Ramona Denby-Brinson remembers the day she decided to pursue a career in academia.
A medical social worker at the time, she walked into the emergency room at University Medical Center to see the familiar face of a young boy; she had worked to find services for him three times already that year.
She regretted that she would need to call the child protective services hotline about him – a decision she always dreaded, given the impact of child removal on both the child and the family.
“I said, ‘Whatever we are doing is not working. In a few months, he’ll be back,’” she recalls, realizing then that life for children like this young patient and many others like him was not changing. She knew she had to take a different approach.
Her time as a frontline social worker often made her wonder what more she and her colleagues could and should do and how to impact larger systemic issues so that children and families do not re-enter the social service system.
“A lot of the problems that people face are larger than the individual,” she says. “How do we get at the root cause and to a solution? The question is, what interventions really work?”
As much as she loved working directly with clients, she knew she wouldn’t find the necessary policy and program answers as a frontline social worker – only more questions. It was at that point she decided then to pursue a doctorate and later a career as a researcher and professor.
That decision eventually led her to UNLV, where she now serves as a senior resident scholar at The Lincy Institute and as a professor in the School of Social Work.
In this role, she conducts research on how social services are provided to the most vulnerable children and their families: those who have entered the child welfare, mental health, and juvenile justice systems.
She has been awarded $10.5 million in nationally competitive research grants since 1996 from such agencies as the National Institutes of Health, the U.S. Department of Health and Human Services, and the Lois and Samuel Silberman Foundation. She has published multiple peer-reviewed articles, books, book chapters, policy briefs, and technical reports; her work has also been disseminated and diffused nationally and internationally via numerous conferences, at which she has served both as an invited speaker and peer-reviewed presenter.
While her scholarly success is certainly noteworthy, Denby-Brinson also counts her accomplishments in terms of the number of people her research has helped. She would be the first to say that she conducts research as a method of advocacy and to drive necessary change.
In one of her empirical studies, she and her research team collaborated with a host of child welfare providers to increase child well-being by supporting the relative caregivers who assume responsibility for them. The findings of this study revealed that Clark County more than doubled the percentage of foster children placed with relatives, as well as the percentage of relatives adopting those children. The intervention used to support the relative caregivers (referred to as the “peer-to-peer approach”) reduced the percentage of alleged re-abuse cases among foster children placed with relatives from 13 percent to 4 percent in three years.
“What excited me about this kind of research is that you can begin to see the impact right away,” Denby-Brinson says. She considers herself a huge proponent of pure research but recognizes that her passion is for helping people to change their lives.
In a way, it is what she always intended to do. Growing up as one of 10 children in a middle class family in historic West Las Vegas, Denby-Brinson saw the poverty around her and wanted to do something about it. Of course, she adds, there was more than just poverty in her neighborhood – it also had strength and a sense of community that she wishes everyone could experience during their youth. But she always knew she would come back to her hometown as a social worker and seek the change she wanted to see.
After earning a master’s in social work from UNLV in 1990, Denby-Brinson worked several years in Southern Nevada, including a stint as a medical social worker at University Medical Center. It was during these years that she began to see the multifaceted nature of social work and that, as a researcher, she could still do her part to effect change. It was then she decided to head to Ohio State for her Ph.D.
Her doctoral research centered on foster families and the mental health of African-American families. Her nine conference presentations during three years of doctoral study included such titles as, “Why foster parents leave” and “Grief reactions in African-American families: Is there a cultural difference?”
After receiving her degree, Denby-Brinson accepted an assistant professor position at the University of Tennessee, Knoxville. She knew she wanted to return home to Las Vegas, but no positions were available at the time.
Her early research produced several peer-reviewed journal articles (two of them in top-tier publications) on parents’ experience in foster care; they continue to be cited today. Also, with one of her research mentors, Denby-Brinson created a statistical model that is still used for predicting which foster parents are most likely to cease continuing care.
“The whole point with us is to use research as advocacy, data as advocacy,” Denby-Brinson says. “If we can show that we have good outcomes that help kids and families and that it’s a better way to invest our social services money, then lawmakers tend to be more responsive.”
This philosophy has led her to seek large grants from the National Institutes of Health to conduct some longitudinal studies.
“Unfortunately, funding for social service research is scarce,” she says, “and at times it results in researchers focusing on the ‘hottest trends’ for the year or focusing on what problems those in the field think donors and foundations want to fund. But this is a misguided approach. It takes time to determine whether an intervention works. Many social problems are deeply engrained into the fabric of our very socio-economic structure.
“In order to see sustainable changes in the types of situations and conditions faced by so many, it takes an investment, not the least of which is research,” she says. “We hope that with the contributions that we make through longitudinal research, we can help inform the field about probable solutions to tough social problems.”
Previously, she would use her skills as a social worker to tap the resources of many agencies to help a client. Now, the client is “the system” instead of a person.
“The solution to a problem is not one agency, not one therapist,” she says. “Solutions require many people bringing their strengths, braiding their funding and their approaches.”
It was in Knoxville, under the mentorship of senior faculty member Charles Glisson, that she received her first NIH grant funding. Two years later, a job opened at UNLV, and she brought her research to the School of Social Work.
