.ns HamPiooneveritingcInhtervPen.I tio A research publication of the USC School of Social Work Hamovitch Center for Science in the Human Services Vol. 3, Issue 2 Summer 2013
[ from the director ]
[ news ]
HEALTH
JOY OF LIVING
SECURITY
COMMUNITY
TECHNOLOGY
SHELTER
What are the great challenges of the social work profession in complex, diverse, and open societies such as ours? What is the profession’s contribution to the betterment of dynamic societies? The USC School of Social Work has taken a leadership role alongside other distinguished schools to formulate Grand Challenges for social work as a profession and science. This Grand Challenges vision will have a considerable effect on how we shape the direction of social work research for the coming 10 years and beyond. The featured article of the current issue introduces the idea of Grand Challenges in social work, particularly from a research perspective. Further, we are happy to report on several research projects, some new and some ongoing. The common denominator of these initiatives is their advanced designs and dedication to underserved populations in the pursuit of examining and developing increasingly effective social work interventions to the benefit of those groups. Finally, USC remains the most diverse research university in the United States, admitting the largest number of students from other countries for the 11th year in row. The Hamovitch Center plays a role in this endeavor by accommodating many visiting
School leads effort to identify grand challenges of social work In neighborhoods afflicted by violence and poverty, in hospitals and substance abuse treatment centers providing care to ailing patients, and in many other settings in which the social fabric is fraying or worn, social work researchers and practitioners are striving to address issues that plague society. Major challenges exist, including fragmented systems of health and mental health care, problems of social stigma and oppression, and a need to reform the child welfare and foster care sector. To frame these issues and bring clarity and guidance to the profession as the next decade
scholars and foreign PhD students every year;
unfolds, a group of social work scholars is leading a Grand Challenges initiative to identify and highlight the most serious societal ills that social work can and should address. “Social work has the chance to capitalize on 100 years of history to make these changes, if we can be clear about what we have accomplished and what we could accomplish,” said Richard Barth, who serves as chair of the American Academy of Social Work and Social Welfare, which is coordinating the effort, as well as dean of the University of Maryland’s School of Social Work. CHALLENGES | continued on page 10
[ inside this issue ]
this issue highlights some of their research experiences here and how they become goodwill ambassadors of the profession and USC as they return to their home countries.
Haluk Soydan, Ph.D. Director of the Hamovitch Center
Graphic/Eric Lindberg
of human condition and disfunctionalities
Assistant professor explores family communication and risk behaviors among children page 2
Visiting scholars draw inspiration from interactions with leading researchers at USC page 5
Doctoral students net three competitive fellowships to support their research page 6
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[ research spotlight ]
Researcher draws inspiration from work with parents and children
“Unless you tell kids what you want and what you feel is valuable, you don’t know if they are taking away the right message. What we want to be providing are modifiable skills on some level that are supported and reasonable enough for people to use with their children.” Julie Cederbaum
For Julie Cederbaum, an assistant professor in the USC School of Social Work, engaging in the principles and practice of social work is a calling she has felt throughout her life. Even as a teenager, the desire to give her time and services for the benefit of others seemed instinctive. “I didn’t know what motivated me,” Cederbaum said. “I just felt very natural as a listener and in helping others with their problems. It was always really easy for me to talk to people I didn’t know and engage with others.” In her current position at USC, Cederbaum examines family communication and parent– child interactions and their possible effects on risk behavior in adolescents. Although much of her research has been directed toward HIV prevention and education for young women, it also extends to general behavior patterns of all adolescents and the role of parental relations in promoting positive choices. “None of us are born with an innate ability to parent,” Cederbaum said. “What is provided in terms of knowledge and skill building helps shape the way you parent. The typical practice of the past has been to intervene with kids or parents, but studies have much less frequently focused on resolving issues as a pair.” Cederbaum seeks to convey how family values and belief systems are major intervening factors in adolescent choices concerning risk behaviors. Parents often assume their children are receiving the messages they desire because of the activities or behaviors in which the parents participate. But that assumption is often incorrect, and a more indepth form of communication is required. “It’s about empowering parents to take the initiative to help shape their kids,” Cederbaum said. “Unless you tell kids what you want and what you feel is valuable, you don’t know if they are taking away the right message. What we want to be providing are modifiable skills on some level that are supported and reasonable enough for people to use with their children.” Empowering both sides of the parent–child relationship through better communication leads to healthier families, Cederbaum said. Adolescents come to understand what is expected
Julie Cederbaum
Photo/Brian Goodman
By Charli Engelhorn
