Editor: Jean Ann Linney University of South Carolina 251 Gambrell Hall Columbia, SC 29208 [email protected] The Community P.sychologist

Volume 29, Number 3 July, '1996

A Publication of the Society for Community Research and Action, Divisiol1 27 of the American Psychological Association

Contributing Editors

BOOK REVIEWS: ~~~rJr~~S~~i~~o~t~~~Sbr ~j~~~~Uri In this Issue: COMMUNITY ACTION David Julian, United Way of Franklin County, OH Special Feature: COMPUTERS: Self Help/Mutual Aid Initiatives by People William HaUman, Rutgers University with Psychiatric Disabilities EDUCATION CONNECTION: Jim Dalton, Bloomsburg University • Editor's Introduction - Keith Humphreys Maurice Elias, Rutgers University Self-Help: Living it, promoting it, and learning from it - Judi CULTURAL AND RACIAL AFFAIRS: Chamberlin Yolanda Suarez, Loyola University Randy PoUS, University of Hartford The lion's den: Social identities and self-help groups - Caroline L. Kaufmann HEALTH POLICY: • Supported partnerships: A pathway into community life for persons Martin McCarthy, Jr., Northwestern Univ with serious psychiatric disabilities - David A. Stayner, Larry INNOVATIVE PROGRAMS Davidson & Jacob Kraemer Tebes Matthew Chinman, Yale University Two community support program research demonstrations in INTERNATIONAL ISSUES: Sacramento: Experiences of consumer staff as service providers - Adrian Fisher, Victoria Unlv, Melbourne, Tom K. Greenfield, Beth C. Stoneking & Evan Sundby Australia Brian Bishop, Curtin Univ, Perth, Australia Do psychiatrically disabled people benefit from participation in self- help/mutual aid organizations? A research review - Elaina M. Kyrouz NATIONAL PREVENTiON COALITION: & Keith Humphreys Sandra McElhaney, NMHA

PREVENTION AND PROMOTION Sally Cannin9, Wheaton College Columns: Heather Barton, Univ of Illinois-Chicago 3 President's Column - Multidisciplinary Activities in SCRA Emily Ozer, UC Berkeley 5 Report from the Representative to APA Council PUBLIC POLICY: 7 Whither the heart and soul of APA? - Edward Seidman Brian Wilcox, University of Nebraska 27 Women in the Community: Making Connections - Anne Mulvey Andrea Solarz, Institute of Medicine STUDENT ISSUES Society News: L. Sean Azelton, Univ of Illinois, Chicago Rebecca Lee, U of Maryland-Baltimore 26 Interest Group Bulletin Board County 29 Regional Activities 31 New Publications TRAINING ISSUES: Catherine Stein, Bowling Green State 34 Announcements Univ 36 Job Listings

WOMEN'S ISSUES: Deborah Salem, Michigan State Univ Karla Fischer, Duke University SCRA Metl1b~rshlp informatIon Executive Committee 1995-96 Regional Coordinators

President Northeast Irwin Sandler, Arizona State University Pat O'Connor, Sage Graduate School Paul Speer, Rutgers University-Livingston Past President Vicki Banyard, U of New Hampshire Roger Weissberg, University of Illinois. Chicago Southeast President-Elect Fran Norris, Georgia State University Manuel Barrera. Arizona State University Jim Cook, NC State University Carolyn Turturro, U of Alabama-Little Rock Treasurer William Davidson, Michigan State University Midwest Leah Gensheimer, U of Missouri-Kansas City Secretary Adrienne Paine-Andrews, U of Kansas Sharlene Wolchik. Arizona State University Joe Ferrari, DePaul University

Student Representatives SouthwesUMountain L. Sean AzeIton. University of Illinois, Chicago Mark Roosa, Arizona State University Rebecca Lee. U of Maryland-Baltimore County Kelly Naylor, Children's Hospital, Denver Lori Martinez, Santa Fe, NM APA Council Representative Ed Seidman, New York University West Debra Srebnik, U of Washington National Coordinator Toshi Sasao, UCLA Carolyn Feist US GAO, Washington, DC Terry Cronan, San Diego State University

Members-at-Large Canada Pabricio BaIcazar, Institute for Study of Richard Walsh Bowers, Wilfred Laurier U DevelopmentaJ Disabilities, Chicago Andrea Solarz, Institute of Medicine Asia Rod Watts. DePaul University Richard Jenkins, Henry Jackson Foundation

Latin America Committee Chairs Luis Mendez Calderon, Gueynabo, Puerto Rico Cultural and Racial Affairs Yolanda Suarez. Loyola University Europe Wolfgang Stark, Munich, Gennany Dissertation Award Jose Ornelas, Lisbon, Portugal Doug Perkins, University of Utah Soutb Pacific Fellowship David Thomas, U of Waikato, New Zealand Roger Weissberg, University of Illinois, Chicago Arthur Veno, Monash University, Victoria, Australia Liaison to Canadian Community Heather Gridley, Victoria University, Psychology Association Melbourne, Australia Richard Walsh Bowers, University of Waterloo Africa Arvin Bhana, U of Durban-Westville, South Membership Africa William Davidson, Michigan State University Rod Watts, DePaul University

International Fabricio BaIcazar, Institute for Study of Developmental Disabilities, Chicago

Nominations & Elections Darlene DeFour, Hunter College

AP A Program Committee Fabricio BaIcazar, Institute for Study of Opinions expressed in The Community Developmental Disabilities, Chicago Psychologist are those of the individual authors and do not necessarily reflect official positions taken by the Society for Community Research Publications Chris Keys, University of Illinois, Chicago and Action.

Social Policy Materials appearing in the Community Karen Anderson, Washington, DC Psychologist may be reproduced for educational and training purposes. Citation of Women the source is appreciated. Marion Terenzio, Sage Graduate School

2 The Community Psychologist, Volume 29, Number 3, July,1996 The President's Column

develop specific projects of mutual concern Multidisciplinary Activities in SCRA emphasizing those pieces of the shared ag~nda that are nearest to our hearts. Several illustrations come to Irwin Sandler mind. During the past year Jean Ann Linney and I co- chaired the Fifth National NIMH Conference on Prevention Research. The conference had a broad he theme of my p~esid~ntial year has been to move TSCRA more decIsively In the direction of being a range of presentations ranging from theoretical multidisciplinary society "devoted to advancing theory, models of development to models of implementing research and social action to promote positive well- prevention programs in community settings. Over the being, increase empowerment, and prevent the past several years prevention has gained increased development of problems of communities, groups and visibi.lity as ~resenting an important research agenda individuals"'. We have, in fact, been moving in this with Increasingly sophisticated methodologies as well direction for many years, so that my intent has been as offering a range of rigorously validated intervention simply to make us more self-conscious of this theme programs. Critical gaps remain in the prevention and and to facilitate actions to increase the momentum for promotion agenda, and SCRA has an important role to this movement. There are multiple actions that we can play. A recent meta-analysis of primary prevention take as a Society to promote multidisciplinary action programs (Durlak and Wells, in press) clearly shows the research. First, we can continue developing the paucity of research to develop evidence for the epistemological base for our work, by developing and efficacy of social-environmentally focused prevention articulating the methods for working collaboratively programs, and the paucity of studies that explicitly with communities. Second, we can collaborate with investigate cross-cultural issues in prevention and other like minded groups to pursue specific projects promotion. The development of models for that are consistent with our values and scientific comm~nity implementation of prevention programs is interests. Third, we can liaison with other groups to becoming a more central part of the prevention explore common areas of interest and concern. There research agenda. The contribution of wellness has been movement on each of these fronts over the promotion activities to this research agenda needs to past year, which I'd like to briefly discuss. be increasingly emphasized. SCRA has an important role to play in developing each of these areas . . The work of our Society to develop and apply action research methods occurs in several forums. A second example of an area where SCRA can Under the leadership of Ed Trickett, the American playa role is the emerging interest within APA to Jou~nal of Community Psychology has increasingly enhance the role of psychology in public health. I've published sophisticated papers that utilize a diversity had some encouraging discussions with people at of methodologies. My own quick review of the APA concerning the contribution of SCRA to issues contents of the journal for 1995 finds a diversity of such as working in the community, evaluation and Implementation of large scale public health methods including experimental trials of new inter- ventions, case studies, ethnographies, narratives, interventions. Interestingly some of the people who multivariate quantitative studies, meta-analyses, a are deeply involved in developing these activities are active members of public opinion survey, an epidemiologic study and a SCRA or are former ~ number of papers that critically discuss methodological members who are . "" Issues. One gets a sense of a Society where quite excited about resear?hers utilizes multiple methods and are actively encouraging the self-critical In thinking through how to integrate these involvement of methods within a larger framework. Under the leader- SCRA in these ship of Bob Newbrough we have a Woods Hole Task activities. Force that is fostering dialogue on methods of collaborative action research with communities. This It is clear that Task Force will be holding an open meeting at APA many of our and will be developing activities for the upcoming Biennial. interests and many of our frustrations as a Society are The phenomena of interest to our Society are shared with multiple other groups. We may often be shared by other groups. One of the able to work effectively by joining with other groups to The Community Psychologist, Volume 29, Number 3, July 1996 3 most useful strategies under these conditions is to identify such like minded groups and identity areas in which we might fruitfully work together. Two recent activities along these lines are worthy of note. Randy Potts has taken the initiative to become the SCRA liaison to the Interorganizational Coordinating Committee of the Society for Applied Anthropology. Call for Papers: Applied! Action Manuel Barrera in one of his first acts as incoming Community Psychology President of SCRA will be hosting a breakfast at Toronto with other APA divisions that have similar The SCRA Applied/Action Interest Group is interested concerns to our own about the directions of APA. in highlighting examples of applied community psychology. To that end, the Interest Group invites As my year as President draws to an end I leave members of Division 27 to submit descriptions of the position more convinced than ever of the pivotal applied work for publication in the Community Action roles SCRA has to play. I look forward to continuing to Column in The Community Psychologist. The Interest contribute to the development of these roles. Group intent is to encourage the publication of a series of articles that inform practice and contribute to References the on-going discussion related to the definition of Durtak, J. A. & Wells, A.M. (in press). Primary applied community psychology. Applied community prevention mental health programs for children and psychology can be defined as the application of the adolescents: A meta-analytic review. American principles of community psychology to solve or Journal of Community Psychology. contribute to the solution of social problems at the individual, group, system and/or community levels. 1 Quoted from the mission statement of the SCRA. Articles should be approximately 2,500 words in length and should address the following questions/issues:

1. Description of project MARK YOUR CALENDARS 2. What was the desired outcome of the project? 6th Biennial Conference on 3. How did the project contribute to the solution of a Community Research and Action social problem at the individual, group, system May 28-31,1997 and/or community levels?

hosted by 4. What principles of community psychology were The University of South Carolina applied? Columbia, SC 5. What was the role of the community psychologisVchange agent?

6. What are the implications of the project for the practice of community psychology? The December Issue of the Community

Psychologist will include the Please submit drafts to: 1996 Membership Directory. Please send address changes, additions or other David A. Julian, Ph.D. United Way of Franklin County corrections to Jean Ann Linney, 251 360 S. Third Street Gambrell Hall, University of South Columbus, OH 43215 Carolina, Columbia, SC 29208 or by e-mail: [email protected] Email: [email protected] Corrections should be received by Oct 1.

4 The Community Psychologist, Volume 29, Number 3, July,1996 Though our long-standing objections remain valid, the "boat has left the dock." Groups, be they Report from APA Council Divisions, Councils of Program Directors, State Edward Seidman Associations, or other self-defined groups, can, and already are, proposing to establish and police new specialties, e.g., psychoanalysis. In seven years, even the currently existing recognized programs in nthis report, I describe in some detail the critical clinical, counseling, etc. will have to be re-evaluated. Ievents that have transpired at APA Council While there may be few groups interested in defining meetings during 1995 and 1996, at least those events the domain of community psychology per se, I fear that that I suspect are close to the "collective heart" of others will quickly move in to define critical areas in community psychology. As I point out the implications which we have established knowledge and expertise. of these actions for community psychology, I reserve Thus, I believe that we are faced with a paradoxical my profound shock and dismay with many of the choice between standing by our values versus taking current actions and probable future directions of APA the lead to define our own specialty, in particular for a separate editorial published in this issue. Beyond prevention which we have successfully "given away" these major actions, I also note a variety of "factoids" to many other areas, before others do. I have been that may prove to be of interest. unable to envision a creative solution to this dilemma. do not believe that ignoring the issue will be Issues close to our collective heart productive. I urge the Council of Community Psychology Program Training Directors to take the lead in addressing this issue that dramatic-ally impacts Policies and Procedures for the Recognition the education of our future students. of Specialties and Proficiencies in Professional Psychology. For some time APA Apportionment ballots. Every November you are has been working on a set of new procedures and policies to define (redefine) specialty areas in asked to apportion 10 votes to some combination of Divisions and State Associations by APA. The results professional psychology, like clinical and counseling psychology; these are the professional graduate of these completed apportionment ballots are used to training programs that are accredited by APA. In determine the number of Council Representatives allocated to each division and state association. addition, the document includes procedures by which Currently, a division or state association receiving to define and recognize proficiencies; these are narrower than specialties, e.g., hypnosis. As some of 1/2% (.5%) or more of the total apportionment ballots us feared, this document was overwhelmingly receive one Council Rep; 1.5% or more of the total votes yields two Council Reps, etc. The basic endorsed without discussion at the February 1995 principle is one person one vote. There is a major meeting. In addition, a commission was established effort afoot to move away from this concept of one with designated membership and $15,000 was allocated to cover start-up costs to implement these person one vote so that small state associations and new procedures. tiny divisions (and that may soon mean us) would have a Council Rep. Many small state associations already send a representative, but they do not have a vote Officially, community psychology, that is, both and APA does not subsidize their attendance at Division 27 and the Council of Community Psychology Council meetings. At first glance, this may seem Program Directors, have opposed the pressures from APA to accredit training programs in community advantageous to us. But with such a new policy, small state associations like Delaware, Idaho, and Rhode psychology as well as other areas. We have opposed Island would have their own APA partially financed seeking recognition of community psychology as a Council Rep. The first proposal introduced at the specialty area. Our long standing position has been February 1995 midwinter meeting recommended that that the implementation of such procedures are !l.Q1 in the .5% needed for a Council Rep be reduced to a the public interest and that they will hamper innovation mere .1% of the apportionment ballots. State in the education of future psychologists! The linked Associations are the forces demanding more voice. A steps of specialty recognition, accreditation proce- substitute amendment postponed the issue until the dures, and licensure do not protect consumers, only DC Court ruled on the constitutionality of the the guiid. In addition, accreditation procedures force amendment. By August, the DC Court had ruled that educational institutions into adopting a prescribed set the amendment was not a constitutional violation. This of courses and experiences; thus, innovation in issue will return! education is severely constrained. Bob Newbrough, Julian Rappaport, and many others have eloquently A somewhat antithetical resolution to create or made these arguments going back about 20 years in dissolve a division that rises above or falls below 1.5% the pages of TCP and AJCP. of the apportionment vote was defeated at the February 1996 meeting. At the same time, the rules

The Community Psychologist, Volume 29, Number 3, July 1996 5 were clarified to let coalitions of state associations/ of privileges to psychologists to prescribe divisions form more easily to achieve their rightful psychophanmacological substances. This arose from democratic representation. the real threat of HMO's on the livelihood of practicing psychologists. This legislation along with a Given SCRA's decreasing proportion of the recommended curriculum for postdoctoral training in rapidly expanding APA pie, passing of the original psychopharmacology has been drafted. These two proposal would guarantee us a Council Rep, even if documents are circulating through the APA structure we drop below .5%. Nevertheless, I took the "high for review prior to being brought back to Council in road" in opposing this amendment; I genuinely August 1996. believe in the principle of one person, one vote. On pragmatic grounds, the State Associations are the Public Education Program. A plan to promote major advocate of the guild interests of private public understanding of the role of psychologists was practitioners. To protect ourselves, the TCP Editor passed in August 1994. By August 1996, it became has already launched a vigorous 10 for 27 clear that what was underway was a program to Campaign in recent TCPs. In fact, it has already promote public understanding (and need) of the yielded positive results: Division 27 rose to .67% of independent practice of psychology. One and a half apportionment votes for 1997 from .55% in 1996 and million dollars were allocated for this public relations .51% in 1995. Obtaining a second representative is, campaign. Once again, the lone voices of a few of us however, out of the question since we would need fell on deaf ears! That is, the diverse roles and greater than 1.5% of the apportionment votes. activities of psychologists would not be highlighted in Nevertheless, as APA grows it will take more Div. 27 this public relations campaign. apportionment votes in each succeeding year for us retain one Council Rep. This past February, an extremely slick and impressive campaign of print, radio, and television spots was unveiled. The goals is for individuals to recognize that they have a problem, that help and effective treatment are available, and that the treatment is probably covered by their insurance. They are given a phone number to call which links them with a practitioner. Your dues money is being used to widely disseminate this advertising campaign Consolidated Resolution on Division through multiple media. Guidelines and Standards. In a related vein, this document was approved for a vote of the full APA Recognition of the masters' degree level as membership in June 1996. The document has many ••Psychological Assistants" and the expansion positives, but it has many constraints that are likely to of accreditation procedures to incorporate these pro- hamper activities of divisions (not state associations). grams once again went down to defeat. For example, divisions will be required to have APA review and approve many routine legal and financial Several task forces, commissions, and ad arrangements in which we engage. All financial hoc committees on social issues central to the arrangements in excess of $10,000 are subject to interests of community psychologists have been review. Thus, we can not freely deal with established and are receiving modest funding to arrangements for the Biennial or AJCP without APA continue their activities. This includes the Task Force intrusion. Clearly, more thought and discussion is on Urban Initiatives (which has produced a resolution needed prior to a vote or, at a minimum, the members that underscores prevention and diversity), the APA should be provided with pro/con statements. Commission on Ethnic Minority Recruitment, Reten- However, questions and discussion "on the floor" tion, and Training in Psychology, the Rural Women's were literally stifled (following parliamentary Work Force, the Task Force on Serious Mental Illness/ procedures in their letter if not spirit). The outcome Serious Emotional Disorder, the Task Force on was that there will be no pro/con statement on the Scientific Perspectives of Intelligence and Group ballot, in large part because it is well established that Differences in Test Scores, and an Ad Hoc Committee when pro/con statements are included, resolutions on Issues of Older Adults. Our Aging Interest Group is are consistently defeated. Let's help turn this tradition to have input regarding the Committee's membership. around: vote NO on this resolution when it appears in your mailbox, despite the fact that it will not contain a Member Dues: A 25% dues reduction for pro/con statement! members of APA who also belong to another scientific organization that is part of the Federation of Model Legislation for Prescriptive Authority. Behavioral, Psychological, and Cognitive Sciences, In August 1995, Council voted on a new business like SRCD, was passed at the February 1996 meeting. item to draw up model state legislation for the granting This was strongly supported in an effort to ward off the