“I had to come back to Las Vegas,” she says. “It’s my community. This has always been my town and my university.”
She received tenure in 2002 at UNLV and continues to bring in large federal grants, as well as state grants from the Division of Child and Family Services and university awards.
Her research has tackled some of the toughest cases in the social service arena.
One study analyzed a “wraparound” model for case management of youths for whom intensive mental health services were needed. The wraparound model takes a holistic approach to youth and their families, giving priority to the preferences of the family and the youth, team-based decision making, individualized plans of care, and services and support for caregivers, family members, and siblings.
“You can’t talk about what might work for a youth without involving that youth and his or her parents in the discussion,” she says. “You can’t help kids to get better without helping the parents to get better.”
She and her colleague Eric Bruns of the University of Washington School of Medicine researched the wraparound model using a randomized experimental approach, which examined the effectiveness of the model when compared to a traditional, intensive case management service approach.
This type of research provides data that justifies the need for sustainable services to families and youth. Legislatively supported funding was provided to extend wraparound services during the time of research efforts.
Another grant-funded study had a similar result. In partnership with Clark County, Denby-Brinson secured U. S. Department of Health and Human Services and state funding to create the Caring Communities partnership for foster families that had taken in the children of relatives.
These kinship families – grandparents taking in their grandchildren, aunts or uncles taking in nieces and nephews, or even older siblings taking in younger ones – had not been given many resources, and local outcomes were not keeping pace with kinship outcomes seen nationally.
“Clark County was not using relative placements at the same rate as many comparable counties and other national jurisdictions,” she says. “People in the field disagree about how safe relative placements are. I had a person tell me once, ‘The apple doesn’t fall far from the tree.’ My experience in the field says this isn’t the case.”
Denby-Brinson and child welfare leaders in Clark County followed their gut instinct on this, developing a five-year study focusing on children who were in foster care – or were headed that way – and their families.
She and the leaders at the Clark County Department of Family Services created a peer-to-peer kinship care model, using grant dollars to hire mentors to work with relatives going through the process of getting licensed for foster care to take in these children.
At first, the program proved to be challenging to implement. But eventually there was a nice complement of services and support given to caregivers by the Department of Family Services professional case workers and the paraprofessional kinship liaisons who had real-world experience in caring for their relatives’ children but no formal training.
The mentors gave the caregivers someone safe to talk to when they were feeling overwhelmed, Denby-Brinson says. Before long, the professionals were referring cases to peer mentors.
Ultimately, the data from the study confirmed Denby-Brinson’s gut instinct. The program initially established through the federal grant was sustained by fiscal action taken by the Clark County Board of Commissioners.
“Children report a sense of belonging when placed with a relative caregiver,” she says. “They have fewer problems with attachment. The outcomes experienced by the children in our research were positive and more favorable than their counterparts.”
Denby-Brinson’s current research is a five year study examining why the teen pregnancy rate among foster children remains stubbornly high while comparable rates among other teens have been steadily falling.
The problem, Denby-Brinson says, is that prevention programs focus on accidental pregnancy. Girls in foster care, she is finding, are getting pregnant on purpose. It gets back to the issues of abandonment and lack of attachment.
“We have found through some qualitative work that many of the foster youth see a baby as a way to heal themselves psychologically,” she says. “The baby is theirs. The baby is a way of re-establishing the family that they lost.”
Denby-Brinson bases her work with these young women on a model developed by her colleague Darla Henry, formerly with Temple University.
“Her premise is that kids in the foster care system are dealing with profound grief and loss, and until we get to the core of that, nothing else is going to matter,” Denby-Brinson says. “The traditional pregnancy-prevention model is not going to work.”
Now that she understands the problem better, her next step is testing interventions to find the right ones.
Denby-Brinson’s study of foster care dovetails well with the mission of The Lincy Institute, which supports and conducts research that focuses on improving Nevada’s health, education, and social services. It’s a practical approach meant to solve real-world problems and build capacity and collaboration in the nonprofit sector. It’s a job description Denby-Brinson might have written for herself.
“It’s a perfect alignment of everything we do as social service researchers,” she says. “We conceptualize a problem, figure out an integrated solution, and go back and implement that approach to see what kind of outcome we get.
“It’s been a great opportunity here,” she says.
The Lincy Institute conducts and supports research that focuses on improving Nevada’s health, education, and social services. This research is used to build capacity for service providers and enhance efforts to draw state and federal money to the greater Las Vegas area. The Lincy Institute highlights key issues that affect public policy and quality-of-life decisions on behalf of children, seniors, and families in Nevada.
The institute was established through a gift from The Lincy Foundation in 2009.
According to the institute’s website, the goals of The Lincy Institute include:
- Support the viability of the economic future of Nevada and the quality of life for its residents, especially in Southern Nevada.
- Create a new model for bringing together state, regional, and for-profit and non-profit agencies to address the large-scale challenges in Southern Nevada.
- Identify and attract federal, state, and private funding opportunities.
- Provide baseline and follow-up assessments of agency activities that can, in turn, highlight applications for these funds.
- Design and maintain a data repository to support research, grant acquisition and application.
Learn more about The Lincy Institute at www.unlv.edu/lincyinstitute