DIVISION OF CHILD AND ADOLESCENT PSYCHIATRY

Brown Department of Psychiatry and Human Behavior

The Division of Child and Adolescent Psychiatry at Brown is nationally recognized as one of the top programs in the country in terms of breadth and depth of clinical, training and research activities. One hundred twenty faculty have full time positions in the various academic tracks, 109 of these being full time at one of the Brown-affiliated hospitals (see Table 1). The faculty is based either at the Bradley Hospital or the Rhode Island Hospital/Bradley Children’s Hospital campuses. In addition, 11 voluntary clinical faculty based in the community contribute supervisory/teaching time to the various training programs. Gregory K. Fritz, MD, has been the academic director of the Division of Child and Adolescent Psychiatry since 1992. Thirteen senior faculty with responsibility for training, research and clinical programs form the Academic Executive Committee in the Division and provide overall academic leadership. The organizational diagram is attached (see Appendix 2).

I. RESEARCH

The research in the Division of Child and Adolescent Psychiatry is organized as the Bradley Hasbro Children’s Research Center (BHCRC). Bradley Hospital has supported a full-time child and adolescent faculty research group, the Bradley Research Center, since 1984. In parallel, the success of child mental health research at Rhode Island Hospital led to the establishment of the Lifespan Center for Child Health and Development as one of three Centers of Research Excellence at that institution. In 2002, the two Centers merged into the Bradley Hasbro Children’s Research Center and consolidated physically in 17,000 square feet of research space in the Coro West Building. Additionally, BHCRC investigators are also housed in the newly renovated Bradley Campus Research Unit (BCRU) at Bradley and the free-standing Bradley Sleep Center on the Butler campus. This coalescence of investigators and expansion /improvement of space has provided numerous benefits to our research and research training – easy consultation, informal conferencing, postdoctoral “bonding,” enhanced collaboration, etc. The physical proximity of investigators, trainees, research assistants and infrastructure has led to a number of collaborative pilot projects, shared resources, and incremental grant applications that would not have come about if the BHCRC had not been formed. In 2015, 25 investigators in the BHCRC had grant funded research projects, totaling $11.5M (of which $2.8M were indirect costs). The range of research programs is unusually broad for a division of child and adolescent psychiatry. The details of the research activities within the BHCRC are summarized in the attached spreadsheet. (see Appendix 3)

NIH-funded research groups are studying bipolar disorder, obsessive-compulsive disorder, autism and ADHD. Other federal grants support programs investing childhood sleep and circadian rhythms, preschool prevention, substance abuse interventions, HIV/AIDS, psychosocial aspects of pediatric asthma, adolescent obesity, child mental health services research and behavioral genetics. Two NIMH T32 Research Training Grants are based in the Division of Child and Adolescent Psychiatry. In addition, two recent successes merit emphasis

The Rhode Island Consortium for Autism Research and Treatment (RI-CART) is a unique, state-wide research registry and academic-community partnership that was founded in 2013 to advance knowledge

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in the area of autism. Based in the Division of Child and Adolescent Psychiatry and housed at Bradley, RI-CART is a true multidisciplinary, multi-organizational effort that has had remarkable success: to date over 1200 individuals have been enrolled and assessed and almost 2300 biosamples have been collected. Sixteen studies from eight different institutions are currently underway that make use of the RI-CART data base. Their focus ranges from basic molecular genetics to social cognition to parenting and treatment outcomes. Jump started with funding from the DPHB, BIBS, and the Norman Prince Neurosciences Institute, RI-CART has also been the recipient of several substantial grants from the Simons Foundation. Led by Eric Morrow and Stephen Sheinkopf, RI-CART constitutes the critical infrastructure that permits the development of a critical mass of investigators, fosters collaborative research projects in this critical area, and lays the groundwork for a COBRE grant in the next year or two.

The Hassenfeld Child Health Innovation Institute was established in 2016 and seeks to integrate research, clinical practice, public health efforts and educational programs to improve children’s health in the region and nationally. It is funded by a substantial philanthropic gift from the Hassenfeld family. The Institute is a joint undertaking of the Medical School, School of Public Health, Hasbro Children’s’ Hospital and Women’s and Infants Hospital. All three of the Institute’s initial focused initiatives have central neuroscience/behavioral components and are co-lead by faculty in the Division of Child and Adolescent Psychiatry.

They include: Healthy weight, nutrition and physical fitness (Jelalian) Autism (Morrow, Sheinkopf) Childhood Asthma (McQuaid, Koinis-Mitchell)

II. TRAINING

CHILD AND ADOLESCENT PSYCHIATRY FELLOWSHIP AND COMBINED PROGRAM IN PEDIATRICS, PSYCHIATRY, AND CHILD PSYCHIATRY (TRIPLE BOARD)

Jeffrey Hunt, MD - Training DirectorProfessor - Teacher Scholar Track

Elizabeth Lowenhaupt, MD - Associate Training Director Assistant Professor, Clinical, Educator Track

The Combined Residency in Pediatrics-Psychiatry-Child Psychiatry has 15 residents (3 per each of 5 years). The Child and Adolescent Psychiatry Residency has 10 fellows (5 per each of 2 years). These programs receive commendations from both institutional as well as national accreditation reviews. Both programs continue to recruit outstanding individuals from top medical schools around the country. The Division also has made a significant effort to attract trainees of diverse backgrounds. The residents have won numerous national awards and often present at national meetings. They also are active in their role as advocates, both locally and nationally.

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The graduates of the Child Psychiatry Fellowship and the Triple Board Residency program are very competitive and are highly sought after at the time of graduation for a variety of clinical, academic, and research positions. Many graduates have gone on to advanced fellowship training, including forensic psychiatry and research. Over the years several of the graduates have developed national visibility as leaders in education and research.

PREDOCTORAL TRAINING PROGRAM IN CLINICAL PSYCHOLOGY

Elizabeth McQuaid, PhD, ABPP - DirectorProfessor (Research)

Greta Francis, PhD, ABPP - Associate Director, Admissions Associate Professor Elissa Jelalian, PhD - Associate Director, DidacticsAssociate Professor

Jennifer Freeman, PhD – Child Track Coordinator Associate Professor (Research)

The clinical psychology pre-doctoral internship is one of the most well regarded programs in the country. Established in 1975, the internship was accredited by the American Psychological Association in 1982 and has maintained its accreditation status, since that time. The program’s stature rests upon its emphasis on the training of clinical scientists, and is one of only a handful of internships elected to the Academy of Psychological Clinical Science. Our emphasis on clinical training in state of the art evidence-based psychological and combined psychologic/psychopharmacologic treatments also distinguishes our program.