of them and why, which can induce a sense of safety and comfort in terms of openly discussing issues they are trying to resolve. “There is enough literature that shows kids will prioritize what their parents say over the opinions of their peers if the parents remain present in their kids’ lives,” she said. Most of Cederbaum’s early experiences in social work revolved around child welfare services. A Santa Monica native, she began working as a peer counselor at an adolescent transitional housing placement center during high school. As an undergraduate at Drew University in Madison, New Jersey, Cederbaum engaged in community outreach as part of the women’s soccer team and studied abroad in Kenya, where she helped organize the Food for Glue program, which encouraged local teens to turn in bottles of glue often used as stimulants in exchange for food. Cederbaum also held two internships during her master’s degree studies at UCLA. At El Nido Family Center, she worked with pregnant teens. At the LA Free Clinic, now the Saban Free Clinic, she received certification as an HIV counselor and test administrator, and also developed CEDERBAUM | continued on page 3
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CEDERBAUM | from page 2 an educational prevention curriculum and content for youth outreach efforts. However, her experience at a housing program for families with an HIV-infected parent in Los Angeles, a position she took after completing her master’s degree, created the largest ripple in her career path. Cederbaum noticed that children living in the program were engaging in the same risk behaviors that had put their parents at risk of contracting HIV. In particular, the presence of a 16-yearold pregnant teenager made her realize that unprotected sex remained a serious issue for HIV-affected teens. This realization caused her to wonder what factors affected the decision-making processes of these adolescents if having an HIV-infected parent did not serve as motivation to make better choices. “I came to recognize that parents were not talking about HIV,” said Cederbaum. “I think that experience completely informed my rationale for going back to school and the research I ended up doing.” During the following 6 years at the University of Pennsylvania, Cederbaum fine-tuned her ideas in a dissertation focused on mother–daughter communication about abstinence and safer sex. Specifically, her research explored the differences between HIV-positive mothers and HIV-negative mothers in terms of their communications with their daughters regarding HIV-risk behaviors. Coming to USC after earning her doctoral degree was an easy decision, said Cederbaum, because of both the collegiality she sensed among the faculty and its proximity to her family. Returning to Los Angeles felt like completing a circle. “Los Angeles is where all these ideas came from,” she said. “Coming back was almost like doing homage to the people who helped lift me to where I am. The experiences I had here really shaped who I am as a researcher, scholar, and thinker. To be able to utilize my connections and engage this community, which is so ripe for social change, is really amazing.” While at USC, Cederbaum has received funding for a number of projects, including a grant from the National Institute of Drug Abuse to investigate communication between mothers and sons about alcohol, tobacco, and marijuana use. She is also currently a coinvestigator on a project funded
Photo/Eric Lindberg
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As an assistant professor in the USC School of Social Work, Julie Cederbaum has focused her research on issues that affect communication between parents and children on topics such as drug use and HIV prevention.
by the Conrad N. Hilton Foundation exploring pregnancy, parenting, and foster youth. Cederbaum also works closely with Professor Suzanne Wenzel to adapt evidence-based HIV risk reduction interventions for use with homeless women. In addition to her research, Cederbaum teaches two courses on topics related to social work and public health; she earned a second master’s degree in public health from the University of Pennsylvania while earning her PhD.
As she continues to pursue her research interests, she hopes to develop strategies for parents to gain proactive knowledge and skills applicable to their everyday lives. “We have so many punitive systems, but that is not the vision I have for how this work should be disseminated,” she said. “I don’t want it to be about troubled families and fixing them. The work should hopefully influence positive parenting and positive relationships and promote family wellness as a requirement for family reintegration.” t
Approximately 700 social work scholars and practitioners will gather in Los Angeles in June to share theories and strategies to improve health and mental health research and practice during an international conference hosted by the USC School of Social Work and the Los Angeles County Department of Mental Health. “This is the main international venue for social work researchers and practitioners who work in health and mental health,” said Haluk Soydan, director of the school’s Hamovitch Center for Science in the Human Services and cochair of the conference. “It is coming to the United States for the first time, so we are really showcasing some of the best work that this country’s social workers perform.” Slated for June 23 to 27, the 7th International Conference on Social Work in Health and Mental Health will have a specific focus on client-centered care. Soydan said the conference, held in various venues around the world since 1995, has typically reflected various aspects of its setting. “We are located in the heart of a very urban and multicultural environment, which gives a special flavor to the conference,” he said. “We chose to have a great emphasis on health and mental health issues in the United States in general but also specific to our school and the Los Angeles region.” This approach is highlighted by the conference’s symposia series on aging, cancer care, health inequalities and equity, health reform, homelessness, Latino health, military social work, and the recovery model. Guided by leading scholars in those key areas, the symposia will feature engaging discussion sessions with invited researchers, practitioners, and policy makers. Local social work agencies and service providers will also have a chance to exhibit their accomplishments during field site visits to more than 30 community locations throughout the Los Angeles metropolitan area, from Long Beach to Sylmar. Soydan said those field visits are PATHWAYS | continued on page 5
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[ news ]
[ news ]
Technology supports scholarly exchange
Visiting scholars connect with researchers
Doctoral student Hsin-Yi Hsiao describes her recently defended dissertation to colleagues at UC Berkeley and UCLA using technology made available by the USC School of Social Work’s Virtual Academic Center.
