Reading and Writing Again

Winter Quarter, 2011 has just begun and I find myself sitting again for hours at a time.  It is a reading and sitting meditation practice. Monkey mind thoughts get in the way sometimes but the lure of ideas inspired by reading draw me into a deeper focus and concentration.  Every few hours I get up for water or to move around.

Blogging is also a distraction and a release -  it is a place to put the thoughts and ideas piling up in my head while I read.  Blogging becomes a place to digest, organize, and make sense of what I am reading and flesh out the forming seed thoughts.  I see connections everywhere.  I want to build bridges between various theoretical frameworks, perspectives and approaches.

My dissertation proposal seminar is taught by Zeke, my former epistemology professor.  He is old-school in the best sense of the word.  Zeke is probably in his 70s and a Michigan alum.

• (An aside:  Michigan is the real deal, where it is too cold to do anything but study and where most grad programs are rated #1 in the country.  Dr. Brown, Director of the School of Social Work at CSULA, is also a Michigan alum and said their graduate school alumni make up the greatest percentage of graduate school deans and directors.)

Zeke is from Israel and his native accent still comes through.  He uses braces to walk because of polio disease.  He is a scholarly heavyweight and a sociologist.  I am a dork because I find myself smiling in class a lot and giving him a thumbs up while I hang on every word he speaks and take copious notes.  It is a small seminar class - 8 students total - so it's hard to be inconspicuous with my painted-on goofy smile and hand gestures.  But I don't care because he is challenging and encouraging at the same time.  He takes my questions seriously and encourages being challenging.

Some nuggets from yesterday's lecture:

• Epistemology shapes the way we think about problems and dissertations.
• By the end of Spring quarter, we will have a well-defined dissertation proposal that we are comfortable defending.
• This is a writing seminar on substance and style, so expect to write and write and write. 
• We will write the proposal piece by piece.  We will read each others work and discuss it in class.  We will write several drafts of each section of the proposal.
• We will create an environment conducive to reflection and being self-critical.
• Dissertations must be well-written, that is, everyone needs to be able to understand the language, concepts and intent.
• Dissertation Proposal:

1. Statement of the Problem (the heart of the dissertation)
2. Critical Review of the Literature
3. Own Theoretical Framework
4. Hypotheses & Research Questions
5. Methodology
6. Timeline

• If you're not passionate about your dissertation topic then you will be miserable and the work will be unbearable
• Shoot above "run of the mill" but not too far in "left field" - get creative and add something new, your own special twist to the knowledge base - frame the problem in such a way that will make it exciting and different
• In his research career, Zeke borrowed a concept from manufacturing and used it as an analogy:  "Human service organizations are like factories and people are raw materials."  Initially controversial, this new way of looking at things set him apart as a scholar.

My assignment is to write the "Statement of the Problem."  He said this is the hardest part of the proposal.  Here I go...

Writing It Out - Integrating Thoughts and Feelings

Pennebaker (1986) conducted a study about journaling.  He randomly assigned subjects (college students) to one of the following groups and asked them to write about...

(1) ... a superficial or trivial topic - for example, a description of their living room or the shoes they were wearing.  (Control Group)

(2) ... their feelings associated with one or more traumas in their life (Trauma-Emotion Group)

(3) ... the facts surrounding traumatic events (Trauma-Fact Group)

(4) ... both their feelings and the facts surrounding the traumas (Trauma-Combination Group)

(all groups wrote for 15 minutes per night on four consecutive nights)

Before and after writing each essay, he measured their...

• blood pressure
• heart rate
• self-reported moods
• self-reported physical symptoms

Four months after the end of the study, subjects completed questionnaires about their health and general views of the experiment.

Before and six months after the study, the health and counseling center records of study participants were collected.