The internship program is vital to the Department of Psychiatry and Human Behavior at Brown and to the individual hospitals. Because the internship is so widely respected, we are able to recruit top candidates from a large national pool. The program typically receives 340-375 applicants for its 22-27 slots. Clinical psychology residents are admitted into one of four areas of concentration or “tracks” within the training program: Child Clinical, Neuropsychology, Health Psychology/Behavioral Medicine, and Adult Clinical. All clinical psychology residents complete a year-long research placement, which provides protected, mentored time for research through the internship. There are currently seven predoctoral internship slots in the Child Track; three are Child Clinical, two are Pediatric, and two are in Juvenile Justice/Behavioral Health.

Many of the residents, typically about half, stay at Brown to receive postdoctoral training. After leaving the program, internship graduates who do not stay in the DPHB are highly competitive for the best postdoctoral training programs and university academic positions in the United States. By all measures, this is one of the top clinical psychology internship programs in the country.

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POSTDOCTORAL TRAINING PROGRAM IN CLINICAL PSYCHOLOGY

Elizabeth McQuaid, PhD, ABPP - DirectorProfessor (Research)

Barbara Tylenda, PhD, ABPP - Associate DirectorClinical Professor

Geoffrey Tremont, PhD, ABPP-CN - Associate DirectorAssociate Professor

Christopher Houck, PhD – Child Track CoordinatorAssociate Professor (Research)

The Postdoctoral Fellowship Program of the Brown University Clinical Psychology Training Consortium was established during the 1992-1993 training year. Postdoctoral training in the DPHB takes place in separate but related programs: The APA-Accredited Fellowship Program, the NIH-funded T32/F32 Institutional and Individual Research Training Program, and the Investigator-funded Fellowship Program. Uniform recruitment and application procedures are used and the training committee reviews the progress of the postdoctoral fellows and programs. Postdoctoral training at Brown allows Fellows to have flexible training experiences. The exact nature of training (e.g. didactic experiences, direct patient care, exposure to ongoing faculty research) is decided on an individual basis by each of the fellows in consultation with faculty mentors. Many research fellows spend some portion of their time in clinical activity; all clinical fellows spend a minimum of 20% of their time in research.

APA-Accredited Fellowship ProgramThe clinically-focused Postdoctoral Training Program was accredited by APA in 2002, and was re-accredited in 2016. There are currently four fellows with a “primary” clinical focus of training in the Child Track of our APA-approved program. Postdoctoral fellows are a valuable resource to the Department and the hospitals. Many of the postdoctoral fellows have stayed on to assume faculty positions at the hospitals.

NIH T32/F32 ProgramsThe DPHB also offers research fellowships funded by NIH T32 Institutional Research Training Grants. There are currently three T32 fellowship programs in the DPHB; two of these are in the Child Track and are listed below.

Current Child Focused T32 Training Programs in the DPHBChild Mental Health NIM

HAnthony Spirito, PhD, ABPP 5 fellows

Child & Adolescent Biobehavioral HIV NIMH

Larry Brown, MD 4 fellows

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The existing infrastructure for postdoctoral training combined with the faculty expertise available in the Department has created an environment conducive to the development of National Research Service Award (NRSA) Individual Fellowships (F32) applications. F32 fellows write their own training grants which are designed to provide training in a specific area of research under a designated faculty mentor. We currently have one postdoctoral trainee funded on an F32 fellowship award in the Child Division.

Investigator Funded Fellowship Program

Some fellowships are designed in an apprenticeship model for a fellow to work collaboratively on a mentor’s research project while gaining experience in manuscript writing and grantsmanship. There are currently three Investigator-funded fellows in the Child Division.

III. FACILITIES

EMMA PENDLETON BRADLEY HOSPITAL

The Emma Pendleton Bradley Hospital, founded in 1931, was the nation's first teaching hospital devoted exclusively to child and adolescent psychiatry. It is one of the country's foremost child psychiatry centers with a national reputation for excellence in patient care, research, and training. Bradley offers a full continuum of care for children and adolescents with significant emotional, developmental, and behavioral problems. In addition to 60 in-patient beds, hospital services include short-term crisis stabilization, partial and day programs, residential treatment, complete outpatient services, and home-based care. With annual revenues exceeding $75 M, Bradley employs approximately 800 people, comprising 650 FTE’s. Daniel Wall, President and CEO, is a highly respected and effective hospital administrator. Faculty unanimously nominated him for the AACAP Cancro Award, which he won in 2011.

The Bradley School, a fully accredited special education program for children and adolescents, combines individual and family therapy and other mental health services in school settings at 3 different sites in Rhode Island. The Developmental Disabilities Program provides highly specialized inpatient, school, outpatient, residential, and home-based services for those with emotional and behavioral problems in combination with mental retardation or autism. Bradley's Outpatient Program provides a range of diagnostic and treatment services for children and families, as well as consultative services for professionals. Six residential treatment programs located in the community and two age specific partial programs are also included in the care continuum.

Bradley supports more than 15 trainee stipends. For the past 10 years, Bradley has had a positive margin from operations. A substantial endowment (>$40M) along with philanthropic support allowed the construction of a new 60-bed inpatient facility that opened in 2009. Renovated space in the old building was converted to research and education areas as well as expanded day treatment programs.

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HASBRO CHILDREN'S HOSPITAL

A 97-bed pediatric hospital, Hasbro Children's Hospital is divided into five sections, including the state's only pediatric intensive care unit. There are approximately 6,750 admissions each year. The patients range in age from birth to 18 years and represent a wide diversity of racial, ethnic, and socioeconomic groups. The pediatric ambulatory services include the Pediatric and Adolescent Primary Care Unit, pediatric specialty clinics (e.g., sleep disorders, endocrinology, gastroenterology) and the Pediatric Emergency Service. There are approximately 62,500 ambulatory visits each year. The unique Hasbro Partial Hospital Program provides integrated pediatric and psychiatric care for children whose problems span the boundaries of the discipline. Sixteen inpatient pediatric psychiatry beds have recently been remodeled and opened to complement the Partial Program. Child psychiatry research and clinical service programs are closely involved with pediatric general and subspecialty programs at every level to a degree that has resulted in Rhode Island Hospital/Brown being used as a model at other Children's Hospitals nationally.

