USC Hamovitch P.I. Volume 5, Issue 1. Spring 2015 by University of Southern California

Hamovitch PI

Spring 2015

A research publication of the Hamovitch Center for Science in the Human Services at the USC School of Social Work

Fighting an emerging epidemic Unacknowledged and unaddressed in many poor neighborhoods, crack cocaine use is becoming a major public health concern in Mexico City. Project directors help realize vision of faculty researchers by managing day-to-day aspects of research

On one of the busiest streets of Mexico City’s Coyoacán district, Mario sells juice from a street stand. He works all day, then breaks down his stand, stores his materials, and goes home. He locks himself in his room and smokes crack cocaine. Mario has been using crack

Chinese clearinghouse on evidencebased practices finds new home, expands its contents

for about 16 years. Two marriages have come and gone, their collapse attributed to his substance use. Now he lives with his parents, who don’t bother him as long as he smokes in his room or on the roof. “I don’t go out,” he tells the researchers. “I stay in my pad.” Crack | continued on page 10

New book examines how to integrate spirituality, religion, and faith in psychotherapy

Vol. 5, Issue 1 Spring 2015 From the Director

In this issue I am delighted that, although long overdue, we are able to recognize the wonderful work of project directors at the Hamovitch Center for Science in the Human Services. Often research assistant professors, project directors are the people who run the day-to-day business of our research ventures. They are highly qualified, researchtrained faculty members and professionals who combine management and scientific skills to provide invaluable support to senior researchers. They constitute the backbone of complex research projects, handling the everyday tasks of research while senior researchers are occupied with conceptualizing and designing studies and writing and disseminating their findings. Globalization of our research and practice is the benchmarking lifeblood of our scholarship. It is an indicator of the quality and competitiveness of our work, that it may contribute to betterment beyond our home nation. It also affords us the opportunity to learn from the successes and mistakes of others. In this issue, we have a few of examples of the many global efforts of our faculty members: in Mexico fighting an emerging crack cocaine epidemic; in China translating and disseminating evidence on what works in social services; in Japan sharing knowledge on disaster relief and evidencebased practices; and at USC, bringing together social workers from Canada, Israel, Singapore, and the United Kingdom to address the needs of service members, veterans, and their families. Enjoy!

Haluk Soydan, PhD Director of the Hamovitch Center

Dean Marilyn Flynn Director Haluk Soydan Editor Eric Lindberg

Hamovitch PI is a research newsletter published quarterly by the Hamovitch Center for Science in the Human Services at the USC School of Social Work. Send questions, comments, and reprint requests to elindber@usc.edu

Front page: A man lights up a crack pipe in Mexico City’s Iztapalapa borough. The use of crack cocaine may be reaching epidemic levels in low-income areas of Mexico’s bustling capital. Photo/Courtesy of Alice Cepeda

New faculty member explores effects of social disadvantages at the University of Washington’s Social Development Research Group, Lee delved into two main areas of inquiry. The first focused on the etiology of health, particularly behavioral and mental health. The second dealt with social inequalities such as poverty and low socioeconomic status across generations. As she settles into her new role at USC, Lee is interested in combining those two She saw how her aunt struggled as a pillars to explore health disparities that divorced single mother to raise four sons persist from one generation to another. in an impoverished neighborhood where “How are we going to break that contihealth care largely consisted of a traditional nuity of social disadvantages among these healer who induced vomiting. vulnerable populations?” she said. She saw the looks of pity and empathy In her recent work, Lee focused on teen from strangers when she visited a park or pregnancy, using data from a longitudinal a playground with her brother, who has a study that followed a cohort of young mothers and their children for approxiphysical disability. Why did some people, through no fault mately 20 years. The study collected a of their own, have to battle social inequali- wealth of information, including data on ties such as poverty and a lack of preventive substance use, mental health, physical health, educational attainment, social envihealth care? “Why in the world are some people like ronmental factors, and parenting. When examining the my aunt, who is such influence of socioecoa fantastic and affecnomic status on their tionate and caring mom, “Right now we are living health and their children’s suffering like this?” she in an exciting period. asked. “My brother is just health, Lee reached some Researchers have the my brother, but somehow surprising conclusions. capacity to provide a he is seen as different “A lot of people think scientific foundation for their life course trajectory than everyone else.” Driven by a desire to our efforts in social work.” is decided,” she said of teen find solutions to those mothers. “That is not the problems, Lee pursued Jungeun Olivia Lee case. After 20 years, their a career in the social scilives are very different.” ences, eventually moving One major factor that to the United States to earn a master’s influenced outcomes was educational degree in social work from the University of attainment. Helping teen mothers finish Wisconsin, Madison, and a PhD in social their high school education can have a drawelfare from the University of Washington. matic effect on their lives, Lee said. Having recently joined the USC School “That was awesome to see,” she said. “We of Social Work as an assistant professor, should not penalize them. If they can get she is continuing to tackle major social enough support and go back to school, it’s problems that affect vulnerable populations going to help their future.” She also noted that children of teen across generations, including poverty, submothers are not necessarily relegated to stance abuse, and health. “Right now we are living in an exciting negative life outcomes such as teen pregperiod,” she said. “Researchers have the nancy or any other health risk behaviors. capacity to provide a scientific foundation As with their mothers, their life trajectories are for our efforts in social work.” During her work as a research scientist very different.

