Final Report Summary - AIDING THE NEGLECTED (Aiding the Neglected: Meta-Analysis of Emotional Maltreatment Prevention and Intervention Programs) During the project, the following objectives were addressed: A. Establish working relations with five research centers in the US (UC-Berkeley, UC-SF, U-Washington, Stanford and the Parent Training Institute at SF) B. Establish working relations with Israeli research centers (Hebrew University, Tel Aviv University, University of Haifa). C. Focusing on the following topics of study: 1. Resilience to trauma 2. Parental emotion regulation 3. Prevention / intervention effectiveness assessment 4. Participatory action research (PAR) 5. Israeli families at-risk D. Learn advanced statistical procedures E. Participate in conferences I would like to elaborate on each of these objectives: A. Establishing working relations with US research institutes. ====================================================During the first period of my fellowship, at the US, I formed connections with research centers at UC San Francisco (UCSF), the University of Washington, Stanford University and the Parent Training Institute. I also worked extensively with my host at UC Berkeley, Prof. Ozer, and her colleagues. For that aim, I made an effort to attend bi-weekly meetings at UCSF. In these meetings, I presented my work and heard other’s presentations of their projects, while learning about various designs that can be implemented within an intervention-based project. Second, I attended weekly lab meetings at Stanford U., extending my collaborations on the one hand, and my knowledge and expertise in emotion regulation. Third, I took several trips to Seattle, to meet with Prof. Katz and her team. During these trips, I advanced my collaborations with Prof. Katz’s team and progressed with my projects. During the reintegration stage of my fellowship, in the Hebrew University in Israel, I continued my collaborations with these research centers and Universities, while adding a concentrated effort to form strong collaborations with Israeli research centers and University researchers. B. Establish working relations with Israeli research centers ====================================================Upon returning to Israel and the beginning of my reintegration phase, I set out to establish working relations with Israeli researchers. During this year I have worked with Prof. Asher Ben-Arieh (the scientist in charge of this fellowship) of the Hebrew university, Dr. Carmit Katz from Tel Aviv University and Dr. Iris Manor-Binyamin from University of Haifa. I have interviewed for faculty positions, and following being accepted to be a faculty member in the School of Social Work in the University of Haifa, I have begun establishing working relations with my co-faculty – in particular, Dr. Ruth Berkowitz. I have also continued my working relations with Prof. Ozer from UC Berkeley, Prof. Gross from Stanford University and Prof. Katz from University of Washington. C. Study topics ====================================================I would like to detail my progress on the four topics of study, with reference to the content and methodological gains. In this section, I will address objectives C (statistical procedures) and D (conferences).1. Resilience to trauma -----------------------------------------------------------1.a. Community violence and family resilience: In this project, I teamed with Prof. Ozer (UC Berkeley) and her colleagues, Dr. Douglas and Dr. Wolf. The aim of the project was to review, qualitatively, how various family factors may – or may not – serve as protective factors for youth exposed to community violence and crime. The study add to knowledge on the range of the ability of parents to protect their child after s/he had been exposed to crime. The differential impact of parental warmth / closeness and parental discipline is shown. In this project, I expanded my knowledge on how to conduct meta-analyses in complex designs. I also expanded my knowledge on resilience theory and the way it is incorporated into studies examining various ecological systems. This project was completed and published in Journal of Clinical Child & Adolescent Psychology (Ozer, Lavi, Douglas, & Wolf, 2015) and was presented in one conference (Lavi, Ozer, Douglas, & Price Wolf, July 2014). 1.b. Conflict trajectories in families of children diagnosed with cancer: In this project, I teamed with the team of Prof. Katz (U. of Washington). We examine family conflict in the year following a child’s diagnosis with cancer. In this project, I have gained ample knowledge in analyses using Multilevel Linear Modeling (MLM) via workshops, courses and consultations with Prof. King (who is a part of Prof. Katz’s team). Results of the preliminary analysis were presented by Prof. Katz in APOS conference (Katz et al., February 2014) and by Ms. Kawamura in SPPAC (Kawamura et al., April, 2015). This paper is in final writing stages (Lavi et al., In preparation), and will be sent for publication by the end of January 2017. A second publication is in revise-and-resubmit stage (Katz et al., Revise-and-resubmit). 