IV. FACULTY ASSESSMENT OFTHE STATUS OF THE DIVISION IN 2016

In an effort to summarize the current status of the Division of Child and Adolescent Psychiatry in 2016, in part in preparation for the Division Director recruitment process and also as a quasi strategic planning process, the Division faculty assessed the Division at the faculty retreat this summer. Members of the Academic Executive Committee co-led group discussions dealing with important elements of academic life within the Division. They then summarized the discussions in a Strength/Weaknesses/Challenges – Opportunities format, the results of which follows.

A. 2016 RESEARCH ASSESSMENT

Prior to 1985, there was essentially no research in the Division; in recent years NIH support to the Bradley Hasbro Children’s Research Center has averaged over $10M annually. The faculty’s recent assessment of the current status of the Division’s research enterprise is summarized below.

Strengths:

1. The Division currently has several, large, multidisciplinary, well-funded research groups that focus on diverse topics such as early childhood, asthma care, depression and suicidal behavior, HIV/AIDS, OCD, weight management, juvenile justice, and adolescent risk behavior. The Division prizes the diversity of its research and its broad biopsychosocial focus.

2. The research groups are collaborative but function independently in an environment that promotes entrepreneurial resourcefulness. Autonomy is promoted by the Lifespan investigator incentive system that rewards PIs for obtaining NIH grants by providing funds that can be used to support the investigator’s research. Clinical investigators can also be easily supported by funding from clinical work, should their research support lapse.

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3. The environment of Rhode Island and its institutions is conducive to research. The hospitals, state agencies (DCYF, DOH, Court) and community organizations can be engaged and our research groups have on-going projects with many collaborators. The State’s small size results in easy access to organizations, enhances long-term collaborations, and is a good location for longitudinal research. The State can function as a “learning lab.”

4. Other research resources are available outside of the Division. The School of Public Health and other centers (e.g. Brown Institute for Brain Science, Center for AIDS Research) have complementary interests and are engaged with our investigators. Research training is a priority in the Division and the Department. The Division has two NIH T32 research training programs. Two other T32 programs, as well as a R25 exist in the Department.

Weaknesses:1. Junior investigators (as well as senior researchers during funding gaps) perceive the lack of a “safety net” because there is no Departmental base salary support for research. Support only comes from grants or the Lifespan investigator incentive accounts, so junior faculty feel vulnerable unless they are part of an established research group. The issue is most acute immediately upon joining the faculty or as a NIH K award ends. Non-clinical researchers do not have access to clinical revenue or other sources of support if research funding lapses, so feel particularly vulnerable.

2. Because there is no stable Departmental research salary support, research growth is not strategic, centralized or integrated in the Division. Growth is dependent on the aims of the investigators who can obtain funding to support themselves.

3. A few structural barriers exist, which limit integration of research with clinical care or inhibit the cross-fertilization of research ideas. With only a few exceptions, researchers are not located near clinical care sites. The growth of research groups has led to several investigators being housed away from the main research group. Some projects have to contend with multiple IRBs (Lifespan, Butler and Brown), which remains complicated.

4. Some infrastructure issues continue to be a challenge. Although statistical support and data storage have improved, they are still limited. Brown University does not have a graduate program in psychology, which is a loss for all of our clinical research programs.

Challenges and Opportunities:

Because of the collaborative nature of Brown, the hospitals and the State (with few structural barriers), there are many opportunities for growth, only dependent on the interests and energy of entrepreneurial independent investigators.

1. A wealth of clinical programs provides enormous opportunities. Although existing research is focused on clinical issues, most programs and RIH and Bradley Hospital do not have integrated research programs. The clinical outpatient, inpatient and partial programs are vibrant and accommodating, but the structures are not optimized for supporting research activities. The Division has a long-standing

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relationship with Pediatrics (through the Triple Board Program) and there are several areas available to behavioral research, including areas of integrated primary care. In no case has there been a problem of investigators competing for access to clinical populations essential for their research.

2. A wealth of academic research collaborators exist at Brown University and nearby. Our Division can expand its collaboration with expertise in Bioinformatics, Neuroscience, Health Services and Community Health at Brown. Numerous other potential collaborators are located at URI, Yale and in Boston. Regional collaborations can address issues that are relevant to service delivery and for unique populations.

3. Alternative revenue streams are essential. Investigators need to look beyond NIH for research funding. Philanthropy, private foundations, non-NIH federal agencies and the state of Rhode Island are all potential sources of support.

4. Potential collaboration between the Hospitals, University, and philanthropy to establish support mechanisms for junior faculty and bridge funding for senior faculty.

Values: Despite few startup packages, no endowed chairs, and modest institutional resources, the Division has one of the largest and most diverse child mental health research programs in the country. Faculty feel that the culture and value system embraced in the Division are essential to the success. Key values are summarized below.

1. Investigator autonomy

2. Collaborations within the department/division as well as outside of the department

3. Respect and equal status for all behavioral health disciplines within the department/division

4. Independence from hospital competitive concerns

5. Research as an equal mission (along with clinical service and training)

6. Respect and equal status for all varieties of research (ranging from bench science to implementation and policy; from clinically relevant to basic behavioral science)

7. Independence from commercial influences (most notably pharma influence)

8. Trainee involvement in research

9. Being a positive influence in the community

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B. 2016 TRAINING ASSESSMENT

The Division supports a child and adolescent psychiatry fellowship, the combined program in pediatrics, psychiatry, and child and adolescent psychiatry (Triple Board) residency, the child/pediatric track of the psychology internship, numerous clinical and research postdoctoral training positions, and two NIH sponsored research T32 fellow programs. The division also provides Brown medical students with educational opportunities in child and adolescent psychiatry. These programs continue to flourish, in large part due to the unwavering support, excellent clinical resources, and opportunities available through the DPHB’s network of affiliated hospitals. Training is a core mission of the hospitals in the Brown Consortium and trainee stipends are stable. Bradley’s firm commitment to training and education was documented with over 25 years of supporting 100% of 10 FTE resident training positions from the annual operations budget until GME funding was secured in 2015.

The large number of dedicated faculty overseeing these training programs has led to a tradition of educational excellence. This has created a national and international reputation that draws applicants from all over the country and from many other countries to compete for division training positions.

Strengths: There is a commitment to collaboration between child, adolescent, and adult psychology and psychiatry within the department and division that has been sustained for many years. There are frequent opportunities for across discipline educational activities that are critical to this ongoing positive relationship. The caliber of our trainees is high across all programs and this has also resulted in successful recruitment to the faculty of our own residents and fellows. The support for training across institutions is very high and there is substantial breadth and depth of clinical programs that enhances our educational programs. Faculty development within the division is of excellent quality and occurs at the department level and also within the medical school, and has served to build collaborations between division members. The Child Mental Health and HIV T32 programs provide an ongoing framework for research training of talented PhD’s within the department; some of these trainees become independent investigators and remain within the Child Division of the DPHB, enriching our ongoing training efforts.