It became clear to Jungeun Olivia Lee as a young child that some things in life just weren’t fair.

Jungeun Olivia Lee has been interested in how health and well-being are affected by social adversities such as poverty since her childhood in Korea, when she witnessed her aunt struggling as a single parent with four sons.

Photo/Eric Lindberg

but it’s very likely that you won’t be able to enroll in a single visit.” She ultimately hopes to develop health literacy training for clients or interventions at the organizational or policy level that will help service providers and government agencies ensure that individuals are able to access the care they need. Lee said the large Korean immigrant population in Los Angeles drew her to the position at USC. She was also intrigued by the school’s strong emphasis on science and the ability of social work to effect change, in addition to the university’s overall focus on interdisciplinary research. “I have a million different angles to my research and I can always name at least two different people who have a certain perspective on the same issue,” she said. Beyond faculty collaboration, Lee is also excited to begin engaging with students, both in the classroom and her research lab. As the instructor of a research methods course this semester, she said her experience thus far has bolstered her Lee hopes to bring data and health disparities in of the enrollment process. belief in science as a solution to from that study to USC and is immigrant populations. “If you are a single mom and social problems. currently writing a grant proMany immigrants struggle you have multiple jobs, you may “After spending so many years posal to conduct another wave to access health care due to have one hour and you don’t in one area, you might start of data collection, in addition issues such as low health lit- have high-speed Internet at to feel a little low energy, but to surveying a new cohort of eracy, she said. They may find home,” she said. “So you go to when you meet with students, teen mothers. She is inter- simply enrolling in health the library and sit in front of a they are so bright and excited,” ested in exploring how health insurance troublesome, given computer and start putting in she said. “It’s so inspiring and I literacy affects teen pregnancy the complex jargon and length all of this sensitive information, feel totally rejuvenated.” t

Project directors guide daily aspects of research

Photo/Eric Lindberg

At its most lofty level, scientific research is a rigorous pursuit of intellectual curiosity.

Hazel Atuel (left) and Harmony Rhoades, both research assistant professors, are among a handful of highly skilled individuals who oversee the complex and varied day-to-day agendas of large-scale research projects at the USC School of Social Work.

It requires creativity, inventiveness, and a visionary understanding of the big picture. But the ability to bring that vision and innovation into reality is just as critical. That’s where project directors enter the scene. These highly trained professionals are responsible for overseeing the everyday facets of research, from handling budgets and personnel to dealing with confidentiality issues. “As a project manager, you are delegating and overseeing administrative tasks, managing the research and data collection process, presenting, and working with various stakeholders,” said Diana Pineda, project manager for a large research initiative at the USC School of Social Work. The tasks of a project director often vary from one research venture to another, but they typically involve handling the daily minutiae of research such as ensuring there are protocols in place for data collection and that data are managed in an efficient manner. For Pineda, the job means overseeing a research team based in San Diego County that is exploring how schools and other community partners can support children from military families. She works closely with school districts and community partners to help implement and evaluate programs that address the socioemotional needs of students. She also helps develop surveys and collaborates with fellow researchers on the development of electronic applications for smartphones and other devices to help military-connected students who are transitioning between schools. “At times it can be challenging, but having a great team with open communication helps and knowing how impactful the programs can be for schools and their families is a huge reward,” Pineda said. Another key member of the team who pushes forward the project’s daily