6 The Community Psychologist. Volume 29, Number 3, July,1996 continued flight of academic/scientists from APA. profound shock and dismay with many of the current and future directions of APA. A proposal to increase each division's share of a member's APA dues from $2 to $5 was defeated. What I witnessed on the floor of the Council Factoids: during the last two years was a far cry from what I believe to be a fair, open, and democratic process. A political circus might be a more apt Two new divisions were created: description. Addictions (51) and the Society for the Psychological Study of Men and Masculinity (52). Last year, a proposed Division of Managed Care More importantly, a functional analysis of went down to defeat in an extremely heated the time spent on the floor of the Council (or of debate and with a roll call vote! We had strange the allocation of expenditures) reveals that the bedfellows, in that many independent heart and soul of APA is not devoted to a psych- practitioners, particularly psychoanalysts opposed ology in the public interest. The guild interests this division's establishment fearing this move as of practicing psychologists, such as prescription asserting the efficacy and financial savings of brief authority, the public "education" campaign, or therapy by managed care. Many feared that the increased influence in Council and APA establishment of such a division would be used by governance, dominate discussion, debate, and managed care folks as placing APA's imprimatur expenditures. With the threat of managed care on managed care. Chris Keys' letter was influential. Many other Council Reps commended and the jeopardy to the livelihoods of practicing us on our stance. For once, our voice was heard. psychologists, this is not surprising. However, (In the end, however, the warring factions united these are not the issues on which, as an to pass a resolution establishing a Task Force on individual, I wish to spend my time (or dues). Managed Care with an initial allocation of $6,000 to SCRA should ask itself the same question. support a task force meeting.) The public education campaign to attract new Two new division journals were approved: clients to practicing psychologists appears to History of Psychology (Division 26) and Children's respect diversity in that it makes use of people of Services: Social Policy, Research, and Practice color in different roles, avoiding stereotypes. (Division 37). The latter may offer some This is of great value to a psychology in the competition for AJCP. public interest. However, at the same time, Political funding: A resolution was passed in these ads suggest that your insurance probably February 1996 to support APA presidential covers the cost of psychotherapy. A public candidates to attend the midwinter APA Council interest psychology might ask: Who are these ads meeting (up to $1000 each). appealing to? Are these the people who are in the greatest need of assistance? How many poor New APA Building Investment: The land has people have insurance? Such questions were not been purchased, finances arranged, construction the topics of extended debate on the floor of commenced, and tenant agreements signed on a Council. lot adjacent to the APA Building for investment only. I do not wish to gloss over the excellent work done by the Committee on Children, Youth and Families and the Public Interest Directorate. Moreover, Council generally supports these Whither the heart and soul of APA: activities. There is a liberal bias in Council that An Editorial supports many progressive activities, though the Edward Seidman support is minimal in terms of serious discussion time devoted to these social issues or the budget allocations. After serving for two years as the Division 27 Representative to the APA Council -- one Let me return to the issue of democratic year completing the last year of John Moritsugu's procedures. Here, I am not alone in my frustra- term and the first year of my elected three year tion. On January 14, 1996, Karen Shore wrote a term -- I have decided to resign. This decision, letter to all Council Representatives posing the not one that I made easily, stems from my question: "How closely does Council reflect the

The Community Psychologist, Volume 29, Number 3, July 1996 7 thinking of the membership, and how democratic What are the benefits and costs of are our procedures?" She underscored this SCRA's secession from APA, or the question with four points: (1) Membership mass resignation of individuals? rarely knows what issues will be on Council's agenda; (2) As a result of the lack of commun- Is there an intermediate path for ication before discussions and voting, SCRA between continued total membership has little or no opportunity to involvement and secession? For discuss issues with their Council example, SPSSI has chosen a path of targeted Representatives; thus Representatives do not involvement around selected issues of import. know how strongly their constituents feel about They, too, have organized their own issues; 3) The APA Monitor is sometimes independent conference. prohibited from informing member-ship about Are there strategies, person power, or controversial agenda items before the vote; and material resources to create a 4) Membership is not informed on how their national organization of psychology in Representatives voted on issues. the public interest as an alternative to a psychology in the interest of The actual practices on the floor of Council practitioners (APA) or scientific do not function in a fair and democratic manner, psychology (APS)? though they may exist as such on paper. Several examples will suffice. New business items are I urge the membership to begin serious raised from the floor at the eleventh hour and discussion of these issues. We still have the old bullied to a vote with inadequate study, fashioned methods of telephoning or writing discussion, and debate, as was illustrated by the members of SCRA's Executive Committee and the demand that APA write model legislation for the even older method of holding town meetings at prescriptive authority of psychologists. APA and the Biennial. Or, as the 21st century Discussion and debate on the floor of Council is approaches, we can air these issues in too often ended prematurely at the discretion of cyberspace via SCRA's Listserve. the chair. There is a strong force to keep pro/con statements from accompanying bylaw In closing, I would like to say that I was changes sent to the member-ship for a vote honored by your selection of me as your Council because when such statements accompany Representative. With my resignation, I will changes, the changes are often defeated. miss working with the Executive Committee. It provides a home and sense of community for At SCRA's midwinter Executive Committee many of us. Despite my dismay with APA, I have meeting I initiated a discussion of the following relearned an important lesson in community questions regarding SCRA's future affiliation psychology, even though it continues to be an with APA. I want to share these questions with especially hard lesson for us to recognize and face the membership because I believe each of us squarely: When your should ask these questions of ourselves as continued efforts are individuals and SCRA as an organization. unlikely to aid in the ~ " .' : facilitation of . v,.:.:. What are the benefits and costs of constructive change, SCRA's (or an individual's) continued your time and energies affiliation with APA, in terms, of could be utilized more time, effort, influence, and money? effectively in other SCRA's Council Representative spends over endeavors. four full days a year at Council meetings and numerous hours reading and responding to a barrage of material, including letters, e- Ed Seidman has been the SCRA Representative to APA Councif for the past two years. He can be contacted at New mails, and faxes. Our influence is minimal. York University, Department of Psychology, by Emaif: SCRA, and not APA, pays for the lodging and [email protected]. per diem costs for their Council Represent- ative to attend the February meeting.

8 The Community Psychologist, Volume 29, Number 3, July,1996 Special Section Self-Help/Mutual Aid Initiatives by People with Psychiatric Disabilities Edited by Keith Humphreys

control (Humphreys & Rappaport, 1994, see also papers by Kaufmann and by Greenfield, this section). Self-help is Introduction currently a powerful zeitgeist in mental health services but Keith Humphreys the number of professional programs that have adopt~d Veterans Affairs Palo Alto Health Care System and self-help language ("empowerment", "consumer control") Stanford University School of Medicine exceeds the number that implement self-help concepts in any meaningful way (Zinman, 1987). If the field is to get his special section was organized by SCRA's interest beyond this problem of old wine in new bottles, we will need Tgroup on self-help/mutual aid. Its purpose is to more examples of hybrid programs that take self-help ideas provide an overview of the many self-help initiatives senously, such as the Crisis Residential Rehabilitation currently being undertaken by people with psychiatric Project described by Greenfield and the Supported disabilities. Reflecting the diversity of the self-help Partnerships Program described by Stayner. movement, the authors include mental health consumers, mutual help program developers, self-help researchers and The section closes with a review of self-help/mutual aid various combinations thereof. Reflecting the broad influ- effectiveness research first-authored by Elaina Kyrouz. ence of self-help ideals, this section discusses community- Overall, the effectiveness literature offers a pos~ive verdict, based self- help groups controlled entirely by participants but with the exception of the consistent finding that self- self-help agencies that are controlled by mental health ' help reduces the use of inpatient psychiatric treatment, consumers but are modeled in some ways on professional conclusions must remain tentative because the research human service organizations, and hybrid programs in which base is quite modest. Kyrouz's call for study of social psychiatrically disabled individuals have a high degree of network and life enrichment outcomes resonates with all the autonomy and control but professionals also exert limited other authors' emphasis on benefits of self-help that are influence. orthogonal to symptom reduction and syndrome remission, namely political empowerment, reduced stigma, increased In the opening article, long-time activist and self-help self-acceptance, and richer relationships with others. There movement leader Judi Chamberlin provides an overview of appears to be a consensus among all of the section's three self-help/mutual aid research and action projects, author~that self-help ~an help people with psychiatric each of which is representative of a broad class of activities disabilities lead better lives independent of whether it can taking place around the US Like Chamberlin, Caroline remove their disability. Kaufmann brings the perspective of mental health consumer and researcher together in her article. She is well- I wish to close with a thank you and an inv~ation. The positioned to offerthoughtful comments on the meaning of thanks ~o to the authors of the papers in this special section, self-help for participants and on the challenges of being a for providing accessible program descriptions and thoughtful self-help researcher. analyses of the purpose, meaning and value of psychiatric- ally disabled people's self-help/mutual aid initiatives. I also The papers by David Stayner, Larry Davidson, and Jacob appreciate the authors' willingness to put structural equation Kraemer Tebes and by Thomas Greenfield, Beth Stoneking, models aSide and Instead offer plain-spoken experiential and Evan Sundby present programs that blend self-help wisdom from themselves and from other self-help partici- approaches with some professional oversight. This pants. The invitation goes to readers of The Community hybridization involves a tradeoff with which most people in Psychologist who wish to join the self-help/mutual aid the self- help movement are familiar. When researchers or interest group of SCRA. We have 300 members in 12 helping professionals have some control over a program, it is countries, and are always delighted to make room for one (or usually easier to implement powerlul evaluation designs more) more. To join, contact me at Center for Heatth Care (e.g., random assignment to conditions) and to gain Evaluation, VA Palo Alto HCS (152 - MPD), 795 Willow credibility with funders and other gatekeepers (e.g., a county Road, Menlo Park, CA 94025 USA. mental health board may endorse a self-help project run by psychtatncally disabled people only if a psychiatrist is on call References for emergencies). At the same time, professional control of Humphreys, K. and J. Rappaport (1994). Researching any sort always has the potential to compromise key self- self-help/mutual aid groups and organizations: Many roads, help values such as voluntary association and indigenous

The Community Psycholo9ist, Volume 29, Number 3, July 1996 9 on~ journey. Applied and Preventive Psychology, 3,217- about its participants to DMH. That contract has been 231. renewed annually ever since, and today the Ruby Rogers Zinman, S. (1987). Is the "partnership model" self help? Center involves more than 100 members in its self-help, In S. Zinman, Harp, H.T., and S. Budd, (Eds.), Reaching recreational, and advocacy activities. across: Mental health clients helping each other, Sacramento, CA: California Network of Mental Health Clients. Paid staff at the Center is composed of members, not mental health professionals, and the staff is accountable to the member-ship through the governance of the weekly business meeting and the elected Executive Committee. In Self-Help: Living It, Promoting It, addition to the paid staff (one full-time and two part-time), nearly twenty members work in stipend positions, working And Learning From It one day a week in exchange for a small payment that does not jeopardize their disability benefit. Judi Chamberlin Ruby Rogers Advocacy and Drop-In Center, The typical member at the Ruby Rogers Center has had National Empowerment Center & long-term involvement with the mental health system, Boston University Center for Psychiatric Rehabilitation including hospitalization, use of out-patient services, and psychiatric medication. Many members are those that have "failed" at other programs and are considered to be am affiliated with two self-help programs operated and "difficult." Nonetheless, many members have blossomed in Irun by psychiatric survivors: (1) a local user-{;ontrolled an environment in which (often for the first time) they have drop-in center, and (2) a project that provides resource had the opportunity to be listened to and taken seriously. At information and technical assistance about similar projects the weekly business meeting, any member can put an item nationwide. In addition, at a professionally operated on the agenda, and everything is discussed until the rehabilitation research and training center, I am involved in membership is satisfied. Members are responsible both for conducting research on self-help from a survivor making and for enforcing the rules of the Center; thus, perspective. Each of these projects will be described members have a genuine stake in developing and separately, and conclusions will then be drawn. maintaining an environment which is safe, comfortable, and nurturing. The Ruby Rogers Advocacy and Drop-In Center The Ruby Rogers Center opened in 1985, but it grew out The Ruby Rogers Center is one of a growing number of of more than ten years of activism by the Mental Patients' similar projects around the United States, each of which Liberation -Front (MPLF), one of the earliest ex-patient run arose independently and has unique features in response to campaigning groups. Over the years, MPLF had conducted local conditions, but all of which have a number of features in demonstrations, written and published a patients' right common, particularly membership control and indepen- handbook', and spearheaded a successful patients' rights dence from the formal treatment system (see Chamberlin, lawsuit on the right to refuse treatment, among many other 1978, for a description of the theory and practice of ex- activities. All this was done with virtually no outside funding, patient run groups) .. except for a few small seed grants from a radical social- change foundation. But MPLF was constantly receiving The National Empowerment Center inquiries from former patients who were looking for support, The growing number of local user-{;ontrolled self-help rather than political action, and who expressed disap- projects and services have often developed in isolation and pointment that MPLF was not a place they could come to . can benefit from increased communication and knowledge meet others like themselves. MPLF had no headquarters; It of one another. The National Empowerment Center was operated out of members' homes and a series of borrowed formed to provide support arid technical assistance to such meeting places, and its activities were limited to people who groups, and to individuals felt themselves ready for political activism. wanting to start local projects. It is operated by a small staff, al Spurred on by the needs of its wider constituency, MPLF of whom are current or former made the decision to go after funding and to broaden its service users, and who activities to include the operation of a totally user-{;ontrolled have experience and skills environment where members could experience freedom in self-help and service denied to them in the typical staff-run program, including, delivery. NEC provides most particularly, the freedom to question or criticize the information over the mental health system and the treatments they were telephone, in print, on receiving. After more than a year of negotiation with the audio tape, via e-mail, and Massachusetts Department of Mental Health (DMH), MPLF through on-site consultation signed a contract that provided funding for the program, with and training. the safeguards that the center would be totally run by the membership and would not have to disclose information NEC was founded in 1992, and operates through a grant

10 The Community Psychologist, Volume 29, Number 3, July,1996 from the Center for Mental Health Services, as well as dependent, and unable to articulate our own best interests. foundation grants and donations. NEC promotes a We have strengths and abilities which all too often go philosophy based on recovery and empowerment, and unrecognized by those who claim expertise in diagnosing strives to nurture the efforts of local groups to develop their and treating us, but who often refuse to listen to us. own services and programs. In self-help groups and programs, people who have NEC's accomplishments include the development of a been ridiculed or ignored when they expressed ideas that curriculum designed to teach professionals about the were different from those of professionals are taken activities and theories of ex-patient run self-help programs, seriously, often for the first time. This experience can as well as a training curriculum designed for both people who drastically change people's sense of self-{;onfidence and hear voices and the professionals who deal with them2• NEC self-esteem, which have often been battered in the mental has developed a large library of audio tapes of speeches by health system. By creating environments which are key leaders in the self-help movement, which it distributes in nurturing, which honor people's perceptions and quantity. A quarterly newsletter circulates to former patients experiences, and which provide opportunities to develop and professionals nationwide. NEC's staff travels widely, and practice skills, we are showing that we have nationally and internationally, spreading the message of competencies which must be taken seriously. hope and recovery and providing living examples of people who, despite diagnoses of severe mental illness, are Notes successful and effective in promoting change. 1. Your Rights As A Mental Patient In Massachusetts is available from the Ruby Rogers Center, One Davis The Center for Psychiatric Rehabilitation- Square, Somerville, MA 02144. Research Projects 2. Information on sponsoring a local "Learning from Us" At Boston University's Center for Psychiatric conference and on "Dealing with voices that are Rehabilitation (Located at 930 Commonwealth Avenue, distressing", can be obtained from the National Boston, MA 02215), I have directed a study of members of Empowerment Center, 20 Ballard Road, Lawrence, self-help groups for people with psychiatric disabilities, and MA 01873. am currently directing another study on the use of the 3. Copies of the instrument are available from Judi personal assistance services model for this population. As a Chamberlin, 2 Dow Street, West Somerville, MA person with a psychiatric disability, and as a researcher, I am 02144. bringing together my personal experiences with my academic skills. The study on self-help groups, which has References been submitted for publication, produced data on the kinds Chamberlin, J. (1978). On our own: Patient of people who use such groups (or at least the six groups in controlled alternatives to the mental health system. New the study, which we believe are representative), the ways in York: McGraw Hill. which they use them, and the value that they believe they have in their lives. In addition, it developed a working definition of empowerment, and an instrument which we believe measures it3• The Lions' Den: The personal assistance model was developed by the independent living movement (primarily a movement of Social Identities And people with physical disabilities). This model is based on the Self Help Groups premise that, with the appropriate adaptations and supports, any disabled person can live successfully in his or her own Caroline L. Kaufmann home and be involved in normal community activities. Pittsburgh, Pennsylvania Personal assistants are selected and trained by the person with the disability, and perform tasks that the disabled ne day last March, the front page of the Washington individual is unable to do along. Our study on personal OPost told of a woman whose mauled body was assistance is in its early stages; we are hopeful that it will retrieved from the lions' den at the National Zoo. The article show that this model, which was developed within the described her as a transient with a history of paranoid independent living movement and has been used primarily schizophrenia. Her death was ruled a suicide. The evening with people with physical disabilities, is a viable alternative TV reports showed grizzly pictures of a rumpled body bag that promotes independence and empowerment. loaded onto a gurney, at the back entrance to the Zoo. The lions were agitated by the incident, their keeper said, and Conclusions were being kept in seclusion. Self-help/mutual support for people with psychiatric disabilities is a growing phenomenon in the mental health I was in Washington that day, working as a peer reviewer field. It is based on the belief that psychiatric survivors are for grants funded through the Center for Mental Health capable of defining our needs and developing our own Services. I was invited to join the review group as a programs, countering the stereotype of us as weak, researcher in psychiatric rehabilitation and as a consumer of

