in almost half of the families, physical violence in almost as many, and the rates of separation and divorce, death, and physical illness or disability were also high. 
 
Therapeutic Nursery Study  Under direction of Alice K. Frankel, MD (Child Development Center)
In order to describe the changing population which has been treated at the Child Development Center's therapeutic Nursery School, and to examine the impact of language impairment, emotional disturbance, family dysfunction, and life stresses on their development and progress, the families of a cohort of "graduates" (1970 through 1984) are being contacted.  Extensive case records during the Therapeutic Nursery School treatment of 178 children are being coded for computer entry, using a comprehensive instrument two years in the devising.  A total of 146 families are bing contacted, sent detailed computer coded questionnaires, and interviewed by a member of the study group.  A teacher, current or most recent, will also provide extensive information about each child.  Upon completion of this two year phase of data collection, it is planned to interview the children themselves and conduct psychological testing.
The CD case records have been coded and the first group of care givers have been contacted and interviewed.  Twenty six out of 27 families approached have agreed to participate.
The study is under the direction of Alice K. Frankel, MD, Director of the Child Development Center.  The research group comprises both CDC staff and volunteers.  Lauren Behrman, PhD, CDC's supervising psychologist; Rick Greenberg, MSW, JBFCS social worker and research assistant; Evelyn Rothchild, PhD, CDC psychologist; Hilda Fischman, MSW, CDC social worker, Patricia Deeley, MSW, volunteer; and Florence Shulman, BA, volunteer.
The study has been privately supported in part by Mrs. Susan Hecht Tofel and her children, Cathy, Robert and Wendy Cramer.
 
 The Prevalence and Correlates of Suicidal Ideation and Behaviors in Preadolescents: An Exploratory Study of a Clinical Population  Principal Investigator:  Dr. Helene Jackson, PhD (CUSSW)  Clinical Investigator: Annaclare van Dalen, PhD (JBFCS)  Consultation from: Cynthia Pfeffer, Cornell University Medical Center  Original Co-Investigator: Peg Hess, PhD (CUSSW)
This exploratory, cross-sectional study has collected data about a little understood phenomenon that many professionals believe to be one of the most common symptoms found in seriously mentally ill young children.  This research is expected to identify specific risk and protective factors associated with preadolescent suicide activity.  Among the variables hypothesized to place preadolescent at high risk for suicidality are childhood traumas and family and environmental stressors.  Among factors expected to be associated with lower risk for preadolescent suicidality are positive child attributes and social and family supports.  Children ages 5-11 and their families who apply for outpatient services at the Madeleine Borg Community Services of JBFCS, Pelham office have been interviewed to determine the prevalence of, and contextual factors associated with, suicidal ideation and behaviors.  Preadolescent suicidality is hypothesized to be a consequence of a complex set of related factors that exist between the child's micro systems and the environment.
The study results will be of use for the development of early identification, prevention and remediation interventions for this at risk population.
The study is being conducted by Principal Investigator Dr. Helene Jackson,  Co-Principal Investigator Dr. Peg Hess, Clinical Investigator Dr. Annaclare van Dalen, with consultation from Dr. Cynthia Pfeffer, Cornell University Medical Center.  The study is partially funded with a grant of $6,000 from the Lois and Samuel Silberman Fund with additional funding from the Center's Research Development Program.  The study began in September 1992.
 
 Research Concerning Older Adults
 
The Center is conducting a series of studies pertaining to older adults under the direction of Dr. Denise Burnette.  Current research includes the following studies.
Barriers to Mental Health Services for Older Adults
Prevalence rates of mental health problems among older adults range from 13% to 25%.  Yet barriers to treatment are multiple including: negative societal regard toward aging and mental illness; negative attitudes of older persons about mental health problems and services, including stigma, fear of loss of independence, misperceptions about treatment; practical limitations like reimbursement and transportation problems, inadequate professional training, lack of research on alternative treatment modalities, unresponsive organizational structures, and inadequate outreach.