As project manager for a large research project based in San Diego County, Diana Pineda has to juggle multiple tasks related to administration, data collection, evaluation, and community collaboration on a daily basis.

research methods, Monro sees his role as more operational in nature. He seeks to give Mennen leeway to be creative and consider different approaches to her research while doing whatever he can to execute her vision. “There’s a mutual trust and respect,” he said. “She trusts that I’m going to do what’s right. The hard part is sometimes you have a potentially awkward responsibility of telling your boss something is not possible. But because there is a lot of trust in the relationship, we can move from that toward a solution.” Monro’s responsibilities include training research assistants, creating protocols for “At times it can be challenging, how data will be collected and managed, and interacting with community partners. but having a great team with That latter role is particularly challenging, open communication helps he said, especially when the research project and knowing how impactful represents an intrusion into the daily lives the programs can be for of clinicians or clients. During a project in which therapists had schools and their families is a to collect data from their clients, he said huge reward.” the executive director of the participating agency offered a suggestion that has guided Diana Pineda his work with community stakeholders. “My employees will probably not collect the data because they want to have a good “The big picture doesn’t help you very much if you don’t have good people research project, but they might collect it who are very organizationally competent, for you,” the agency director told Monro. One of the benefits of working in understand the purpose of the research, and are able to hire and manage other a research environment such as the people to handle the daily workflow,” said Hamovitch Center for Science in the Astor, who is the Lenore Stein-Wood and Human Services is the opportunity to William S. Wood Professor of School share those kernels of wisdom with other Behavioral Health. “Without Diana and project directors and researchers. Harmony Rhoades, a research assistant Hazel, these projects would not be possible. You have to have somebody with professor who works in the same office suite as Monro and Atuel, said she regutheir skills and expertise.” Some project managers are lucky enough larly confers with her colleagues about data to only be tasked with overseeing one collection strategies and other approaches research initiative, whereas others play to project management. “It’s a really nice collaborative community,” a more nebulous role, shifting from one responsibility to another. Bill Monro, for she said. “It helps you not fall into the same example, handles the day-to-day aspects pitfalls that other people have experienced.” As the project manager of a 3-year project of three projects led by associate professor that involved interviewing more than 1,000 Ferol Mennen. Although some project managers offer homeless teens and young adults, Rhoades is technical expertise in data analysis and Research | continued on page 9 Photo/Brian Goodman

agenda is Hazel Atuel, a research assistant professor. She shares responsibility for project management with Pineda and handles issues related to subcontracts, personnel, interactions with the university’s institutional review board, and development of survey items. Although she is one step removed from data collection on the ground, Atuel said she appreciates the bird’s-eye view of the project she has in her current role. “When you are further from the data, what you lose in precision you gain in perspective,” she said. “That’s what is exciting for me, being able to see the big picture and how things are going to roll out from start to finish. I’ve had enough on-the-ground experience to know what needs to happen.” Being open to change is one key lesson she learned from her previous work as a data collector, field coordinator, and study coordinator. The ability to pivot quickly when a problem arises and find other options that allow the project to progress is a necessary attribute for project directors, something Atuel emphasizes when sharing her experiences with students when teaching courses on research methods. “You need to be open to surprises and see them in a positive light,” she said. Atuel credits her time working as a senior research associate at the Child and Adolescent Services Research Center in San Diego for her appreciation and understanding of the multifaceted nature of research. “The scientific enterprise has three strands—intellectual, fiscal, and operational—that are inextricably linked to one another,” she said. “In a competitive funding environment, a good scientist is a good steward as well, especially of public resources.” Because she has supported herself with research funding since she was 21, maintaining public accountability is a large part of how she views her work. Ron Astor, who leads the multi-million-dollar projects that Atuel and Pineda help manage, said the position of project director requires flexibility, strong communication skills, and trust, especially in largescale research ventures that involve many moving parts. For example, a recent project involved eight school districts, 145 schools, approximately 117,000 children, and multiple universities and community groups.