Weaknesses: Financing these outstanding educational programs has become more and more challenging. The system is incentivized towards clinical revenue – clinical training rotations are interwoven. Funding for teaching is limited and faculty with high clinical, administrative, or research demands carve out the time to teach, often at considerable personal cost. It has also become more difficult to ensure that clinical programs have regularly assigned trainees because of the dramatic increase in services over the last few years. Program directors are challenged to ensure high quality teaching even when other demands are high and as the service requirements increase – the faculty are at times too busy to support intellectual curiosity of trainees. An additional problem with the increase in the breadth of the service line is that there are greater numbers of academically interested clinicians but the same number of trainees. This means that many interested faculty are not able to find a teaching role. Training within research has had to rely on the good will from research-based faculty to supervise the trainees’ research efforts. In the current funding climate, research faculty are challenged

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to maintain their own funding to support their own position and those of their staff, leaving less time and resources for mentoring.

Challenges and opportunities

1. The Division needs to continue to find ways to increase the financial support for training (clinical supervision, research supervision, etc). This is an issue across the entire medical school. While the medical school sees it as the hospital’s responsibility to do this, we need to engage the school in a dialogue about this issue.

2. Funding support for trainees that are not supported through GME funds (mostly psychology trainees, but also forensic fellows) can be tenuous. Creative brainstorming regarding funding of training positions through outside funding sources or revenue generation need to be explored more systematically.

3. There is limited funding for training directors and ever increasing demands from outside regulatory entities The program directors (those supported through GME and those who are not) require more protected time. Possible source of support include a portion of the (relatively) new GME funds for philanthropy.

4. How can we facilitate additional trainee involvement in research?5. We need to find ways to illustrate the value of clinical faculty. Academic and teaching efforts should

be incorporated in ongoing performance appraisals to illustrate the value of teaching at the hospital administrative level.

C. 2016 CLINICAL PROGRAMS ASSESSMENT

The relative autonomy of Bradley Hospital and the financial structure at RIH/Hasbro for psychiatry permit an entrepreneurial approach to developing clinical programs. Essentially, if we can develop a realistic business plan for a new program that contributes a margin or at least breaks even, the likelihood is that it will be approved. While Rhode Island reimbursement in general lags behind neighboring states, the need is great and the competition is minimal. The result of these interacting factors has been a steady growth in the number and breadth of clinical programs that involve Division faculty and trainees. We see no reason to expect a near-future change in these factors or the pattern of growth.

Strengths:The range of clinical expertise in virtually every area of child mental health is rarely found in academic programs across the country. Notable for their regional-to-national referral base are the Center for Autism and Developmental Disabilities, the Intensive OCD Program, the Hasbro Pediatric Psychiatry Inpatient and Partial Programs, and the Pedi-partial (toddler and preschool) Program. All elements of the mental health treatment continuum are available, from 1:1 inpatient units to partial programs and residential treatment to outpatient and home-based treatment, allowing us to fit the treatment to the child’s needs rather than fitting the child into the available treatment. Most programs are running at or above budgeted census.

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The merger with Gateway and subsequent combing duplicative programs has expanded our clinical capacity in the home-based and residential treatment areas. A final funding decision from the state means that the hub-based telephone mental health consultation for primary care physicians (PERC) is soon to start on a state-wide basis.

Efforts to ensure uniformly high standards and efficiency across Bradley and Hasbro for outpatient and emergency services are progressing well. The movement to increase evidence based treatment is seeing steady success, most recently in the med/psych, early childhood and DBT programs. Increasingly, specialty expertise in our program is being tapped to inform work in other programs; examples include motivational interviewing training for the substance abuse team and the CRAFT screening tool being integrated into EPIC for wide utilization.

Weaknesses:The large number of inpatient, residential and partial programs lead to many patients in need of outpatient services to continue their progress, but the need exceeds our capacity. Low fee for service reimbursement rates are the limiting factor.

A serious absence in the clinical services has for years been a lack of expertise and programming in adolescent substance abuse. There is finally significant movement in that area; hopefully a true substance abuse program will actually be operating within a year.

The growth in clinical programs has exceeded the number of trainees available and faculty disappointment is noted. The opportunity to teach and supervise trainees has been a big draw in faculty recruitment, and the fact that most clinical programs now are not “trainee dependent” is seen as a mixed blessing. This fact, combined with the shortened length of stay and the increased administrative burden on the intensive services, has led to some recruitment difficulties and positions open for a prolonged period.

Challenges and opportunities:

1. The potential for Rhode Island to be on the cutting edge of the shift to population health and integrated care, including the role for telehealth, is exciting. “Executing this shift while still in a fee for service model (with low reimbursement at best) is challenging and at times daunting.

2. Faculty pride themselves in being experts in their area but to truly keep up with new developments in the midst of intense clinical demands is a huge challenge. Possible solutions brainstormed at the retreat include a) developing a faculty listserve for intra-divisional consultation, shared information, etc; b) focusing one grand rounds per year on the “top 10 articles” in child psychiatry; and c) establishing remote access to grand rounds.

3. The structure of outpatient work, with the inevitable focus on billable hours and the poor remuneration, can feel challenging. It is possible to become a lone provider, isolated in an office seeing one patient after another. Attention to both the finances and team involvement are needed to enhance this clinical component of our services.

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D. 2016 DEVELOPMENT AND MARKET ASSESSMENT

The Division has made substantial progress in both of these areas in the past 10 – 15 years, after a history of little effort or success in previous decades. Faculty believe that development and marketing are closely linked, as without a clear and well-known brand, it is hard to attract philanthropists.

Strengths:

1. Bradley has steadily increased its success with development. There is an active Bradley Foundation Board comprised of influential supports from RI and MA. The Board sponsors “Bravo Bradley”, an evening fundraising event that has grown steadily since its 2011 inception; it grossed approximately $ 500,000 in 2016.

2. The sophisticated and highly successful development office of Brown University is theoretically available to the Division but the process is complicated and the impact has been minimal. DPHB Chair Steve Rasmussen is committed to pursuing this option and has longstanding relationships that make it conceivable.

3. Marketing our programs regionally and nationally is possible and has been moderately successful in recent years. The programs have excellent stores, and faculty appreciate the rationale behind increased marketing.

4. Partnering with Hasbro Children’s Hospital is now embraced and moving forward.

Weaknesses:

1. Rhode Island is a small and relatively poor state. Individuals with substantial philanthropic capacity are well know and vigorously pursued.