1.c. Generational transmission of trauma in foster care children: In this project I am working with the team of Prof. Lieberman from UCSF. This project examines the differences between two groups of mothers. In the first are mothers who were foster children, and their own children are also in foster care. The second group has mothers who were foster children, and their children are in their care. We have worked on understanding the consequences of childhood trauma on trajectory of trauma in the family. As a mainly quantitative researcher, this project has given me an opportunity to learn qualitative analysis – various considerations in its implementation and how to conduct such an analysis. I also have had considerable learning gains, focusing on comparative studies and on complex qualitative coding systems (such as the Adult Attachment Interview, the AAI). The results of this project were presented in six conferences (Green et al., September, 2014; Green, Van Horn, Smith, Lavi, & Halloway, August, 2013, August, 2014, September, 2013; Lavi, Green, Chen, Glowacki, & Lieberman, February, 2015; Lavi, Green, et al., March, 2015).2. Parental emotion regulation -----------------------------------------------------------2.a. Parental emotion dysregulation and child maltreatment: In this project I am collaborating with my UC Berkeley host, Prof. Ozer, with Prof. Katz from U. Washington and with Prof. James Gross from Stanford. We are examining how parents’ emotion regulation tendencies are related to risk for child maltreatment and how child maltreatment affects the development of emotion regulation in abused/neglected children. We conducted a large scale meta-analysis (includes 61 papers) and we are in advanced writing stages. The preliminary results were presented in four conferences (Lavi, Ozer, Katz, & Gross, February, 2015; Lavi, Ozer, Katz, & Gross, July 2014; Lavi, Ozer, Katz, & Gross, March, 2015; Lavi, Ozer, Katz, & Gross, October 2014). We expect to send the study for publication by March 2017. 2.b. Emotional maltreatment and parental emotion regulation: Emotional maltreatment is understudied although many regard it as the most common sub-type of child maltreatment. In collaboration with Dr. Manor-Binyamini (U. of Haifa) and Ms. Elizabeth Siebert (University of South California Graduate Student), we are reviewing existing data pertaining to emotion reactivity and emotion regulation of emotionally maltreating parents. This project is in final writing stages. 2.c. Parental co-regulation of sadness: In this project I am collaborating with Prof. Gross team (Stanford). We are examining how parents might change their parent’s emotional reactions (here: sadness) in reaction to events relating to their child. Previous studies have shown interesting patterns in the co-regulation of anger in the context of parenting, showing a difference in contamination and compensation of emotions is different in parenting, in comparison to other social relations. This study will advance this knowledge to the emotions of sadness. Our team conducted two empirical experiments, and are in the midst of conducting the third. 2.d. Emotion regulation and nature exposure: In this project I am collaborating with Prof. Gross team (Stanford) in examining the relations between physiological indications of emotion regulation, natural experiences and rumination. There is a greater understanding of the importance of emotion regulation to the well-being of the person, on many respects. In this paper, we are conducting a meta-analysis, examining these three relations: nature experiences and rumination, rumination and emotion regulation, nature experiences and emotion regulation. In this, we aim to shed light on these different relations and their relative strengths. This project is in advanced data analysis stage. 3. Prevention / intervention effectiveness -----------------------------------------------------------3.a. Perinatal CPP intervention for pregnant women: This project was conducted with the team of Prof. Lieberman. We examined whether an adaptation of the Child-Parent Psychotherapy (CPP) – designed for pregnant women – could be effective in lowering risk for intergenerational transmission of trauma. We explored whether women who took part in this Perinatal CPP intervention show lower levels of depression, post-trauma and better attitudes toward child rearing. This project is complete and the paper was published (Lavi, Gard, Hagan, Van Horn, & Lieberman, 2015) and was presented in three conferences (Lavi, Gard, Hagan, Van Horn, & Lieberman, April, 2015; Lavi, Gard, Hagan, Van Horn, & Lieberman, February, 2015; Lavi, Gard, Hagan, Van Horn, & Lieberman, July 2014). 3.b. The impact of personal and organizational factors in the effectiveness of parenting programs: This project is in collaboration with Dr. Stephanie Romney from the San Francisco Parent Training Institute. The parent-training institute trains therapists to work as parent group therapists within two evidence-based parenting programs: the Triple-P and the Incredible Years. In this study, Dr. Romney and I examine how effective these programs are in their application in San Francisco, and whether this effectiveness is dependent upon client’s personal pre-intervention characteristics (e.g. need level). We will also examine whether this effectiveness is dependent on organizational factors (e.g. age of the institute, level of training of therapists). This project is in final data analysis stages. 4. Participatory action research (PAR) -----------------------------------------------------------4.a. Critical thinking and self-efficacy in students participating in youth participatory action research: In this project, Prof. Ozer and I co-guided an undergraduate student, Ms. Jessica Saba, in a project for a scholarship she received. In this study, I guided Ms. Saba in her generation of hypotheses and qualitative data analysis. 5. Israeli families at risk -----------------------------------------------------------5.a. Dissemination of evidence-based interventions in Israel: I have established connection with Prof. Sanders, the developer of Triple-P, an evidence-based intervention program for parents. Triple-P (Positive Parenting Program) aims to better the parent-child relationship and prevent child maltreatment (Sanders, Kirby, Tellegen, & Day, 2014). With Dr. Manor-Binyamini (U. of Haifa), we are planning the dissemination of the program in Israel. This project is very complex due to language differences, and will have to be accompanied by careful scientific research. For this aim, I have been trained in Triple-P level 4 and 5, and am an accredited therapist. 