Researchers to evaluate crisis hotline for sexual minorities

Led by Assistant Professor Jeremy Goldbach from the USC School of Social Work, the one-year, $168,356 initiative will evaluate the Trevor Project, which offers a crisis hotline and chat and text messaging services to young LGBTQ individuals who are contemplating suicide. “Suicidality among LGBTQ kids is between four and seven times higher than among their heterosexual peers,” Goldbach said, noting that an estimated 45 percent of sexual minority youths have seriously considered or attempted suicide. “It’s a disparity that demands attention.” Considered the leading crisis intervention and suicide prevention provider for LGBTQ youths in the United States, the Trevor Project’s crisis team engages in more than 50,000 interactions with individuals between 13 and 24 years old each year. Goldbach and his colleagues, including Michael Marshal from the University of Pittsburgh and Sheree Schrager from Children’s Hospital Los Angeles, hope to find ways to improve the organization’s crisis and referral services and tailor a model of suicide intervention specific to LGBTQ individuals. The researchers will follow 600 randomly selected individuals, 200 from each service offered by the Trevor Project (phone line, chat, and text messaging), to assess various risk and protective factors via online surveys immediately after participants contact the organization and one month later. “We’ll look at some of the traditional suicide-related factors, such as intent and

Photo/iStock

A new research project will explore the effectiveness of a popular suicide hotline for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youths and provide guidance on how it can enhance its services.

means to commit suicide and feelings of hopelessness, but we will also explore identity-related factors such as family rejection, presence of supportive peers, meaningful connection with organizations in the gay community, and internalized homophobia,” Goldbach said. “Hopefully we see improvements in all of these things and with these improvements will be lower suicidality.” In addition to offering suggestions for enhancements to the Trevor Project’s approach, Goldbach is hopeful that the project will lead to additional research initiatives and improve knowledge about how to mitigate the link between stressful experiences of LGBTQ youths and the disproportionate rate of suicide attempts in the population. He is particularly interested in the

A study by Assistant Professor Jeremy Goldbach will evaluate the effectiveness of a national crisis provider’s services for sexual minority adolescents and young adults contemplating suicide.

experiences of adolescents who don’t identify as lesbian, gay, bisexual, or transgender but nonetheless are questioning their sexual identity. “How do you recruit someone who isn’t out?” Goldbach said, referring to individuals who have not publicly disclosed or personally acknowledged their sexual minority status. “This is a group that has very little voice and we make a lot of assumptions about their needs. Until we ask them directly, we really are just working in the dark.” t

Chinese clearinghouse finds new home

Established in partnership with the USC School of Social Work several years ago, the Chinese Clearinghouse for Evidence Translation in Child & Aging Health is now based at Lanzhou University and is expanding in content and reach. Emphasizing the importance of having strong scientific evidence to back up social work interventions and practices is critical to ensure social services are effective and beneficial, said Haluk Soydan, associate dean of research and director of the Hamovitch Center for Science in the Human Services. “It promotes social work as a profession and a science,” he said. “We are promoting high-quality evidence that supports practices they want to introduce and teach.” In essence, scholars and practitioners can access detailed information via the clearinghouse’s website about the strength and effectiveness of certain social work practices. In addition to modules on child welfare and aging, the clearinghouse will soon feature guidelines related to translational research and academic publication standards. Understanding how to translate research findings from Western nations to the societal and cultural context of China is the key focus of the third module, which is based in large part on Translation and Implementation of Evidence-Based Practice, a book authored by Soydan and Lawrence Palinkas, the Frances L. and Albert G. Feldman Professor of Social Policy and Health. “We’re not only talking about implementation and translation in our terms, which is from bench to trench or from the university to the agency,” Soydan said. “It’s from the West to China. You have this transcultural, transnational dimension.” The fourth module will describe publication ethics and the technical aspects of developing academic manuscripts. Creating standards for research, practice, and publishing in social work will be essential in the coming decades, Soydan said,

Photo/Courtesy of Zhenggang Bai

A clearinghouse for evidence-based practices has a new home in China.

“It promotes social work as a profession and a science. We are promoting high-quality evidence that supports practices they want to introduce and teach.”

