Author: byxrose97

Before this internship, I did not know what I should do after graduation. I started this internship with a hope to try out whether I liked research and whether I can do research. As I have spent seven weeks in this internship, there is a clearer path before me, and I am more determined about the path I choose.

Before this summer, I did not have a lot of experience in psychology laboratory or clinical psychology. I had passion for clinical psychology, but I was overwhelmed by everyone telling me how difficult it was to pursue a career in clinical psychology. I was anxious and lost as I did not know what I should do and what I can do. When I applied for this position, I was not sure whether I wanted to be a researcher or not, but the only way of knowing was by doing it.

It turned out that my anxiety and worries were relieved once I started trying. Part of my anxiety came from the fact that I was not doing anything instead of being worried, and an internship is a great way of trying out which path is suitable for you. I have noticed that many people my age, including me before this internship, are stressed about the unclear future and afraid of trying. Many of us are too eager to point out a clear future. The fact we often overlook is that very few people have a linear career path, and that uncertainty is in the nature of life. It is okay to be unsure of what to do in the future, and the key is to try. If you do not know which field is the one that you want to devote the rest of your life to, try all that you are interested in. There are so many possibilities in front of us, and we are so young that we have the privilege to explore them all. In the meantime, it is okay to find this not to be the right path for you, because career paths are frequently not linear but full of trials and failure.

In my case, I intended to join the field of economics or business up until the end of my sophomore year. After I realized that I could not fit into this field, I decided to see if psychology worked for me. My internship during this summer has confirmed my passion for clinical psychology. The arduous laboratory work can be boring to many people, but I find it interesting and feel motivated by the high-end purpose behind it. It is important for me to be happy with my job and feel like I am making a difference in the world. Every week, I need to process, scan, and store data collected from patients, but I can overcome this tedious work and stay motivated when I see how the patients are getting better every week. Being around people who share passion for the field is helpful. It is not as difficult as I thought once I started working on it, and once there are peers working hard along with you. The supervisors also gave valuable advice and made the path ahead clearer for me, as they are ahead of us along the way and have been through what we are struggling with now.      

In my previous three blog posts, I have stated how Community Psychiatry PRIDE, my internship organization, addresses social justice. I have spent plenty of time elaborating on the social problem we are targeting, the significance of our work, and the difference we aim to make.

At the midpoint of my internship, I feel I should also talk about the arduous work behind the higher purpose. It is exciting how we are trying to bring treatment to the most-needed communities or to help high-risk young men break the cycle of incarceration and poverty, but the hard work building up to the glamour of social justice practice should also be noted. While I am working on a project about implementing evidence-based treatment to resource-limited communities, it includes endless data entry and going back and forth to check data. No matter how excited you feel about the high order purpose, you will need to deal with the arduous part of the job. It is important to be aware of this, and find a way to stay motivated.

There are some incidents I want to share that keep my morale up. The first time I tried to take the commuter rail from Chelsea to North Station after work, I took the wrong one and I ended up in Lynn. I was worried and anxious, looking into the map at the Lynn station that did not make any sense to me. A middle-age man approached to me and asked me whether I took the wrong train too. He started talking to me and told me that the next train back to Chelsea was in twenty minutes. He was super talkative and based on what he told me, it was not hard to notice that he was struggling as he constantly switched from job to job, frequently visited emergency rooms, and was chronically involved with psychiatrists. I was suspicious when he first approached me, and I felt embarrassed for thinking this way as I found him to be a genuinely good person. He talked about his favorite novel and showed me how he learned math by himself on the back of the train ticket.

The idea of Community Psychiatry PRIDE to bring culture-sensitive treatments to resource-limited communities is based on getting to know people’s lives and the struggles in the communities. That incident in Lynn was my first time to be with one of the people I want to help through this internship, and I was moved by his faith in life, curiosity about the world, and eagerness to learn. This experience helps me to stay motivated through this arduous work, because they are not just quantitative and qualitative data anymore, but real people who are holding on to faith in life and seeking help.  

-Bingyu Xu ’19

 

The goal of Community Psychiatry PRIDE is to increase the access to and quality of mental health care in community-based agencies across Massachusetts, by conducting research that explores the disproportionate mental health burden in underserved communities. Community Psychiatry PRIDE is located in Chelsea, MA. Chelsea is one of the most densely populated cities in Massachusetts, with nearly a quarter of its 39,000 residents living in poverty. According to the Boston Globe article “As Chelsea begins to blossom, struggles remain”, as of 2015, there were 138 drug-related arrests and 45 overdoses in Bellingham Square district alone. As Chelsea struggles with crime, violence, and poverty, mental health is subsequently a concerning problem. Due to the limited financial and human resources, adequate and effective health care is often not provided to these communities in need.