This is what he found:

• At first, the Trauma-Combination Group writers had a large increase in blood pressure from before to after the essay.  After the first writing session, they showed moderate decreases in blood pressure from before to after the session.
• Those that wrote about trauma reported more negative moods after writing the essays, whereas Control Group writers felt more positive.
• There was an overall increase in health center visits for illness in all conditions except the Trauma-Combination group.
• A trend suggesting that those in the Control Group reported the most days their activities had been restricted due to illness and the Trauma-Combination Group the least.
• Overall, participants in the Trauma-Combination and Trauma-Emotion Groups reported reductions in health problems relative to those in the Control and Trauma-Fact Groups.
• Those in the Trauma-Emotion and Trauma-Combination Groups were more likely to have thought about their essays than those in the Trauma-Facts or Control Groups.

"Although I have not talked with anyone about what I wrote, I was finally able to deal with it, work through the pain instead of trying to block it out.  Now it doesn't hurt to think about it." -- Trauma-Combination writer

In his discussion, Pennebaker notes:
"Theorists argue that the resolution of a trauma is associated with the cognitive work of organizing, assimilating, or finding meaning to the events surrounding the trauma."

"...tying both the cognitions (thoughts) and affect (feelings) surrounding traumatic events was optimally effective in maintaining long-term health."

"Jourard (1971) argues that self-disclosure allows for one's feelings and thoughts to become more concrete, which ultimately results in greater self-knowledge.  Disease results, according to Jourard, when the motive toward self-understanding is blocked."

"We have argued that the act of inhibiting behavior is physiologically stressful.  Previous surveys indicate that not confiding in others about a traumatic event - which we view as a form of behavioral inhibition - is associated with disease."  (We avoid to take a break from the pain of talking about or thinking about the memory, but avoidance takes its toll)

"Although writing about traumas appears to have positive long-term health effects, we must pinpoint the aspect of this exercise that is beneficial.  Possibilities include making an event concrete, linking the affective and cognitive aspects, the reduction of forces associated with behavioral inhibition over time, and so forth."

Reference:
Pennebaker, J.W. & Beall, S.K. (1986).  Confronting a Traumatic Event:  Toward an Understanding of Inhibition and Disease.  Journal of Abnormal Psychology, 95, 274-281.

The Books and Article That Made an Impact On Me in the Last Year

I have read a lot of stuff since I started the program almost a year and a half ago. Something I wish for everyone is the time and space to read good stuff. If your time is limited and want to know what is a good read, here are some of my suggestions:

1. Israel, B.A., et al. (Editors). Methods in Community-Based Participatory Research for Health. Josey-Bass: San Francisco, CA. 2005.

What I like about this book is that it lays out Community-Based Participatory Research (CBPR) in action through case studies (tell me a story about what you did and how it is done). The descriptions are easy to read (compared to most journal articles) and describe CBPR step-by-step.

"From an ethnographic perspective, community-based participatory research offers an approach to conducting culturally competent research that aims for a cultural interpretation of research findings and that uses community members as researchers. CBPR includes community members as researchers in all aspects of the research process, including the development of research concepts, the conduct of the research, and the interpretation of the findings."

"Groups and community members become agents of change by telling their stories, articulating their perspectives on the health and social issues affecting them, and recommending strategies for addressing these issues that are grounded in the realities of their environment and experience."

2. The entire issue of Ethnicity & Disease, Volume 19, Number 4, Autumn 2009.

Seven chapters of clear and concise writing describing, in step-by-step fashion, how to carry out a Community-Partnered Participatory Research (CPPR) project with many examples drawn from the authors own experiences on a Witness for Wellness project addressing depression in South Los Angeles.

It's all good and important stuff about engagement, visioning, organization and structure, and so on. One of my favorite chapters is on evaluation written by Ken Wells. I know Ken and he is brilliant (I have a serious brain crush on him and will work with him someday although he is not aware of either truth just yet). One of the marks of a brilliant person is that they can take the complex and make it simple again. The chapter is elegantly simple and illustratively clear.