Scholars at Lanzhou University welcomed Haluk Soydan (bottom row, third from left) as he helped install a clearinghouse for evidence-based practices.

much interested in evidence-based practice,” he said. “The more they know, the more they become interested.” Haluk Soydan This type of scholarly exchange is encouraging to Soydan, who said he frequently gets requests from Chinese scholars to as China begins tackling looming issues visit USC to learn more about Western related to its aging population, domestic methods of research and inquiry. In fact, a former visiting scholar to USC, migration, ethnic conflict, socioeconomic Zhenggang Bai, now works at Lanzhou divisions, and other social problems. The central government is planning to University’s department of public health dramatically increase the number of schools and helped relocate the clearinghouse of social work in an effort to build capacity from its original post in Chengdu. He to address those social issues, so ensuring also worked with Iris Chi, the Chinesethat high academic standards are main- American Golden Age Association/Dr. tained is a major focus of the clearinghouse. Frances Wu Chair for the Chinese Elderly, Soydan said in addition to developing to develop the module on aging and health. “This exchange has a positive goodwillthe two new modules, clearinghouse leaders are investing time and energy into generating effect in a political global conmarketing the clearinghouse to schools of text with many cleavages and hardship and threats of conflict,” Soydan said. “If they social work and service delivery agencies. “I have been holding talks in China over implement evidence-based practice and the years and there are always people very they see it works, there is a clear benefit.” t

New book explores sacred side of therapy

level when using these expressive practices, including research evidence that supports these methods as effective. “The expressive traditions are horribly underutilized,” Land said. “Basically they have been the domain of art therapists and music therapists and so on. There are many interventions that can be used quite easily and have way more robust research in terms of their efficacy than most of us even know about.”

Photo/Lyceum Books

Perhaps they perceived the topic as too personal or felt uncomfortable discussing the sacred world. By doing so, they may have overlooked the greatest source of resilience or the key to psychological issues among many of their clients. At least that’s the contention in Spirituality, Religion, and Faith in Psychotherapy: Evidence-Based Expressive Methods for Mind, Brain, and Body, a new book by Helen Land, associate professor with the USC School of Social Work. “We are becoming more and more of a secular society, but I think this idea of what people hold as sacred, whether it’s religious or not, will always be useful,” Land said. “Everyone has some sort of philosophy of life and it doesn’t have to be connected to a deity or organized religion.” Although spirituality has found its way into clinical practice in a general sense, typically viewed as a source of wellness for individuals dealing with trauma, death, or other difficult experiences, few clinicians truly delve into the sacred beliefs of their clients and how those beliefs influence their ability to cope with problems or may actually be causing those problems. In her book, Land outlines various strategies to integrate three broad domains of sacred content into psychotherapy, particularly through the use of expressive methods such as art, movement, and music therapy. “Often people are stuck in concrete thinking,” she said. “These kinds of issues—spirituality, religion, and faith—are very hard to put into words. Talk therapy has its limitations.” By engaging the creative and intuitive aspects of the brain, clients can begin to unlock and process memories and experiences of trauma or pain, she said. The book offers an in-depth discussion of how that process occurs at the neurobiological

Photo/Brian Goodman

For many decades, therapists and clinicians have skirted the edges of religion and spirituality in their work with clients.

Land’s interest in the sacred world as a potentially critical component of therapy for many individuals stems from her work leading support groups during the height of the AIDS crisis. During a research study on how people cope with the stress of caregiving for a loved one with AIDS, she noticed that many times these caregivers would not tell other family members or friends about the disease. So how were they handling this tremendous personal burden? “The thing that came up over and over again was, I turn to God or I pray,” she said. “Many people used these spiritual and religious coping strategies.” Issues such as illness, death, and trauma often spur individuals to consider previously unacknowledged existential questions, Land said. Why are we here? What is a person’s essence? Her book is peppered with examples from her personal experience as a clinician that describe how people struggle with those quandaries in the wake of tragedy. For example, she worked with a woman whose family had been killed by a drunk driver when she was a senior in high school, leaving her devastated and angry. In another instance, a woman in her 30s died from ovarian cancer, leaving behind her husband and 18-month-old daughter. “It can be very disabling for people who are in mourning,” Land said, referring to the struggle to rectify their loss with their spiritual or religious convictions. “Some people would maybe deepen their spirituality and call on it. Other people would say they truly felt let down by their belief system.” In Spirituality, Religion, and Faith in Psychotherapy (Lyceum Books), she describes a new assessment model she developed to help clinicians evaluate the sacred beliefs of their clients in addition to the standard A new book authored by Helen Land, associate professor with the USC School of Social Work, offers guidance to clinicians seeking to address the psychospiritual needs of their clients. It outlines the process of integrating sacred content into psychotherapy via evidence-based expressive methods such as art and dance therapy.