2. The Division has no endowed chairs.3. To date, neither Brown University nor its Alpert Medical School have demonstrated much initiative

to include child mental health in their development efforts.4. Most of the marketing is Lifespan-based and tends to have a very local focus.

Challenges and opportunities:

The biggest challenge and also the biggest opportunity involve getting a connection with Brown University Development, given their national network of philanthropy and their recent successful campaigns. This likely entails making the development office aware of clinical expertise within the Division (associated with research) and then providing it promptly to their families in need. A related challenge is getting a national focus to Lifespan marketing to complement development efforts. Establishing and marketing elite destination programs with development potential with the same interest and sophistication as local programs is also a challenge, especially give the shortage of capital. However, it is seen as having a great deal of potential in the not-too-distant future.

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E. 2016 INTERDISCIPLINARY COLLABORATION ASSESSMENT

Effective interdisciplinary collaboration, within the Division between child psychiatry and psychology and externally most prominently between Division faculty and the Department of Pediatrics, has been a major factor in the success of the Division over the years. The consensus was that there is no better interdisciplinary collaboration I the child and adolescent realm anywhere in the country. As integrated care increasingly becomes the norm, the Division is well-positioned to be a model player in this realm. Faculty are unanimous in their desire to see smooth interdisciplinary research and clinical collaboration continue to be a core value within the Division.

Strengths:Multiple strengths were identified within our current institutional and community-based infrastructure including a longstanding history of collaborative work between colleagues in Psychiatry and Psychology, as well as multiple clearly defined clinical and research collaborations between the Division of Child and Adolescent Psychiatry and the Department of Pediatrics. This degree of clinical (C) and research (R) collaboration involves a number of programs: Hasbro Partial Hospital Program, Hasbro Med/Psych Inpatient Program, Hasbro Emergency Medicine (C,R), Hasbro Primary Care and Rhode Island Hospital Medicine/Pediatrics clinics, Hematology/Oncology, Sleep (C,R), Gastroenterology(C,R), Refugee services, HIV clinic, Asthma/Draw-a-Breath program(C,R), Adolescent Weight Management (CHANGES) (C,R) and The Adolescent Leadership Council (TALC) (C). Established collaboration between Division faculty and other Lifespan and Brown-affiliated departments are also notable current interdisciplinary strengths, including Social Work, Nursing, Nutrition, Children’s Rehabilitation (PT, OT, Hearing and Speech), and CLPS. Additional collaborations between the Division and community and state agencies represent another sphere of interdisciplinary strength, including Rhode Island Family Court(C,R), Rhode Island Training School(C,R), DCYF, Rhode Island Department of Health, Head Start, and multiple local school departments.

Additional current interdisciplinary strengths include multiple current multidisciplinary training opportunities. In particular, resulting from proximity and access via the aforementioned clinical services, Psychiatry and Psychology faculty currently interact with and contribute to the training of trainees in other disciplines via shared case conferences, “buddy systems”, and shared complex care rounds. Additionally, the fact that Psychology and Psychiatry trainees share some overlapping training experiences (eg, PARC, Hasbro PHP) and are currently supervised by both MDs and PhDs represents another significant strength in our current institutional structure.

Challenges and Opportunities:In the context of acknowledgement of the multiple current strengths noted above, certain weaknesses and opportunities for improvement were also identified. Such areas include gaps in behavioral health integration in several specific areas in Pediatrics, including Endocrinology, Adolescent Medicine, and Primary Care. Additional weaknesses were identified in the current need for improved collaboration across Child and Adult Psychiatry for the purposes of clinical care, mutual awareness of services offered by child and adult providers, and resource sharing. Additional challenges in our current structure

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include the increasing specialization of training in Psychology and Psychiatry, the increasing fragmentation of services and resources (with a corresponding need for either a Division newsletter or more frequent Division-wide meetings), intermittent lack of clarity in clinical roles of multiple different mental health providers (MD, PhD, LMHC, LMFT, LICSW, etc), and lack of robust integration and collaboration with Brown University Computer Science faculty.

F. 2016 FACULTY WELLNESS/BURNOUT ASSESSMENT

With the increasing clinical and bureaucratic demands of faculty comes the risk of burnout and the need to address faculty satisfaction and wellness on a proactive basis.

Strengths: Faculty described clinical work as interesting and many reported feeling energized and professionally satisfied by clinical contact with their patients. Burnout was not seen as an immediate, pervasive problem although faculty could clearly identify symptoms of burnout in some individuals at some times. Academic involvement in teaching and/or research was seen as an antidote to burnout and a source of professional satisfaction – assuming adequate time is available for such involvement. A large system such as ours provides the opportunity to periodically change services or jobs; such variety (when accessed) can be sustaining.

Weaknesses: A number of risk factors for burnout within our system were identified. Especially problematic are periods where acute services are short staffed (due to vacations, illness, parental leave or recruitment issues). At such times, remaining staff pick up the slack – but generally feel stretched too thin and inadequately supported. The increasing administrative and regulatory requirements add to the workload while decreasing satisfaction – and they are often very inefficient as well. Some junior faculty identified a generational difference regarding the prioritization of self care and felt judged for the different priorities.

Challenges and opportunities: A lack of consistent attention to faculty wellness and support for those who experience symptoms of burnout was identified. Establishing regular burnout self assessments and in-services sessions regarding elf care could help in this regard. More junior faculty mentoring by senior faculty would also be helpful. Greater involvement in academic pursuits was widely seen as a desirable antidote but the challenge of funding – and paying for – such protected time was recognized. The need for as yet unidentified workflow efficiencies, especially regarding the EMR, was a consistent theme. Finally, there is a widely held belief that support staff and salaries for faculty in the Division are less than those for faculty working with adults. If this is a fact, it needs to be addressed; if it is a misperception, it needs to be corrected with data.