Cognitive Behavioral Therapies (CBT) have been proven to be effective for a wide variety of psychiatric diagnoses, and have been used as a first-line treatment for a variety of mood and anxiety disorders. It is important to monitor treatment quality and make sure the treatment is delivered as intended. Some studies suggest that many providers do not implement CBT with fidelity. In fact, assessing fidelity on large scale has been a major challenge in implementation science. Through one project specifically–imAPP leveraging routine clinical materials and mobile technology to assess CBT quality–Community Psychiatry PRIDE aims to relieve the mental health burden in resource-constrained communities by developing a novel instrument to evaluate and improve the quality of CBT for anxiety, depression, and Post-Traumatic Stress Disorder (PTSD).

As a research assistant, I have been working on processing, storing, and tracking data for this project. Following data from weekly therapy session over three months, I have noticed how providers are getting familiar with this evidence-based treatment. Providers are continuously getting better at sticking to the manual protocol and incorporating CBT worksheets into therapy. It is also noticeable how patients benefit in terms of symptom improvements from the process. This study uses the Post-traumatic Stress Disorder Checklist-Specific (PCL-5) to assess PTSD symptoms. With the total scores ranging from 0-80, the DSM-V defined cutoff score for PTSD is 33. As I processed data from  early therapy sessions (i.e., protocol sessions 1 and 2), many of the patients scored over 60. The noticeable high scores of the PCL-5 within this sample demonstrates the mental health burden caused by the high rates of trauma in community settings. Patients reported seeing loved die in tragic accidents, sexual abuse, seeing a loved one overdose, being bullied, and being victims of physical assault. Through the therapy sessions, these patients’ PCL-5 scores decreased. Some patients even reported to score less than 10 at the end of the treatment!

Besides working with hard copy data, I also processed, stored, and tracked data from Qualtrics, a secure App for data collection. Other than the exciting progress mentioned above, there were problems that drew our attention. Some providers randomized to App group were not using Qualtrics to input data at all, and when they were using Qualtrics, they sometimes did not use the App in the right way. This led to having some problematic data that needed additional steps to be fixed. This data included data that had incorrect patient ID and incomplete worksheets. This problem showed that there were multiple barriers to incorporate technology into treatment in community settings.

Another problem that we came across was the length of treatment. The treatment protocol was intended to be delivered in 12 therapy sessions, but many patients went  beyond 12 sessions. The repetition of session could mean that patients did not always show up in their session, or patients were not understanding the materials. This study is bringing attention to these situations that are specific to community settings.

As for my tasks for the imAPP study, properly organizing data avoided measurement errors and ensured future analyses to be accurate, thus correctly representing the community. Maintaining datasets helped continue the relationship between research based groups and community partners. When I tracked data, I monitored where each patient was at, thus helping the research team to keep their promise of payment for participants, prepare and deliver the next materials that providers needed, and schedule post-treatment interviews.

Another task I did earlier in this internship was printing and organizing Cognitive Processing Therapy (CPT) binders. In terms of organizing binders, useful information was extracted from the manual and I helped organize and print materials with different colors. This task facilitated providers to use CPT as we made it easier for providers to use CPT materials with their patients, and know what materials needed to be returned to the research staff. By providing materials to providers and strengthening the relationship between the research team and providers, I helped take steps towards decreasing the practice and research gap in the field of clinical psychology.

There are countless small steps building up to the high-end purpose of a study. Following along the process of one project has helped me to see how I had contributed to the whole process through small but meaningful efforts.

-Bingyu Xu ’19

During my three years as a member of the Brandeis community, I have been deeply absorbed in and profoundly impacted by the Brandeis culture that values diversity, equity, and inclusion. Brandeis considers social justice as one of its central missions, aims to involve students in this just and inclusive campus culture, and encourages students to become active citizens in this multicultural world. I am grateful that I can experience such campus culture while going through the stage of my life where I am establishing values and building self-identity.