Scholars at the USC School of Social Work are taking advantage of innovative technology to engage with faculty and doctoral students at two other leading universities without ever leaving campus. As part of an interuniversity colloquium with colleagues at UC Berkeley and UCLA, doctoral students and faculty members have been sharing their research and exchanging feedback on topics of aging, organizations and management, and child development using videoconferencing technology offered by the school’s Virtual Academic Center. “It gives our students exposure to experts in other schools. It’s wonderful,” said Michàlle Mor Barak, director of the PhD program at the USC School of Social Work, where she also serves as the Lenore Stein-Wood and William S. Wood Professor in Social Work and Business in a Global Society. “That’s what scholarship is all about—breaking down barriers and creating scientific collaborations.” USC students and professors gathered recently in a classroom at the School of Social Work for the second meeting of the three-part series, during which doctoral students from each university gave short presentations on their research initiatives and sought advice and comments from other participants. Hsin-Yi Hsiao, a USC student who
successfully defended her dissertation just days before the gathering, said the opportunity to interact with her peers and researchers at other institutions was valuable. “It’s good to get feedback from different perspectives,” she said. “When I finished my study and looked at the findings, it was sometimes very hard to interpret them from my own mind-set.” Her research on cultural and gender differences in work and family conflict across 24 countries resulted in some counterintuitive findings. For example, national family leave policies did not seem to protect women from experiencing stress and conflict between family and work responsibilities after giving birth. Hsiao said advice from scholars during the meeting allowed her to reconsider how she interpreted the results of her work, in addition to broadening her perspective and providing some guidance for future research. In particular, one student from UC Berkeley suggested exploring the effects of subsidized child care on work–family conflict. “That is one thing I had never thought about,” Hsiao said, “but it’s a very important element I should consider in the future.” Students at the other universities also received suggestions for how to strengthen their research. Sara Pilgreen, a first-year EXCHANGE | continued on page 9
When Hongbo Li came to the USC including her Ukrainian roommate and School of Social Work from China as a another visiting scholar from South Korea. participant in the school’s popular Visiting She admits she struggled at first with Scholars program, she expected to put the English language but forced herself to her head down and grind away at her engage with others and has seen significant dissertation research. improvements. That will be critical during To a certain extent, she has prioritized the coming months as she interviews local her academic work, which focuses on nonprofit officials, including CEOs, board comparing marketing efforts by public members, and employees. nonprofit organizations in China and the “If I want to do a field study, I have to United States. But Li also found herself talk to people,” Li said. “So I found every opening up to other aspects of American chance I could to talk to people in English.” culture during her yearlong stay. Li plans to stay until September before “As a PhD student in China, I always returning to China to complete her disserwork. I don’t have much free time,” she tation. Short said USC has invested heavily said. “Nobody pushes me, but I push in cultivating relationships with Pacific myself. When I came here, I was able to Rim countries, and the Visiting Scholars separate my life from my program has attracted job. When I work, I work numerous participants hard, and then I can have “The idea is to be able from China, Japan, and some fun.” to link people with the other Asian countries. That is an encouraging same research interests However, school leaders result for Cherry Short, are reaching out to other and abilities with our the school’s assistant dean regions as well, including faculty here and to of global and community northern Europe, Israel, initiatives. She has made allow our faculty to India, and South America. a concerted effort to bring Many participants are be a bit more open to a stronger sense of cultural understanding different invited by their faculty exchange and commusponsor for stays ranging cultures with regard to from six months to two nity engagement to the their research.” Visiting Scholars program, years. Others seek out which typically enrolls 20 one of the school’s leading to 25 participants at any Cherry Short scholars based on their given time. shared research interests. Although each of the Børge Skåland, a lecturer participants is paired with a faculty member at Oslo and Akershus University College in who shares similar research goals, Short Norway, is among the latter. Prior to pursaid there is a greater effort to integrate suing his doctorate, he taught at a school them into the school, the university, and the for children with serious behavioral issues. culture of Southern California in general. When he began noticing incidences “The idea is to be able to link people of violence or intimidation by students with the same research interests and abili- against his fellow teachers and realized ties with our faculty here and to allow our they were receiving little attention, Skåland faculty to be a bit more open to under- was intrigued by the lack of response from standing different cultures with regard to school officials and society in general. their research,” she said. “Even though they “Teachers and even social workers who have this relationship with a specific faculty experience violence are often ostracized,” he member, we really try to engage them in a said. “It is kind of looked upon as a deficit, more holistic way.” that something is wrong with you if you have In addition to receiving advice and been exposed to violence. You are regarded sharing ideas with Dean Marilyn Flynn, as less competent and portrayed as weak.” her faculty sponsor, Li said she has also While exploring what happens to benefited from interactions with her peers, SCHOLARS | continued on page 11
Photo/Courtesy of Elizabeth Clark
Pathways to care
hamovitch p.i. | usc.edu/socialwork/research
Photo/Andrew Taylor
[ conference ]
Elizabeth Clark, executive director of the National Association of Social Workers, will deliver the keynote address during the upcoming conference.
