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Despair Interrupted

Vulnerable youth have a friend in Ramona Denby-Brinson, the 2015 Harry Reid Silver State Research Award winner.

Research  |  Feb 26, 2016  |  By Afsha Bawany

Members of the DREAMR research team include, from left, Emily Ingalls, Anntesha Chesterton, Ramona Denby-Brinson, Peter Holloway, Sarah Izaguirre, and Efren Gomez. (R. Marsh Starks, UNLV Photo Services)

She was a 21-year-old single mom who grew up in the foster care system, and she already had four children. Minutes into their first interview, UNLV’s Ramona Denby-Brinson was able to tease out the depressingly familiar arc of her life story: absent parents, broken relationships, and grief and loss disguised as anger.

The young woman said she began having babies to prove that she could be a better mom than her own had been, that she would actually care for her children, and that, in return, she herself would be loved. Denby-Brinson nodded empathetically, but knew more complicated issues were at work.

“This situation is much too common for foster youth who become parents at an early age,” Denby- Brinson says. “We find that despite declining national rates of teen pregnancy over the past decade, the rates remain high for foster youth.”

Beginning early in her career as a social worker, Denby-Brinson wanted to shed more light on this aspect of foster care, especially given the fact that foster youth are three times more likely than their counterparts to maltreat their own children and subsequently have them removed from their care.

Denby-Brinson is a professor of social work in the Greenspun College of Urban Affairs and a senior resident scholar of social services at UNLV’s Lincy Institute. In her 17-year academic and professional career — both as a scholar and a social worker — she has become deeply familiar with the realities of situations like that of the mother of four. She has also gained national recognition for developing programs aimed at assisting youth as they struggle, typically with little or no professional support, to overcome the attachment disruptions, physical and emotional traumas, personal losses, and, perhaps most tellingly, the profound grief that arises from the difficult hand fate has dealt them.

Throughout her career, Denby-Brinson has been changing conversations about child welfare (including foster care), children’s mental health, cultural competency, and social policy. Her goal? To help Nevada’s most vulnerable citizens get a shot at a better life.

This work has earned her the Harry Reid Silver State Research Award, one of UNLV’s most prestigious accolades. Named for the U.S. senator who has been a longtime supporter of UNLV, the award recognizes faculty researchers who exemplify a commitment to advancing understanding of issues that address the changing needs of the community, state, and nation. It includes a $10,000 cash prize funded by the UNLV Foundation. Denby-Brinson is the first female to win the award.

“It’s humbling to be part of a group of such accomplished people who have received the award,” she says. “I don’t see it as an award for me as much as I see it as recognition of the host of social science researchers across campus. Social science researchers pose tough questions, tackle seemingly insurmountable problems, and often pursue lines of inquiry that don’t have easy answers. The university is recognizing the value of social science research and our ability to change the landscape of the community with the type of research we do.”

Denby-Brinson is a Las Vegas native and licensed social worker. She earned a master’s degree in social work from UNLV in 1990 and a doctorate from The Ohio State University several years later. After three years as an assistant professor at the University of Tennessee, Denby-Brinson returned home to join the UNLV faculty in 1998.

Since then she has been awarded more than $12 million in competitive research grants from some of the nation’s most important funding agencies, including the National Institutes of Health, the U.S. Department of Health and Human Services, and the Lois and Samuel Silberman Foundation.

“Ramona has used her research to advance the public good and to effect change on behalf of Nevada’s most vulnerable citizens,” says Stan Smith, associate vice president for research at UNLV. “She is highly deserving of this prestigious award.”

Smith notes that funding agencies tend to reward researchers who get results, and Denby-Brinson has done so by translating research into action. Her development of the Kinship Liaison Program, a mentoring project aimed at supporting foster families who care for the children of relatives, is one notable example.

Statistics indicate that maltreatment recurrence rates — the continued abuse or neglect of foster children who enter the system after experiencing mistreatment at home — for kids fostered by relatives can be high. Denby-Brinson’s research has shown that care by relatives is a preferred form of placement given its potential to increase overall well-being for children. However, when relative caregivers are not supported or trained, or do not have adequate resources, maltreatment can persist. Many relative caregivers struggle financially and can feel overwhelmed by their new responsibilities. Some are unprepared to care for children who, due to previous traumatic experiences, may need help adjusting to their new homes.

The Kinship Liaison Program, overseen by Denby-Brinson and officials working with the Clark County Department of Family Services, aimed to reduce maltreatment recurrence, increase home stability and permanence for children, and improve their overall well-being. Relative caregivers were paired with well-trained mentors, or “kinship liaisons,” men and women whose similar experiences and support helped ameliorate the conditions that can lead to abuse and neglect. It’s working, she says. Maltreatment recurrence rates have been cut in half and children are improving academically and emotionally.

The program’s achievements have been lauded by the U.S. Department of Health and Human Services, and it has since become a model adopted in one form or another by several U.S. cities. Its success has also led to ongoing funding by Clark County, and it has been described as a model family engagement and system-of-care approach and is cataloged in the Child Welfare Information Gateway description of exemplary programs.

“Ramona Denby-Brinson develops research questions that produce solutions for Las Vegas and the nation,” says Robert Ulmer, dean of UNLV’s Greenspun College of Urban Affairs. “Her research is so important because the innovative solutions she develops protect and make the lives of children better. As a faculty member in the Greenspun College of Urban Affairs, she conducts research that captures the value of creating urban solutions for the most pressing needs in our communities.”

For her part, Denby-Brinson says she is motivated by the “change in conversation” that happens when programs like the Kinship Liaison Program are successful.

“Now policymakers want to invest in the kids and invest in supporting caregivers and families,” she says. “That’s the neat part: when you can use your research for advocacy. We use our research to change policies and to create programs that, in the real world, make a difference for families.”