Helen Land psychological, biological, and social factors. Understanding how their clients perceive religion and spirituality can help therapists determine if a particular sacred domain is influencing their ability to recover from trauma. Land theorizes that maintaining balance in the sacred triad—religion, faith, and spirituality—can be critical to psychological well-being. Each domain has strengths and drawbacks, she said. Religion tends to cause the most difficulty, particularly if individuals are struggling with certain tenets that conflict with their personal identity, such as dogma regarding sexual orientation. In such cases, religion can be very scarring. “But some people have problems with loss of faith,” Land said. “Other people have problems doing lots of rituals and prayers but really not having a very enriched spiritual life, if any.” Despite her own spiritual awakening and continuing journey, Land acknowledged that until recently she had kept her academic and practice career relatively separate from discussions of sacred topics. She joined a society of fellow professionals interested in spirituality and social work, even rising to the rank of president, but it wasn’t until she began writing her book that she integrated the concepts into her work. “The book has really helped me broaden my scope of practice,” she said. “I may have been able to function fairly well working with clients from my own faith, but I didn’t always use it. When I started writing, I began trying to see how these practices worked in session for my clients.” She is hopeful that other social workers and helping professionals will have a similar reaction to the book. “It’s very important for clinical social workers to move out of their comfort zone,” she said. “In many ways, these practices really change the brain and help people recover quicker.” t

determining how many interviewers are REsearch | from page 5 familiar with the hiccups that can occur needed, how to reimburse research staff during large-scale research initiatives. members for certain expenses, and whether When one of the drop-in service centers an agency prefers that study participants where the research team was conducting receive cash or gift cards as incentives. interviews abruptly closed, she had to “In the beginning of any project, the scramble to find another location that [principal investigator] absolutely has to be would allow the project to proceed. hands-on,” she said. “They are making sure One of the most gratifying parts of the that their vision is going to be carried out. job is proving that she can handle those But once things get rolling and they trust kinds of issues, Rhoades said, not to the project manager, they can go back to mention the countless other daily tasks the trillion other things that have built up of a typical research enterprise such as in the meantime.” t

Photo/Eric Lindberg

“We are becoming more and more of a secular society, but I think this idea of what people hold as sacred, whether it’s religious or not, will always be useful.”

As project manager of three grant-funded research initiatives, Bill Monro oversees a wide variety of daily tasks, from working with community partners to creating data collection protocols.

Photo/Courtesy of Alice Cepeda

Crack cocaine use has exploded in Iztapalapa, an impoverished area of Mexico City, yet it seems less stigmatized in the community.

Crack | from page 1 Mario’s story adds a little more detail to an emerging picture of crack cocaine use in Mexico’s capital, a picture that is becoming increasingly clear thanks to the efforts of a research team led by scholars from the USC School of Social Work. For several years, they have canvassed select neighborhoods in the bustling capital city, speaking with crack users and trying to understand how a population that had little interaction with the potent drug just a decade ago is now in the midst of an emerging epidemic. “It had gone under the radar,” said Alice Cepeda, an assistant professor. “We started poking around and realized how the rate of crack use treatment admissions had increased dramatically during the past 10 years.” Interviews with more than 150 current crack users led to disturbing findings. High rates of sexual risk behaviors such as prostitution and trading sex for crack are being paired with risky practices such as sharing drug paraphernalia, exposing users to HIV and other infectious diseases. Although the Mexican government provides universal access to antiretroviral therapy, testing, and treatment services, individuals in certain impoverished districts of Mexico City face significant barriers to receiving that assistance, primarily because outreach efforts rarely extend into their neighborhoods. “These delegaciónes have some of the highest crime rates, a lot of the organized crime networks are

embedded in those communities, a lot of the contraband and counterfeiting that goes on in the city is housed in those areas, and a lot of people who are kidnapped are found there,” said Avelardo Valdez, a professor who has been conducting research in Mexico’s capital since the late 1980s. He first became aware of the emergence of crack use in Central and Latin America while studying drug patterns in New Orleans following Hurricane Katrina. When the city reopened after the disaster, nearly half of its population consisted of Latinos, mostly immigrants, hired to assist with the rebuilding effort. Focus groups and interviews with those day laborers revealed they were using crack cocaine. Up to that point, epidemiological data had suggested that crack was not a major issue among Latinos and that immigrants were less likely to use this drug. “Certainly there was little evidence that Latinos in the United States were using crack cocaine,” Valdez said. “But all of a sudden there was this crack use among immigrants.” Initially suspecting that these individuals were introduced to the drug in New Orleans, Valdez and his fellow researchers were surprised when many of their study participants said they had started using in Mexico City or San Salvador or Managua. Intrigued, the research team tried to assess levels of crack use in Mexico City. But the federal government had failed to distinguish between crack and powder