The Community Psychologist, Volume 29, Number 3, July 1996 11 psychiatric services. I was quietly proud to join the review select group of people. panel. It was something I have done before and enjoyed doing. I caught the first flight into National, feeling efficient Participatory Research in Self Help and respected for my knowledge and hard work - feelings My work on self help groups developed as I struggled to that evaporated as I walked through the terminal and incorporate my experiences with disability into my scanned the headlines of the Washington Post. professional life. In the first study, we designed a randomized experiment to test the effects of self help group In contrast to this public act of self destruction, the work I participation on the social rehabilitation of people with do as a researcher and a person with disabilities (I have serious mental illnesses (Kaufmann, Schulberg, and survived both polio and major depression) is rather obscure. Schooler, 1994). A sample of 90 individuals with treatment Research by and about people with psychiatric disabilities histories and diagnoses indicating severe mental illness and rarely makes front-page news. Nevertheless, there is an no prior participation in self help groups were invited at emerging network of highly trained people whose research random to either join a self help group in conjunction with is informed by their experiences as survivors of psychiatric their regular treatment(s) (the experimental condition) or disability and treatment (Campbell and Ralph, 1993). What continue with their regular treatment(s) without attending self follows is a brief description of my own experience in this help groups. The results from this study were surprising. A dual role. majority of people invited to join a self help group did not do so. Overall participation rates were 17%. Those who Internalized Stigma and the Social Identities. participated were positive in their evaluation of the groups In social psychology, the term stigma refers to a personal but showed no significant reduction in symptoms over the attribute that is deeply discrediting to one's standing in a course of the study. We had succeeded in demonstrating social group. More recently, it has been challenged as the that self help group did no harm, but we were unable to test primary obstacle in rehabilitation of people with psychiatric effectiveness in a controlled experimental design due to the disabilities. Much of the writing about stigmatization of small number of subjects who actually experienced the mental illness criticizes ij as a process of inaccurate and unfair treatment. characterization of people with mental illness that excludes them from full participation in society. Self, helpgrolJPs and mutual aid are an It is easy to identify the basis for negative stereotypes of antidote to stigmatization. people with mental illnesses. Most people learn about mental illness from the popular press. Human beings like to ...those who Join a self help group do so only simplify reality, and stereotypes are one way to do it. Violent because they are accepted as members sharing a or bizarre behavior, however infrequent among people with common predicament of menlf!l distress. mental illness, is understandable in common sense terms as a manifestation of mental illness. Less recognized is the ability of someone with a psychiatric disability to live They are not a fonn of therapy, but a type of productively and find value and personal enrichment in the soc(aI affiliafioll where people are free to process of coping with emotional distress and disability. rRractice~sociallnteractlon In real time. There is Most people who recover from mental illness internalize the r' no problem of "carryover" into real life sense that society's confidence in their mental faculties has situations because self help groups are real been permanently compromised. This produces a type of social encounters self--<:ensorship that muffles public discussion of psychiatric disability. As a result, we are most likely to hear about mental illness from an outsider's point of view. More The second study also employed a randomized design to importantly, those of us who have been treated for test whether self help group participation had measurable psychiatric problems incorporate the public sense of shame effects on vocational rehabilitation for people with severe and degradation into our own sense of ourselves. As mental illnesses (Kaufmann, Cook and Roth, 1990). In this members of society, we are painfully aware of the public study, we succeeded in recruiting a sample of 146 perceptions of psychiatric disability. We have incorporated a individuals. Half of these participated in the experimental negative stereotype as an aspect of our social identities. treatment condition. This sample size meant that we would be able to test for treatment effects with a reasonable degree Self help groups and mutual aid are an antidote to of statistical power. We found significant improvements in stigmatization. They give individuals the opportunity to vocational rehabilitation and self esteem among those present themselves as valued members of a social group. participating in the self help experimental condition. In contrast to their experience in society as a whole, those However, we also found that those in the experimental who join a self help group do so only because they are condition tended to prefer informal friendships and voluntary accepted as members sharing a common predicament of "chat groups" to the more regularly scheduled support mental distress. This is ostracism in reverse. Only those with groups expressly designed as a key feature of the the stigmata may join the group, making one's private experimental treatment. experience of illness the basis for status in a small, highly

12 The Community Psychologist. Volume 29, Number 3, July,1996 Both of these studies indicated an important feature of difficult to establish and maintain as they are in the self help self help groups that I had missed in our original groups I have studied. Many people in active professional conceptualization of the problem. The self heip groups I roles fear the negative social consequences of such joined and studied as a consumer and a participant observer affiliation. Others find that psychiatric disability or illness were naturally occurring social cliques developed and alone does not create a sufficient common bond on which to nurtured in the context of more formal community mental build social relationships. A great many have full social lives health services. A person's decision to join a self help group already and are not looking for additional supports or was guided by his or her own sense of communality with one friendships. Any combination of these reasons comes into or more members of the group. The groups themselves play in one's decision to seek out and maintain voluntary were informal and relatively unstructured with loose ties and social affiliation in a self help group. semi-permeable boundaries. Recruitment occurred over a long time and was highly idiosyncratic. Both studies Social Change through Peer Mutual Support attempted to formalize self help as a type of adjuvant Self help and mutual aid are significant tools in efforts to treatment. The experimental design encouraged me to reshape the public image and personal experiences of distort a core aspect of the phenomenon of self help. It is by people with psychiatric disabilities. At the current phase of nature a voluntary activity in which people engage for self help group research, we tend to characterize it as a type relatively brief periods of time in the absence of more formal of quasi-therapeutic encounter. We tend to look for effects organizational structures. Although it is possible to build a on individuals. In a larger sense, the value of voluntary formal structure around a self help group, that structure will affiliation and self help among people with psychiatric not assure universal access to or participation in self help disabilities are more likely to be found at the societal level. activities. The appeal of self help groups stems from their Self help and mutual aid may have little effect on the primary voluntary, open nature. symptoms associated with psychiatric diseases. They are likely to have stronger effects on the social consequences of Social Affiliation Among People with Psychiatric mental illness. Self help groups are a foundation for people Disabilities to establish a positive social identity that incorporates a The self help groups I have studied are supported within highly stigmatized human condition. To the extent that the context of the public system of community mental health stigmatization and demoralization contribute to psychiatric services. In this context, I met people from diverse disability, self help groups are effective because they backgrounds, but I was the only Ph.D. and the only counteract both of these social correlates. researcher among the members. In my role as a participant observer in self help groups, I introduced myself as a consumer who was interested in doing research on peer Note mutual supports. I joined in group discussions and was Support for this paper was provided in part by grants from candid about my own experiences in psychiatric treatment. I the Public Health Service, National Institute of Mental Health, found some common perceptions with other members and Clinical Services Research Branch (MH45218) and some circumstances that were unique to individuals. Substance Abuse and Mental Health Services Administration, Center for Mental Health Services Self help groups provide individuals who are socially (MH47686), Rockville, MD. Address correspondence to isolated with a mechanism for forming voluntary social Caroline Kaufmann, Ph.D., 9279 Marymount Drive, affiliation. The value of such affiliation may lie in the Pittsburgh, PA 15237. idiosyncratic and transitory features that make self help groups valuable among people with psychiatric disabilities. References They are not a form of therapy, but a type of social affiliation Campbell, J., Ralph, R.O., & Glover, R. (1993, April). where people are free to practice social interaction in real From lab rat to researcher: The history, models and policy time. There is no problem of "carryover" into real life implications of consumer/survivor involvement in research. situations because self help groups are real social Proceedings of the Fourth Annual Conference on State encounters. As in any social group, individuals are free to Mental Health Agency Services Research and Program exercise their own discretion in terms of whom they select as Evaluation. Alexandria, VA: National Association of State friends and how long they remain in the group. There is no Mental Health Program Directors Research Institute. reason to assume that people who share a common predicament will immediately agree with one another about Kaufmann, C.L., Schulberg, H.C., & Schooler, N.R. what that predicament means to them or how they will (1994). Self help group participation among people with add ress it. severe mental illness. Prevention in Human Services, 11, 315-331. In the course of my professional work, I have met a number of people who admit privately that they are Kaufmann, C.L., Cook, M., & Roth, L.R. (1990). The Self consumers of psychiatric treatments. These are usually Help Employment Center for People with Severe Mental people of similar backgrounds to mine, with admirable Illness (Grant Number 5R18 MH476861. Rockville, MD: professional credentials and impressive lists of accom- Center for Mental Health Services. plishments. Social supports among this group are as

The Community Psychologist, Volume 29, Number 3, July 1996 13 described his life by stating. "I am a lonely nothing ... I have a dreadful fear of not loving ... I want to love. I envy those who Supported Partnerships: can relate to each other" (from Bouricius. 1989. pp. 202- A Pathway Into Community Life 20~). Such first-:-person accounts, including the passage which opened this article. suggest that many persons with For Persons With Serious severe psychiatric disabilities retain an essential, often Psychiatric Disabilities painful yearning for companionship and caring. and that what they lack are the acceptance and opportunities to fulfill these David A. Stayner. Larry Davidson. desires. and Jacob Kraemer Tebes Yale University School of Medicine This recognition that mental health consumers experience not only social isolation and impaired social functioning but also lasting. often painfully thwarted. desires "What makes life valuable for those of for friendship and caring is central to the design of The us with mental illness? ... Exactly what Partnership Project. Building upon the potential of a peer is necessary for other people. We need support model that pairs individuals with others who have to feel wanted. accepted and loved ... been through similar experiences and are now in recovery. We need support from friends and the project rests upon the fundamental assumption that family ... We need to be accepted by given acceptance. opportunity, and support. many persons and welcomed into our communities. with severe mental illness can begin to take steps toward We need to feel a part of the human renewed social connections by participating in a relationship race. to have friends. We need to give with another adult. In addition. this project has been and receive love" (Leete. 1993. p.127). informed by the "helper-therapy" principle established in the self-help literature. that people benefit from feeling any persons with serious psychiatric disabilities useful to and valued by others. by being able to "give back" Mexperience impaired social functioning and sharply to their peers (Riessman. 1965). The aim of The Partnership diminished social connections. Clinical researchers have Project. then, is to investigate whether providing consistently described these persons as socially withdrawn opportunities for peer support and mutual assistance or isolated. as existing within narrowly constricted social between individuals with serious psychiatric disabilities and networks. as lacking social judgment and basic social skills. other adults will enhance their social functioning and and as experiencing debilitating anxiety in unfamiliar social involvement in the broader community. so as to facilitate contexts. They are seen to have few friendships. and to rely recovery and community integration. on family members for support and community access. often in strained relationships that have little or no reciprocity (for a Program Description. review. see Davidson. Stayner & Haglund. in press). The Partnership Project is a research demonstration study funded by a grant from the Center for Mental Health Some clinical researchers have gone even further in Services of The Substance Abuse and Mental Health describing persons with schizophrenia. suggesting that Services Administration. This project is designed to facilitate positive psychotic symptoms often "burn out" over the nine-month. supported partnerships between persons course of the illness. leaving behind only a vague outline of experiencing serious psychiatric disabilities and volunteer the former person. an "empty shell ... [who] cannot think. partners, and to investigate the impact of these peer feel. or act.... [who] has lost the capacity both to suffer and relationships on the social functioning, community hope" (Andreasen. 1984. pp. 62-63). From this integration. and recovery of participants. A total of 260 perspective, not only is social connection lost, but even the persons with clinical histories of serious mental illness are motivation. wish. or desire to reach out for this connection is participants in the study. All participants are currently living in lost. This belief in the emptiness of individuals with serious the community and receiving regular outpatient psychiatric mental illness is accepted by many conventional social services at community mental health centers; however. a programs. Some of such programs attempt to "fill the void" large percentage of them have experienced significant by teaching social skills. whereas others relegate people inpatient hospitalizations in the past. All participants were with mental illness to a marginal existence of roaming the referred by outpatient clinicians on the basis of impaired new back wards that have been recreated in the community. social functioning and significant- social isolation.

Mental health consumers, however. offer a perspective To study the impact of peer support on their social that differs starkly from the image of an "empty shell" who can functioning and isolation. participants were randomly no longer either suffer or hope. Although their accounts do assigned to one of three experimental conditions: 1) a include descriptions of social withdrawal and isolation. they volunteer partner with his or her own history of mental illness are also pervaded by themes of loneliness and interpersonal (a mental health consumer). 2) a volunteer partner from the loss, and a wrenching desire for social contact. general community who does not have a personal history of companionship, and caring (Davidson. Stayner & Haglund. in mental illness. or 3) no partner. Volunteers and participants press). One young man with schizophrenia. for instance, were asked to spend two to four hours per week for a period

14 The Community Psychologist. Volume 29. Number 3. July.1996 of nine months participating together in social or recreational Although a few participants noted that being assigned a activities in the community. To facilitate these activities, all partner and receiving $28 per month to participate in participants (including those without a partner) and all activities together was an artificial beginning to a relationship, volunteer partners receive $28 per month. Decisions as to most made it clear that their partnership had become a true activities, meeting times, and other arrangements are left to friendship over time. In fact, nearly all participants reported the discretion of participants and their partners. Volunteer that they and their partners had decided to continue meeting partners receive an initial orientation/training session and even after the official program and stipend ended. For participate with other volunteers in ongoing, monthly peer some, this was an especially important moment in the support/supervision meetings facilitated by project staff (who partnership, in which they were able to recognize the are also composed of a mix of consumer and non-consumer friendship that had been built between them. As one members). participant put it: "We have no reason now ... but friendship to get together and call each other, so it seems even more As part of the study, all participants complete research like we're friends. But it always seemed that way anyway- interviews upon enrollment in the project, at four and one- that we were friends." half months, and at nine months in which they are asked to provide information about their current functioning, quality of Again and again, participants emphasized the importance life, sense of well-being, and social network. Although of their regular involvement with a partner who became, over quantitative data is still being gathered, and results are not time, a stable presence in their lives who could be counted yet available, semi-structured, qualitative interviews have on. One participant described, for instance, how her been conducted with 21 of the first 27 participants to partnership differed from other social contacts in which complete the intervention, 7 in each of the three people would talk to her when in the same room; but" ... experimental conditions. These interviews began with when you leave, that will be the end of it. .. They say they're participants giving open-ended, narrative descriptions of my friend, but they never come around me." With her their experience with their partner during the previous nine partner, however, she had repeatedly experienced feeling months. They also described their experience before "like, 'Oh, boy, somebody's calling me. I'm going someplace. meeting their partner and reflected on whether and how their And they're calling because they care." partnership experiences may have affected their ongoing lives. Prompts were given when necessary to facilitate Participants clearly valued being able to get out into the participants' descriptions of the qualities of the partnership community with their partners. These excursions allowed relationship, participation in shared community activities, past them to participate in "normal" activities, and to experience social experience (including isolation, stigma, or community new possibilities for involvements beyond the narrow integration), and any differences in their ongoing lives and confines of daily routines dominated by their mental illness. recovery. Interviews were conducted by a trained As one participant put it: investigator and were audio-taped and transcribed verbatim. Transcripts were analyzed according to established "We always had a good time whenever qualitative procedures (Davidson, Stayner & Haglund, in we went out. We saw a movie. And It press). Preliminary findings that are most essential to an was fun, y'know. Then I realized ... initial understanding of the impact of peer support on Hey, I can have more fun, too. It just participants' social functioning and community integration are opened my eyes that there are other presented below. things to think about besides mental illness ... It was just realizing that Qualitative Findings y'know, I could go places and have fun." Although social isolation, interpersonal losses, and loneliness dominated participants' descriptions of their lives Participants also learned from being with their partners in before their partnerships, findings also make it clear that they these social interactions in the community, and some found retained an essential desire for friendship and caring that had themselves becoming less uncomfortable around strangers not diminished over time. It was this desire that allowed them and unfamiliar social situations. "I could see the way my to take the risks involved in trying The Partnership Project, partner handled himself in a crowd of people, and I could and in attempting to begin a relationship with the stranger learn from that. And it made me feel that I could handle who had volunteered as a partner. myself better in a situation - in a social situation."

