IOM’s conceptualization of the intervention spec-
trum for mental disorders.
Prevention Research. Planning, developing, and
evaluating prevention programs are a multistage
process requiring years of community psychologists’
time. To guide prevention researchers, the Institute
of Medicine (1994) recommends a series of steps
focusing on the conceptualization, design, imple-
mentation, and evaluation of prevention interven-
tion research programs. Figure 16-4 depicts these
steps. First, the problem or disorder to be addressedBOX16-1 Clinical Psychologist Perspective: Kristin Hawley, Ph.D.Dr. Hawley is Assistant Professor of Psychological
Sciences at the University of Missouri, Columbia. Before
joining the faculty at MU, she received her Ph.D. in
clinical psychology from the University of California,
Los Angeles, completed clinical training at several
community mental health agencies in the Los Angeles
area, and received postdoctoral research training in
child mental health services research at the Child and
Adolescent Services Research Center in San Diego. In
addition to her current faculty position at MU, she is
also co-director of the Missouri Therapy Network, a
collaborative network of community mental health
providers and services researchers who are committed
to practice-based research, and she is a co-investigator
with the Center for Mental Health Services Research at
Washington University in St. Louis. Dr. Hawley’s pri-
mary research interests include community-based
mental health services for children and families,
including service use, engagement, and outcomes as
well as clinician training and implementation of
research-supported treatments. Her research has been
funded by both nonprofit and governmental organi-
zations, and she is actively involved in disseminating
information about research-supported treatment
options to the public and professional communities.
Dr. Hawley provided responses to several ques-
tions we posed concerning her background and
assessment of the field of community mental health:What originally got you interested in community
mental health services for children and youth?
I had long-standing interests in child development and
psychopathology and knew as an undergraduate that I
wanted to pursue some sort of career in that area. How-
ever, I did not have a clear idea what form that career
would take and college seemed like a good time to figure
that out. I took a volunteer position (and later a paid
position) at a mental health hospital, where I worked on
the child, adolescent, and adult inpatient psychiatric units.
This experience had a powerful impact on me and on my
career. I saw clearly the toll that a lifetime of poorly
treated mental illness can take on an individual while alsoseeing some fairly dramatic improvements in several of
the patients. Particularly for some of the younger chil-
dren, these changestook place within days of arriving and
being integrated into the behaviorally oriented treat-
ment program provided on the inpatient unit. As I con-
tinued working, though, I began to notice children being
discharged only to come back weeks or months later—
right back where they had started and sometimes far
worse. I also began to notice that parent and family
involvement in the hospital-based treatment was rare.
Some families were overwhelmed, a few seemed indif-
ferent, and many simply lived hours from the hospital
with a work schedule or financial situation that made it
impossible to attend regular therapy appointments dur-
ing their child’s stay. With no changes being made to
parenting behaviors or family environment, the same
children who had made such strides with the application
of basic social learning principles were sent home to a
situation that had not improved and may well have con-
tributed to their difficulties in the first place.
For other patients, particularly those with more
long-standing problems, the treatments that my clinical
supervisors had at their disposal were not very helpful.
These individuals struggled with long stays and minimal
improvement. This experience left me confident that I
wanted to pursue a career where I could both work to
discover the treatments that would be most helpful to
those struggling with emotional and behavioral prob-
lems and work to ensure that those treatments were
available to the children and families who needed them
and in the communities in which they lived. A Ph.D. in
clinical psychology provided me with the training in
psychopathology, clinical interventions, and research
methods to allow me to pursue just such a career.Describe what activities you are involved in as a
clinical psychologist.
I am a faculty member at a large research university. This
position allows me to be actively involved in conducting
research on community mental health services, teaching
courses in developmental psychopathology and clinical
interventions for children and families, providing clinical468 CHAPTER 16