Photo/Courtesy of Alice Cepeda

Professor Avelardo Valdez (second from right) and Assistant Professor Alice Cepeda (right) are working with colleagues in Mexico City to examine patterns of crack cocaine use in lowincome neighborhoods. Their collaborators (left to right) are Victor Hugo Jimenez Carapia, a graphic design architect; Guillermina Natera-Rey from the Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz; and Eduardo Zafra Mora, project coordinator.

cocaine in national surveys on drug use. Compared to the extreme moral panic To that end, she is testing a unique So the researchers turned instead to sub- that surrounded crack use in the United strategy to spread the word about the danstance abuse treatment providers, whose States in the 1980s, these communities in gers of crack cocaine. Funded by a Grand data revealed an alarming trend. In 2003, Mexico City seemed much more accepting Challenges Explorations grant from the only 8 percent of admissions were related of the practice. The drug appeared less Bill & Melinda Gates Foundation, she is to crack cocaine. Just four years later, that demonized, its use less stigmatized. exploring the use of projection mapping, figure was approximately 40 percent. Despite a widespread belief that crack an emerging technology that casts twoTo understand how that spike occurred, cocaine is highly addictive and leads to dimensional images and animated text Valdez and Cepeda teamed up with col- destructive behaviors, many individuals in onto buildings and other large surfaces. leagues from Mexico’s federal Instituto the study were holding down steady jobs Collaborating with Elisabeth Mann, an Nacional de Psiquiatría Ramon de la and self-regulating their drug use. associate professor with the USC School of Fuente Muñiz to interview crack users in That holds promise for a harm reduction Cinematic Arts, and partners at the Instituto three city districts: Cuauhtémoc, Coyoacán, approach to addressing crack cocaine use Nacional de Psiquiatría Ramon de la Fuente and Iztapalapa. in Mexico City, an approach that focuses Muñiz, she plans to create and project live Who introduced these individuals to on alleviating the negative consequences action, text, and graphic animations in sevcrack cocaine? How did they learn how to of compulsive use and helping individuals eral Iztapalapa neighborhoods. These short smoke crack? Where do they use drugs? find a balance. and captivating messages will focus on soWhat kinds of risky behaviors are called behavioral nudges designed they engaging in to obtain crack? to promote healthy behaviors such These questions led to surprising “One of the beliefs about crack cocaine is that as HIV testing and treatment, offer preliminary conclusions. tips for negotiation of safer sex and it’s highly addictive and once you start using There was certainly the presdrug use practices, and describe the it, you rapidly move along this trajectory of ence of problematic crack use, of risks of chronic crack use. compulsive use and your life just disintegrates individuals who spent much of “It’s a very innovative idea, wedin front of you. Does that pattern hold up in their time either using crack or ding new directions in cinema engaging in illegal or legal activithese populations in Latin America?” and advertising with public health ties with the primary goal of messages for marginalized populaacquiring more crack. But another Avelardo Valdez tions,” Valdez said. archetype emerged. A team of promotores, or outreach “What was most striking was this workers, will also be on hand to idea of the stable user—that crack could be “With this population, it’s hard to get engage individuals who appear interested something that people are able to use without users to desist from using from one day to in the projections to discuss the project, moving on to compulsive use,” Valdez said. the next,” Cepeda said. “The harm reduc- deliver more HIV risk reduction informa“People are working and using crack on tion component recognizes that these indi- tion, and encourage testing and treatment. the weekends or every other day,” Cepeda viduals are using, so let’s begin by giving Researchers plan to distribute safer crack added. “We aren’t seeing as many compul- them the tools and knowledge to reduce use kits to people who acknowledge that sive, chronic users.” their behavioral risk.” Mexico | continued on page 12

USC hosts global summit on military research by Claudia Bustamante The nation’s nearly 22 million veterans and their families are confronted with difficult and enduring challenges, including high unemployment rates, homelessness, severe physical injuries, and untreated mental health concerns. During a recent two-day summit held at USC, about 50 researchers from national and international universities gathered to discuss how research could help understand these and other critical issues. Attendees included representatives from the Institute for Veterans and Military Families at Syracuse University, the Military Family Research Institute at Purdue University, the Bronfenbrenner Center for Translational Research at Cornell University, and the Uniformed Services University of Health Sciences.