Findings reveal that participants often recognized in their Interviews made It clear that it was not simply getting away involvement in the project an implicit contract or agreement that made a difference to participants, but rather the that they and their partners would see each other every presence of a friend who could enrich a simple, common week for nine months. The fact that both parties were activity quite profoundly. One participant poignantly committed to this time frame seemed to ameliorate some of described how eating a hamburger with her friend rather than the awkwardness and anxiety associated with meeting a new alone had helped her to notice and enjoy the taste and the person and trying to begin a relationship. In fact, one experience. She went on to state: "Even if you had to cook participant described this as receiving "a friend on a silver your own can of beans; it's better because you're not alone. platter." You're able to eat talking to somebody, so that can of beans

The Community Psychologist, Volume 29, Number 3, July 1996 15 could have been in a gold bowl." on medication, I'm on, I take medication. And, so, we had a lot in common really. Another overarching theme in participants' descriptions And, you know, some of his difficulties I was the importance of being able to give as well as receive in can understand. Some of my difficulties, their friendships with their partners. The $28 dollar monthly he can understand. So ... I think that's stipend was seen to provide not only access to community one of the reasons we could relate fairly activities but also opportunities for participants to buy a well. We just had a lot in common ... partner a cup of coffee or pay some money toward gasoline He's in the same boat. The only expenses, for instance. Similarly, participants appreciated difference is that he drives, and I don't, being able not only to receive concern and care from their and that he does certain things that I partners, but also to listen to some of their partne~s don't, but I do certain things that he problems at times. One participant described struggling at doesn't." times to deal with difficulties his partner shared, but stated: "Regardless of his problems and how they overwhelmed me, Beginning from this common point of departure, I would rather have met him and gone through that rather participants and their consumer partners were able to go than to have never met him at all. .. It was nice to have beyond their experiences of disability and stigma to explore somebody to care for and to care about." Experiences like numerous dimensions- of their relationships that had these seemed to provide an important sense of nothing to do with mental illness, but were based on their empowerment and equality in partnerships that helped to interests and strengths, and on the promise of resuming a transform them into friendships. normal life. Participants often described these friendships as similar to ones they had had in high school, in which they had Similarly, participants emphasized the importance of engaged in "male bonding" around athletics or spent hours experiencing that they were respected and taken seriously on the phone engrossed in "girl talk." Perhaps even more by their partners, that their ideas and preferences made a important than providing an avenue of access to community difference in which activities they chose to do, for instance. activities, then, these relationships felt to participants like As one participant put it: "I have a lot of mental health people true friendships, that could restore at least their faith in their in my life. But with [my partner] it was more like fun. It was ability to establish and maintain caring human connections just having fun and being equals. He treated me as an equal. with others beyond the limits of their disabilities. I respect him very much. He wasn't condescending at all." Conclusion Perhaps more than any other dimension mentioned by participants, it was this kind of mutuality and reciprocity in "Just basically the experience has their relationships with their partners that set these friend- opened up some doors for me in terms ships apart from others they had experienced since first of dealing with people ... Like I could becoming disabled. Although we have found no significant choose to be a nobody and a nothing differences thus far between friendships with consumer and and just hell with it, hell with everything. non--<:onsumer volunteers in the presence of these .. And yet, I'm part of the world. I'm a qualities, we have found preliminary suggestions of human being. And human beings differences in the processes by which these relationships usually kind of do things to help each develop. other out. And I want to be part of that worldly involvement. .. I have For participants paired with non--<:onsumer volunteers, something to offer ... That's all I'm reciprocity and mutual respect seemed to develop over time talking about. And I think the project as each partner got to know the other, and as the participant maybe in a sense made it a little bit came to feel that he or she was capable of doing "normal easier for me to think in those terms, to activities" and rejoining the "normal" (i.e., non-disabled) not be afraid to give things to people, world. For participants paired with consumer volunteers, on and not be afraid to take things from the other hand, this sense of mutuality seemed to be them in return." present from the beginning, as each partner identified with the other through the sharing of similar experiences, such as It is clear that social isolation and impaired social hospitalization, medication, stigma, and continuing functioning comprise particularly debilitating and painful outpatient treatment. These participants seemed to be factors in the complex array of disabilities faced by persons especially affected by how their partner, despite these with severe mental illness. Findings of qualitative interviews shared experiences, had progressed a long way toward suggest that supported peer relationships of the sort resuming a "normal" life in the community; and they seemed provided by The Partnership Project can help these persons to derive inspiration and hope from this example. One begin to find their way into viable community interactions and participant remarked with surprise: participation, and toward the recovery of basic social connections. Not only can these relationships enhance and "[My partner] is mentally ill and to an enrich the quality of life of persons with psychiatric extent he's fairly, you know, with it. He's disabilities, they can also fill an important gap in service

1 6 The Community Psychologist, Volume 29, Number 3, July,1 996 delivery systems that focus on symptom amelioration and Two Community Support management, or on forms of socialization that remain limited to social clubs and mental health centers. In such restnctlve Program Research Demonstrations contexts, experiences of peer support like those described In Sacramento: Experiences above can instill a sense of hope that fundamental aspects of Of Consumer Staff As a person's life can be healed and restored, as they re- Service Providers engage in caring relationships with others and move beyond the limited, passive role of "mental patient" to the more Tom K. Greenfield active, encompassing, and liberating role of friend. Western Consortium for Public Health and University of California-San Francisco

Note Beth C. Stoneking Work on this report was supported by Public Health ComCare of Phoenix, Arizona Service Grant #SM47644 from the Substance Abuse and Mental Health Services Administration. The authors wish to Evan Sundby acknowledge the contributions of Joan Bushey, Karl E. Sacramento Crisis Residential Research Project, Western Haglund, Maureen Kennedy, M.A., and Jaak Rakfeldt, Ph.D. Consortium for Public Health All authors are also with The Consultation Center and the Center for Mental Health Policy, Services and Clinical Research of the Connecticut Mental Health Center and the acramento County Division of Mental Health has Department of Psychiatry, Yale University School of Srecently been the site of two sequential three- year Medicine, 34 Park Street, New Haven, CT 06519. research/ demonstration (R/D) projects involving self-help principles and mental health consumers in paid service provision roles. Although both projects were funded by . References grants to the State of California from the federal Community Andreasen, N.C. (1984). ]he broken brain: The Support Program (CSP) of the SAMSHA's Center for Mental biological revolution in psychiatry. New York: Harper & Row. Health Services, each has distinct features. We summanze both projects, emphasizing experiences of the consumer Bouricius, J.K. (1989). Negative symptoms and workers and noting how learnings from the first infomned emotions in schizophrenia. Schizophrenia Bulletin, 15, implementation and design of the second. The first of these 201-208. innovative services research projects, the CSP Consumer Case Manager Project (Stoneking & Greenfield, 1991; Davidson, L., Stayner, D. & Haglund, K.E. (in press). 1994), is completed. This RID study investigated client and Phenomenological perspectives on the social functioning staff outcomes following the addition of trained, paid of people with schizophrenia. In K.T. Mueser & N. Tamer consumer workers to a traditional case management agency. (Eds.), Handbook of social functioning in schizophrenia. The second, ongoing project, called the Crisis Residential Needham Heights, MA: Allyn & Bacon Publishers. Facility, Sacramento, studies a consumer-run residential alternative (Stroul, 1987) to civil commitment for those In Leete, E. (1993). The interpersonal environment - A psychiatric crisis (Arntzen, Greenfield, Harris & Sundby, consumer's personal recollection. In A.S. Hatfield & H.P. 1995). It is comparing client outcomes of graduates of the Lefley (Eds.), Surviving mental illness: Stress, coping and Crisis Residential Facility (CRF), staffed and managed by adaptation (pp. 114-28). New York: The Guilford Press. consumers (with contracted psychiatric and nursing support) versus a profession ally staffed, locked inpatient psychiatric Riessman, F. (1965). The 'helper-therapy' principle. health facility. This project has just completed client Social Work, 10,27-32. enrollment, and will follow both groups of clients for 12 months post crisis admission, so results are not yet in. The research design testing differences in client outcomes of both projects has involved a fully randomized clinical trial but both also involve a qualitative exploration of the expenences of consumer staff.

Sacramento's projects are among a number in the nation that have examined the role of mental health consumers in providing case management or residential services. Although each of these projects had distinctive features, they share the philosophy that consumer providers offer a perspective to their clients with severe mental illness that IS unique, bringing experience of the system "from the inside" and potentially represent powerful models of having 'been there too." In the Sacramento projects, involvement of

The Community Psychologist, Volume 29, Number 3, July 1996 17 consumers in paid service provision roles emphasizes that providers and at the same time, help consumer workers in work can be an important source of esteem and ingredient in accessing and linking future clients to needed services. recovery from mental illness. At their core, the projects attempt to harness self-help principles including As we have noted elsewhere: "Integrating people who empowerment, skill building, and validation of the client's have experience as mental health clients into existing power to make important life choices. Here we sketch how systems or agencies can be difficult ... a conscious effort to consumer staff were brought into one county's mental health system using the CSP R/D grant and how our understanding recognize and address this at the outset of a project is of their experiences and contribution has evolved during the critical" (Stoneking & Greenfield, 1991; p. 15). Therefore, two projects. consumer SCs were given extensive further on-the-job training, provided a job coach through Crossroads, and had At the beginning of the first project in 1989, consumers in frequent meetings with both self-help consultants and an the community were recruited to participate in training for organizational psychologist. In addition, reasonable helping roles (Stoneking & Greenfield, 1991). At graduation accommodations were made in the workplace to increase the eight were selected and employed on a half-time basis as likelihood of survival in a stressful job. consumer "Service Coordinators" (SCs) in newly created paid positions, joining case management teams in During the demonstration period, services to case Sacramento County's Case Management Services (CMS). management clients were provided in one of two ways. SCs averaged 11 years experience as clients in the mental Staffing the "experimental" condition were the usual case health system; all had experience with psychotropic managers together with the new consumer staff, working as medications and all but one had prior hospitalizations (that a team. In the control condition, case management services individual had been homeless). were delivered as usual by the case manager working alone. The CSP Project followed clients of these two groups for up Training Consumers for Helping Roles to two years and examined outcomes on an approximately At the start of the Sacramento CSP Project, from a field of six month basis. Clients were given intensive interviews and about 50 applicants interested in careers in human services completed a number of questionnaires about their living about half were offered a course in human services helping arrangements, level of functioning, satisfaction with services, skills at the local Community College. The training committee life satisfaction, and use of services, among other things. that oversaw the design and implementation of the course Client results have been reported elsewhere (Stoneking & and included two consumer consultants, the director of Greenfield, 1994) and will not be the focus here. Crossroads (a local supported employment agency for those with mental disabilities), the course instructors, the County's Roles and Experiences of Consumer Staff CMS supervisors, a rehabilitation counselor from Department In the training phase, 22 consumers completed training, of Rehabilitation; and the County's Planning and Evaluation with eight selected as SCs; 10 of the remaining trainees Chief who became the CSP Project Director and later initially secured other mental health positions. The role of Principal Investigator of the the consumer SC in CMS project (Stoneking). involved providing self-help support services where clients ... consumer trainees working The course was designed to lived; providing opportunities to in the other not-for profit community meet the college curriculum increase social networks by telling agencies were in committee requirements so that clients about, and going with completers would receive settings that were mostly them to, different places in and college credits and so that a smaller and had fewer out side the mental health mainstream course offering of professional staff. In these system; offering crisis support this kind could be established. agencies, non-consumer staff and referrals; and providing All trainees were selected to be resistance, if any, was less noticeable. practical assistance and skill both Crossroads and development in areas like Department of Rehabilitation housing, transportation, and clients to ensure availability of a benefits acquisition. To full array of supports during their training, and later on the determine whether different work settings affected trainees job. The course began with a two month 2D-hourlweek differently, Boltz and Greenfield (1992) studied the didactic-experiential class that included field visits to local experiences of 19 trainees through three months of training agencies. This was followed by one month of intensive on- and nine months on the job. Boltz and Greenfield (1992) the-job training and four months of 4 hours/week, compared three groups: seven original SCs (one dropped group/case presentations that exposed trainees to a large out with family problems at 5 months), seven trainees number of referral contacts and agencies. Over 25 different working in other settings for at least six months, and five who mental health providers served as guest speakers so that did not secure work or worked less than six months trainees would have the opportunity to get to know people at (including those who had begun job development at relevant agencies face-ta-face. We believed that this Crossroads). Trainee outcomes included symptomatology, process would demystify the consumer trainees to the self esteem, quality of life, community tenure, social

18 The Community Psychologist, Volume 29, Number 3, July,1996 supports, leisure time and self- ranked overall functioning. between groups. The total number of social supports for The first two groups of working consumers undertook SCs did significantly increase during their working periodic assessments of their working environment using experience, while there was a reverse tendency for trainees scales assessing program philosophy, job satisfaction, and not working. Other positive changes following from work burnout. Qualitative views of the work experience were also included increased involvement with self-help services and studied. with co-workers.

Despite the prestige for consumer staff of securing a paid Compared to their prior living arrangements, working position in a county agency, "there were mixed feelings trainees enjoyed the same or better housing whereas the among the professional CMS staff about the project and nonworking trainees had more mixed outcomes on some staff resisted it feeling it would be a burden, add to community tenure, including hospitalizations and their workload and threaten the security of their positions" homelessness. However, these differences might indicate (Boltz and Greenfield, 1992, p. 16). In contrast, consumer that the agencies hired more stable consumers and not be trainees working in the other not-for profit community an effect of employment per se. There was a tendency for agencies were in settings that were mostly smaller and had SCs to report improvement in several indicators of fewer professional staff. In these agencies, non-consumer satisfaction with living situation while nonworking consumers staff resistance, if any, was less noticeable. Four trainees situations seemed to be worsening. Better incomes may became interns in the Consumer Self-Help Center, a have played a role. Annual incomes of SCs increased consumer owned and operated drop-in program. However, approximately $3,000 over baseline compared to no change trainees in these agencies did not typically have the status of for the other groups. This suggests the tangible benefit of other program staff and were often in peripheral roles. employment and improved incomes for those with mental illness who find stable work. Conversely, although SCs had Although consumer SCs saw CMS as emphasizing client objectively greater pay and security than the other working empowerment and vocational services, and having a service trainees, there was no group difference in satisfaction with interest in clients with serious mental illness, work group pay and security on the Job Diagnostic Survey Scale and cohesion, teamwork, and supervisory support were viewed neither group was satisfied with these aspects compared to as only moderate. Trainees working in other community population norms. Lower work satisfaction might be settings rated their agencies as high on innovation, housing expected for interns and volunteers, but given that the SCs assistance and referral advocacy, in keeping with the had paid positions and the additional assurance that they agencies' social rehabilitation and self-help orientation and would be moved to paid social service positions at the end of services to homeless clients. But they also saw low staff the project, we anticipated increased satisfaction for SCs. cohesion, job involvement, and supervisory support. We However, SCs may have compared themselves, as the speculate that this may reflect these consumers for the most project continued, to their professional coworkers. SCs part working in the roles as interns and volunteers and made only $6.00 per hour whereas their colleagues were possibly not yet being well integrated as staff. making about $15.00 per hour in civil service positions seen as much more secure. We also looked at other outcomes that jobs might affect. Over the first nine months on the job, scores on depression As measured by job "burnout", both working groups and somatization appeared to worsen for the SCs, relative to increased in emotional exhaustion over time, but the SC's those working in the other community agencies. We believe increase was significant. By the end of the project their that stressors in the more medical model CMS, and the average emotional exhaustion score was higher than the anecdotally reported resistance of many original staff, may norm for mental health workers in general. On the other have added to the increased symptomatology (Boltz & hand, by the end of the period both groups felt more Greenfield, 1992). Another unexpected outcome in both personal accomplishment on their jobs than mental health employed groups was that self esteem dropped significantly workers generally. Positively, again, we found that on over time (with no group difference). This self esteem several other facets of job satisfaction-social, supervision decline ran counter to expectations, but it is unknown and growth opportunities-both groups of working whether the lower self esteem might have stemmed from the consumers were at or above population norms. experience of working in itself, or rather from the unique status of the consumer workers in their organizations. For Nine months is too short a time to understand the longer- example, despite considerable efforts in the CMS to address term impacts of employment in new jobs. Immediately after organizational issues, the SCs entered as a group and with training, students reported measurable gains in self esteem distinct roles from the professional case managers' and were and confidence, and a sense of accomplishment. Some of not readily integrated into the existing staff. Although the "hard knocks" of the workplace may have dented the first retaining their own identity as consumers helping others, of these but not the last. We speculated that some of the many SCs appear to have felt pressure to "be like" the other findings seen after nine months may be short- term professional case managers. We wonder if this did not make responses to workplace re-entry. In addition, these it harder to draw strength from self-help values. A positive consumers were inserted into existing agency work settings result in spite of this apparent difficulty was that self- with all the attendant organizational stresses this entails, assessed overall functioning did not differ over time, or added to the unique stigma which people with mental illness