Through social norms and expectations, we grow up to know about social identity categories such as socioeconomic status, race, gender, and sexual orientation. Such learned social identity categories can be the roots of discrimination and bias, as people are often defined and confined by these categories. One morning during this summer when I took the commuter rail from Waltham to Chelsea for work, I noticed the diversity in the carriage of people from different cultures with different jobs. I was struck by the fact that I never felt labeled based on my race, gender, age, or any other social identity categories. In that carriage, I did not feel like I was labeled as an Asian or a girl; I was just a person who was ready to start another day of life like everyone else in that carriage. After all, we are all the same after stripping off the identities society imposes on us. Regardless of race, gender, socioeconomic status, and other social identity categories, we should all be given the same opportunity to pursue our dreams. The world we are now living in is far from perfect. In fact, it is unfortunately full of inequity, bias, and discrimination. When I think back, I feel extremely grateful that the Brandeis campus culture and the people I am close to have given me the reassurance to disregard the identity categories the world tries to impose on me and the confidence to stand as equal to pursue my dreams.

Lee Anne Bell (2013) defines social justice in Readings for Diversity and Social Justice as “full and equal participation of all groups in a society that is mutually shaped to meet their needs.” While I am lucky enough to have such a supportive environment and the resources, such as a college education, to reach towards my dreams, many people are not given the same opportunities to meet their needs. There are many poor communities suffering from the reverberations of perpetual imprisonment, sustained violence, and family instability. Each year, tens of thousands of inmates are either released from Massachusetts correctional facilities or are serving probation sentences. The high risk 17-24 year old young men are the target population of Community Psychiatry PRIDE’s interventional model. Because of the way resources are allocated in our society, these young men in poor communities are disadvantaged in terms of education, more vulnerable to mental health problems, and more prone to crimes. The problem progresses as there is lack of the resources necessary to keep themselves from re-offending and returning to jail. More efficient programs are needed to give them the chance to change behavior, keep a job, and break the cycle of incarceration and poverty.

Community Psychiatry PRIDE’s local community partner organization aims to build transformational relationships with high-risk young men through outreach to those who suffer from reverberations of crime and poverty. Community Psychiatry PRIDE hopes that by engaging these young men in stage-based programming, they can provide resources necessary for these high-risk young men to break the cycle of incarceration and poverty. Community Psychiatry PRIDE’s role in this program is to develop an evidence-based treatment of cognitive behavioral therapy tailored to the community’s specific struggles. We hope this program can help high-risk young men to move out of violence and into jobs.

-Bingyu Xu ’19

Hi! My name is Bingyu Xu and I am a rising senior at Brandeis double majoring in Psychology and Economics. This summer, I am completing an internship at Community Psychiatry PRIDE as a research assistant. Based out of Massachusetts General Hospital under the Division of Public and Community Psychiatry, Community Psychiatry Program for Research in Implementation and Dissemination of Evidence-based Treatments (PRIDE) aims to reduce the disproportionate mental health burden in resource-constricted communities. Community Psychiatry PRIDE has built strong partnership with community-based providers across Massachusetts to close up the gap between science and practice in the field of clinical psychology. Research projects of Community Psychiatry PRIDE focus on effective delivery of evidence-based treatment for mental health disorder that are culturally relevant and responsive to the unique challenges of the community.

One of the projects that I mainly work on is Implementing evidence-based life skills programming for reducing recidivism among high-risk youth. My tasks include data collection, entry, and tracking, and formatting codebook. Together with a local community organization, Community Psychiatry PRIDE works to disrupt the cycle of incarceration and poverty in urban communities across commonwealth. Because of the reverberations of perpetual imprisonment, sustained violence, and family instability, tens of thousands of inmates each year have difficulties keeping themselves away from re-offending and returning to jail. The 17- to 24-year young men that this project targets on are disconnected, under-educated, and unable to success in traditional programming. Therefore, Community Psychiatry PRIDE aims to develop evidence-based treatment of cognitive behavioral therapy that are good cultural fit for participants. Community Psychiatry PRIDE holds the belief that these incarcerated young people, when re-engaged through positive and intensive relationships, can change their behaviors and develop life, education, and employment skills to disrupt the cycles of poverty and incarceration.

Community Psychiatry PRIDE’s determination to improve the mental health in resource-limited community is what attracted me to this position in the first place. People who in live neighborhood full of crime and violence are more vulnerable to mental disorders. Their incarceration and disadvantages in term of education and socio-economic status exist not due to what kind of people they are, but because of the way our society is structured and the way the resources are allocated in our society. I share the belief with Community Psychiatry PRIDE that when provided with appropriate resources, these high-risk youth can break the vicious circle and thrive. Community Psychiatry PRIDE has been dedicating to understanding the challenges of implementation and dissemination these recourses, and developing culturally suitable treatments for these communities.

My goal for this summer is to become familiar with all kinds of psychiatry research laboratory activities. Since I plan to enter a doctoral program in clinical psychology, I consider this internship as opportunity to train myself as a future researcher.       

-Bingyu Xu ’19