Social Work

The overriding goal for the Department of Social Work is to guide and enrich our clinical, teaching, and research capabilities at the New York State Psychiatric Institute. The Clinical and Research Social Work staff aim to provide individuals with psychiatric illnesses and their families with the most effective, modern, and compassionate psychosocial treatments while at the same time advancing our scientific knowledge of psychosocial dimensions of mental disorders and their treatments.

The Department of Social Work has during this past year focused on developing our clinical competency in providing psychoeducational services for patients and their families an area integral to social work practice and a significant component in recovery, rehabilitation, and prevention. The development of effective models for providing psychoeducation has thus continued to be a major focus for the department.

The Patient and Family Education Committee, an interdisciplinary committee chaired by Helle Thorning and Michael Weiss, this year completed and implemented the Orientation Project, which consisted of the development of a patient and family orientation brochure and the Family Orientation Night, a clinical intervention for families of patients newly admitted to NYSPI. The overall objective for these two initiatives is to involve patients and families from the point of admission as active participants in the treatment. The Family Orientation Night takes place every other week in the Patient and Family Library and serves as a forum for families to become familiar with NYSPI's mission, and with the treatment and research offered.

The long-term goal of the department is the continued expansion of our capacity to design and implement a program of psychosocial research intended both to improve the effectiveness of existing Social Work services at PI and to contribute to the development of new approaches to providing services to mentally ill individuals and their families.

Center for Family Education and Research (CFER) continues to be the main research focus of the department. Headed by Helle Thorning, Ellen Lukens, and Daniel Herman, CFER functions as an umbrella under which a variety of related research initiatives take place. It aims to develop synergies between various clinical investigators both within and outside the department whose interests are in the area of psychosocial research pertaining to the needs of patients with severe mental disorders and their families.

CFER's primary objectives are: to establish and evaluate the effectiveness of services focused on the needs of patients and families during transition from hospital to community; to facilitate and strengthen Social Work research on the impact of mental disorder on the family, intervention, and support; and, to provide training and education for Social Workers and Social Work interns on effective models of family services. Current progress on specific CFER projects is described below.

The Sibling Project: Assessing the Impact of Severe Mental Illness on Adult Siblings Using a Triangulated Research Design In 1997, CFER and the Columbia University School of Social Work received funding from the National Alliance for Research on Schizophrenia and Depression (NARSAD) to assess the impact of severe mental illness on adult well siblings. The Sibling Project, now in its third year, was designed to identify and describe interactive patterns among key variables as a primary step in devising rigorous proactive interventions that build on strengths and resiliency, target problem areas, and reduce stress and enhance coping for all family members, including both siblings and persons with illness. The research uses both qualitative and quantitative methods, including focus groups, in-depth interviews, and a survey to provide cross-sectional data on role functioning, life quality, health indicators, knowledge and attitudes regarding illness, as well as availability for advocacy and support among this underserved group. Preliminary research findings were presented at the Society for Social Work and Research Conference in Charlotte, South Carolina in January, 2000 and at the New York State Office of Mental Health Research Conference in December, 2000.

The Multiple Family Psychoeducation Group Project (MFPG) CFER received funding in 1998 through a NYSPI Research Support grant (PIRSG) to conduct a pilot study of the impact of time-limited multiple-family psychoeducation with families of patients following discharge from inpatient treatment. This study, which has enrolled Spanish-speaking and English-speaking family members of persons recently hospitalized at NYSPI, is expected to supply important information regarding the feasibility and effectiveness of providing psychoeducation to this economically disadvantaged and traditionally underserved group of families at the critical point of transition from hospital to community. Besides the intervention, CFER has instituted a comprehensive psychoeducation internship that trains and supervises Social Work students at the master's and pre-doctoral levels in the theory, practice, and evaluation of family-based psychoeducation. In doing so, we are evaluating both efforts, and are preparing a psychoeducational treatment and dissemination protocol that can be used by other community-based mental health clinics and/or professional schools of Social Work to implement similar collaborative programs in other communities.

A Study of Self-help Groups: The Awakenings Groups This pilot study was initiated as a collaborative project between CEFR, the late Ken Steele, and Dan Frey, both mental health consumers and activists in the developing consumers' self-help movement. The study is designed to understand the role that self-help groups play in the recovery of people with severe mental illness. Through direct observation of self-help groups and using qualitative methods, researchers document consumers' perspective on recovery and strive to identify important stages of the recovery process, and the impact of peer support, group process, and meaningful work on that process.

Of interest, demographic information revealed that 71% of the participants are male and 80% of participants are Caucasian. An overwhelming majority of participants had at least some history of college attendance, with many also having a graduate education. Qualitative analysis of the field observations has begun to be analyzed by multiple coders. Recurring themes were presented along with the demographic information at the December, 2000 Office of Mental Health Research Conference.