The Community Psychologist, Volume 29, Number 3, July 1996 19 face in the workplace. A very important outcome of the Summary demonstration is that many of the trainees have continued to Perhaps the most lasting achievement of Sacramento's be employed in Sacramento's mental health system. The first CSP Project is the effectiveness of its helping-skill project created a pathway to meaningful, remunerated jobs training program as a strategy for increasing meaningful for many consumers, showing the value of skill training and consumer participation in the public mental health sector. job supports, as well as demonstrating specific efforts to The course was clearly very successful in placing most of its increase access to jobs in a county mental health system. graduates in employment within helping agencies, both County service settings and private not-for-profit and self- The Crisis Residential Facility Project help agencies ( including the second, CRF project). Five The second project, the Crisis Residential Facility (CRF), years on, many of these careers in human services are still in is staffed and managed by consumers. When completed, progress, still unfolding. Radical change has taken place in this will allow some comparison on how consumer staff the system's acceptance of the idea of consumers as service experience their work as service providers to those with providers, making Sacramento County a leader in this serious mental illness (staff data are still being collected and incomplete revolution. A large number of consumers who no formal findings are yet available). Anecdotally, consumer completed the course are still working in the County, many in staff at the CRF are extremely enthusiastic about the facility's paid positions, and several in management positions having mission and early accomplishments (Arntzen, Greenfield, tremendous responsibilities and opportunities. Harris and Sundby, 1995). This project evolved from the first and overcomes some of its limitations. But for consumers The two projects differed in the extent to which self-help working in State- licensed and regulated alternative principles could be expressed and flourish. In the lirst agencies, there remains the challenge of retaining their self- project, a small number of consumer workers joined an help values in practice while performing as formal service established, large, traditional, professionally dominated providers in a county mental health system. As Arntzen et al. agency, whereas in the CRF, although professionals are (1995) comment: "because they are more autonomous and available to provide medication and help for specialized in the majority, these consumer staff have, we believe, less problems, consumers are in the majority and also manage chance of being co-opted into 'junior mental health worker' the program. The facility's dominant philosophy is one of roles that would potentially subvert their practices and self-help, the approach more social model than medical convictions as self helpers" (po36). Using a blended model. The initial project's experiment with consumers in consumer-professional staff encourages collaboration while traditional settings increased the County government's still emphasizing client's choices about the services they readiness for the second, but also convinced us that a fuller receive. demonstration of the potential of consumers as service providers required us to test a program where consumers "owned" the program itself . ... A very important outcome of the demonstration is that many of the trainees Note have continued to be employed in Sacramento's Support in preparation of this article is gratefully mental health system. The project created a acknowledged from the Center for Mental Health Services, pathway to meaningful, remunerated jobs for SAMHSA (grant numbers R18 MH51339 and R18 many consumers MH46146), the State of California and the County of Sacramento. Opinions are those of the authors and may not necessarily reflect those of the involved agencies. Address Client outcomes have not been the focus here, but may correspondence to Tom Greenfield, Western Consortium for differ markedly between the two projects. Early indications Public Health, 2000 Hearst Avenue, Suite 300, Berkeley, based on only half the client participants enrolled in the CRF CA 94709-2176. research project, are that satisfaction with the CRF at 30 days following admission is extremely high, significantly higher References than that with the randomized control condition (treatment Arntzen, B., Greenfield, T. K., Harris, A. M. and for psychiatric crises in a traditional, locked inpatient setting). Sundby, E. (1995) CRF: Early experiences at In the earlier case management experiment, overall service Sacramento's consumer crisis residential program. satisfaction did not differ significantly between the control Journal of the California Alliance for the Mentally III, 6(3), and experimental groups, although the was a trend for the 33-36. participants whose usual case manager was supplemented with a consumer case manager to show higher satisfaction Boltz, S., and Greenfield, T. (1992). Consumer case with urgent care on the Service Satisfaction Scale management service coordinators: Outcomes one year (Greenfield & Stoneking, 1993). The preliminary CRF post employment. Paper presented at the Centennial finding suggests that some impacts on the client of the Convention of the American Psychological Association, consumer run program may be more clear cut than in the Washington, DC, August 16. model augmenting existing staff with consumer coworkers. Greenfield, T. K. and Stoneking, B. C. (1993). Service satisfaction with case management: An

20 The Community Psycholo9ist, Volume 29, Number 3. July,199B experimental test of augmenting staff teams with mental effects of mutual help organizations on non- participants health consumers. Paper presented at the Fourth have been little studied, so we focus here on how mutual Annual National Conference on State Mental Health help groups affect participants. We include studies of self- Agency Services Research and Program Evaluation, help groups and "self-help agencies" (e.g., consumer-run National Association of State Mental Health Directors, drop in centers, Mowbray, Chamberlin, Jennings, & Reed, Annapolis, MD, October 2-5. 1988) modeled on professional human service organizations but primarily or entirely staffed and controlled by Stoneking, E., and Greenfield, T. K. (1991). Adding psychiatrically disabled individuals. Trained Consumers to Case Management Teams as Services Coordinators: Design and Early Outcomes. Different seif-help organizations (Humphreys & Paper presented at the American Public Health Kaskutas, in press) and members (Young & Williams, 1988) Association Annual Meeting, Nov. 10-14. have divergent goals, so a simple and universal definition of "benefits" is not possible in seif-help/mutual aid research. Stoneking, B. C., and Greenfield, T. K. (1994) Hence, we distinguish five different domains in which the Sacramento County's Consumer Case Manager Project effects of mutual help groups and agencies have been (Final Report to the Center for Mental Health Services, evaluated: satisfaction, social networks, mental health and Grant No. R18 MH46146). Sacramento: Sacramento coping, reliance on professional care, and life enrichment. County Department of Health and Human Services and California State Department of Mental Health. Satisfaction Satisfaction may seem a prosaic outcome to evaluate, but Stroul, B. A. (1987). Crisis residential services in a seif-help groups and agencies can only survive if community support system. Rockville, MD: National psychiatrically disabled people are satisfied with them (the Institute of Mental Health, Community Support Program. same cannot always be said of professional mental health services). Mowbray and colleagues (1988) found that most participants expressed satisfaction with two seif-help/mutual aid initiatives implemented by psychiatrically disabled Do Psychiatrically Disabled people: a drop-in center and a program that eased patients' transition from the psychiatric hospital to the community. People Benefit From Participation However, the meaning of these findings is not clear because In Self-Help/Mutual Aid the methods by which satisfaction was assessed were not Organizations? described. Kurtz's (1988) study of seif-help organization A Research Review member satisfaction provided stronger data because it employed a validated and standardized client satisfaction questionnaire (the CSo-8, Attkisson & Zwick, 1982). Elaina Kyrouz and Keith Humphreys Members of the Manic Depressive and Depressive Center for Health Care Evaluation Association reported global satisfaction levels comparable to Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine those reported by clients of professional mental health agencies.

Not surprisingly, length of membership in the organiza- eople with psychiatric disabilities have been heavily tion was positively correlated with satisfaction in Kurtz's P involved in the self-help/mutual aid movement for several decades (Zinman, Harp, & Budd, 1987). However, study. This suggests that cross-sectional evaluations of the satisfaction of current members may present an overly rosy researchers have only recently begun to evaluate the effects of self-help/mutual aid (also known as mutual help) picture of a mutual help organization's appeal because individuals who were dissatisfied have dropped out. organizations on psychiatrically disabled participants Therefore, data on current participants' satisfaction should (Borkman, 1991). This may be due in part to the challenges be considered in light of the organization's participation and limitations of employing traditional methodological attrition rate (I.e., is the organization satisfying to most of approaches in this research area (Humphreys & Rappaport, those who ever come to it, or is it satisfying only to a highly 1994; Lieberman & Bond, 1978). To consolidate select subgroup of newcomers?). In the only published knowledge in this important area, we review research study of participation attrition rates in mutual help groups for examining the effects of psychiatrically disabled people's self-help initiatives. psychiatrically disabled people, Luke, Roberts and Rappa- port (1993) noted that approximately haif of new members Scope of the review drop out within three months, and thereafter the dropout rate slows substantially. The same dropout curve is found In addition to affecting participants, seif-help groups may also influence non-participating individuals and institutions across a variety of voluntary organizations and activities (e.g., PTA meetings, social clubs, diets). This suggests that self- (Maton, 1993). For example, a seif-help group composed of help organizations for psychiatrically disabled people are former mental patients may encourage members to interact in new ways with family members and friends and advocate comparable to most voluntary organizations in the proportion of newcomers who enjoy the group enough to become for better conditions in psychiatric hospitals. However, the ongoing members. The Community Psychologist, Volume 29, Number 3, July 1996 21 It is not clear whether a significant proportion of the reported coping better with their illness since joining the psychiatrically disabled population is interested in attending self-help group, and 83% reported increased acceptance of a self-help group (Kaufmann, 1994). However, the studies their illness. Length and intensity of involvement in the just reviewed provide limited but positive evidence that self- group significantly predicted perceptions of improved help organizations are satisfying to a reasonable proportion coping, but did not predict acceptance. Because these data of psychiatrically disabled people who attend at least one were obtained from retrospective self-reports, longitudinal meeting, and, that most active members enjoy their groups. studies are needed to confirm these results. When considered in light of the substantial recent growth of mutual help organizations, the evidence for this conclusion Recovery, Inc., The Association of Nervous and Former appears considerably stronger. Mental Patients, places strong emphasis on improving mental health by teaching members coping skills, such as Social Networks cognitive self-monitoring and anxiety reduction techniques. Social network effects include the development of In Raiff's (1984) study, 393 Recovery Inc. member leader/ networks of relationships with friends, family, neighbors, administrators, group leaders, and "helpers" experienced no group members, and helping professionals, as well as the more anxiety about their health than does the general amount and impact of support provided by such linkages population. Members who had participated for two years or (Buchanan, 1995). Because people with psychiatric more had the lowest level of worry. Caution in interpreting disabilities often experience social these data is warranted, however, rejection and tend to have small because membership in the group social networks (Ribisl & Luke, was voluntary and therefore self- 1993), social network enhancement selection processes may provide ... a significant amount of evidence effects are a critical topic for self-help alternate explanations for the indicates that self-help groups and group evaluations (Kaufmann et aI., results. 1994). organizations for psychiatrically disabled people ... may be effective in Several studies have examined One line of evidence supporting reducing the number and length of the remission of addiction as a the idea that self-help group psychiatric hospitalizations. mental health outcome in self-help participation can expand members' groups for those "dually diagnosed" social networks is that, prior to We consider life enrichment with both severe mental illness and affiliation, many members are socially outcomes to be very important. alcohol or drug addiction. In two small ethnographic studies, use of isolated. For example, most new These outcomes reflect the more self-help groups aimed at members of GROW are unmarried holistic orientation of self compared and unemployed (Kennedy, 1989), substance abusers who have no with professional and 40% of members of an urban comorbid psychiatric problems did treatments that focus on an self-help agency studied by Segal, not relate to remission of addiction Silverman, and Temkin (1995) were individual's illness or diagnosis. among the dually diagnosed homeless. (Noordsy et aI., 1994). Preliminary Self-help involvement is often results of two ongoing studies also Rappaport and colleagues (1985) more like a way of life than showed that, although some found that long-term GROW a treatment. dually-diagnosed members found members had larger social networks substance abuse self-help groups than newer members, although they useful, remission from addiction could not fully rule out the possibility could be achieved just as well that this was an artifact of self-selection. Similar studies have without such self-help. Many psychiatrically disabled people shown that greater use of self-help groups is associated fear standing out in substance abuse seif-help groups that with better social abilities (e.g., Noordsy et aI., 1994). do not explicitly cater to dually diagnosed people, raising the important issue of person-group fit. Groups designed and This handful of studies suggests that self-help run exclusively for the dually diagnosed (e.g., "Double participation can strengthen the social networks of people Trouble," see Caldwell & White, 1991), or for those with with psychiatric disabilities. Future projects should subject particular types of psychiatric problems, may help to increase this tentative conclusion to careful examination. this fit.

Mental Health and Coping Reliance on Psychiatric Care Mental health and coping outcomes researched thus far Avoidance of psychiatric hospitalization is the most include improvement in stress management, increased studied index of the effects of mutual help groups for acceptance of illness, reduced worry about and increased psychiatrically disabled people. This index allows satisfaction with health, and remission from addiction. Kurtz researchers to draw useful conclusions about the cost- (1988) studied coping and acceptance among depressed effectiveness and impact of self-help in the professional individuals in her study of the Manic Depressive and service system. Its weakness, however, is the unknown Depressive Association. Of the 139 members, 82% variance in the outcomes experienced by the non-

22 The Community Psycholo9ist, Volume 29, Number 3, July,1996 hospitalized, some of whom may be too ill to get needed In summary, a significant amount of evidence indicates treatment, or may be in other institutions (e.g., jails). that self-help groups and organizations for psychiatrically disabled people, like groups for people with substance The percentage of respondents (N=139) reporting abuse problems (Humphreys & Moos, 1995), may be hospital admissions before joining the Manic Depressive and effective in reducing the number and length of psychiatric Depressive Association was 82%, but the percentage hospitalizations. reporting admissions since becoming a member was only 33% (Kurtz, 1988). Length and degree of involvement in Life Enrichment the group, however, had no effect on hospitalization. Out of The absence of psychiatric problems and treatments 199 Recovery, Inc. members with previous hospitalizations, does not necessarily imply a rich and rewarding life. only 35 (17.6%) had been hospitalized since joining the Therefore, a distinction must be made between if and how organization (Raiff, 1984). Frequencies of ECT treatments groups affect traditional psychiatric outcomes (e.g., and treatments received for nervous/mental conditions were hospitalization, coping, symptoms) and whether they help also reduced after joining Recovery. Finally, in a preliminary members lead personally, spiritually, and politically study with a small sample, only two out of twenty-four meaningful lives. For example, mutual help groups often participants retumed to the hospital in the first six months of give former mental patients a rare opportunity to have a consumer-run case management program for psychiatric someone ask their opinion, respect what they say, and treat patients (Nikkel et aI., 1992). The convergence of findings them as an expert. Self-help also enables psychiatrically- of these three studies is impressive, but none of them used disabled people to be in the meaningful and rewarding role a comparison group or controlled for the fact that the period of helper, rather than always in the role of service recipient. of time prior to self-help participation was longer than the period of involvement. Recovery Inc. has been shown to enrich the members' lives. Long-term leaders of the organization report both Fortunately, other studies have used control groups. strong feelings of cohesion with the membership and the Galanter (1988) surveyed 356 Recovery members, including organization as a whole, as well as commitment to the 201 randomly selected group leaders and 155 newer organizations' philosophy (Galanter, 1988). Indeed, as a members. Although 49% of leaders and 52% of newer group, the members of Recovery Inc. report levels of life members had been hospitalized before joining, only 8% of satisfaction similar to those of the general population (Raiff, leaders and 7% of recent members had been hospitalized 1984). since joining. Both leaders and newer members used more outpatient non-psychiatric resources (e.g. medical doctors, Kennedy's ethnographic study of GROW (Kennedy, nurses, clergy) than a comparison group drawn from the 1989) provides a rich, phenomenological account of how community, indicating that self-help participation may long-term GROW members experience transformation in increase use of outpatient care even as it decreases use of their worldview as a result of participation. Worldview inpatient care. From a health policy point of view, as well as transformations occur in multiple domains, including beliefs from the point of view of patients, such a crossover in about the self, relationships with others, the universal utilization pattem is a very positive outcome. order/God, and psychiatric problems (Kennedy & Humphreys, 1994). Through analysis of members' In a randomized clinical trial on a program that attempted narratives, Kennedy has shown that these transformations to fuse self-help and professional approaches, Edmunson are accompanied by greater feelings of security and self- et al. (1982) found that after ten months of participation in a esteem, lower existential anxiety and a broadened sense of patient-led, professionally supervised social network spirituality, and an ability to accept problems without blaming enhancement program, one half as many former patients as oneself or others for them. in a control group required rehospitalization. Average length of hospital stay for the experimental group was seven days, Although the effects of mutual help organizations on the in contrast with twenty-five days for the control group. politicization and empowerment of psychiatrically disabled Further, a higher percentage (53%) of members of their individuals has not been systematically examined, this may social network enhancement program than members of a be one of the most powerful effects of organizations for a control group (26%) could function with no contact with the subset of members (Chamberlin, 1978; Deegan, 1992; mental health system. A similar result was found in a study of Harp, 1987). How often this process occurs and how it GROW, a self-help organization controlled and operated occurs are not well understood, making this a fruitful area for entirely by people with chronic psychiatric problems. systematic study (with Kieffer's, 1984, methodological Members of GROW spent significantly fewer days in the approach, a promising potential starting point). psychiatric hospital than did a control group matched on race, sex, age, marital status, number of previous We consider life enrichment outcomes, often overlooked hospitalizations, number of days in the hospital during the by researchers focusing on cost- effectiveness or symptom prior thirty-two months, community tenure, discharge reduction, to be very important. These outcomes reflect the region, diagnosis, legal status, and religious affiliation more holistic orientation of self-help compared with (Kennedy, 1989). professional treatments that focus on an individual's illness or diagnosis. They also are appropriate to evaluate given