Participants from the United Kingdom, Israel, Canada, and Singapore also provided their unique perspectives. “USC has the research expertise and relationships to drive this conversation and begin the long-term collaborative process,” said Anthony Hassan, clinical professor and director of the Center for Innovation and Research on Veterans & Military Families at the USC School of Social Work, which hosted the summit. “We are each doing great work in our respective fields, but all of us together can do so much more to advance the health and well-being of our military, veterans and their families.” The inaugural summit was the first step in developing a national research agenda to address the most critical issues facing service members, veterans, and military families during the coming decade. t

The National Child Traumatic Stress Network Center’s Treatment and Services Adaptation Center for Resiliency, Hope and Wellness in Schools has received supplemental federal funds of $795,533 for the next two years. These funds, only awarded to three sites nationally, will be used by Marleen Wong, clinical professor and associate dean of field education, and her colleagues to further develop and evaluate innovative school-based interventions that address the needs of traumatized children and school staff. Wong has also been invited to Kobe, Japan, to open an international symposium commemorating the 20th anniversary of the Great Hanshin earthquake, which resulted in more than 6,400 deaths. Wong offered trainings in disaster response and trauma recovery in Kobe following the earthquake, relying on her experience leading a crisis response team for the Los Angeles Unified School District after the Northridge earthquake in Los Angeles. Steve Hydon, clinical professor of field education, has also been invited to the symposium to discuss secondary trauma among teachers. One of the USC School of Social Work’s newest clinical teaching faculty members, Terence Fitzgerald, has published a new book titled Black Males and Racism: Improving the Schooling and Life Chances of African Americans. Drawing on extensive interviews with black men, Fitzgerald explores the persistence of racism in public schools and higher education in the United States. He also offers strategies and proposals to counteract structural racism and improve the lives of black youth. A keynote address delivered by Haluk Soydan, associate dean of research and director of the Hamovitch Center for Science in the Human Services, during the annual conference of the Institute of Human Sciences at Ritsumeikan University has been published in Japanese and English. The address focused on evidence-based practice in human services. This is the first time Soydan’s work has been published in Japanese and is reflective of increased collaboration and intellectual exchange with social work scholars in Japan.

Photo/Paradigm Publishers

Mexico | from page 11 they smoke crack; these kits will include lip balm, hand wipes, condoms, brass metal screens, and pipes that won’t burn the mouths or hands of users. Cepeda will interview approximately 50 people in the target neighborhoods prior to projecting the health messages, immediately after the project ends, and three months later to assess any changes in their knowledge of HIV and sexually transmitted diseases, their sexual risk, and their drug use and addiction severity. “Hopefully we can have some kind of impact before it gets out of control,” she said. If the project is successful, Cepeda can apply for up to $1 million in funding from the foundation to expand her efforts. The researchers are also pressing forward with a proposal to conduct a larger survey of crack use throughout Mexico City, hoping to validate some of their preliminary findings. They view their work as closely aligned with the broader global effort being led by USC President C. L. Max Nikias to develop research initiatives and educational collaborations in Central and Latin America. “It’s very important to build partnerships at different levels, including research and higher education,” Valdez said. “We’ve never been in a better position.” For more than a decade, he has led a summer training institute to support and advance the careers of students and new researchers interested in issues of substance abuse among Hispanic populations. One participant now heads the research department of Mexico City’s Instituto Para La Atención y Prevención de las Adicciones and has collaborated with Valdez and Cepeda on a needs assessment of drug treatment providers in one of the city’s boroughs. Valdez hopes to share findings from that project and other initiatives with highranking officials when Nikias leads a USC delegation to the capital city this spring. If successful in Mexico, he also envisions developing comparative studies in other nations to the south to fully understand the crack use phenomenon. “There is some work being done, especially in Brazil, but it’s not getting as much attention in other places,” Valdez said. “Certainly crack use has spread all over Latin America and it is a serious problem.” t