Appendix 1

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Division Faculty

The Division has been extremely successful in the recruitment and retention of stellar faculty. The Division has a total of 120 faculty located at our affiliated hospitals and in private practice. A breakdown of faculty by rank is as follows:

Full-time Academic

Research Scholar and Teaching Scholar Tracks:

Professor 7

Associate Professor 4

Assistant Professor 0

Full-time Academic (Research grant supported):

Professor (Research) 2

Associate Professor (Research) 4

Assistant Professor (Research) 18

Clinician Educator: (full time hospital based)

Professor (Clinical) 1

Associate Professor (Clinical) 2

Assistant Professor (Clinical) 16

Clinical Voluntary (most full time hospital based)

Clinical Professor 2

Clinical Associate Professor 9

Clinical Assistant Professor 48

Clinical Teaching Associate 3

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Appendix 2

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Gregory Fritz, MDDivision Director

ACADEMIC EXECUTIVE COMMITTEE

BRADLEY/HASBRO CHILDREN’S RESEARCH CENTER

WIHResearch

CHILD & ADOLESCENT PSYCHIATRY & PSYCHOLOGY TRAINING

Center For ChildrenAt Risk

(Lester, Sheinkopf & Levine)

Sleep(Carskadon & Boergers)

Developmental Psychopathology/

Early Childhood(Seifer, Silver

Low & Shepard)

Childhood Asthma Research

(Fritz, McQuaid,Koinis-Mitchell)

Adolescent Obesity(Jelalian & Hadley)

Anxiety Disorders(Freeman, Garcia & Case)

Pedi-MIND Program(D. Dickstein)

Behavioral Genetics(Knopik, McGeary & Nugent)

Autism/RI-CART(Morrow & Shienkopf)

Sibling Adaptation(Lobato & Plante)

HIV/AIDS (Brown, Barker, Houck, Hadley,

Nugent, Whiteley)

Suicide(Spirito, Lin)

Adolescent Psychopathology

(Spirito, Hunt, Dickstein & Wolff)

Pediatric GI(Lobato, Nassau, Plante

& Edwards-George)

Forensic(Kemp, Myers &

Lowenhaupt)

Neuroplasticity(Oberman)

Pediatric Psychiatry(Rickerby & Houck)

C & A Psychiatry Fellowship

(Hunt/Lowenhaupt)

Triple Board Residency(Hunt/Lowenhaupt)

Psychology Internship(McQuaid)

Postdoctoral Training(McQuaid)

Appendix 3

…….. …….

17

Intensive Svcs.J. Hunt, MD

Henry Sachs, MDMedical Director, Pediatric Psychiatry & Behavioral Health

Services, LifespanB G H N

Emergency ServicesK. Donise, MD

Residential SvcsP. Gillen, PsyD

Med/PsychM. Rickerby,MD

OutpatientK. Horowitz, MD

Integrated Svcs.D. Lobato, PhD

CFTOS. Stevenson

Substance AbuseTBD

ForensicsTBD

Adolescent Inpatient

B

Adolescent Partial

B

CADD Inpatient

B

CADD PartialB

Children’sInpatient

B

Children’s Partial

B

OCD / PARCH B

Pedi PartialB

SafequestB

Hasbro PESH G B

Bradley KidsLink ServicesH G B

Community Based Services

G B

CADD Group Homes

B

CaritasG B

CRAFTB

DBT Programs

G B

Hasbro 6 Inpatient

H B

Hasbro Partial

H

Consultation Liaison

H

BradleyB

HasbroH

GatewayG B

Mindful Teens

B

Coast ClinicB

PERCN B

EarlyChildhood

H B

CADD Outpatient

H B

CHANGES (weight)

H

Co-occurring Disorders

G H

AutismB G H

Early Childhood

B G

TraumaB H G

GeneralB H G

Med PsychG H

Rhode Island

Training School

H G

Court Clinic

H

Outpatient

Clinic

NewportN B

B – Bradley HospitalG - GatewayH – Hasbro HospitalN – Newport Hospital

South CountyG

Pedi Sleep Disorders

H

Refugee ClinicH

Medical Pedi Clinical

H

Pediatric GIH

Feeding D/OH

Pediatric Specialty

Clinic, E.G.H

Pediatric Cardiology

H

Pedi PainH

Appendix 4

Bradley Hasbro Children's Research Center - Summary September 2015

PI Name Project Title Project Start Date

Project End Date

Total Project Direct

Total Project Indirect

Total Project Total

Sponsor/Contractor

Original Source .

Direct Cost Indirect Cost

Total Costs

Barker, David

Improving Adolescent HIV Treatment Adherence through the use of Peer-led Adherence Team CFAR

10/1/2014

9/30/2015 40,000.00 0.00 40,000.00 CFAR NIAID 40,000.00 0.00 40,000.00

Barker, David

Comparative Efficacy of HIV-Prevention Programs Among Youth in Mental Health Treatment

5/15/2014

3/31/2019 315,703.00 22,991.00 338,694.00 NIMH 157,805.00 11,681.00 169,486.00

Brown, Larry

A Pilot Gaming Adherence Program for Youth Living with HIV

9/28/2012

6/30/2016 673,465.00 332,209.00 1,005,674.00 NICHD 333,488.00 131,622.00 465,110.00

Brown, Larry

LOC-IMPAACT Leadership Group

4/1/2015 11/30/2015

12,562.00 7,663.00 20,225.00 JOHNSHOPKINS NIAID 12,562.00 7,663.00 20,225.00

Brown, Larry

Integrated Mental Health Treatment & HIV Prevention for Court-Involved Youth

7/5/2010 2/29/2016 912,689.00 458,269.00 1,370,958.00 NIMH 394,604.00 197,034.00 591,638.00

Brown, ATN 3/1/2006 2/29/2016 198,399.00 105,945.00 304,344.00 ALABAMA NICHD 27,140.00 16,013.00 43,153.00

18

Larry Coordinating Center

Brown, Larry

Digital STAR:HIV Prevention for Youth in Mental Health Treatment

8/1/2013 7/31/2015 143,323.00 84,560.00 227,883.00 VirBetterInc NIH 82,946.00 48,938.00 131,884.00

Brown, Larry

Training in Child/Adolescent Biobehavioral HIV Research

7/1/2013 6/30/2018 597,926.00 35,318.00 633,244.00 NIMH 288,453.00 21,996.00 310,449.00

Carskadon, Mary

Enhancing Sleep Duration: Effects on Children's Eating and Activity Behavior

12/1/2013

11/30/2015

20,986.00 6,490.00 27,476.00 TEMPLE 8,587.00 2,696.00 11,283.00

Carskadon, Mary

Mechanisms Underlying the Relationship between Sleep Problems and Cannibis Use in Adolescents