This study seeks to: examine the role of these barriers in mental health services utilization; and, test whether providing these services in normative settings (senior centers, nutrition sites, and congregate housing programs) as compared to traditional mental health clinics could improve mental health outcomes such as participation, compliance, and goal achievement.
On-site services are already being delivered and this research will generate comparative data to refine a model of mental health service delivery to improve access services to older adults, family members, and aging-service and health care providers.  The principal investigator is Dr. Denise Burnette, and the Co-Investigator is Ms. Evelyn Blanck.  The study is funded through the Center's Research Development Program.  A proposal for this research was submitted in January, 1993 to the Retirement Research Foundation requesting $102,000 over two years.  Although this proposal was not funded efforts to secure external funding to conduct this study continue. 
Raising Grandchildren in the Inner-City: The Effects of a "Skipped Generation" on Older Women
Grandparents Raising Grandchildren: A Group Intervention
Principal Investigator: Denise Burnette, PhD, MSSW (CUSSW Group Leader and Project Facilitator: Randy Tanzer, CSW (JBFCS) Project Facilitators: Jennifer Crumpley, CSW, Jonathon Katz, CSW; Vicki Rosenstreich, ASCW   and Ruby Thompson, CA (JBFCS)   The U.S. Bureau of the Census estimates that 3.4 million children, or 5% of all children age 18 and under lived with a grandparent in 1990--representing a 40% increase over the prior decade (U.S. Bureau of the Census, 1991). The AARP Grandparent Information Center newsletter recently reported on data from 1993 and 1994 Current Population Surveys that show a 25% increase in the number of grandchildren in grandparent care in that one year alone. 
This continuing trend is due to a confluence of factors, including structural changes in the multigenerational family, the effects of social health problems, notably illicit drug use and the HIV/AIDS epidemic, and sociocultural norms and public policies that govern family responsibility (Burnette, in press a). Self help/mutual aid strategies remain the most popular means for helping caregiving grandparents cope with the multiple stressors they face. Such resources include written guides (de Toledo & Brown, 1995; Takas, 1995), local, regional, and national resource centers (AARP, 1994) and a proliferation of support groups. The AARP Grandparent Information Center (1994) currently lists more than 400 such groups nationwide. Yet the content, format, and efficacy of these groups are still largely undocumented.
The purpose of the school-based small group intervention co-led by a JBFCS on-site social worker and the principal investigator was to explore the efficacy of a structured, time-limited group intervention based on principles of psychoeducation and mutual aid. Pre- and post-test scores on measures of well-being, coping, social support, and knowledge of service were examined. Findings on the General Health Questionnaire indicated that group members were doing well overall. Of the 4 subscales, the only significant change observed was improvement in scores on severe depressive symptoms. This subscale assesses feelings of hopelessness, worthlessness, and suicidal ideation. 
Scores on 3 of the 8 subscales of the Ways of Coping Inventory changed significantly. "Distancing" strategies decreased, while "Seeking Social Support" and "Planful Problem Solving" increased. Significant changes were thus observed in the priority of one emotion-focused  (distancing) and one problem-focused (planful problem solving) strategy. Social support, which encompasses both types of coping also increased, indicating that grandparents used this way of coping widely--a finding further confirmed by the Social Support Behaviors Scale, which showed high levels of support at both points and little change over time. 
With the exception of child nutrition programs, which 82 % of grandparents were familiar with, the proportion of group members who knew how to access each of 16 available community-based services either stayed constant or increased at post-test. Knowledge of services available to meet grandchildren's needs was higher at pretest, and the greatest increases were for services related to grandparents' mental health and well-being (i.e. stress management, a toll-free hotline, and personal, marital, and family counseling). 
Finally, group members also evaluated their perceptions of the group. These reports indicated a high level of satisfaction and suggested that most benefits were derived from sharing their experience with similarly situated grandparents and from learning problem solving skills for coping. Satisfaction with emotional aspects of caregiving, e.g. feeling shame and overcoming hurt, were reported as less important, perhaps due to the group's short-term nature or to participants having access to these supports from other social and/or spiritual sources. The findings of the study were presented at the Council on Social Work Education 1996 Annual Program meeting and the 48th Annual Scientific Meeting of the Gerontological Society of America. An article on the study will appear in Research on Social Work Practice in 1997. 