PATHWAYS | from page 4 reflective of the both the school’s emphasis on community partnerships and the conference’s focus on bridging the divide between research and practice. “This is realized by different means during this conference, perhaps foremost by the abstract submissions,” he said, noting that more than 300 paper and poster presentations have been accepted. “A considerable number of them are actually accounts of practitioners and practices rather than research outcomes.” Finally, the conference will feature a keynote address by Elizabeth Clark, executive director of the National Association of Social Workers, as well as several plenary sessions by internationally renowned scholars such as Bengt Westerberg, former minister of social affairs and deputy prime minister of Sweden and current board chair of the University of Linköping and the Swedish Institute for Disability Research. Other plenary speakers include Elyn Saks, who serves as the Orrin B. Evans Professor of Law, Psychology, and Psychiatry and the Behavioral Sciences at the USC Gould School of Law; Nancy Krieger, a professor of society, human development, and health at the Harvard School of Public Health; and Sarah Gehlert, the E. Desmond Lee Professor of Racial and Ethnic Diversity at the George Warren Brown School of Social Work and the Department of Surgery at Washington University. More information is available at www.pathways2013.com, including an overview of the history of the conference, a description of field visit locations, and a full program of events. t
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Changing health
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[ student research ] Photos/Courtesy of Davis, Hernandez; Charli Engelhorn
[ grant ]
Doctoral students to benefit from competitive research fellowships Photo/Brian Goodman
By Charli Engelhorn
A new project led by Erick Guerrero, an assistant professor with the USC School of Social Work, will explore how recent health care legislation affects the ability of substance abuse treatment programs to serve racial and ethnic minority clients. In particular, Guerrero is interested in examining how the Affordable Care Act (ACA), known colloquially as Obamacare, will improve the integration of substance abuse treatment, mental health care, and HIV prevention programs, as well as its effects on treatment outcomes among African-American and Latino clients. Guerrero’s study is one of just five federally funded grants in the country focused on these questions. “This area of inquiry is still developing, and it offers many opportunities to explore this historic policy legislation and its impact on people, particularly low-income racial and ethnic minorities,” he said. Guerrero received a $428,327 grant from the National Institute on Drug Abuse to support the first two years of the project. Successful achievement of milestones during the initial phase will lead to funding for an additional three years, totaling $1.1 million. The phased nature of the project fits well with the framework of the ACA, which is slowly being introduced into the health care landscape over a matter of years. Guerrero hopes to establish a baseline understanding of treatment and care before the legislation is fully implemented to better understand its overall effect. GUERRERO | continued on page 7
training and psychoeducation to enhance Three doctoral candidates in the the well-being and community functioning USC School of Social Work are among of individuals with schizophrenia and siman exclusive group of students selected to ilar disorders. receive a graduate fellowship for advanced “The intervention is designed to help PhD scholars. people improve their self-regulatory capacLisa Davis, Mercedes Hernandez, and ities through mindfulness training,” Davis Diana Ray received fellowships featuring said. “The psychoeducation portion targets $30,000 stipends, in addition to tuition, stress reduction, self-care, and goal setting. fees, insurance, and possible travel grants The fellowship will provide me with the necfor further research opportunities. essary resources to recruit participants from The fellowships, offered in three cat- a community-based psychosocial rehabiliegories, provide suptation agency, implement port to USC students as the intervention, and evalthey complete their PhD “Getting these uate the results.” studies. Particular focus John Brekke, Davis’ facfellowships and having is given to programs in ulty mentor and advisor this kind of work done which research assistantand the Frances G. Larson here is a feather in ships are not available Professor of Social Work our cap as a doctoral and teaching is the main Research, said her work source of financial supprogram. I think on this project has the port, said Meredith Drake potential to significantly these students will be Reitan, assistant dean of improve how mental wonderful examples of fellowships for the USC health agencies deliver the kind of candidate Graduate School. interventions to the seri“The selection process for faculty positions we ously mental ill. is highly competitive and produce.” “Lisa is doing very only a small number of sophisticated intervention candidates were selected Concepción Barrio development work with a by an interdisciplinary fachighly vulnerable populaulty committee,” she said. tion,” he said. “These funds Davis, Hernandez, and Ray are among can supercharge her dissertation, allow her only 58 students who received a fellowship to gather more data, and help her to produce out of hundreds of applicants throughout more powerful publications from that data.” the university. Brekke said her research will increase In addition to Endowed Fellowships Davis’ competitiveness in the job market and Dissertation Completion Fellowships, and has implications for her productivity which have been awarded in past years, as a junior faculty member, a sentiment university officials introduced the Research shared by Concepción Barrio, an associate Enhancement Fellowship. The $30,000 sti- professor who serves as a faculty advisor pend included with each fellowship is also and mentor for Hernandez. a substantial increase from the $23,000 “I think it is to their benefit to leave the award provided in previous years. program completely equipped, not just in Davis received a Dissertation Completion writing and conducting statistical analysis Fellowship, which is intended to support of data, but in how to undertake a study students during the final stages and submis- from conceptualization to the completion,” sion of their dissertations. Her dissertation Barrio said. “This fellowship and experiinvolves evaluating an innovative group ence will carry [Hernandez] through as an intervention that combines mindfulness AWARDS | continued on page 7
PhD students Lisa Davis, Mercedes Hernandez, and Diana Ray (left to right) are among a select group of advanced scholars at USC that received fellowships to support their research efforts as they complete their dissertations.