"...the long-range goal is to build capacity in the community for evaluating partnered projects...The evaluation is part of the whole process of respectful and equal engagement, which is the goal of Community-Partnered Participatory Research."

3. Public Policy and Program Evaluation by Evert Vedung

Who knew that Swedish folks had it going on? I have come across lots of interesting research coming out of that country. And I am looking forward to celebrating Swedish Christmas with friends this year for the first time ever. But I digress. This book was written after the author conducted a series of lectures on the topic and it shows. That is, it has a great conversational style and covers a lot of ground. I may have been conceptually predisposed to the topic but he managed to make me fall in love with the idea of policy evaluation - who knew there were so many ways to carry it out! It's like the Kama Sutra of policy evaluation.

4. Experimental and Quasi-Experimental Designs for Generalized Causal Inference by William R. Shadish, Thomas D. Cook, Donald T. Campbell

Okay, this is like a dictionary or reference manual for intervention research designs. Hardly the stuff of love, unless you are passionate about intervention research, which I am. Too much to digest or remember but exceedingly thorough and clear. Like any good reference, I will be coming back to it again and again.

5. Statistical Methods for the Social Sciences by Alan Agresti & Barbara Finlay

I used this book for two quarters of Stats with two different professors and one TA - each with their strengths and weaknesses. This book single-handedly taught me stats so I am grateful to the authors. I love a book that I can count on. My mother used to say she never worried about me because I had my mother - the books. So I guess it is not too much of a stretch to say, "I love you Agresti and Finlay!"

6. Empirically Based School Interventions Targeted at Academic and Mental Health Functioning by KIMBERLY E.HOAGWOOD, et al.

Hoagwood is another one of my brain crushes. Nearly every one of her 85 articles in PubMed is something I would like to have worked on with her. I must admit I came across this particular article before I came back to school but it helped lead me to where I am today. I have read, quoted and referred back to this article many times for the last year and a half.

The abstract reads...
This review examines empirically based studies of school-based mental health interventions. The review identified 64 out of more than 2,000 articles published between 1990 and 2006 that met methodologically rigorous criteria for inclusion. Of these 64 articles, only 24 examined both mental health and educational outcomes. The majority of school-based mental health intervention studies failed to include even rudimentary measures of school-related outcomes.

Analysis of the 24 studies yielded several key findings:

• The types of mental health outcomes most frequently assessed included self-, peer-, teacher-, or parent-reported measures of social competence, aggression, or problem behaviors.
• Academic scores and school attendance were the types of educational outcomes most frequently assessed.
• The majority of interventions focused on elementary students, had a preventive focus, and targeted prosocial, aggressive, and antisocial behaviors.

Only 15 of the 24 studies demonstrated a positive impact on both educational and mental health outcomes, 11 of which included intensive interventions targeting both parents and teachers. (This is what it takes to make an impact on both education and mental health outcomes. Sad that only 11 out of 2,000 did so.)

The studies that had an impact only on mental health outcomes tended to be less intensive with more limited family involvement. (Thee money line! If you want to make an impact on academics, then you have to involve families!! Duh, right? So what are we waiting for?)

This review discusses the implications of these findings for school-based mental health services and identifies directions for future research.

So what were the "methodologically rigorous criteria for inclusion"?

"To be included in the review, studies had to use a prospective, longitudinal design, with either random assignment or a quasi-experimental comparison. They also had to be published between 1990 and June 2006. In addition, the intervention being evaluated had to have taken place in a public school. School-based programs included a wide variety of services, and some involved both students and their families. Mental health outcomes were defined broadly to include behavioral issues, emotional problems, impaired functioning, or psychiatric diagnoses. Educational outcomes consisted of students’ academic progress (e.g., grades, special education placement) as well as their functioning (e.g., attendance, suspensions) within the school."

Okay, folks, that is my top six. Now I really have to get back to writing for school. I have a Community Project Plan due for Ken's class and based on what I've told you about him so far, you must realize I really want to do a good job.