Social Work
Helle Thorning, M.S., C.S.W., Director
Psychiatric illness can have a catastrophic impact not only on the life of the
person with psychiatric illness but also on the family as it can encroach on the
quality of life of all of its members. The episodic and ambiguous nature of
psychiatric illness and its often bleak prognosis, accompanied by stigma,
imposes inordinate stressors on the family. The aim of the Social Work
Department is to provide individuals with psychiatric illness and their families
with the most effective, modern and compassionate psychosocial treatments while
at the same time advancing scientific knowledge about psychosocial dimensions of
mental disorders and their treatments. This may take the form of learning about
how families adapt to illness, psychosocial interventions in personal, family,
vocational and social domains, understanding the impact that mental illness has
on the individual as well as other members of the family, and advancing our
ability to provide each family and psychiatrically ill individual with the most
up-to-date information regarding illness management and adaptation. Hence, the
mission of the Social Work Department is to provide and enhance clinical care,
education and research at the New York State Psychiatric Institute.
The Social Work Department has this year maintained its strong clinical focus
while at the same time expanding its research capabilities.
Clinical Services in Social Work
Inpatient Clinical Social Work
The Social Work Department provides Social Work services on clinical and
clinical research services in the Institute and works in collaboration with all
disciplines in the patient's treatment program.
Although the social worker's role varies considerably from service to service,
clinical Social Work is primarily concerned with the study, evaluation, and
treatment of the patient at the interface of the patient and family's social and
emotional functioning.
The Social Work staff at NYSPI is actively engaged in collaboration with members
of other disciplines, under the direction of a unit chief, in all phases of the
patient's treatment while in the hospital from evaluation for admission through
discharge. The staff is responsible for individual, family, and group treatment
of patients and their families. The staff leads (often with members of other
disciplines as co-leaders) multiple family groups, psychotherapy groups and
other groups on most inpatient and outpatient services.
Outpatient Clinical Social Work
Social workers at the Washington Heights Community Service Outpatient Department
provide the services listed above, and also serve as case managers or individual
therapists, advocating for and helping their patients negotiate the complex
network of City, State, and Federal Agencies to receive the services to which
the patients are entitled by law.
During this past year the Department has 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
of recovery, rehabilitation and prevention. The development of effective models
for providing psychoeducation continues to be a major focus for the department.
The goal of the patient and family psychoeducation is to improve patients’
mental health outcomes by promoting healthy behavior and engaging patients and
their families in care and care decisions regarding life planning.
New Clinical Initiatives
As the Social Work Department together with the rest of the staff at NYSPI faced
the aftermath of the attack on the WTC, the department worked hard at ensuring
that both patients and their families were managing the trauma. Each of the
units held special community meetings that offered a forum where patients and
staff together could discuss the events. The social work staff offered their
services both within NYSPI and externally to the community at large.
Subsequently, social work staff participated in Initial Community Meetings
through New York City and the Metropolitan area to provide psychoeducation as
well as referrals to people who needed further attention. In addition, social
work staff participated in providing education and training to mental health
providers in psychoeducation and responses to trauma through the NYSPI Trauma
Response Team and the Employee Assistance Program.
The Center for Family Education and Research (CFER)
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 in providing services to
families. Dr. Daniel Herman, the department’s Director of Research, working in
close collaboration with Ms. Thorning and the Leadership Group for Research in
Social Work, spearheads the department's research and research training efforts.
The 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. The Center’s goals are 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, and in intervention and support, to understand
families response to trauma in the wake of disaster, and to provide training and
education for social workers and social work interns on effective models of
family services.
CFER Projects
Healthy Outreach through Psychoeducation. HOPE-NY In the spring of 2002, Helle
Thorning and Ellen Lukens received a grant from The Liberty Project (FEMA) to
provide psychoeducational groups intervention and to evaluate the intervention
which will provide education for the general population based on the
evidence-based principles of psychoeducation. The intervention fosters an active
facilitator-participant interaction by providing information and promoting
psychological assimilation and integration of knowledge needed to identify and
prevent severe stress reactions and enhance the process of recovery and healing,
both at the individual and community level.