3/3/2014 5/31/2015 25,783.00 8,096.00 33,879.00 UMARYLAND NIDA 25,783.00 8,095.00 33,878.00

Carskadon, Mary

Smart Lights: A Biophilic Lighting System to Enhance Secondary Education

8/1/2014 7/31/2015 94,994.00 29,068.00 124,062.00 BROWN NSF 94,994.00 29,069.00 124,063.00

Carskadon, Mary

Food Choices in Overweight & Normal Weight Adolescents-Sleep & Circadian

1/16/2014

12/31/2018

1,942,290.00 570,135.00 2,512,425.00 NIDDK 347,132.00 104,878.00 452,010.00

19

RhythmsConelea, Christine

Integrative Examination if Neurobehavioral Mechanisms in Tic Suppression

7/1/2014 6/30/2018 324,825.00 25,209.00 350,034.00 NIMH 162,681.00 13,015.00 175,696.00

Dickstein, Daniel

HPA & Neural Response to Peer Rejection: Biomarkers of Adolescent Depression Risk

7/1/2011 6/30/2016 311,398.00 95,853.00 407,251.00 MIRIAM NIMH 73,957.00 23,223.00 97,180.00

Dickstein, Daniel

HPA & Neural Response to Peer Rejection: Biomarkers of Adolescent Depression Risk

7/1/2011 6/30/2016 311,398.00 95,853.00 407,251.00 MIRIAM NIMH 1,256.00 394.00 1,650.00

Dickstein, Daniel

Intensive Outpatient Protocol for High Risk Suicidal Teens

11/1/2012

6/30/2016 225,139.00 68,893.00 294,032.00 BROWN NIMH 103,861.00 32,612.00 136,473.00

Dickstein, Daniel

COGFLEX: Pilot Translational Intervention for Pediatric Biopolar Disorder303282

9/1/2014 8/31/2017 513,307.00 157,071.00 670,378.00 NIMH 184,557.00 56,474.00 241,031.00

Dickstein, Daniel

Genetic-Imaging Study of Obsessive Compulsive Behavior in Autism

10/1/2013

7/31/2018 24,295.00 7,541.00 31,836.00 BROWN NIGMS 13,339.00 4,188.00 17,527.00

Freeman, Jennifer

CBT for Pediatric OCD: Effective

6/6/2012 5/31/2017 486,636.00 281,927.00 768,563.00 NIMH 207,664.00 112,300.00 319,964.00

20

therapist behaviors and community training pilot

Hadley, Wendy

Reduce the Risk: An Affect Management Program for HIV Prevention

4/1/2013 9/30/2015 294,264.00 171,728.00 465,992.00 VirBetterInc NIMH 192,893.00 113,807.00 306,700.00

Houck, Christopher

Partner Violence Protection for Middle School Boys: A Dyadic Web-Based Intervention

1/1/2015 12/31/2017

74,377.00 41,407.00 115,784.00 NORTHEASTERN USDOJ 74,377.00 41,407.00 115,784.00

Hunt, Jeffrey

Henrietta Leonard Medical Student Fellowship in Child and Adolescent Pyschiatry, funded by the Klingenstein Third Generation Foundation

2/1/2015 1/31/2018 3,000.00 0.00 3,000.00 KLING 3,000.00 0.00 3,000.00

Hunt, Jeffrey

Course and outcome of bipolar youth

8/1/2011 4/30/2016 103,318.00 33,357.00 136,675.00 BROWN NIMH 30,213.00 9,485.00 39,698.00

Kemp, Kathleen

Dating Violence Prevention for Juvenile Justice Girls

4/15/2015

3/31/2020 457,502.00 279,076.00 736,578.00 NORTHEASTERN NICHD 78,891.00 48,124.00 127,015.00

Knopik, Valerie

Multi-method assessment of suicide

7/17/2012

4/30/2017 275,121.00 138,578.00 413,699.00 BUTLER NIMH 68,208.00 40,242.00 108,450.00

21

Koinis-Mitchell, Daphne

Asthma and Physical Activity in Urban Children: Cultural and Contextual Factors

7/20/2013

3/31/2016 506,221.00 296,310.00 802,531.00 NHLBI 250,573.00 147,838.00 398,411.00

Koinis-Mitchell, Daphne

Community Asthma Program

10/1/2014

9/30/2015 8,000.00 0.00 8,000.00 RIHDEV 8,000.00 0.00 8,000.00

Koinis-Mitchell, Daphne

"Peer-Adminstered Asthma Self-Management Intervention in Urban Midddle Schools"

8/1/2013 7/31/2016 331,529.00 110,699.00 442,228.00 NICHD 176,914.00 52,606.00 229,520.00

Koinis-Mitchell, Daphne

Asthma and Academic Performance in Urban Children

9/30/2009

8/31/2015 1,132,058.00 373,621.00 1,505,679.00 NICHD 344,616.00 182,274.00 526,890.00

Koinis-Mitchell, Daphne

Community Asthma Programs: Expansion Grant for After-School and Lunch Workshops- Daphne Koinis Mitchell sub project

2/1/2010 9/30/2015 78,821.00 14,181.00 93,002.00 RIDH CDC 5,405.00 595.00 6,000.00

Liu, Richard

Life stressors, impulsivity, and adolescent suicidal behavior

2/1/2014 1/31/2019 1,647,927.00 339,128.00 1,987,055.00 NIMH 338,897.00 71,008.00 409,905.00

McGeary, John

Genetic Influences on

4/1/2012 1/31/2017 195,484.00 115,335.00 310,819.00 UTEXAS NIH 3,145.00 1,855.00 5,000.00

22

Dual Processing Modes of Reward and Punishment Learning

McGeary, John

Children's Attetional Biases: A Key Component of Negative Valence Systems

10/1/2012

6/30/2016 483,861.00 285,478.00 769,339.00 BinghamtonUniv NIMH 121,402.00 71,627.00 193,029.00

McGeary, John

Genetic Influences on Dual Processing Modes of Reward and Punishment Learning

4/1/2012 1/31/2017 195,484.00 115,335.00 310,819.00 UTEXAS NIH 68,553.00 40,447.00 109,000.00

McGeary, John

Pathways to Depression in Children of Depressed Mothers

9/1/2011 8/31/2015 27,473.00 16,140.00 43,613.00 BinghamtonUniv NICHD 6,566.00 3,874.00 10,440.00

McGeary, John

Marijuana Relapse: Influence of Tobacco Cessation and Varenicline

10/1/2010

8/31/2015 94,281.00 54,972.00 149,253.00 COLUMBIA NIH 19,371.00 11,429.00 30,800.00

McQuaid, Elizabeth

New England Asthma Innovations Collaborative (NEAIC)

7/1/2012 6/30/2015 235,870.00 58,083.00 293,953.00 HRA CMMI 13,440.00 3,360.00 16,800.00

McQuaid, Elizabeth

Comprehensive Approach to Improve Medicine

1/1/2015 12/31/2018

15,123.00 8,922.00 24,045.00 ALABAMA NCI 15,123.00 8,922.00 24,045.00

23

Adherence in Pediatric Luekemia

McQuaid, Elizabeth

Examining A Behavioral Family Lifestyle Intervention for Weight Management in Overweight or Obese Children with Asthma