The Community Psychologist, Volume 29, Number 3, July 1996 23 -

that self-help involvement is often more like a way of life correlations with service utilization and psychotherapy than a treatment. Further studies of life enrichment effects outcome. Eva/uation and Program Planning, 5, 233-237. would be a very valuable addition to the literature on mutual help groups for psychiatrically disabled people. Borkman, T. (1991). Introduction to the special issue. American Journal of Community Psychology, 19(5), 643- Conclusions 649. The studies reviewed here, although few in number, generally conclude that self-help groups and agencies run Buchanan, J. (1995). Social support and by and for psychiatrically disabled people significantly benefit schizophrenia: A review of the literature. Archives of members. From these studies we have learned that self- Psychiatric Nursing, 9(2), 68-76. help participation (1) increases with appropriate person- group fit (and satisfaction with many self-help organizations Caldwell, S. and K.K., White (1991). Co-creating a is fairly high), (2) can enhance participants' social networks self-help recovery movement. Psychosocial (3) can improve mental health and coping outcomes by Rehabilitation Journal, 15,91-94. improving stress management skills, increasing acceptance of illness, and reducing worry about health, (4) can reduce Chamberlin, J. (1978). On our own: Patient control/ed reliance on professional psychiatric treatments and services, alternatives to the mental health system. New York: and (5) has the potential to enrich members' lives. McGraw-HilI. Questions have been raised, however, about the methods used in some of these studies, and these positive Deegan, P.E. (1992). The independent living conclusions should be viewed as tentative. Fortunately, movement and people with psychiatric disabilities: Taking self-heip researchers (e.g., Roberts et aI., 1991) are back control over our own lives. Psychosocial increasingly finding creative ways to conduct sound studies Rehabilitation Journal, 15,3-19. of self-help groups (see Humphreys & Rappaport, 1994, for a review). Edmunson, E. D., J. R. Bedell, R. P. Archer and R. E. Gordon (1982). Integrating skill building and peer Future studies should investigate the effects of support in mental health treatment: The early psychiatric disability self-help groups and organizations on intervention and community network development non-participants, including families, medical providers, the projects. In A.M. Jeger and R.S. Slotnick, eds .., health care system and the public. It would also be useful to Community Mental Health and Behavioral Ecology, New develop more direct and accurate measures of the cost- York: Plenum Press. effectiveness of self-help organizations as treatment vehicles (el. Kaufmann et aI., 1993). Finally, we recommend Galanter, M. (1988). Zealous self-help groups as greater attention to the processes by which self-help adjuncts to psychiatric treatment: A study of Recovery, groups generate outcomes at different levels of analysis Inc. American Journal of Psychiatry, 145(10), 1248- (Maton, 1993). Variables which predict outcomes include 1253. factors outside the group (e.g., group connection to professional support, resources available to the group), Harp, H.T.. (1987). Philosophical models. In Zinman, within the group (e.g., interaction processes, social climate, S., Harp, H.T., and S. Budd, eds., Reaching Across: member leadership skills), linking the individual and the Mental Health Clients Helping Each Other, Sacramento, group (e.g., person- group fit, attendance frequency, CA: California Network of Mental Health Clients. involvement intensity, role in the group), and within the individual (e.g., demographic factors, psychiatric status, Humphreys, K. and J. Rappaport (1994). Researching personality, worldview). Quantitative and qualitative studies self-help/mutual aid groups and organizations: Many of how such factors produce changes in the five participant roads, one journey. Applied and Preventive Psychology, outcome domains reviewed here would be of significant 3,217-231. scientific interest and could also be of practical value to psychiatrically disabled people who are involved in self- Humphreys, K. and Kaskutas, L. (in press). World help/mutual aid organizations. views of Alcoholics Anonymous, Women for Sobriety, and Adult Children of Alcoholics/AI-Anon mutual help groups. Addiction Research. Note Preparation of this paper was supported by NIAAA Grant Humphreys, K. and R. H. Moos (1995). One year AA10652 and the Department of Veterans Affairs Office of outcomes and alcohol-related health care cost offset of Academic Affairs and Health Services Research and Alcoholics Anonymous participation. Paper presented at Development Service. the International Congress of Alcohol and Drug Dependence, San Diego, CA. References Attkisson, C.C. and R. Zwick (1982). The Client Kaufmann, C.L., H.C. Schulberg, and N.R. Schooler Satisfaction Questionnaire: Psychometric properties and (1994). Self help group participation among people with

24 The Community Psycholo9ist, Volume 29, Number 3, July,1996 severe mental illness. Prevention in Human Services, 11(2), 315-331 Nikkel, R. E., G. Smith and D. Edwards (1992). A consumer-operated case management project. Hospital Kaufmann, C. L., C. Ward-Colasante and J. Farmer and Community Psychiatry, 43(6), 577-579. (1993). Development and evaluation of drop-in centers operated by mental health consumers. Hospital and Noordsy, D. L., B. Schwab, L. Fox and R. E. Drake Community Psychiatry, 44(7), 675-678. (1994). The role of self-help programs in the rehabilitation of persons with severe mental illness and Kennedy, M. (1989). Psychiatric rehospitalization of substance use disorders. In T.J. Powell, ed., GROWers. Paper presented at the Biennial Conference Understanding the Self-Help Organization: Frameworks of the Society for Community Research and Action, East and Findings, Newbury Park, CA: Sage. Lansing, Michigan. Raiff, N. R. (1984). Some health related outcomes of Kennedy, M. and K. Humphreys (1994). self-help participation. In A. Gartner and F. Riessman, Understanding worldview transformation in mutual help The Self-Help Revolution, New York: Human Sciences groups. Prevention in Human Services, II, 181-198. Press.

Kieffer, C.H. (1984). Citizen empowerment: A Ribisl, K. and D. A. Luke (1993). Social network developmental perspective. Prevention in Human characteristics of persons with dual diagnosis. Services, 3, 9- 36. Community Psychologist, 27, 44-45.

Kurlz, L. F. (1988). Mutual aid for affective disorders: Roberts, L. J., D. A. Luke, J. Rappaport, E. Seidman, The Manic Depressive and Depressive Association. P. A. Toro and T. M. Reischl (1991). Charting uncharted American Journal of Orthopsychiatry, 58(1),152-155. terrain: A behavioral observation system for mutual help groups. American Journal of Community Psychology, Lieberman, M. A. and G. R. Bond (1978). Self-help 19(5), 715-737. groups: Problems of measuring outcome. Small Group Behavior, 9(2), 221-241. Segal, S. P., C. Silverman and T. Temkin (1995). Characteristics and service use of long-term members of Luke, D. A., L. Roberts and J. Rappaport (1993). self- help agencies for mental health clients. Psychiatric Individual, group context, and individual-group fit Services, 46(3), 269-274. predictors of self-help group attendance. Journal of Applied Behavioral Science, 29(2), 216-238. Young, J. and Williams, C.L. (1988). Whom do mutual-help groups help? A typology of members. Maton, K. (1993). Moving beyond the individual level Hospital and Community Psychiatry, 39(11), 1178-1182. of analysis in mutual-help group research: An ecological paradigm. Journal of Applied Behavioral Science, 29, Zinman, S., Harp, H.T., and S. Budd, eds., (1987) 272-286. Reaching across: Mental health clients he/ping each other, Sacramento, CA: Califomia Network of Mental Mowbray, C. T., P. Chamberlain, M. Jennings and C. Health Clients. Reed (1988). Consumer-run mental health services: Results from five demonstration projects. Community Mental Health Journal, 24(2), 151-156.

The Community Psychologist, Volume 29, Number 3, July 1996 25 SCRA INTEREST GROUP BULLETIN BOARD

Aging Disabilities Rural The Aging interest group focuses The Disabilities interest group The Rural interest group is devoted on the productive role of aging in promotes understanding of the to highlighting issues of rural the community and the prevention depth and diversity of disabilities environment that are important in of mental health problems in the issues in the community that are psychological research, service and elderly. for more information ready for research and action; and teaching. For more information contact Margaret Hastings at 708- influences community psychol- contact Michael Blank at 804-979 - 256-4844 or Ann Steffen at 314- ogists' involvement in policy and 8372 or Email: 516-5382, Email: practices that enhance self- [email protected]. [email protected]. determination, personal choice, and full inclusion in the community for people with disabilities. For more information contact Glen Stress and Coping White at 913-864-4840, Email: The Stress and Coping interest [email protected]. Community Action group aims to preserve the The Community Action interest Society's ties to an area of research group explores the roles and that has been important historically contributions of people working in in the development of community applied community psychology psychology and facilitate settings. For more information Prevention and Promotion communication among researchers contact David Julian at 614-227- The Prevention and Promotion in this area and with other 2700, Email: interest group is a forum to community psychologists. For [email protected]. enhance the development of information, contact Fran H. Norris prevention and promotion at 404-651-1610. research, foster active dialogue about critical conceptual and methodological action and imple- mentation issues, and promote the Children and Youth Undergraduate Awareness rapid dissemination and discussion The Children and Youth interest The aim of the Undergraduate of new developments and findings group facilitates the interests of Awareness interest group is to in the field. This Interest Group child and adolescent development promote the awareness of seeks to continue the traditional in high risk contexts, especially the community psychology among leadership role of SCRA in the area effect of urban poverty and undergraduate students and to of prevention and promotion community structures on child and increase student involvement in research. For more information family development. For more community psychology. For more contact Jean Ann Linney (803-777- information contact Mark Aber at information contact Kim Kobus at 7161, Email: [email protected]) 217-333-6999, Email: 312-996-3036 or Email: or Irwin Sandler (602-727-6121, [email protected]. [email protected] Email: [email protected]).

Community Health School Intervention Self Help and Mutual The Community Health interest The School Intervention interest Support group focuses on health group addresses theories, The Self Help interest group is an promotion, disease prevention, methods knowledge base, and international organization of and health care service delivery setting factors pertaining to researchers, self-help leaders, and issues as they relate to the prevention and health promotion in policy makers that promotes community. For more information schools. For more information research and action related to self- contact Frank Wong at South Cove contact Joseph Zins (513-556- help groups and organizations. For Community Health Center, 885 3341, Email - [email protected]) more information contact Keith West Washington Street, Boston, or Marsha Kline (203-789-7645). MA 0211, phone: (617) 521-5702. Humphreys at 415-617-2746 or Email D6. [email protected]

26 The Community Psycholo9ist, Volume 29, Number 3, July,1996 individuals and communities and even within all too often "split" parts of ourselves. We attempt to "bridge" theory and practice, and community psychology and SCRA COMMITTEE ON WQMEN feminist theory, and to make connections between Column Editors: Karla Fischer the personal and the political, feelings and intellect Deborah Salem and individual and community levels.

In tliis column on teaching, Anne A.,1ulveyprovidesan Rather than continue with a general description elegantly insightful description of how a COUf$8can of the course, I'd like to describe some of the particular bring together women in the community and women dilemmas, challenges and rewards the field work on campus. The forum that she has created, .in component of last semester offered. Having partnef$hip with.her students,is a nice exemplar of discovered two new anthologies dealing with feminist integrating theory and practice,thepef$onafandthe organizations and concepts of community, I did a major professional, the local and the global, Itls a moving revision of readings and created an entirely new field story, and we are grateful to Anne for sharing/to work project (Ferree & Martin, 1995; Weiss & Friedman, 1995). Each student was required to conduct a case study of an organization of their choice that supported women. This did not have to be an Women in the Community: organization that called itself "feminist." Selection Making Connections yielded a diverse mix of organizations including three shelters for women and children, two specifically for Anne Mulvey women who'd been battered; two rape crisis service programs; a women's reproductive health program, a community-based non-profit day care program; a large ince the early 1980's, I have been teaching a graduate course entitled, Women in the human service organization that runs several program S for women who are poor, a women's political Community. This course examines women's lives in organization, and a community based after-school community settings with particular attention to analyzing "women's issues" including rape, battering, program serving girls and young women. reproductive health and the feminization of poverty. Making contact with people in various roles of the The course adopts an interdisciplinary and multi-level organizations turned out to be a challenge in most framework, focuses on resources and strengths, and develops interventions in the interest of diverse cases and impossible in some. Smaller organizations exclusively focused on women's concerns were more groups of women. Though course materials and field work have changed over time, a few themes have likely to have constraints in terms of staff and client participation in the project. For example, rape crisis persisted: services and battered women's shelters were very Incorporation of research and theory from feminist short-staffed and had serious concerns regarding scholarship and community psychology; safety and confidentiality of clients. These constraints comparing and contrasting philosophical were magnified with an organization that served only frameworks and change strategies associated with women of Asian backgrounds. Cultural and language women's studies and community psychology; and barriers posed additional challenges. engaging in field work to apply what's being studied while supporting women in community settings. So, what to do? Original expectations regarding number of interviews and inclusion of people from different locations in the organization were modified. Early in the semester, we discuss Shula Refnharz's (1983) article, "Women as competent Respecting organizations' needs took precedence over pre-set guidelines. community builders," to review contributions women have made to community life and highlight the diversity among women and the roles gender, race I had obtained funding from our University's Council on Diversity and Pluralism to support an and class play in informing women's priorities, evening program to recognize participating identities and change strategies. We also read literature that introduces key concepts from organizations. Again, for some of the groups, an evening event was experienced as a strain rather than community psychology and from women's studies, an opportunity for positive recognition and exchange. reviewing areas of overlap and distinctiveness Despite this, we had a good turnout. (Mulvey, 1988; Swift, Bond, & Garcia, 199; Riger, 1992). Students created posters that displayed As is suggested by the core components listed information about the organizations they had selected above, goals are to build bridges and make including history, goals organizational structure, connections across areas of inquiry, between programs, resources and "successes." Each

The Community Psychologist, Volume 29, Number 3, July 1996 27 organization was invited to bring material about their Driving home from the event, I was again moved organization to share with the other groups. We tried to tears. My tears were not only for the pain of this to be informal so as not to burden already strapped woman and so many others including myself who have organizations while also facilitating whatever exchange experienced violence at the hands of rapists and the organizations saw as constructive. batterers. They were also tears of joy from experienc- ing this woman's strength and courage in the face of Some students felt that doing field work in adversity ... the power of supportive communities like addition to other requirements was very stressful. the one we had created in less than one semester ... Scheduling interviews posed serious challenges, and the network of women's programs spawned by particularly for those employed full-time. Some raised the women's movement now spanning decades. I concerns about relevance of field work to class read- also thought about my teaching and issues I had been ings, while others greatly appreciated and eloquently grappling with throughout the semester. Seeing the articulated the resonance between the two. Most support and engagement of the students and com- students worried about their posters from the sub- munity women and recognizing what I think to be the stantive content to aesthetic design. We collectively important role they played in creating a "safe space" to worried about having no one come to our evening explore our stories and make these connections, I event or attracting too many people to feed! Many began to sing a song to myself. I truly felt this exper- times during the semester, I asked myself why I had ience and project had "bridged" many dimensions developed a new syllabus and created a new field making connections that spanned the intellectual, work component. emotional and spiritual. I later crafted a poem about my reactions to all of this (something quite new for me). Perhaps or perhaps not surprisingly, everything came together the night of the event and it was quite I brought the poem to the final meeting of our wonderful for students and organizational participants seminar group, another first. Since then, I've also alike. The posters--impressive and diverse in both shared it with people at my university (locally) and aesthetics and organizational information--provided a others including Heather Gridley, a colleague and rich visual backdrop that encouraged informal friend in Australia (globally). Heather plans to share it ·discussion and exchange. Organizational represent- with one of her students, also a survivor of violence. atives expressed appreciation of the poster that hon- So our stories and our bridging goes on in new ways ored their organization and reviewed others with great inside the classroom, in our communities and in our interest. After sharing a meal together, each student deepest selves. I end with an excerpt from the poem, made a statement about successes of their organiza- "Re-membering A-gain:" tion and what they had learned in the process. what a long journey One person's presentation stood out. It was a toward wholeness story that was very hard to listen to as it chillingly forme described the rape at knife point of a young woman. for you The rape occurred almost 20 years ago when rape for all of us crisis services were few and far between. The young sometimes woman's treatment by the police and by medical staff it feels too hard felt like other assaults. The story was riveting--the only tome glimmer of light was brief contact with a rape crisis to you counselor who, among other things, simply held the to all of us young woman's hand and stood by her. Toward the so many routes end of the story, the presenter revealed that she was such rough terrain both victim and survivor and described her healing forme process including this, the first time she had spoken in for you public of her rape and its aftermath. Most of us were for all of us moved to tears. This powerful presentation made other times connections from the most personal to the political, a story turns the tide from the past to the present, from the grassroots for you women's movement to literally saving lives of girls and forme women, from victimization to survival to empowerment for all of us and wholeness. Changes in laws, treatment by medi- a word cal and legal systems and prevention and education a poem initiatives by rape crisis organizations were described a dream along with the current dismantling of such services. All from you of this had a depth of meaning that would not have tome been possible without the real and "personal" story, for all of us which was about changing self and communities. and we move along a-qain 2B The Community Psychologist, Volume 29, Number 3, July,1996 toward me toward you toward all of us Regional Activities References Ferree, M. M., & Martin, Y.M. (Eds.). (1995). Feminist organizations: Harvest of the new women's movement. Philadelphia, PA: Temple University Press. Mulvey, A. (1988). Community psychology and feminism: Tensions and commonalities. Journal of Community Psychology, 17,70-83. 1996 SOUTHEASTERN ECO-COMMUNITY Reinharz. S. (1983). Women as competent CONFERENCE. Call for Papers community builders. In A. Rickel, M. Gerrard, & I. Iscoe "BUILDING STRONG COMMUNITIES: (Eds.). Social and psychological problems of women RESEARCH AND ACTION IN FAMILIES, (pp. 19-43). Washington, DC: Hemisphere SCHOOLS, AND NEIGHBORHOODS" Publishing. Riger, S. (1992). Epistemological debates, The annual Southeastern Eco-Community feminist voices: Science, social values and the study Conference provides an informal atmosphere in which of women. American Psychologist, 47, 730-740. to discuss current interests within the areas of Swift, C., Bond, M.A., & Serrano-Garcia, I. (in ecological and community psychology. The 1996 press). Women in community psychology: conference, hosted by the University of South Empowerment in process. In Rappaport, J., & Carolina, will be held November 15-17, 1996 at Seidman, E. (Eds.). Handbook of Community James Island County Park (near Charleston, SC). Psychology. Plenum Publishing Co. Weiss, P.A., & Friedman, M. (Eds.). (1995). The keynote speaker for the conference will be William Feminism and community. Philadelphia, PA: Temple S. Davidson, III, of Michigan State University. Dr. University Press. Davidson's interests include both research and intervention in the area of social change domains. Anne Mulvey is on the faculty at the University of This interest has involved Dr. Davidson in such efforts Massachusetts Lowell. She can be reached by Email at as the Adolescent Diversion Project, an alternative [email protected]. treatment approach for juvenile offenders.