While design and sample size limitations common to agency-based research preclude definitive conclusions about the effects of the group per se, the findings do suggest areas for future research on well-being, coping strategies, social support, and knowledge of health and social services for this rapidly growing population and significant subgroups. A two-year grant from the AARP- Andrus Foundation has enabled me to examine the strengths and needs of skipped-generation Latino families in New York City, which is now being completed. 
References
 AARP (Summer, 1996). Parenting grandchildren: A voice for grandparents, 2 (2), 1-2. Washington D.C: Author.
 American Association of Retired Persons (AARP) (1994). The trend continues. The AARP Grandparent Information Center Newsletter. Washington DC: Author.
 Burnette, D. (In press a). Grandparents rearing grandchildren in the inner city: Background, service needs, and directions for practice and policy.  Families in Society
 Burnette, D. (In press b). Grandparents rearing grandchildren: A small-group, school- based intervention.  Research on Social Work Practice.
 de Toledo, S. & Brown, D.E. (1995). Grandparents as parents: A survival guide for raising a second family. New York: Guilford Press.
 U.S. Bureau of the Census (1991). Current population reports: Marital status and living arrangements: March 1990. (Series P-20 No. 450). Washington, DC: U.S. Government Printing Office.
 Jewish Grandparenting Project
This is a study of older, Jewish adults who are responsible for providing primary care to both their grandchildren and their disabled adult children.  The study focuses on psychosocial effects of this population's caregiving responsibilities.  This is a needs assessment designed to survey the health and mental health needs of this 'new' population.
The Principal Investigator for this study is Dr. Denise Burnette, and the  Co-Investigators are Ms. Evelyn Blanck and Ms. Leah Mason.  While the program is operating at JBFCS,  funding is being sought for the research component.
 Cross Cultural Validation of the Geriatric Depression Scale
The Geriatric Depression Scale is a screening instrument which is widely used for screening for depressive symptomatology.  This study is examining the cultural and linguistic relevance of the  Geriatric Depression Scale for screening for depression in older Chinese and Hispanic populations.  The  Principal Investigators are Dr. Denise Burnette and Dr. Ada Mui.  While funding is being sought this study is supported by the Center's Research Development Program.    
From Research To Practice: The CDISC (Diagnostic Interview Schedule for Children) in Clinical Services  New York State Psychiatric Institute: Principal Investigator: David Shaffer, MD; Co-  Investigators: Prudence Fisher, MS, CSW and Christopher Lucas, MD  Center for the Study of Social Work Practice: Principal Investigator: Ed Mullen, DSW   (CUSSW)   Co-Investigators: Bruce Grellong, PhD (JBFCS); Robert Abramovitz, MD (JBFCS)
This NIMH funded study examines the impact of introducing a standardized assessment procedure, the Diagnostic Interview Schedule for Children ("C-DISC"), on diagnostic and clinical practice in community based child mental health services.  Clinicians and patients (ages 9 to 18) from JBFCS Madeleine Borg clinics and a second site will be included in the study.  At both sites a total of 80 clinicians and 800 patients are expected to participate in the study.  The study will use a repeated measures, matched group design in which secular trends and seasonal changes in diagnoses are controlled for to experimentally examine the impact of the C-DISC, a user-friendly computer assist version of the DISC.  The C-DISC will be administered by lay interviewers to children and adolescents (and their parents) at the child's initial psychiatric during the first 12 month period.  Diagnosing clinicians will be provided with reports from the C-DISC prior to their first evaluation interview.  During this time a second contrast group, Group B, will continue with standardized observations and recording.  During a second 12 month period, Group B will receive the C-Disc intervention and the original experimental group, Group A, will not receive the C-DISC but will have standardized observation and recording.  It is hoped that the adoption of standardized assessment procedures, in this instance, the C-DISC, will lead to better evaluations and more appropriate treatment decisions being made.  With increasing pressure on clinical services, such a diagnostic aid could enable scarce resources to be focused more quickly and with greater accuracy to children and adolescents in need of mental health intervention.