Depression, Grief and Health: The Impact of Caregiving Dynamic on Caregivers Helle Thorning, M.S. is currently conducting a secondary data analysis of the impact caregiving has on a caregiver's mental health. Caregiving has tremendous impact on the caregiver's mental health as indicated by a high level of depression, grief, and health found in this data. The data is based on the Family Impact Study, conducted by Dr. Elmer Struening, which consists of interviews with 180 primary caregivers of persons suffering from severe mental illness.

Under the leadership of Sandy Speier, M.S.W., the Social Work Student Internship continues to be a highly sought after training program for second year graduate Social Work students and doctoral students, and the students continue to rate the placement highly. In the academic year 2000-2001, sixteen master's students and four doctoral students successfully completed their training.

Social Work Research Investigators Dr. Daniel Herman completed the second year of his Young Investigator Award from NARSAD to continue the development of a randomized controlled trial of Critical Time Intervention (CTI) at Rockland Psychiatric Center. This time-limited intervention is designed to prevent homelessness and other adverse outcomes among high-risk patients following discharge. Along with his co-PI, Dr. Ezra Susser, Dr. Herman resubmitted a successful R01 proposal to NIMH for a full-scale trial at Rockland. This study, a randomized controlled trial with a projected N of 250 persons, will begin during the early part of 2001. Dr. Herman delivered papers at annual meetings of the Society for Social Work and Research and the American Public Health Association.

Dr. Ellen Lukens has continued to conduct research on well siblings of adults with severe mental illness through a NARSAD Young Investigator Award. In addition, she has continued to develop a research and programmatic agenda for CFER in collaboration with Ms. Thorning and Dr. Herman. Dr. Ellen Lukens delivered papers at annual meetings of the Society for Social Work and Research, the Office of Mental Health Research Conference, and the Annual Schizophrenia Conference at Columbia University.

Helle Thorning, M.S., C.S.W has continued to work as the Principal Investigator for the Multiple Family Group Treatment Protocol and for the Awakening Group. In addition, she is the Co-PI on the Sibling Study and the Family Stress Study. Ms. Thorning delivered papers at annual meetings of the Society for Social Work and Research, the Office of Mental Health Research Conference, and the Annual Schizophrenia Conference at Columbia University.

In May, 2000, Helle Thorning, M.S. and Ellen Lukens, Ph.D. received an award: Outstanding New Mental Health Initiative Award National Picnic for Party, Inc. The award is for innovative inclusion of primary consumers, siblings, and family members as guest instructors in the teaching curriculum of social workers at NYSPI and Columbia Graduate School of Social Work.

Dr. Janet B.W. Williams has worked with the Fordham University Graduate School of Social Service to get their NIMH-funded Social Work Research Development Center up and running. Several mentors have been assigned to Fordham faculty and students from research departments at NYSPI. She has also continued to collaborate on data analysis from the PRIME-MD Patient Health Questionnaire study. She completed data analysis from a validation study of a new instrument she helped develop, the Mood Disorder Questionnaire.

Dr. Shoshana Peyser, Ph.D. is a member of multiple interdisciplinary clinical research teams with 15 public and major pharmaceutical funded clinical treatment research protocols investigating the effectiveness of ECT, VNS, rTMS, and psychopharmacology. Her current work emphasizes research on depressive spectrum disorders in adults and the elderly.

Accomplishments of Social Work Clinical Staff Sandy Speier, M.S.W. was invited to present at New York University's Job Hunting Panel and also at the Hunter College School of Social Work's Fields of Practice Specialization Speakers Forum. In addition, Ms. Speier continued her active involvement in NYSPI's trauma initiative. Carla Sadik Blumenthal, M.S.W. was invited to join the New York University School of Social Work Professional Speakers Bureau. This year she has presented to clinical staff on the treatment of borderline families, and on eating disorder. Amarilis Lendoff, M.S.W. and Ana Rivera, M.S.W., both received training in conducting pre- and post-counseling for patients being tested for HIV.

Academic appointments and Promotions This year a number of the Social Work staff both received academic appointments and promotions. Social Work faculty continues to be committed to contributing to the excellence of the education provided to all the trainees at the Institute. Appointments to Instructor in Clinical Psychiatric Social Work (in Psychiatry) were awarded to Maritza Cardona-Cambell, M.S.W., Quisqueya Mereles, M.S.W., Miquel Moreles, M.S.W., Raquel Ramos, M.S.W., and Naomi Glicken, M.S.W. Promotion to Assistant Professor of Psychiatric Social Work (in Psychiatry) was awarded to Amarilis Lendof, M.S.W. Furthermore, Ana Rivera, M.S.W. received her certificate in supervision. These two promotions enable us to add them to the Social Work faculty which provides supervision for graduate Social Work students.