AWARDS | from page 6 independent researcher after she graduates.” Hernandez received a Research Enhancement Fellowship, designed to provide financial support to students whose research requires work in complex or distant settings or results in other unusual expenses. This fellowship is particularly helpful to Hernandez, who is conducting a mixedmethod study on the role of protective factors in intervention outcomes for Latino consumers with schizophrenia or families of individuals living with schizophrenia. “It is very challenging for doctoral students who decide to collect their own data,” Barrio said. “It takes a great effort to locate participants and schedule interviews. [Hernandez] stands out because she goes beyond what normal students do, and her work speaks to her capacity to perform this sort of study.” Hernandez said time-intensive efforts in the field required to complete her dissertation will be more manageable and the award will allow her to develop as a researcher focused on creating and enhancing psychosocial treatments for Latinos with serious mental illness. Ray, who received the Oakley Endowed Fellowship, is also interested in issues that affect an underserved minority population. The Endowed Fellowships are awarded to students making good progress in both the quality and timeliness of their research and degree completion. Her dissertation examines the complex dynamics that contribute to surprising physical and mental health outcomes among Asian Americans, an approach that involves conducting secondary analyses of a large, nationally representative data set. “I am seeking to answer whether there are cultural protective factors that can mitigate
a decrease in health for Asian American immigrants after arriving in the United States,” Ray said. “How can social workers and those in behavioral health support the maintenance of cultural traditions to protect their health? The fellowship will allow me to dedicate a year of full-time study to delve into the nuances of these questions to hopefully produce an accurate portrayal of this very heterogeneous segment of U.S. society.” Karen Lincoln, Ray’s faculty advisor and mentor and an associate professor, said Ray’s research will contribute to knowledge about mental health and health disparities for this population. “Her work challenges us all to expand our current thinking around treatment to include intellectual and theoretical frameworks that incorporate psychology, public health, and social work, as well as sophisticated quantitative methods,” Lincoln said. Lincoln believes this fellowship will support Ray’s future efforts and position her as a groundbreaking social work and mental health scholar whose work will be highly influential across health-related disciplines and behavioral sciences. Ray said she feels unbelievably fortunate to have received the fellowship, and all three students believe the fellowship is a boon beyond their current endeavors and will benefit their professional careers. Receiving these fellowships will clearly benefit the research careers of these three scholars, but the awards are also seen as a win for the USC School of Social Work. “Getting these fellowships and having this kind of work done here is a feather in our cap as a doctoral program,” Barrio said. “I think these students will be wonderful examples of the kind of candidate for faculty positions we produce in our program.” t
GUERRERO | from page 6 Guerrero plans to conduct surveys with approximately 750 staff members in 157 substance abuse treatment programs in Los Angeles County, including program directors, supervisors, and counselors. Information on organizational factors, such as expansion of the public health insurance program known as Medicaid and pressure from policy makers and regulators to provide health and mental health care under one roof, will be linked to data about all clients receiving treatment for substance use issues, an estimated 10,000 people annually. Making those connections between national health care policies and how individual clients respond to treatment is an innovative component of the project, Guerrero said, and will provide a better understanding of how services can be delivered more effectively, particularly to low-income and minority clients. “This is a nice contribution to trying to link historic policy initiatives with organizations’ practices and roles, such as leadership and readiness for change, to client outcomes that are reported by the clients themselves,” he said. “That’s what I’m feeling the most optimistic and excited about.” In addition to collaborating with Lawrence Palinkas and Chih-Ping Chou at the USC School of Social Work, who are serving as coinvestigators on the project, Guerrero will work closely with representatives from the county’s Substance Abuse and Prevention Control division. He said county officials have been involved in his previous research efforts and characterized the collaboration as critical to the success of the new project. By identifying strategies to reduce health disparities, increase access to integrated care, and reduce HIV infection rates in some of the more impoverished areas of Los Angeles County, Guerrero said the project can create a roadmap for improving standards of care among other vulnerable populations throughout the United States. “Everybody talks about the need, but when you look at the kind of research that is funded and the interventions that are funded, they aren’t being implemented in these areas with low resources,” he said. “We just have to do a lot more work and make the extra effort to reach out to the neediest communities.” t
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Physical injuries and the psychological effects of war can have devastating consequences on the sexual functioning of service members and veterans. Despite recent advances in protective gear, members of the U.S. military face a serious risk of genital injuries due to improvised explosives and other unique aspects of the wars in Afghanistan and Iraq. Psychosocial challenges, such as posttraumatic stress disorder and depression, can also exacerbate issues with sexual functioning and libido. A new study led by the USC School of Social Work’s Center for Innovation and Research on Veterans and Military Families (CIR) is among the first to directly address the topic, which has been plagued by stigma and a relative lack of attention until recent years. “It’s always hard to get people to talk about sex and problems with sex,” said Sherrie Wilcox, a research assistant professor who is leading the project. She noted military personnel may be even less willing to open up about problems with sexual functioning. “They have a certain culture that they are used to living with. There’s definitely stigma around the issue.” Funded by a $650,000 gift from the Iraq Afghanistan Deployment Impact Fund via the California Community Foundation, the 18-month project will involve gathering data about the scope of the problem through literature reviews and surveys with veterans and service members. Insight from that process will inform a training toolkit with resources for social workers and behavioral health professionals, as well as a policy report with specific recommendations for federal officials and veterans organizations. Although previous research is very limited, Wilcox and her research team found estimates that between 5% and 25% of recent veterans report issues with sexual functioning. An estimated 1,500 service members have experienced genital injuries, including infection caused by pulverized sand embedded in the groin area or mutilation caused by projectiles and other explosive devices. Anthony Hassan, director of CIR and
Photo/Courtesy of U.S. Army/Andy Dunaway
Study explores sexual functioning among veterans
Psychosocial problems and physical injuries can have negative effects on sexual functioning and libido among military personnel, issues that will be explored in a new study at the USC School of Social Work.