CTI in the Transition from Hospital to Community Dan Herman, Director of
Research in the department, received a five-year grant from NIMH to conduct a
randomized trial of CTI. CTI is a time-limited psychosocial intervention whose
purpose is to reduce the risk of homelessness and other adverse outcomes among
persons with severe mental illnesses following hospital discharge. The study,
conducted in collaboration with the State Office of Mental Health, is currently
being implemented at Rockland Psychiatric Center and Bronx Psychiatric Center.
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 enhance stress and
coping mechanisms 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.
A total of six focus groups were conducted during this study, representing 19
siblings and five other family members. Data from these group interviews have
been reviewed and analyzed using Atlas 4.1, a qualitative data management and
analysis program. Additionally, information from these data was utilized to
assist in the design of the in-depth interview schedule for the survey phase of
the study. The research team is currently completing several articles
summarizing the major findings.
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 masters and predoctoral
level 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 CFER and the late Ken Steele and
Dan Frey, both mental health consumers and activists in the developing consumer
self-help movement. The study is designed to begin 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 using qualitative methods,
clinician 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; many having a graduate education.
Psychiatric diagnosis varied, with schizophrenia being reported foremost.
Qualitative analysis of the field observations has begun to be analyzed by
multiple coders.
Grief: 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 can have tremendous impact on the
caregiver’s mental health as indicated by the high level of depression, grief
and poor health found in this data. The data is based on a study conducted by
Dr. Elmer Struening entitled The Family Impact Study, which consists of
interviews with 180 primary caregivers of persons suffering from severe mental
illness.
Research Training
CFER is currently training both doctoral students and masters students from
Columbia University School of Social Work and New York University School of
Social Work. During the 2000-2001 academic year five doctoral students and four
masters students were engaged in CFER projects. In addition, CFER has
established ongoing collaborations with other schools and departments at
Columbia University including the School of Social Work and the Joseph L.
Mailman School of Public Health.
During this year, participation in CFER has expanded significantly. In addition
to the involvement of numerous Social Work interns, we have gained collaborators
from the Joseph L. Mailman School of Public Health as well as Fordham
University's NIMH-funded Center for Hispanic Mental Health Services. In
collaboration with Columbia's School of Social Work, we developed a grant
proposal to the Van Ameringen Foundation to support Social Work student training
and the basic infrastructure of CFER. Although this grant application was not
successful, we plan to use it as the basis of a similar submission to another
private foundation during the early part of 2001.
Social Work Intern Training Program
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 2001 through 2002, sixteen
masters-level students and four doctoral students successfully completed their
training. Steve Lohrer, Ph.D. successfully completed his dissertation using data
from the Sibling Project.
Social Work Accomplishments
Following the terrorist attacks of September 11, Dr. Daniel Herman headed the
development of a statewide assessment of mental health needs related to the
attack. This assessment, which produced a 75-page report detailing level of
projected service need, types of services needed, and recommendations for future
preparedness, was undertaken on behalf of the New York State Office of Mental
Health and submitted to the United States Center for Mental Health Services in
December.
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. During the 2000-2001
academic year she supervised five doctoral students from Columbia University
School of Social Work who completed their research practicums through CFER.
Accomplishments of Social Work Clinical Staff
Sandy Speier, M.S.W., participated in the organization of a conference on Sunday
September 23, 2001 entitled, “Initial Mental Health Responses Following
Disaster” and was a co-leader for a workshop on Initial Group Interventions.
Cynthia Kolbowski, M.S.W. joined the faculty at Columbia University School of
Social Work where she taught Foundation to Social Work Practice.
Academic Appointments and Promotions
Naomi Glicken, M.S.W, was promoted to Assistant Clinical Professor in
Psychiatric Social Work
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