In another project, Denby-Brinson is seeking to better understand why young women in foster care — such as the aforementioned 21-year-old mother of four — so often end up in difficult circumstances. Mindful of the tremendous risks that foster youth face, she created the Determined, Responsible, and Empowered Adolescents Mentoring Relationships (DREAMR) project in 2012. DREAMR is a randomized experimental-control group study situated in Clark County and funded by the U.S. Department of Health & Human Services Children’s Bureau. Young women are eligible for participation in the DREAMR project if they are between the ages of 12- 21 and are currently or were formerly in the foster care system. A team of public and private providers administer an array of services. Denby-Brinson is partnering with several community stakeholders to conceptualize and implement the intervention, and she and her research team have been studying the effects of the intervention for the past five years. Her early research findings indicate that these women typically aren’t making spontaneous or irrational decisions. They are instead consciously choosing pregnancy and childbirth as psychological salves.

Denby-Brinson also finds that a significant number of her foster-child cohort struggle to envision a better future for themselves. Parenthood, by providing a sense of purpose, worth, and meaning, thus becomes a satisfying stand-in for the significant and meaningful relationships that are otherwise missing in their lives.

“This research provides social work professionals with greater understanding of the psychology behind early pregnancy — particularly intentional pregnancies — in foster care youth,” she says. “It allows professionals to appropriately and more effectively intervene. Such interventions can potentially stop the cycle of generational maltreatment and bring about more positive financial, educational, and psychological outcomes for young adults.”

Denby-Brinson seeks to address social problems in a fashion typical of her professional values and philosophy: She cultivates relationships, galvanizes community interests, and brings together community partners and stakeholder groups. The DREAMR project involves active and long-standing partnerships with a number of organizations, including the Clark County Department of Family Services, Big Brothers and Big Sisters, the Southern Nevada Health District, and the Nevada Institute for Children’s Research and Policy. She also partners with local nonprofit groups serving foster families and at-risk children, such as Olive Crest and SAFY (Specialized Alternatives for Family), to create various intervention programs.

In the DREAMR program and others, Denby-Brinson credits the dozens of graduate students who have assisted her over the years. Currently, senior research associate Efren Gomez, whose academic background is economics, manages the DREAMR project and supervises a group of graduate research assistants who are studying social work and marriage and family therapy.

“We conceptualize the interventions and related research components, and then we teach graduate students how to collect, manage, store, and analyze data,” she says. “Graduate students are a vital part of our work, and we could not run longitudinal, multifaceted, large projects without them. In fact, the graduate students become so skilled and they get so invested that they can decipher things that sometimes we miss. It’s truly a case of the students becoming the teachers.”

In addition to graduate students the DREAMR study actively involves technical advisors — young adults who were once in the foster care system and now help others by sharing their insights and experiences. “Our technical advisors assist in every aspect of the project. They help us to collect data but most importantly, they help us to understand and translate our research findings,” she says.

In the DREAMR study Denby-Brinson and her team are developing a variety of activities used to help foster youth reconcile feelings of separation and the trauma that they have experienced in the past. In order to more rigorously assess the interventions’ effectiveness, Denby-Brinson uses a control group, a tool that is fairly unique in social science research. Particularly in child welfare research, the use of control groups is not always welcomed; this is because public child welfare administrators and other leaders seek to deliver services to all children.

In this case, however, Denby-Brinson convinced her community partners to use a randomized control group design, hoping to provide a clear indication of whether the variables introduced affect outcomes. The subjects were randomly selected to participate in either the control group or the intervention-receiving DREAMR group.

Final results are expected early next year, but preliminary findings indicate decreasing depression and anxiety rates for the DREAMR group participants. Pregnancy rates among them have also dropped. The program is expected to end in 2016 but may continue if grant funding is available.

Denby-Brinson has used her empirical research findings to create a new project that organizes the efforts of local and state public and behavioral health partners to develop and expand clinical social work education. The three-year project, titled “Meeting Behavioral Health Workforce Needs Project,” was funded by a $1.4 million grant funded by the U.S. Department of Health and Human Services. Its goal is to produce more than 100 highly competent practitioners who can intervene on behalf of children, adolescents, and transitional-age youths who are at risk of (or who have already developed) mental and/ or behavioral health disorders.

The project’s research component involves multiple methods, including geodemographic recruitment, youth- and family-informed teaching models, mentoring groups, field site environmental scans, and clinical, cultural, and linguistic self-assessments/self-efficacy measures.

Led by project coordinator Natasha Mosby, the initial cohort of trainees have started their specialized training, which includes a series of courses and field education to prepare them to intervene with children and youth using evidence-based mental health treatment models. Denby-Brinson says faculty will emphasize the importance of connecting with the families and parents of children, as they need support just as much as the children do and must be valued as equal partners in helping children succeed.

In addition to courses taught by UNLV faculty, the social work mental health trainees will take a course that will be co-taught by adolescents who have been diagnosed with mental health difficulties and their parents or a family representative. Denby-Brinson says the idea is to help students to hear first-hand how families live with mental health issues.

She says this new method of delivering the course material should help students overcome their biases and stereotypes about children who live with mental health disorders.

Involving family members will also help students understand that treatment of mental health disorders is a team effort — a partnership among patients’ families, doctors, nurses, school officials, counselors, social workers, and other mental health professionals.

“One of the rewarding aspects of my work is being able to use research discoveries to change the lives of children, youth, and families who have been overlooked and counted out,” Denby-Brinson says. “It’s amazing to see how even a minimal level of support and investment can help children thrive and grow up to live normal, productive, and fulfilled lives.”

The Harry Reid Silver State Research Award is funded by the UNLV Foundation.