an Air Force veteran, said the relationship between physical injuries and sexual functioning has emerged as a critical issue for service members returning home from conflicts in the Middle East. “It’s a more common injury in these wars because of the use of improvised explosive devices for ground troops who are walking and patrolling,” he said. “It’s not unique to these wars, but there is more prevalence because of the types of weapons, as well as
“It’s a more common injury in these wars because of the use of improvised explosive devices for ground troops who are walking and patrolling. It’s not unique to these wars, but there is more prevalence because of the types of weapons, as well as advances in battlefield treatment.” Anthony Hassan
advances in battlefield treatment.” Problems linked to these injuries can be extensive, including diminished sexual function, infertility, loss of libido, chronic pain, and urinary dysfunction. Although protective equipment for the groin is available to military personnel, compliance has reportedly been an issue due to discomfort. “For the traditional Army or Marine Corps infantryman, it’s just another five pounds, it’s in the way, it makes you less mobile,” Hassan said. He said there are efforts underway to redesign the gear, which includes a thinner garment worn at all times and a heavier device used by soldiers on foot patrol. Regardless, the equipment is largely designed to protect against debris from a blast rather than a direct explosion, and serious injuries remain a distinct possibility. Beyond physical disfigurement, the psychological scars of war often disrupt sexual functioning and have negative effects on general quality of life. Wilcox said issues such as depression and trauma-related stress can affect sexual performance, which CIR | continued on page 9
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CIR | from page 8 can exacerbate those same psychological problems, creating a negative cycle that damages relationships with spouses and significant others. In addition to reaching out to reconstructive surgeons and contacts at military hospitals to locate those with physical injuries, the research team plans to conduct a survey with community-dwelling veterans to gain a better understanding of how sexual issues are perceived by military personnel in general. That information will inform a training toolkit focused on the most critical issues related to sexual functioning, as well as guidance for professionals on how to broach the topic with clients. “It’s about finding the best way for a clinician to start the conversation,” Wilcox said. The toolkit, which will feature video vignettes, case scenarios, resources, and assessment tools, will be embedded as a module in a course on human sexuality offered to master’s students at the USC School of Social Work beginning next year. “The objective is to educate providers so they at least know how to do an assessment and be able to make appropriate referrals or know what treatment models and interventions are available,” said Doni Whitsett, a clinical professor and licensed social worker who teaches the course. “The educational component will also raise the awareness of social workers and sensitize them to the psychological and social issues of blast injuries.” The toolkit will be offered to behavioral health care professionals, social work scholars and researchers, and other professionals who work with military populations. The research team plans to hold a short training conference to raise awareness of the issue and disseminate materials developed during the study. Another significant component of the project is an effort to advocate for change at a policy level. For instance, Hassan said there is concern that Veterans Health Affairs is not providing advanced treatments for veterans who have suffered injuries to their reproductive and urinary tract systems, such as in vitro fertilization and counseling for spouses. Although health care insurance for injured service members covers some fertility care, it doesn’t pay for embryo implantation or specialized care for spouses in most cases, he said.
Photo/Courtesy of Sherrie Wilcox
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Sherrie Wilcox
A policy report authored by the research team will address these and other critical issues that arise during the study and offer recommendations for federal policy makers on how to improve treatment and support for military personnel who face problems with sexual functioning. Nancy Berglass, director of the Iraq Afghanistan Deployment Impact Fund (IADIF), said the absence of reliable research and data on the topic, as well as the stigma associated with discussing it, inspired the gift. The $650,000 grant is one of approximately 60 made by the fund, which has distributed nearly $250 million to various efforts to address issues faced by service members and veterans. “IADIF is the largest philanthropic intervention in the lives of service members, veterans, and their families ever known in this country,” Berglass said of the fund, which was established in 2006 by a then-anonymous donor. Berglass and the donor felt CIR was well positioned to address issues surrounding sexual functioning among service members and veterans. “CIR is an excellent choice to lead this project because of its equal reach into the world of veterans, military families, policy, academia and the community,” she said. “Moreover, having access to leading subjectmatter experts at the university makes this a very dynamic and doable project for CIR.” t
EXCHANGE | from page 4 doctoral student at UCLA, is just beginning to develop her dissertation on why nonprofit health services organizations flourish in some low-income neighborhoods but fail in others. She plans to examine sociodemographic variables, social perceptions, political influence, gang activity, and other factors in an effort to determine why nonprofit organizations seem to thrive in the Los Angeles neighborhood of Boyle Heights but struggle in Watts. Erick Guerrero, an assistant professor at the USC School of Social Work who has focused his research on similar issues surrounding substance abuse treatment in low-income communities, offered some suggestions to Pilgreen on how to frame the study, including a recommendation to consider the role of government funding. “Intellectually, it’s very stimulating,” Mor Barak said of the colloquium series. “Having doctoral students and faculty from the three schools together in the same environment is fantastic.” She noted that a similar collaborative effort had taken place years ago between scholars at USC and UCLA, but they met in person, a more time-consuming approach that would be difficult for institutions located farther apart. During a recent conference on doctoral education, Mor Barak connected with Jill Duerr Berrick and Laura Abrams, who lead doctoral programs at UC Berkeley and UCLA, respectively. The trio decided to test a virtual exchange. “Our goal was mostly to give doctoral students exposure to presenting their work to other schools and getting some feedback,” she said. “It’s also an opportunity for the schools to scout potential talent and for students to see what their future employment options might be.” She credited the USC School of Social Work’s embrace of emerging technology, particularly through its web-based master’s degree program known as the Virtual Academic Center, for making it feasible to seamlessly share video and audio feeds. Mor Barak noted that there is interest in developing more scholarly exchanges, not just among the three universities participating in the current colloquium series. “It’s a terrific way of creating an intellectual community around a certain topic, freeing us from physical limitations,” she said. t
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Leading scholars at the USC School of Social Work, including members of the Research Council (pictured), are playing a key role in outlining key challenges for social work.