The Center is conducting the study of the JBFCS sites under subcontract.  The Principal Investigator for the subcontract is Dr. Edward Mullen with Dr. Robert Abramovitz and Dr. Bruce Grellong as CO-Investigators.  The Principal Investigator for the multi-site study is Dr. David Shaffer, who is Director, Department of Child and Adolescent Psychiatry, New York State Psychiatric Institute, and the Irving Philips Professor of Child Psychiatry,  Columbia University College of Physicians and Surgeons. The study extends three years beginning 7/1/94.  Total requested costs for the Center study are $360,000.
The Odyssey Project: A Descriptive and Prospective Study of Children and Youth in Residential Treatment Group Homes and Therapeutic Foster Care  Principal Investigator: Neil Guterman, PhD (CUSSW)  In collaboration with the Child Welfare League of America
The Odyssey Project is the first national-level study in the U. S. detailing the psychosocial characteristics of children placed in residential care and the outcomes of their treatment.  Earlier work in the field of residential treatment has documented the demographic characteristics of children in residential placements (Dore, et al., 1984; Pappenfort, 1983; Pappenfort, et al., 1973), factors that appear to be associated with positive outcomes such as post-discharge supports and family involvement (e. g. Wells, et al., 1991; Guterman, et al., 1989),  and ecologically-based factors in a child's life that shape the course of residential treatment and its impact on the resident (Whittaker, 1995; Guterman & Blythe, 1986).   However, sorely lacking in the empirical literature is fundamental information on such pressing questions as: What is the current psychosocial profile of the children and  youth entering residential care in the U. S.?  What is their prior history of supports and out-of-home care?  What is the composition of services provided to children and youths entering residential care?  What services and psychosocial characteristics appear to match with what outcomes in residential care?  What kinds of supports in the community correlate with positive adjustment after discharge?
In response to the pressing need to develop a more comprehensive empirical base undergirding residential care in the U. S., the Child Welfare League of America enlisted over two dozen residential treatment and group home facilities to participate in the Odyssey Project study, with an expected subject enrollment of over two thousand children and youth across the country. Under the auspices of the Center for the Study of Social Work Practice, three sites of the Jewish Board of Family and Children's Services have joined the national study:  Hawthorne Cedar-Knolls Residential Treatment Center, Linden Hill School and the Jerome M. Goldsmith Center for Adolescent Treatment.  The database resulting from this study is expected to make a major contribution to the field of residential treatment as it evolves into the 21st century. 
At the three JBFCS sites, researchers are centering their interests on children's experiences in their home communities, and most particularly with experiences of community-based violence.  Familial factors have long been considered important in the functioning of  children in residential settings, yet less focus has traditionally centered on the importance of children's experiences outside the family.  At the three JBFCS sites, data is being gathered on the types and frequencies of  violence children have experienced in their communities.  These data represent the first systematic study of  exposure to community violence among children living in residential treatment settings.    
The Odyssey Project design is composed of a descriptive phase of three years and a prospective phase of an additional two years.  The descriptive phase is collecting data on children entering residential treatment.  The prospective phase then follows children in their "journey" through residential care, collecting data every year while the child is in residence, at discharge, and at three post-discharge points: six months, one-year and two-years after discharge.  Now in its second year of enrollment at the three JBFCS sites, over 75 newly admitted residents are presently enrolled in the study.  Approximately double that number are anticipated to join the study prior to the close of new enrollment in the Fall of 1997.  After this, children will continue to be followed as they progress through each setting and through two years after discharge.  Researchers have found that while this population is extremely difficult to enroll in such an intensive and longitudinal study, particularly given unanticipated premature discharges and the challenges of receiving consent from families where a child is placed, over 60% of the eligible families are choosing to enroll in the study.  More so, the children interviewed to date have shown a great deal of interest in their own participation and engagement, particularly while completing interviews on their exposure to community violence and their social networks.  Many youths have come back asking researchers, "when are you going to interview me next?"  