5.b. Strong communities in Haifa: With my colleague in U. of Haifa, Dr. Ruth Berkowitz, the head of the School of Social Work in U. of Haifa, Prof. Miri Cohen, and the Haifa welfare department, Mr. Saed, we are working on a community intervention that follows the outline of Strong Communities (Haski-Leventhal, Ben-Arieh, & Melton, 2008). This is done in close collaboration with the Haruv Institute and the head of the Strong Communities initiative in the Tel Aviv municipality, Dr. Carmit Katz. This project will be followed by close research and evaluation. 5.c. Youth Futures: I am collaboration with Youth Futures , the Jewish Agency’s flagship program. Starting its work a decade ago, Youth Futures provides community-based mentoring for at-risk children. In 2016, Youth Futures is starting a new path, targeting primary intervention. I am consulting to this organization on how to use advanced evaluation methods that I learned during my Fellowship, with the expectation that the evaluation will be part of future study targeting the effectiveness of the various Youth Future interventions. 5.d. Neglect center: I am part of the Neglect Center, an initiative headed by Dr. Hagit Turjeman, Dr. Benny Baily (West Galil College) and Dr. Alon Yulevitch (Nahariya Hospital). This initiative sets out to enhance the process of locating neglecting families. The current identification of neglect in families is greatly tied with economic disadvantage. Children who are emotionally neglected and children who are from mid- to high economic status (and are neglected) may be under-identified. This project held initial meetings with professionals in the field of welfare, and continues with in-depth interviews with such professionals. 5.e. Yali Conferences: I am in the organizing committee of the Yali Conferences – a series of conferences that set out to better the knowledge regarding family violence. The conferences have started almost a decade ago, and are taking place in the peripheral northern area of Israel. In that, it aims to advance knowledge and collaboration in the field of family-violence prevention in areas that are far from the cultural center in Israel. 3. Project objectives:====================================================The objectives for my Fellowship were to gain knowledge and expertise from top US universities in the field of family stress, prevention and intervention of child maltreatment and basic processes that might explain familial stress reactions and child maltreatment. My aim was to conduct high quality research that will be advance knowledge regarding child maltreatment prevention and intervention, publish this research and disseminate the conclusions from the research. In addition, I aimed to enhance my knowledge and understanding of advanced research methods and statistical procedures. Upon returning to Israel, I aimed to form working-relations with Israeli labs and research departments, and to begin new collaborations of Israeli based research that is based on the knowledge and techniques acquired during the UC Berkeley phase of the fellowship. I also aimed to continue my work as a faculty member in one of the Israeli Universities. 4. Work progress and achievements:====================================================During my Fellowship, I secured long-lasting working relations in several leading labs in the US (UC Berkeley, Stanford U., U. of Washington, UCSF) and in Israel (Hebrew U., Tel Aviv U. and U. of Haifa). I worked and am working with several welfare agencies and third sector organizations (PTI, the Neglect Center, the Yali conferences, Youth Futures). I have initiated 15 projects in the course of this 3-year long fellowship. Four of which have been completed and published in papers (Lavi et al., 2015; Ozer et al., 2015) and presented in conferences (Green et al., September, 2014; Green et al., August, 2013, August, 2014, September, 2013; Lavi et al., April, 2015; Lavi, Gard, et al., February, 2015; Lavi, Gard, et al., July 2014; Lavi, Green, et al., February, 2015; Lavi, Green, et al., March, 2015; Lavi, Ozer, Douglas, et al., July 2014). Seven projects are in various analysis and write-up stages (Lavi et al., In preparation) (Katz et al., Revise-and-resubmit; Slone, Lavi, Ozer, & Pollak, Under submission), and include six conference presentations (Katz et al., February 2014; Kawamura et al., April, 2015; Lavi, Ozer, et al., February, 2015; Lavi, Ozer, Katz, et al., July 2014; Lavi, Ozer, et al., March, 2015; Lavi et al., October 2014). Four additional projects are relatively new projects that I initiated during the reintegration phase in Israel and are in collaboration with Israeli researchers. I have gained much knowledge in several fields: emotion regulation, child maltreatment, emotional maltreatment, youth participatory action research, randomized control trail studies, evidence-based intervention programs and physiological measurement of emotion regulation. I have learned much regarding longitudinal designs, intervention programs, qualitative studies and qualitative analysis, and mixed methods studies. I gained knowledge and expertise in several statistical techniques, including MLM and enhanced my knowledge in meta-analytic procedures. I also experienced working as an integral part of several labs, and gained valuable practical knowledge regarding managing big studies with large teams. Lastly, as part of my collaboration with the PTI, I took part in a Triple-P facilitator’s course and gained accreditation as a group levels 4 and 5 facilitator in the parental intervention program, the Triple-P. During the reintegration year I worked with Prof. Asher Ben-Arieh (the scientist in charge of this fellowship) of the Hebrew university, Dr. Carmit Katz from Tel Aviv University and Dr. Iris Manor-Binyamin from University of Haifa. I was accepted to be a faculty member in the School of Social Work in the University of Haifa, I have begun establishing working relations with my co-faculty – in particular, Dr. Ruth Berkowitz. I have also continued my working relations with Prof. Ozer from UC Berkeley, Prof. Gross from Stanford University and Prof. Katz from University of Washington.