7/1/2014 6/30/2016 4,580.00 0.00 4,580.00 UFLORIDA-JASONVILLE

ALA 2,324.00 0.00 2,324.00

McQuaid, Elizabeth

Friends, Family, and Food: Interactive Virtual Environments for Children with Food Allergies

9/22/2014

7/31/2015 128,238.00 75,660.00 203,898.00 VirBetterInc NIH 128,238.00 75,660.00 203,898.00

McQuaid, Elizabeth

New England Asthma Innovations Collaborative (NEAIC)

7/1/2012 6/30/2015 235,870.00 58,083.00 293,953.00 HRA CMMI 74,386.00 17,239.00 91,625.00

Morrow, Eric

Autism and Development Disorders Inpatient Research Collaboative

10/1/2013

9/30/2015 75,776.00 7,578.00 83,354.00 MMC 48,100.00 4,810.00 52,910.00

Morrow, Eric

Rhode Island Population and Genetics Study of Autism and Intellectual Disability: A Component of the Rhode

4/1/2013 3/31/2016 630,365.00 120,870.00 751,235.00 SFAR 403,569.00 74,470.00 478,039.00

24

Island - Consortium for Autism Research and Treatment

Nugent, Nicole

Biomarkers, social, and affective predictors of suicidal thoughts and behaviors in adolescents - old title: Social and Affect Dynamics in Adolescents after Psychiatric Hospitalization

NEW TITLE -

3/1/2015 2/28/2020 2,278,166.00 952,292.00 3,230,458.00 NIMH 527,336.00 239,388.00 766,724.00

Nugent, Nicole

Mechanisms of Intergenerational Impact of Maternal Trauma

7/1/2014 5/31/2016 22,093.00 13,035.00 35,128.00 EMORY NIH 11,119.00 6,560.00 17,679.00

Oberman, Lindsay

Investigation of Neurojplasticity Mechanisms in Autism Spectrum Disorders

12/1/2013

11/30/2015

284,000.00 0.00 284,000.00 NLMFF 144,000.00 0.00 144,000.00

Orchowski, Lindsay

Integrated Alcohol and Sexual Assault Intervention for College Men

9/20/2012

8/31/2016 536,860.00 215,611.00 752,471.00 NIAAA 186,435.00 65,253.00 251,688.00

Orchowski, Lindsay

Preventing Sexual

9/30/2014

9/29/2018 1,111,348.00 651,564.00 1,762,912.00 CDC 277,837.00 162,891.00 440,728.00

25

Aggression Among High School Boys

Palmer, Rohan

System Genetics of Alcoholism: Network-based Approaches for Genetic Association

8/20/2012

7/31/2017 620,021.00 47,284.00 667,305.00 NIAAA 158,429.00 12,675.00 171,104.00

Parade D'Atri, Stephanie

Adverse Childhood Experiences in the Parent Generation: Impact on Family Engagement and Program Efficacy of MIECHV Home Visiting

4/1/2015 3/31/2018 200,194.00 62,445.00 262,639.00 HRSA 200,194.00 62,445.00 262,639.00

Parade D'Atri, Stephanie

HPA mechanisms underlying links between inter-parental violence in pregnancy and infant mental health at 6 months

1/15/2014

1/14/2016 59,596.00 0.00 59,596.00 BBRF NARSAD

30,000.00 0.00 30,000.00

Seifer, Ronald

TEEN JOIN: A scalable weight control intervention for adolescents

7/1/2014 6/30/2016 9,544.00 2,998.00 12,542.00 RIH NIH 9,544.00 2,998.00 12,542.00

Seifer, Ronald

Maternal, Infant, and

8/1/2012 9/30/2015 1,325,627.00 186,017.00 1,511,644.00 RIDH HRSA 811,035.00 111,453.00 922,488.00

26

Early Childhood Home Visiting Evaluation

Seifer, Ronald

Childhood maltreatment and risk for psychopathology: Gene-enviornment interactions

1/1/2010 11/30/2015

367,328.00 133,707.00 501,035.00 BUTLER NIMH 116,101.00 36,456.00 152,557.00

Seifer, Ronald

RFP #7548911-Early Childhood Mental Health Consultation (ECMHC) Intervention Supports

2/1/2015 6/30/2015 118,106.00 11,811.00 129,917.00 RIDOE 98,871.00 31,046.00 129,917.00

Seifer, Ronald

Fostering Mental Health: A Hospital and Community Partneship to Promote Evidence-Based Practices for Rhode Island's Foster Children and Families

1/1/2015 12/31/2015

64,556.00 0.00 64,556.00 RIF 64,556.00 0.00 64,556.00

Seifer, Ronald

Dating Violence Prevention for Juvenile Justice Girls

4/15/2015

3/31/2020 120,795.00 37,930.00 158,725.00 NORTHEASTERN NICHD 24,159.00 7,586.00 31,745.00

Seifer, Ronald

Addressing Toxic Stress in Early Childhood

6/1/2014 5/31/2015 343,595.00 30,341.00 373,936.00 RIDH 309,042.00 30,909.00 339,951.00

Seifer, Ronald

Asthma and Academic Performance in Urban Children

9/1/2011 8/31/2015 35,994.00 12,166.00 48,160.00 RIH NICHD 4,784.00 1,502.00 6,286.00

27

Spirito, Anthony

Research Training in Child Mental Health

7/1/2014 6/30/2019 331,524.00 25,226.00 356,750.00 NRSA 347,484.00 26,503.00 373,987.00

Whiteley, Laura

A Multilevel Gaming Intervention for Persons on PrEP

3/11/2015

1/31/2018 450,000.00 265,500.00 715,500.00 NIMH 150,000.00 88,500.00 238,500.00

Wolff, Jennifer

Intensive Outpatient Protocol for High Risk Suicidal Teens

11/1/2012

6/30/2016 118,979.00 70,198.00 189,177.00 BROWN NIMH 76,784.00 45,303.00 122,087.00

Wolff, Jennifer

Adolescents with Major Depression and AUS: Community-based Integrated Treatment

9/1/2012 4/30/2016 185,885.00 109,672.00 295,557.00 BROWN NIAAA 56,536.00 33,356.00 89,892.00

TOTALS 22,993,872.00

7,935,429.00

30,929,301.00

8,641,259.00

2,807,794.00

11,449,053.00

28

29