CHALLENGES | from page 1 “It’s an opportunity for our field to square its scientific and social justice aspirations and to communicate more effectively within the profession and to other professions and the general public about what social work is working on, what its capacity is, what its needs are to solve important problems, why it’s a fascinating and compelling field to be a part of, and what important advances to our quality of life could occur with advances in our social work science,” Barth said. Inspired by similar efforts in the field of engineering and by organizations such as the Gates Foundation, social work leaders gathered in the fall of 2012 to begin the process of identifying the profession’s most pressing challenges, led by Marilyn Flynn, dean of the USC School of Social Work, and Eddie Uehara, dean of the University of Washington School of Social Work. Flynn said those early discussions led to the creation of four general criteria that each challenge must meet to be considered. Challenges must be broad and integrative issues, solvable within 10 years, applicable to the profession of social work, and universal and public in nature. Using a similar approach, leaders in engineering identified four broad categories with 14 specific challenges, such as providing access to pure water, making solar energy affordable, and preventing nuclear terror. In 2003, the Gates Foundation began focusing on 16 major global health challenges, dedicating nearly half a billion
dollars to issues such as creating effective vaccines, developing strategies to combat disease-carrying insects, and discovering biomarkers of health and disease. Flynn said social work is in a comparable position to engineering, whose leaders in the United States felt a need to reinvent the profession at the turn of the century due to increasing dominance by individuals from Asia and a lack of women in the field. “Social work is at a crossroads,” she said. “It has a large number of challenges in areas such as child welfare, it is constantly being challenged on all sides by other professions, and it has a gender problem, much like engineering, in that it doesn’t attract many men.” By identifying key challenges, she said the profession can begin to restructure its curriculum and educational approach, faculty activities, and research projects. To determine how to engage with as many people as possible, Flynn said a handful of schools of social work are experimenting
“Social work is at a crossroads. It has a large number of challenges in areas such as child welfare, it is constantly being challenged on all sides by other professions, and it has a gender problem, much like engineering, in that it doesn’t attract many men.” Marilyn Flynn
with grassroots efforts to collect suggestions and integrate that information into the larger national initiative. That process may be complicated but it’s feasible, said Philip Browning, director of the Los Angeles County Department of Children and Family Services. He led a project to develop a new strategic plan for the department, which involved brainstorming sessions and discussions among thousands of members of staff. “How do you succinctly describe what you want to do in a manner that is not so detailed that you lose interest but that you capture the spirit of what you want to do?” he said. “There is a need to think in a broad enough manner that you can attract the attention of a lot of people, but you have to drill down to the detail level with some of the challenges to make it specific enough that you see some actual changes.” Browning described two distinct components of such a project: the final product and the process of developing that final product. He said considering how people will view the Grand Challenges Initiative in a decade or two is a critical component of its success. “Many times, the people who will actually be implementing that roadmap won’t be the people in the room who are coming up with those ideas,” he said. As a participant in the initial stages of the initiative, Browning said he is hopeful that the project will lead to an even stronger working relationship between the INITIATIVE | continued on page 11
hamovitch p.i. | usc.edu/socialwork/research
said several broad themes came up repeatedly, including challenges related to health, human potential, and community. Those concepts should serve as a general starting point for the initiative’s recently selected executive committee, which is led by John Brekke, the Frances G. Larson Professor of Social Work Research at the USC School of Social Work, as it begins developing a strategy to elicit ideas from the professional community. Flynn noted that although some preliminary work has been done to identify general areas of interest, the national committee is stressing a communal and grassroots approach “There is a need to to the project. “We want to be more organic think in a broad enough in how we develop these grand manner that you can challenges,” she said. “We’re attract the attention of still formulating how we will a lot of people, but you organize input and then dishave to drill down to the seminate that information.” Although the committee detail level with some of will be soliciting suggestions the challenges to make for individual challenges, one it specific enough that aspect of the initiative will be to you see some actual ensure the themes fit together changes.” as a package, are representative of social work, and offer a sense Philip Browning of attachment and engagement to all members of the social work profession. can be spurred on by individIn the coming months, the uals who learn that sort of rigor committee will begin to engage in school and appreciate some with potential contributors of our data sources and how to through the media and social capture information.” media to solicit and describe He also believes setting a challenges, explain the profesbroad vision for the profes- sion’s past accomplishments, sion will not only benefit social and highlight how social work work scholars, but ultimately can build on its history. the individuals who depend on Barth