The Center for Family Education and Resilience (CFER)

Helle Thorning, M.S., Ellen Lukens, M.S.W., Ph.D. & Dan Herman, D.S.W., Directors

The Center for Family Education and Resilience (CFER) was established in 1998 as the research arm of the Department of Social Work at New York State Psychiatric Institute and Columbia University Department of Psychiatry. With the overriding goal of improving quality of life for all, CFER was formed to bring clinicians, researchers and trainees together who share an interest in understanding the impact that severe mental illness has on consumers, family members, significant others and communities.

CFER's primary goals are:

1. to build on psychoeducation, support and partnership among consumers, families and professionals to develop models of strengths-based and culturally sensitive psychosocial interventions

2. to design, implement, and evaluate innovative and effective clinical interventions focused on the needs of consumers and families

3. to facilitate and strengthen research on the impact of mental disorders on the consumer and the family

4. to establish research partnerships among consumers, families, clinicians, researchers, and community members

5. to provide training, education and supervision for mental health professionals and student interns on effective models of family and consumer models of intervention.

6. to develop opportunities for collaboration across disciplines


ONGOING CFER PROJECTS: The staff at CFER is currently conducting several research studies which are funded by both local and private sources (see the attached organizational chart): The Sibling Project In 1997 two investigators at 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.

HOPE NY (Healthy outreach through psychoeducation)

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 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 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. The subjects for the study are being recruited through the Alliance for the Mentally Ill of New York State (NAMI-NYS). To increase validity, subjects are also being recruited from communities which are ethnically and socioeconomically diverse.

The Multiple Family Psychoeducation Group Project (MFPG) In 1998 investigators at CFER received funding through a New York State Psychiatric Institute 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 began by enrolling Spanish-speaking and English-speaking family members of persons recently hospitalized at New York State Psychiatric Institute, 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. The overriding goal of implementing a family-based psychoeducational program at the Washington Heights Community Service is to introduce and evaluate the intervention in a community that has not had access to this treatment before. 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 Ken Steele and Dan Frey, both consumers, and CFER staff. 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 of important stages of the recovery process, and the impact of peer support, group process, and meaningful work on that process.

The Family Stress Study

The Family Stress Study was funded by NARSAD in 1995. The goal for this research has been to examine prospectively the relationship among variables that reflect external stressors and quality of life for patients and their family caregivers, and external and physiological variables that measure stress among those individuals diagnosed with schizophrenia. The study has been conducted with a sample of patients admitted to the Schizophrenia Research Unit (SRU) at the New York State psychiatric Institute (NYSPI), and their primary family caregiver. Subjects included 45 patients admitted to the SRU during the period between 1996 and 1998 and available family caregivers. Baseline data was collected for subjects at the point of admission to the SRU to participate in on-going research protocols on the unit. The data collected for this study included the development of a series of measures that reflect different aspects of stress as it relates to persons suffering from severe mental illness and their caregivers.

The Caregiver Impact Study

The CFER staff is using data from the Family Burden Study in the Epidemiology of Mental Disorders Department at NYSPI to examine the psychological impact on caregivers of persons who are living with severe mental illness, with specific attention to depression, grief and health concerns. Information gained from this study will inform other intervention studies to be conducted by CFER.

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 are engaged in CFER projects. In addition, CFER has established ongoing collaborations with other schools and departments at Columbia University such as the School of Social Work, the Joseph L. Mailman School of Public Health, and the Department of Epidemiology of Mental Disorders. Collaborations have also been established with the NIMH-funded Center for Hispanic Mental Health Services in the Fordham University School of Social Service, as well as the New York University School of Social Work. These collaborations have greatly enhanced and broadened the scope of the above mentioned projects as well as provided a research infrastructure that can support both the research and the clinical components of CFER.