While the empirical results of the study will not be ready for dissemination for some time, early qualitative insights have resulted in the development of a new assessment framework and guidelines for measuring children's experiences with community violence serviced in clinical settings (Guterman & Cameron, under review; 1996a; 1996b).  These findings are expected to have broad applications for a host of social work settings servicing children and youth, as no guidelines are yet available for practitioners seeking to assess the role of community violence in their young clients' lives.  
Principal Investigator (Local JBFCS site): Neil B. Guterman, PhD (CUSSW), Co-Principal Investigator: Bruce Grellong, PhD (JBFCS); Odyssey Project (National) Principal Investigator: Patrick Curtis, PhD (CWLA); Co-Principal Investigators (National) Cynthia Papa-Letini (Berkshire Farm Center for Children and Youth), Gina Alexander, MSW (The Villages of Indiana); Project Director (National) Lisa Lunghofer, PhD (CWLA)
References Dore, M. M., Young, T. M., & Pappenfort, D. M. (1984).  Comparison of basic data for national survey of residential care facilities: 1966-1982, Child Welfare, 63, 485-495.
Fitzpatrick K. M. & Boldizar, J. P.   (1993).  The prevalence and consequences of exposure to violence among African-American youth, Journal of the American Academy of Child and Adolescent Psychiatry, 32, 2, 424-430.  
Guterman, N. B. & Cameron, M. (under review). Assessing the Impact of Community Violence on Children and Youth, Social Work.
Guterman, N. B. & Cameron, M. (1996a).Assessing Children's Exposure to Community Violence in Child Maltreatment Service Settings, presented at the Fourth National Colloquium of the American Professional Society on the Abuse of Children, Chicago, IL, June 28.
Guterman, N. B. & Cameron, M. (1996b).  Assessing for Exposure to Community Violence in Children and Youth: Methodological Considerations, presented at the Trauma and Memory: An International Research Conference, Durham, NH, Family Research Laboratory of the University of New Hampshire, July 26.  Guterman, N. B., Hodges, V. G., Blythe, B. J., & Bronson, D. E. (1989).  Aftercare service development for children in residential treatment, Child and Youth Care Quarterly, 18, 119-130. 
Guterman, N. B. & Blythe, B. J. (1986).  Toward Ecologically-Based Intervention in Residential Treatment for Children, Social Service Review, Dec.,  253-266.
Pappenfort, D. M., Kilpatrick, D. M., & Roberts, R. W. (eds.) (1973).  Child Care: Social Policy and the Institution, Chicago: Aldine.
Pappenfort, D. M., Young, T. M., & Marlow, C. R. (1983).  Residential group care 1966 and 1981: Facilities for children and youth with special problems and needs.  Chicago: University of Chicago School of Social Service Administration.
Lunghofer, L.  (1995).  The Odyssey Project:  Literature Review.  Unpublished manuscript. 
Richters, J. E. & Saltzman, W. (1990).  Survey of Children's Exposure to Community Violence: Self- Report.  National Institute of Mental Health.  
Taylor, D. A.  & Alpert S. W. (1975).  Continuity and Support Following Residential Treatment, NY: Child Welfare League of America.
Wells,   K.  (1991).  Long-term residential treatment for children: Introduction, American Journal of Orthopsychiatry, 61, 324-326.
Whittaker, J. K. & Pfeiffer, S. I. (1994).  Research Priorities for Residential Group Child Care, Child Welfare, 73 (5), 583-601.  
  Domestic Violence Among Families with Allegations of Child Abuse or Neglect: Evaluation of a Protocal for Identification of Domestic Violence and Service Provision  Co-Investigators: Kathryn Conroy, DSW; Peg Hess, PhD; Randy Magen, PhD and   Barbara Simon, PhD (CUSSW)  With the cooperation of the New York City Child Welfare Administration
Concerned about the co-occurrence of child abuse/neglect and other forms of domestic violence an inter-agency consortium in New York City has sponsored a program to implement a new protocol developed by the Protective Services Division of the city's Child Welfare Administration.