said the committee is social services. hopeful that a set of specific “The end goal at some point challenges will be selected and has to be not just the students, announced to the public by but what they do to improve early 2015. the lives of children and other The American Academy of clients,” Browning said. Social Work and Social Welfare During early discussions is already seeking suggestions among USC School of Social at www.aaswsw.org regarding Work faculty members, Flynn potential challenges. t INITIATIVE | from page 10 Department of Children and Family Services and researchers at the USC School of Social Work. The school’s faculty members have partnered with county officials on numerous research projects, an effort bolstered by the creation of a research cluster on child development and children’s services. “I think our department has come a long way in the last couple of years, but I think there is a lot more information we could use to validate what does and doesn’t work,” Browning said. “That process
Photo/Eric Lindberg
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Photo/Eric Lindberg
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Børge Skåland, a visiting scholar from Norway, has gained insight on issues related to violence toward teachers and other professionals during his six-month visit.
SCHOLARS | from page 5 teachers after they are threatened or assaulted by students, he came across several articles and a book by Ron Astor, the Richard M. and Ann L. Thor Professor of Urban Social Development at the USC School of Social Work, and his longtime colleague from Israel, Rami Benbenishty. “They were the most thorough pieces of research I have come across that were looking at what is happening in the real world,” Skåland said. He contacted the researchers directly and traveled to Israel in November before arriving at USC in January, where he has benefited from discussions with Astor about the American school system and perceptions of violence, among other topics. He has also engaged with Charles Kaplan, the school’s associate dean of research, on issues related to an experiencebased approach to research known as phenomenology. Skåland lauded the university’s academic resources and said he appreciated being invited to several scholarly events and lectures, including a gathering of the International Association of Schools of Social Work. “There are lots of very good
literature and good scholars who have done research in the field,” he said, citing R. Paul Maiden, vice dean, and Beverly Younger, a clinical associate professor, as two examples. Short said although many of the visiting scholars concentrate on their own research rather than assisting faculty members with specific projects, they often report that the experience helped them focus their work or take a new perspective as a result of discussions with USC researchers, something Skåland confirmed. “It has been a very welcoming and positive experience for me, both meeting good people like Ron Astor’s research team and the inspiration of the high academic level,” he said. Short said school officials remain strongly supportive of the program, and she is hopeful it will continue to expand to other areas of the world, strengthening the global reach of the school and building on its status as a leading hub of research on social work. “It’s seen as a benefit and a resource in terms of learning and sharing knowledge with people from other cultures,” she said. “It’s really a unique program.” t
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[ awards ]
Clinical professor and associate dean of field education Marleen Wong received the George D. Nickel Award for Outstanding Professional Services by a Social Worker in recognition of her work with traumatized populations, including those affected by school shootings, terrorist attacks, and natural disasters. A preeminent expert in school crisis and recovery, Wong has developed mental health recovery programs and crisis and disaster training for school districts and law enforcement in the United States, Canada, Israel, and Asia.
Photo/Brian Goodman
Heather Halperin has been selected to receive the Lifetime Achievement award from the San Fernando Valley unit of the National Association of Social Workers. The clinical associate professor has dedicated her career to issues involving children and families, as well as the education of aspiring social workers. In addition to assisting with field placements at the USC School of Social Work since 1983, Halperin has worked William Vega, Provost Professor and executive director of the closely with families affected by child abuse, Roybal Institute on Aging, received the Rema Lapouse Award neglect, and violence. She also maintained a from the American Public Health Association. The honor is given private practice in the San Fernando Valley annually in recognition of excellence in psychiatric epidemiology for more than three decades. and the scientific understanding of mental health disorders. Associate professor Maria Aranda received the California Elder Mental Health and Aging Coalition’s Older Adult Leadership and Advocacy Award in recognition of her efforts to improve the mental health and well-being of aging Latinos in the state. Aranda has led and contributed to multiple behavioral and epidemiological studies and has been widely acknowledged for scholarship on problem-solving therapy as a treatment for depression with older and middle-aged Latinos.
Dean Marilyn Flynn received the first Provost’s Prize for Innovation in Educational Practice at the USC Academic Honors Convocation. The award honors achievements by members of the USC community who advance the university’s mission and prestige in higher education. Flynn’s accomplishments include establishing the school’s military social work program and launching the Virtual Academic Center, the first web-based master’s of social work program at a major research university.
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Hamovitch P.I. is a publication of the USC School of Social Work. Send suggestions and comments to eric.lindberg@usc.edu