Call for Papers Presentation proposals are now being accepted for the 1996 conference. These can include completed COl1)mlttee 0" Women research or studies, works in progress, research E-mail Llstserve proposals, or critical reviews. Thesis and practicum The new e-mail list sponso~ed ~ytfleSCRA experience presentations from graduate students are Committee on Women is up an(j.mn also encouraged. We will also be accepting proposals Is to provide a space fordis for poster sessions. communitypsycl1olog sl1aring.ofldeas The official theme of the conference is Building issues. Strong Communities Through Research And Action. To subscribe to theUst, We are especially interested in presentations related [email protected] to these themes, but all titles are welcome. Proposals message sI10uld should include a brief summary of the material; a NAME. Plea$e I presentation title; and the name, affiliation, address, or if you have trouble and phone number of the presenter(s). CecileL8(1jon, Pboo 9964404. E-Mail;C Please send presentation proposals to: 1996 Eco-Community Planning Committee CIO Catherine Ward Department of Psychology University of South Carolina Columbia, SC 29208 Fax: (803)777-9558 Phone: (803)777-4137

The Community Psychologist, Volume 29, Number 3, July 1996 29 1996 MIDWEST ECO CONFERENCE Call for Proposals "TAKIN' IT TO THE STREETS"

Preparations for Midwest Student Conference are underway! Students in the Personality and Social Join SCRA's Email Network: Receive Ecology and ClinicaVCommunity programs at the updates on current events and post messages to all University of Illinois at Urbana-Champaign are working SCRA members signed on the list. The list is a forum hard to plan the 1996 Midwest ECO Conference (ECO for discussions within the Society, and all members are '96). This year's conference will be held October 4-6 encouraged to sign-on and participate. at the University of Illinois 4-H Memorial Camp In Monticello, IL. The 1995 Midwest ECO To become connected: Conference, hosted by Michigan State University is 1) Send an Email message to: certainly a hard act to follow. But thanks to all of their [email protected]. hints about planning the conference, things are going 2) In the body of the message, type: well. We are m the process of scheduling conference SUBSCRIBE SCRA-L followed by your first and last activities and planning a delicious menu. Of course, name with a single space between each word. For we'll save some time for entertainment. example, John Doe could join the list by typing: SUBSCRIBE SCRA-L JOHN DOE. The theme for this year's conference, "Takin' it to the Within 24-hours, you should get a message back Streets," is a call for community advocacy and political from listserv stating that you have been added to the action. As scholars in communitylecological SCRA-L list. If there was any problem, it will instead psychology, we have a responsibility to ensure that mform you of the problem. our work reaches farther than bound journals on library shelves. Our work should be directed toward those An introduction to LISTSERV is available! Once who will directly benefit from it. We should make our logged on to the list, you can get an introduction to work relevant for the communities we study and use LlSTSERV documents with two steps: our knowledge to advocate for communities. And, we 1) Send an Email message to: have voices that will be heard by policy makers and the [email protected]. EDU. media. We have the tools to affect change at the 2) In the body of the message, type: GET LlSTSERV policy level. We hope that this year's conference will REFCARD. be an opportunity to discuss how we can disseminate A file (LiSTSERV REFCARD) will be sent to you which knowledge effectively and become active participants gives a general introduction to LlSTSERV commands In social change. In this election year, these issues and their usage. seem particularty important. Sending group messages to SCRA We are currently accepting proposals for members. presentations that reflect any aspect of community 1) Email your message TO: SCRA-L@ research and social intervention, although those that UICVM.UIC.EDU. address the theme will be favored. The deadline for 2) Type and send your message in your normal proposals is August 30, 1996. For more information manner. The message will be forwarded to all signed- about the conference or the format for submissions on members! please contact Sharon Lambert at ECO '96 ' Questions or problems? Send an Email message Department of Psychology to L. Sean Azelton@ uic.edu. If you need to hear a 603 East Daniel Street human voice, call Roger Weissberg at (312) 413- Champaign, IL 61820 1012. Welcome on-line! ([email protected])

See you October 4th - 6th at the Midwest ECO Conference 1996.

~3~OiTh.:'r.::=::::a::";:::::=:::;::-;';~=~:-:':~~-::--:-:~==------The Community Psychologist, Volume 29, Number 3, July,1996 everywhere. Editor Bill Berkowitz, Ph.D., the author of three books on community, seeks out innovative NEW PUBLICAnON' ideas, organizations and individuals for feature articles. I Tom Wolff, Ph.D., publisher, adds articles on advocacy issues, and takes lead responsibility for production of a popular series of Tip Sheets, which take a close look at a single issue facing coalition builders. Recent titles Homelessness in America (available in this series have included 'What Coalitions are Not" September, 1996), Edited by Jim Baumohl. and "The Care and Feeding of Coalition leaders. " A collection of 19 papers looking at the broad social issue of homelessness from a multidisciplinary group To subscribe, send a check or money order for $15 of authors. The volume includes essays on the (six issues) to: causes of homelessness in an affluent society, legal AHEC/Community Partners, 24 South Prospect and civil rights issues, demographic and descriptive Street, Amherst, MA 01002 or e-mail to research, employment, housing •• income [email protected] and we can send an invoice. maintenance and the legal regulation of public space. Authors include SCRA members Marybeth Shinn, Mark Greenberg, David Snow, Norweeta Milburn and VIDEO: Healthy Communities: An Elmer Struening, among others. Overview by Trevor Hancock with Joan Prepublication orders will receive a 17% discount on the $39.50 (US) price. Contact Diana Messina, Twiss and Ted Landsmark,and Tom Wolff. Oryx Press, 4041 North Central at Indian School Road, This video set provides an introduction to the healthy Phoenix, AZ 85012. FAX 602-265-6250, Email: communities concept. Dr. Hancock, who has worked [email protected]. with the World health Organization on its healthy Communities movement provides a basis for understanding how to create a healthy community From the Ground Up! A Workbook on where you live. Tom Wolff expands on this issue in his companion paper, which focuses on Massachusetts Coalition Building and Community and how healthy communities are being created there. Development: This 200-plus page workbook, Available for $45 (US) from AHEC/Community edited by Tom Wolff, Ph.D. and Gillian Kaye, is a Partners, 24 South Prospect Street, Amherst, MA practical, hands-on workbook for those involved in 01002. coalition building and community development work. It's chapters are clearly written in layperson's language, and worksheets are included at the end of each VIDEO: Community Hopes, chapter to clarify concepts and make them applicable Community Dreams with John McKnight. for individual use. Chapter titles include: Guru of the "community way" from Northwestern University, John McKnight talks to folks at the 1992 Barriers to Coalition Building and Strategies to Overcome Them Involving AHEC/Community partners annual conference. His Mobilizing the Grassroots approach to, and reproach of, human services will make you think (60 minutes). Available for $20 (US) Dealing with Conllict in Coalitions from AHEC/Community Partners, 24 South Prospect Community Assessment: A Key Tool for Street, Amherst, MA 01002. Mobilization Involvement Monitoring and Evaluation of Coalition Activities Chapter authors include SCRA members Tom Wolff, WATERFRONT BOOK NETWORK (1- David Chavis, Vince Francisco and Steve Fawcett. 800-639-6063) is an information center serving Gillian Kaye, Beth Rosenthal and David Foster also parents and professional working with children and the contributed chapters to the work. challenges they face at home, at school, and in the To order your copy, send $30 (includes postage) community. Materials are available on topics such as to: AHEC/Community Partners, 24 South Prospect healthy coping skills, overcoming barriers to learning, Street, Amherst, MA 01002 or e-mail a request to support for families and parenting, loss and grieving, [email protected] and we'll send an invoice. illness, drugs and alcohol, safety and sexuality, special needs, etc. Community partners also publishes a bi-monthly To receive a catalogue of books, videos, and newsletter, the Community Catalyst. This games call 1-800-639-6063 or Email to newsletter of community innovations focuses on [email protected], or visit the web site: Massachusetts, but is relevant to community builders http://www.waterfrontbooks.com/kids/

The Community Psychologist, Volume 29, Number 3, July 1996 31 NEW JOURNAL: Analysis of Social Forthcoming: Journal Of Social Issues, Issues and Public Policy (ASAP) Vol. 52, NO.1: Social Psychological ASAP, is an electronic journal published by the Perspectives on Grassroots Society for the Psychological Study of Social Issues Organizing. Issue Editors: Michele A. Wittig and (SPSSI). ASAP publishes theoretical and empirical B. Ann Bettencourt analyses of social issues and public policy with the aim of making recommendations to decision makers. Each INTRODUCTION AND OVERVIEW paper must not only focus on a social issue or public An Introduction to Social Psychological Perspectives policy, but must provide an analysis that is action on Grassroots, Michele Andrisin Wittig oriented. All papers must make 'warranted Coming Together for Action: The Challenge of generalizations" that reflect the existing knowledge Contemporary Grassroots Community base as informed by the analyses presented. The Organizing, Marc Pilisuk, JoAnn McAllister, and journal publishes papers in three categories: General Jack Rothman Social Issues, Public Policy and Intervention Research. Manuscripts must be in APA style and to SOCIAL IDENTITY AND GROUP PROCESSES be written to be accessible to readers who work Grassroots Political Action as an Intergroup outside of disciplinary bounds. Papers submitted to Phenomenon, Steve Hinkle, D. Lee Fox- ASAP will be reviewed by members of the editorial Cardamone, Julia A. Haseleu, Rupert Brown and board and the editor. Submit manuscripts (and Lois M. Irwin inquiries) to [email protected]. Electronic Grassroots organizing, Michele Andrisin Rupert W. Nacoste, Editor Wittig and Joseph Schmitz Pawns Department of Psychology Victims, or Heroes: The Negotiation of Stigma and the 640 Poe Hall Plight of Oregon's Loggers, Theresa A. North Carolina State University Satterfield Raleigh, NC 27695-7801

COMMUNITY EMPOWERMENT MODELS The Social Psychology of Citizen Participation in Canadian Journal Of Community Community-Based Grassroots Organizations, Mental Health; fall, 1995 issue on the topic of Douglas D. Perkins, Barbara B. Brown, and Ralph "Mutual-Aid Groups and Support Groups." B. Taylor The issue is edited by Francine Lavoie and Miriam Grassroots Organizing with Homeless People: A Stewart and runs 244 pages and includes six sections: Participatory Research Approach, Susan Veich The Cooperative Movement Nicaragua: 1) the interface between formal and informal Accompaniment and Empowerment of Severely sectors (5 articles), Disadvantaged Peasants, Caroline J. Kroeker 2) activities of mutual-aid groups and organizations(4 articles), STRATEGIES FOR MOBILIZING AND SUSTAINING 3) support group evaluations (4 articles), PARTICIPATION 4) brief notes (1 short report), Mobilizing and Sustaining Grassroots Dissent, Laura 5) literature review (1 article on social support R. Woliver and breast cancer, and Grassroots Groups Confront the Corporation: 6) a commentary by Ben Gottlieb on the issue. Contemporary Strategies in Historical Perspectives, Munroe Friedman Copies of this issue can be purchased for $12.50 US The Intragroup Dynamics of Maintaining a Successful or $17.50 Canadian if ordering from outside of Organization: A Case Study, B. Ann Bettencourt, Canada. George Dillmann, and Neil J. Wolman For more information contact t Geoll Nelson, Dept. of Persuasion and Democracy: Strategies for Increasing Psychology, Wilfrid Laurier University, Waterloo, ON Participation and Enacting Social Change, N2L 3C5 Anthony R. Pratkanis and Marlene E. Turner Phone (519) 884-0710 extension 3314 Grassroots Organizing: Recurrent Themes and Fax (519) 746-7605, Email [email protected] Research Approaches, B. Ann Bettencourt

Research Agenda for Psychosocial 111111II11 I1111I1111 and Behavioral Factors in Women's Health (1996), a publication of the Advisory Committee of the 1994 Women's Health Conference (Psychosocial and Behavioral Factors in Women's Health: Creating an Agenda for the 21st Century), is

::12 The Community Psychologist, Volume 29, Number 3, July,199B available from the Women's Programs Office of the APA Public Interest Directorate. This agenda defines research priorities identified by the conference Call for Nominations Advisory Committee as pertaining to specific diseases Seymour B. Sarason Award for and health practices that greatly affect women. The Community Research and Action. 32-page document builds on the growing body of knowledge implicating psychosocial and behavioral The award recognizes those working in the factors in a number of major chronic diseases and conceptually demanding, creative, and ground- conditions that influence women's health across the breaking tradition of Seymour B. Sarason. This life span and concludes with recommendations for tradition includes: educational and policy priorities. A copy of the publication can be obtained by contacting the 1) novel and critical rethinking, reframing, and Women's Programs Office at (202) 336-6044 or reworking of basic assumptions, approaches, and sending an Email request to [email protected]. issues in the human services, education, Mail orders should be sent to the Women's Programs psychology, and other areas of community Office, Public Interest Directorate at the APA, 750 First research and action; St., NE, Washington, DC 20002-4242 2) major books and other scholarship that reflect these approaches, within the context of historical wisdom; and 3) action-research and other action efforts that reflect these new approaches.

Those working in both academia and applied settings, Late Notice! WORKSHOP AT APA: including government, are eligible for the award. The award is not restricted to senior-level people; younger Creating Video "Futures":A individuals who are doing exciting work that meets the criteria also can be considered. People may nominate Community-Based, Clinical themselves or others. Intervention The award winner will present an address at the annual Half-day, available for 4 CE credits. convention of the American Psychological Association Saturday, August 10, 2pm-6pm. in Chicago in August, 1997, and receive $1,000.

Practical concepts of using video for adaptive behavior The award has been made possible through the explained and demonstrated. Video futures teach financial contributions of scores of former students skills and illustrate goals for challenging situations, and colleagues. It was established through the including transitions faced in the community. For auspices of Division 27 of the American Psychological example, a video may be made of "Ricco" coming Association. and is presented every other year at the home to an apartment and meeting with roommates, or annual convention of the APA. The first two recipients going to the lunch room at a new job, or facing were Edward Zigler of Yale University and Emory criticism, etc. -- before Ricco ever moves to an Cowen of the University of Rochester .. apartment, takes a job, or expects to be criticized. Along with the name of the nominee, please send a At the workshop, you will participate and leam about paragraph of support for the nominated individual by scripting, videotaping, and editing personal video December 1,1996 to: Cary Cherniss, Ph.D., GSAPP, futures. It's a powerfully effective strategy, innovative, Rutgers University, Box 819, Piscataway, NJ 08855- and fun. 0819. Presented by : Peter W. Dowrick, Director of Video Research and Those interested in making a contribution to the award Development at Children's Seashore House and fund can make checks payable to the "Sarason Award University of Pennsylvania (Philadelphia) -- Fund" and mail to Kenneth Maton, Ph.D., Psychology internationally consulted on video futures, Department, UMBC, Catonsville, MD 21228. feedforward, and self-modeling; James Weidle, Community Transitions Project, Center for Human Development and University of Alaska Anchorage.