This protocol systematically provides for an assessment of domestic violence in cases where there is an allegation of child abuse and/or neglect.  Provision is made for referrals to specialized services in those instances in which domestic violence is found.  The protocol is being implemented in one zone of Manhattan.  The Center is conducting the evaluation of this new program.  The evaluation is examining the prevalence of  domestic violence and child abuse/neglect as coexisting in cases investigated; actions taken by staff when domestic violence is identified (such as referrals to preventive services programs, domestic violence shelters, or court; child placement, etc.);  staff attitudes concerning domestic violence and the usefulness of the protocol; and, the benefits of and obstacles to protocol implementation.  The study Principal Investigator is Dr. Peg Hess, the Research  Director is Dr. Kathryn Conroy, and Co-Investigators are Dr. Barbara Simon and Dr. Randy Magen.  The research is funded by the Center's research development program, and external funding is being pursued.  The research was initiated in November, 1993.
 The Empirical Development of an Early Child Maltreatment Prevention Program  Principal Investigator: Neil B. Guterman, PhD (CUSSW)  Project Steering Committee: Robert Abramovitz, MD; Bruce Grellong, PhD; Jackie   Miller, MSW, CSW; Alan Siskind, PhD (JBFCS)
While programs are in place which detect and treat child abuse after it occurs, little is known about how to effectively address the problem proactively -- before it ever occurs.  While early child abuse prevention gives great hope, potentially alleviating the tremendous social and economic consequences of child abuse, the promise of early intervention has, as yet, not been rigorously tested. This study is evaluating a state-of-the-science program which targets high-risk families transitioning into parenthood for the first time.  The program addresses the underlying risk and protective factors typically found in abuse and neglect cases including: parents knowledge of child development and the demands of parenting; bonding, attachment, and communication between parent and child; parents' coping skills in caring for an infant or child, including caring for children with special needs; managing the burdens of child care; family isolation and resource deprivation; access to appropriate social and health services for family members; and, history of abuse and neglect in first-time parents.
The program incorporates those components found to be supported by researchers and practitioners in the field.  Accordingly, the program components include: differential screening and assessment, prior to or at birth; hi-intensity services; provision of home-based and community-based services; medium to long-term duration of services; integrating and complementing existing support services and programs; ethnically responsive and empowerment oriented; linked to a medical home for screening and referral of cases, and coordination of medical support services; and complimentary components of parent support and education, social support, assertive case management, and referral.
The program development and research uses a developmental research approach which incorporates a scientific approach to program problem analysis, design, development, evaluation, and diffusion and adoption.
The Principal Investigator is Dr. Neil B. Guterman.  The study is being funded through the Center's research development program with additional support by JBFCS.  The developmental work for the program began in September, 1993 and the research is planned for three years.
 Attrition Study for Battered Women  Principal Investigators: Janet Geller, PhD and Carl Hesselbart, MSW
This study is examining the differential effects of providing phone support from trained volunteers to battered women who were awaiting more intensive services.  In the Attrition Study, women who called The Battered Women's Hotline were randomly assigned to the experimental condition, in which potential patients were contacted by phone on a regular basis until they could be seen for treatment.  Currently, researchers are examining the outcome of the program.   The Principal Investigators are Dr. Janet Geller and Mr. Carl Hesselbart.  This study is being funded by the Center's research development program.