The Community Psychologist, Volume 29, Number 3, July 1996 33 If you would like your work to Research, this conference be reviewed for electronic- provides an excellent opportunity ANNOUNCEMENTS publishing by the National Urban to combine an outstanding three I League, please send the work (in day educational event with the hard copy AND on disk) to B. best New England has to offer in Keith Fulton, Director of sightseeing. CALL FOR PAPERS: Electronic Communications, For a submission packet, contact INTERNATIONAL CONGRESS National Urban League, 500 East Judy Lovelace, Hartman Biennial FOR APPLIED PSYCHOLOGY. 62nd Street, New York, NY Conference, c/o Child and Family The Scientific Program 10021. Add your contact infor- Agency, 255 Hempstead St., Committee for the 24th mation, a photo (color or black New London, CT 06320. 860- International Congress of and white), credit information (for 443-2896 or FAX 860-442-5909 psychology, taking place August the by-line), and a signed Email 9-14,1998 in San Francisco, has statement granting the National HN4611 @HANDSET.ORG. issued the call for papers. Urban League the right to publish Hosted by the APA on behalf of your work in electronic form. CALL FOR REPRINTS the International Association of A team of editors will review We are currently reviewing Applied Psychology, the your work and publish selected Community Psychology's Congress will feature an array of pieces as a public service on our theoretical and empirtcal individual and group presen- Leadership Network. Manuscripts contributions to the study of tations on: organizational can be as short as 3 pages and as violence against women. psychology, psychological long as 300 pages (hard copies). While we have conducted a evaluation and assessment; Disk copies (electronic versions) content review of the Journal of psychology and national should be sent in ASCII or a Community Psychology and the development; educational, WordPerfect compatible format American Journal of Community instructional and school (sorry to MS Word users). Psychology and are also psychology; clinical and Call (212-310-9244) if you have interested in receiving community psychology; applied questions related to this public references to/reprints of works gerontology; health psychology; service. This is a FREE service on violence against women economic psychology; and accordingly there is no published in other joumals by psychology and law; political payment if we decide to publish those who identity themselves as psychology; sport psychology; your article. Community psychologists, since traffic and transportation B. Keith Fulton 1980. Your assistance is greatly psychology; and other areas ([email protected]} National appreciated, as traditional such as applied social, applied Urban League, Inc. World Wide literature searches are not helpful developmental, human factors Web: http://www.nul.org in this regard. and ergonomics, and social Phone 212-310-9244 - Fax 212- Again, our criteria are: issues. 935-1 927 1. Theoretical or empirical work To request a copy of the call, related to violence against contact: Congress Secretariat, women, sexual harassment, APA Office of International CALL FOR physical battery, sexual assault. Affairs, 750 First Street, NE, PRESENTATIONS 2. Authored by a person who Washington, DC 20002-4242; Hartman National identifies as a Community fax 202-336-5956, e-mail: Conference on Children psychologist. [email protected]. and Their Families. 3. Published in journals 21h!tl Theme: Healthy Children 2010: than JCP or AJCP since 1980. School-Based Strategies to Please respond to either Dick CALL FOR BEST Enhance Social, Emotional and Reppucci ([email protected]) or PRACTICES: National Physical Wellness, June 1997. Sarah Cook (SLC4S@VIRGINIA. Urban League's "Leadership Child and Family Agency will hold EDU). US Mail address is Network" on America Online (call its fourth national conference on Department of Psychology, 800-652-0808 for FREE disk and the inter-relationships that exist Gilmer Hall, University of Virginia, 10 FREE hours). is in the process between families, schools and Charlottesville, VA 22903 of collecting "best practices" communities and how they covering the broad topics of influence children's health. The community leadership, tech- conference will take place along NEW EDITOR SOUGHT for nology, youth development, Connecticut's scenic coastline. the Nonprofit and economic self-sufficiency, and Co-sponsored by the journals of Voluntary Sector Quarterly racial inclusion. Primary Prevention, Early (NVSQ). Now 25 years old, Adolescence, and Adolescent NVSQ is the joumal of the

34 The Community Psychologist, Volume 29, Number 3, July,1996 Association for Research and institution. Applications should year cooperative agreements to Nonprofit Organizations and be received no later than prevent HIV infection among Voluntary Action (ARNOVA). September 16. Send to young men (18-23 year old) who The new Editor will work with the Professor Susan Ostrander, have sex with men. The first two current Editor, Carl Milofsky, Chair, NVSQ Search Committee, years will be devoted to formative during 1997, and will assume full Department of Sociology, Tufts research and development of a responsibility on January 1, University, Medford, MA 02155. common intervention and 1998. Professor Ostrander may be research protocol. The last three The Editor is to ensure that reached by phone at 617-627- years will be devoted to the journal address central and 3561; fax 617-627-3032, or conducting and evaluating the cutting-edge issues dealing with Email: intervention. Each recipient will philanthropy, the role of the [email protected]. have at least one pair of sites nonprofit sector, volunteerism, Affirmative action candidates are matched in terms of target civil society, and the nature and strongly urged to apply. population size and operation of nonprofit and demographics. Assignment of voluntary organizations. sites to control or comparison Responsibilities include World-Wide Academic status will be random. providing overall leadership and Visitor Exchange (WAVE). Average award: $400,000 to direction for the content of the To facilitate international travel $900,000 journal; soliciting, receiving, and and exchange, a searchable Applications due: August 21, sending out manuscripts for database has been installed on 1996 review; collating reviews, the WWW.Scientists about to Announcement #626 - responding to authors in a timely travel abroad are encouraged to Secondary Analysis of HIV way; overseeing add their itinerary to the WAVE Behavioral Intervention correspondence with authors database. Colloquium organizers Research Data and reviewers, identifying key and other prospective hosts are This RFA is for 1-year grants to people to develop special issues encouraged to search the WAVE conduct additional analyses of on important and emerging database for colleagues visiting existing data sets from completed issues in the field; overseeing their area. HIV behavioral interventions editing and production of the The home page can be research studies. It provides journal in collaboration with the found at http://www.psy.uwa. funds for two types of activities: publisher, and ensuring that four aU.edu.au/wave/. 1) secondary analyses of regular issues of appropriate outcome, process, or economic length are issued in a timely data, or 2) secondary analyses of fashion each year plus occasional FUNDING OPPORTUNITIES data with methodological impli- special issues. A small stipend is in AIDS research through cations for conducting, analyzing, provided plus the possibility for CDC's National Center for HIV, or interpreting research findings. supporting expenses for course STD, and TB Prevention. The grant will not support on- release and travel. Specifically, these will be funded going interventions, the collec- Qualifications include a through the Behavioral Inter- tion of supplemental data, nor record of significant scholarly vention Research Branch in the data from behavioral surveys. The achievement with accompanying Division of HIV/AIDS Prevention. applicants must demonstrate the familiarity with literature in the For more information on the effectiveness of the intervention field; recognized reputation RFP's, please call the contact that generated the data sets and among scholars and practitioners; persons listed below. the public health need for further administrative, managerial and analyses. Average award: editorial skills; capacity for detail Centers for Disease Control and $80,000 to $120,000 work; understanding of the Prevention National Centers for Applications due: August 15, international community of HIV, STD, TB Prevention Division 1996 scholars and practitioners and of HIV/AIDS Prevention, strong interpersonal skills. The Behavioral Intervention Research Announcement #627 - NVSQ is published by Sage and Branch. To receive an Replication of Effective HIV currently co-sponsored by the application kit for Behavioral Interventions Program on Non-Profit Announcements 601, 626, 627, This RFA is for 2-year cooperative or 630, please call (404) 332- agreements to replicate existing, Organizations at Yale University. 4561. effective HIV behavioral Interested nominees should Announcement #601 - interventions. The first year will send a letter addressing the job Prevention of HIV Infection be devoted to developing a and qualifications listed here, a in Youth At Risk This Request "package" of all materials CV, and a statement of support for Applications (RFA) is for 5- necessary for replicating the from the applicant's home selected intervention and to The Community Psychologist, Volume 29, Number 3, July 1996 35 identifying other nearby sites to interventions, 2) creation of post-doctoral experience. adopt and implement the datasets that contain detailed (Positions will be advertised in intervention. The second year will information about the studies, 3) the Chronicle of Higher Educa- be devoted to assisting the sites collection of missing descriptive tion and the Times Higher in implementing the intervention. and outcomes data from original Education Supplement.) The recipients will analyze the investigators, 4) use of the Fellowships are for 3 years each process and use process datasets to carry out meta- with the normal conditions of an feedback to refine the "package" analyses, and 5) observation of academic appointment in an and their technical assistance. how the interventions and related Australian university. Starting Average award: $200,000 contextual factors effect salary (12 mon) of $AUS43,000. Applications due: August 15, outcomes. Annual updates to the They also have a $10,000 1996 system, following the same research establishment grant, Announcement #630 - selection criteria and applying the plus relocation expenses. Prevention of Sexual same codebooks and analytic Research related to the Major Transmission of HIV by HIV- methods, will begin in the third Research Areas of the Univer- Seropositive Men year of the contract. sity's Research Management This RFA is for 2-year cooperative For additional information Plan. Community Psychology can agreements to conduct formative about any of these funding lit under either Human Perfor- research on behavioral opportunities, mance, Health and Development, intervention strategies to prevent please call Bob Kohmescher at or Culture, Community and the sexual transmission of HIV by (404) 639-8302. Communications. HIV-seropositive men. The HIV- Full details of the positions seropositive men may be and applications procedures are injection drug users or men who available at http://www.vut. have sex with men. Recipients edu.au (choose the RESEARCH are expected to work JOBS. JOBS. and button) collaboratively in developing more JOBS Anyone interested in common data collection protocols discussing the position can and intervention activities. The contact Adrian Fisher by Email: intervention, or its core elements, Adrian [email protected]. will be piloted and evaluated on a limited basis during the award POSITIONS IN Senior Researcher And period. Average award: PSYCHOLOGY ON THE $250,000 WORLD WIDE WEB Statistician. The UNISA Health Psychology Unit and Applications due: August 19, Positions in Psychology is a new 1996 WVVW site that maintains an up- World Health Organisation to-date listing of position Collaborating Centre for Injury and Violence Prevention seeks To receive an application kit for openings in psychology. It is to employ a senior researcher the following Request for based at the Australian National with good statistical skills and at Proposals, please call Linda University in Canberra, but it least a Master's degree in the Young at (404) 842-6728. includes academic and clinical health, human or social sciences. RFP 200-96-0520(P) - positions worldwide. Each Cumulative Research announcement includes the Using descriptive and inferential statistical procedures. Synthesis System for location of the job description, the incumbent's main respon- HIVIAIDS Behavioral and contact information, and sibilities will be to manage and Social Science Intervention frequently links to the posting analyse the Unit's epidemi- Studies. This Request for agency's home page. ological data bases on injury and Proposals (RFP) is for a 3-year You may register to have violence; design and implement contract to develop a cumulative new position announcements outcome evaluation methods; research synthesis system that sent directly to you as they are assist in the development of will be used to examine factors posted. Positions in Psychology research designs and associated with effective is located on the Web at questionnaires for new projects, interventions and to identify http://www.anu.edu.au/psycholo and participate in the inter- areas that require further study. gy.PiP/pip.htm pretation and write-up of current Findings from this system also can be used for technology Research Fellowship projects. transfer activities. Activities positions, Victoria The incumbent should have required by the contract include: University, Melbourne, at least live years of appropriate 1) systematic identification and Australia. Up to 5 Research research experience in a selection of existing scientific Fellowship positions, looking for developing country setting, and a studies of behavioral people with two or more years strong command of DOS and

36 The Community Psycholo9ist, Volume 29, Number 3, July,1996 Windows. spreadsheets, development of his or her own Radiology, the School of Social databases, statistical and scholarly work. This should be in Work, and the health care system graphics packages, and word areas that are related to the associated with Washington processors. A good publications statistical needs of projects of the University Medical School. record will be an advantage, and a Center for Health Behavior Those interested in this position valid drivers licence and own car Research. The other half of should contact are highly recommended. position entails coordinating Edwin Fisher, Jr., Ph.D. Remuneration is according statistical evaluation and Washington University to University academic scales, consultation to the Centers Center for Health Behavior and is dependent on health education and health Research qualifications and experience. promotion projects in both 4444 Forest Park Ave., Subsidised medical aid and a community and clinical settings. SI. Louis, MO 63108 thirteenth cheque are provided. Responsibilities will include Phone: 314/286-1901; FAX: This is a one-year contract post, statistical analyses of projects as 286-1919 with the strong possibility of well as consultation to other E-mail: [email protected] renewal. professional staff regarding Applicants should submit a statistical analyses of their INTERNSHIP Available. The curriculum vitae and the names of projects. Responsibilities will also National Mental Health three referees to: include work with a Data Association's Department of Alex Butchart Management Core within the Prevention has an immediately Deputy Director Center. available internship to assist the UNISA Health Psychology Unit JOB SETTING Current projects of Director of Prevention. This NCOH, PO Box 4788 the Center include community, recurring internship will be Johannesburg 2000 clinical, and professional offered for the Spring, Summer, Fax: 011-725-1320 education programs related to and Fall sessions and provides a diabetes, cardiovascular disease, stipend of $500 per term. To be asthma, cancer, smoking eligible for the stipend the intern Instructor/Assistant cessation, and other health should be enrolled as an Professor in Statistics and problems. Conceptual undergraduate in an accredited Evaluation, Center for Health perspectives guiding program college or university psychology Behavior Research, Division of planning and evaluation include program. Students in other General Medical Sciences, the Precede-Proceed model, programs and recent graduates Department of Medicine, health beliefs and related seeking experience may also be Washington University School of models, social support, eligible for consideration. A Medicine community organization, general background in prevention is The Center for Health social learning theory, and desirable. Intern must be able to Behavior Research at proactive/stages-of -change work independently, have strong Washington University approaches. writing skills, basic knowledge of announces a job opening in Center staff and represent a computer software, and a creative statistics and evaluation. The variety of disciplines, including mind. Primary duties will include position will be tenure track at the anthropology, clinical assisting the director of assistant professor or instructor psychology, data management, prevention on the following: level, contingent on experience dietetics, health education, 1. Various federal advocacy and qualifications. educational psychology, nursing, efforts conducted by the National ELIGIBILITY Individuals with public health, and social work Prevention Coalition on behalf of training in statistics, biostatistics, and, in medicine, colleagues in prevention. psychological statistics and asthma and immunology, 2. Communication with the NMHA evaluation, or educational cardiology, clinical oncology, Prevention Advocacy Network. statistics and evaluation. Many of general internal medicine, 3. Coordination of activities the projects of the Center metabolism and endocrinology, associated with NMHA's national address topics that are best pediatrics, and pulmonary anti-violence initiative, Voices vs. pursued by multivariate, medicine. Violence. longitudinal analyses. The Center is part of the 4. Writing and editing for NMHA Experience with such statistics as Division of General Medical Prevention Update newsletter. well as evaluation in both social Sciences within the Department The National Mental Health science and health would be of Medicine. In addition to several Association: Founded by Clifford desirable. divisions within the Department Beers in 1909, aims to work for DUTIES Approximately 50% of of Medicine, the Center has America's mental health and fight the time of the person taking this ongoing collaboration with the for victory over mental illness. position will be protected for Departments of Pediatrics, Our national office works directly Psychiatry, Psycholoqy, The Community Psychologist, Volume 29, Number 3, July 1996 37 with 325 affiliates across the offers unique opportunities to degree of familiarity with and insight il country to provide advocacy and design an innovative clinical and issues involving the gay community, services, encourage research, vocational program, organize the young gay and bisexual men's educate the public about mental community resources, initiate subculture, and HIV prevention and health and mental illness, work for treatment outcome and program intervention research. Responsibiliti improved access to quality health evaluation research, and work include: a) Assisting in the design an care, promote mental health and with an exciting interdisciplinary implementation of a community-level prevention mental illness. team. Requirements include a HIV prevention intervention for youn For consideration or Ph.D. from an APA-accredited gay men in two communities, b) additional information, contact: program, completion of an APA- Providing ideas and problem-solving Sandra McElhaney, Director of accredited internship, strong developing and refining the Prevention, National Mental commitment to residentially- intervention in each community, c) Health Association, 1021 Prince facilitated treatment, excellent Assisting in the implementation of th, St., Alexandria, VA 22314 organizational/administrative intervention in each intervention phone: 703-838-7506 skills, leadership abilities, and community, including supervision of fax: 703-684-5968; e-mail: expertise with complicated and project coordinators residing in the [email protected] treatment refractory patients. communities, d) Overseeing Research expertise is desirable. recruitment and data collection for a FAST-Track Program - Interested applicants should longitudinal cohort of 1000 young ga Research Scientist - DATA immediately send a curriculum men, e)Writing scientific articles base ANALYST for University of vita, three letters of on research project, g) Assisting in Washington prevention recommendation, and relevant developing a manual and other intervention project for children reprints to: Jessica Wolfe, Ph.D., dissemination materials for the projec (FAST Track). Must have Ph.D. Director, Women's Health Opportunities exist for the Project with strong quantitative skills, Sciences Division, National Manager to develop his/her own emphasis in multivariate and Center for PTSD, Boston DVA individual projects in conjunction witt longitudinal analyses, experience Medical Center, 150 S. this project and he/she will be expeCi with SAS preferred. Application Huntington Ave., Boston, MA to assist in writing grant proposals to is open until position is filled. 02130. Applications will be continue funding interventions base- AAIEOE. Send vita, letter of accepted until positions are filled. on the research. Please submit a lett interest specifying your The Department of Veteran of application, CV, and names of thre qualifications, and Affairs is an Equal Opportunity references to Dr. Susan Kegeles, recommendation letters to Mark Employer. Ph.D., Center for AIDS Prevention Greenberg, Ph.D., University of Studies (CAPS),74 New Montgomer Washington, FAST-Track, 146 N. Assistant Research Suite 600, San Francisco, CA 94105 Canal St., Suite 111, Seattle WA, Psychologist (or related field). The UCSF is an Equal Opportunity/ 98103. Young Men's Study, a NIMH-funded Affirmative Action Employer. research project at the Center for AIDS COMMUNITY/CLINICAL Prevention Studies (CAPS), University Director of Community PSYCHOLOGIST: The of California (UCSF), Department of Initiatives-United Way of Women's Health Sciences Medicine, has an opening for a Project St. Paul, MN. $39,000-48,000. Division of the National Center for Manager to assist in the design, Facilitate discussions between PTSD, Boston VA Medical implementation, evaluation and non-profit, for profit and CenterlTufts University School of dissemination of HIV prevention government agencies. Enable Medicine, seeks licensed or intervention research for young gay diverse groups to participate in license-eligible men (age 18-27). Applicants must decision making. Understand and community/clinical psychologist possess a doctoral level degree in one appreciate volunteer/citizen with demonstrated administrative, of the social or behavioral sciences or in decision making. Additional community, and clinical skills to a relevant public health field. information can be obtained from coordinate development, clinical Applicants should have experience in David Julian at 614-227-2700 or programming, and administration applied, field research and skill in writing by Email at of transitional residence for articles for scientific publications. This is [email protected]. women veterans with trauma- a four year position, beginning August related problems. This position 1996. Applicants must have a high

311 The Community Psychologist, Volume 29, Number 3, July,1996