Defining Grief in Childhood: Test-Retest Reliability of the W.T. Grant Consortium Grief Inventory  Principal Investigators: Linda N. Freeman, MD, Prudence Fisher, MSW and Robert   Abramovitz, MD
Despite evidence which suggests that loss in childhood or adolescence can result in disruptive and enduring symptoms after the death (Brown & Harris, 1978), there is little information about the grief process and grief recovery in bereaved inner city children.  Information  about developmental and gender differences in the grief process which lead to children's vulnerability or resilience to subsequent problem behavior is needed to determine optimal interventions with children suffering the sudden loss of a significant other.  Social work practitioners on the front line receiving the causalities of the violence and AIDS epidemic have an important role to play in developing understanding of the youthful grief process, intervening in pathological grief, and prevention planning to reduce the risk of dangerous sequelae to losses due to violence and AIDS.  This study is an attempt to develop one of the important tools necessary to study the phenomenon of childhood and adolescent grief.     The study of  child and adolescent bereavement has been hampered by the lack of clinically useful standardized instruments to measure children's grief reactions.  After extensive search the investigators have only been able to identify two grief measures that are specific for children and adolescents, The Hogan Sibling Inventory of Bereavement (1990) and the W.T. Grant Consortium Grief Inventory (1994).  Some adolescent bereavement studies have used an adult measure of grief, the Texas Inventory of Grief  (Brent, 1993, Faschingbauer et al., 1987), but this measure does not tap many of the domains of the bereavement experience that are of clinical interest in younger children and adolescents.  In addition, researchers who study bereavement due to sudden unexpected loss in adults (Rynearson, 1994) who have used the Texas Inventory have found it is not useful in discriminating subjects who are experiencing pathological grief from those who have uncomplicated bereavement.  This is because the measure is not comprehensive enough to identify intrusive recollections of the lost person, a symptom that seems to differentiate the two groups. 
The Hogan Sibling Inventory of Bereavement was designed for use with young adolescents who have lost a sibling, but it is used for young people whose siblings' deaths were expected after a long illness.  It has not been used in inner city populations of children or with children who suffer sudden and or unexpected losses.  In addition, the measure has not been widely used.
The W.T. Grant  Consortium Inventory of Grief (Clark et al.,1994) shows promise of being a comprehensive bereavement measure that would be appropriate for different childhood and adolescent study populations.  It was developed in 1990 by a consortium of researchers who were interested in loss in childhood including Madelyn Gould, Ph.D., Robert Pynoos, M.D.,  David Clark, Ph.D., David Brent, M.D. and David Balk, Ph.D.  Members of the consortium each added items to the scale that they thought represented important domains of grieving among children and adolescents.  A factor analysis was performed which identified four factors. Six reliability tapes were rated by an average of 8 raters per tape.  The factor analysis was performed on 48 response sets of 142 questionnaire items each.  Items which showed no or inadequate variance were removed.  A four-factor solution with factors of Avoidance, Identification, Affective Compensation,  and Anticipated Neediness was recommended but no further reliability or validity studies have been done on this measure.
The significance of the current study lies in the major public health and social work practice concern about children's exposure to untimely death and the loss of significant others to violence and AIDS. Unfortunately, these losses are becoming more common, particularly in inner city areas.  Because grief is considered to be a normal phenomenon, few social workers become involved in understanding or intervening in the grief process.  But, children who have lost significant others due violence can have responses similar to those who are direct victims or witnesses to violence(Freeman, et al., 1996).  These symptoms can disrupt the child's functioning and influence his future development (Pynoos & Nader, 1990).  There can be long-term consequences on their ability to regulate aggression and their  propensity toward violence or victimization.   In addition, sudden unexpected loss is associated with the highest risk of persistent grief (Pynoos & Nader, 1990).  Reminiscing about the deceased, a necessary part of grief resolution, can be aborted because the child cannot think about the deceased without recalling mutilation or violence. 
The purpose of this study is to examine the test-retest reliability of the W. T. Grant Consortium Grief Inventory and to compare it with the Texas Inventory of Grief (a measure that is commonly used in adult and in some adolescent bereavement studies). If the W.T. Grant inventory is found to have acceptable reliability, it will be used to evaluate the practice outcome of bereavement groups.  Further, a clearer description of grief in childhood, obtained by using this instrument, will contribute to the definition of grief and the construct called complicated grief in childhood.  If it is found to be unacceptable, further modifications will be made so that the authors can develop an acceptable instrument to measure grief among children and adolescents. The correlation of the W.T. Grant inventory and the Texas Inventory of Grief would allow  workers who use the Texas Inventory to compare the data 
THE CURRENT STUDY: The Wm T. Grant Grief Inventory Test-Retest Study. The aims of this study are to demonstrate the test-retest reliability of the W.T. Grant Grief Inventory when used by raters examining inner city children and adolescents and to determine its correlation with a standard bereavement scale used in adult populations, the Texas Inventory of Grief.
Questions for the current study include: Is the W.T. Grant Inventory reliable (correlation of 0.8 or above) when administered twice over the course of one week?  Can the W.T. Grant Inventory distinguish between children and adolescents who are bereaved and who are not bereaved?  What is the correlation between the W.T. Grant Inventory and the Texas Inventory of Grief?
The study is being conducted in collaboration among the New York State Psychiatric Institute and the Center for the Study of Social Work Practice.  Bereaved subjects are 9-18 years old inner city boys and girls who have been bereaved by the loss of a significant other within the two years prior to the interview. The subjects of the Co-PI's studies are within this age group and the vocabulary in the Inventory seems appropriate for this age group.  The up to 2 year interval between loss and interview was selected because a loss occurring within 2 years is likely be actively grieved but the  subjects will be a different stages of grief.  This will increase variability in our responses.  Bereaved subjects are being recruited through the Jewish Boards of Family and Children's Services.  Subjects who incurred losses due to any type of death will be included to maximize variability in response.  Announcements of the study and subject inclusion criteria will be sent to administrators at JBFCS sites.  Consecutive referrals of any children who meet the criteria  will be accepted regardless of their treatment status, i.e., whether they are referred at initial intake, or while they are in treatment for bereavement related or other difficulties.  Significant others who have died will be parents or primary caretaking parent figures, siblings (full, half-, or step siblings) or other relatives with whom the subject has had at least biweekly contact over the year prior to their death.
Non bereaved subjects are 9-18 year old inner city boys and girls who have not suffered the loss of a significant other as defined above.  They are recruited from a Boys and Girls Club in Bronx, New York. Twenty subjects between the ages of 9 and 18 years will be recruited.  Ten of the subjects will be bereaved and ten will be non bereaved.  After signing consent, subjects will be given the W.T.Grant Inventory individually by a research assistant.  The assistant will read the 67 item Grief Inventory to the subjects and they will code their response on their individual answer sheets.   At the first interview only, the 23 item Texas Inventory will also be read to the subjects and coded on their individual answer sheets.   The assistant will audiotape the session so that intra-rater reliability may be examined.  The sessions will be timed but are expected to last approximately one to one and a half hours each.  The assistant will review the answer sheets for completeness before the subject leaves.  Any incomplete answers will be re-asked and completed.  One week, (seven days) after the completion of the Inventory, the same subjects will be given the W.T. Grant Inventory by the same interviewer.  The procedure outlined above will again be followed.  The non bereaved subjects will be asked the same questions which appear in the inventories, but about a living significant other.  Questions that refer to the time period since a death will be rephrased to "in the past month, how often have you...".
Responses will be analyzed to determine test-retest reliability of the W.T. Grant Inventory and correlation between the responses on the W.T. Grant Inventory and the Texas Inventory of Grief. We will obtain simple sums of the scores of four factors which have been identified i.e.,, Avoidance, Identification, Affective Compensation, and Anticipated Neediness and a total score.
The test-retest paradigm will be a one-way random effects analysis of variance which will estimate the components of variance due to subject and to error variance.  An inter-class coefficient, i.e., coefficient of reliability will be calculated from these components of variance (Bartko, 1966) for the four subscale scores and for the total score. Correlations between the two inventories will be determined with the Pearson correlation  coefficient.
At this writing, data have been collected from 10 non-bereaved subjects and from 5 bereaved subjects. After data are collected from 5 more bereaved subjects, the analysis will be performed to determine the reliability of the measure. If it proves reliable, we three investigators who are currently studying different aspects of bereavement in children and adolescents i.e., the grief of children who have lost significant others to homicide(Freeman),  suicide(Fisher), and AIDS (Abramovitz) will utilize it in our respective studies of treatment outcome, identification of pathological grief in childhood, and the description of grief recovery.  It is important for us and for the field of childhood bereavement to have a reliable valid measure of grief that is appropriate for inner city children and adolescents.   References:
Freeman, L.N., Shaffer, D., & Smith, H. I. (1996) Neglected Victims of Homicide: The   Needs of Young Siblings of Murder Victims. American Journal of    Orthopsychiatry, 66, 337-345.