Center develops research-informed practices, partnerships to curb impacts of exposure to violence

—by Paul M. Kubek

There is no denying the impact of news-making incidents of violence, such as school shootings and armed standoffs between fugitives and the police. They shock and disorient everyone involved, not only victims but also first responders, eyewitnesses, and viewers who are safely situated in front of televisions and smart phones, observing from the vantage point of a hovering helicopter that is hundreds of feet above the scene.

Yet, less dramatic incidents of violence, those that occur every day, have negative effects that are just as staggering. There are numerous children, adolescents, and adults in our communities who are victims of and witnesses to assaults within their own homes and neighborhoods and exposed to violence frequently on the job or through media outlets, such as television news and dramas, movies, internet videos, and interactive video games.
For over 10 years, researchers and trainers from the Begun Center for Violence Prevention Research and Education at the Mandel School of Applied Social Sciences have been conducting studies of the impacts of violence exposure upon physical health, mental health, and social functioning and have been developing and disseminating interventions that work to minimize and reverse the negative consequences. Among the Center's most notable accomplishments this past year were the creation of a research-based intervention program for use by police in public housing communities and the hiring of a new full-time director, Daniel Flannery, PhD, a nationally recognized violence researcher who was a professor of public health at Kent State University and founding director of its Institute for the Study and Prevention of Violence.

Flannery has been a long-time collaborator with Begun Center Interim Director Mark Singer, PhD, who held that post for five years, building many research and practice collaborations within the community and preparing the Center for this next phase in its evolution.


Mark I. Singer, PhD, the Leonard W. Mayo Professor in Family and Child Welfare at the Mandel School, has over 25 years of research, training, and consulting experience. He is the type of guy who won't think twice about getting into the front seat of a police cruiser to ride along on patrol for a closer, more personal look at the people behind the data he collects.
Throughout his career, Singer has developed numerous academic-community partnerships, including those with police and nonprofit organizations that work in some of Cleveland's toughest neighborhoods. He has primarily studied the experiences of children and adolescents who have been exposed to violence as victims or witnesses and has been the principal investigator of numerous research and training projects and author or co-author of over 40 peer-reviewed articles and book chapters. He has also conducted training with the US Army, Cleveland Police, and other police departments and school-security personnel in Northeast Ohio. Singer also has extensive clinical experience, which includes developing and directing two adolescent inpatient dual diagnosis psychiatric units, and he has served as chairperson of numerous community-wide committees focusing on youth problems in Cleveland.


Singer recently developed and began disseminating a research-informed intervention, called Police Assisted Referral (PAR), which is funded by the U.S. Department of Justice. PAR is a partnership among the Begun Center; the Cuyahoga Metropolitan Housing Authority (CMHA) Police Department; Children Who Witness Violence, a program of Cuyahoga County Public Safety & Justice Services; and two nonprofit organizations in Cleveland, Mental Health Services, Inc. and Partnership for a Safer Cleveland.

PAR teaches police officers how to recognize signs of exposure to violence among children, adolescents, and adults; how to intervene constructively without provoking the escalation of problematic behavior; and how to effectively and efficiently connect people to crisis services, mental-health services, other human services, and healthcare. Police officers learn to look out for and to respond to calls about domestic violence, child abuse, and exposure to violence.

"We teach officers how to approach and to talk to kids and parents in a way that's not going to make them react defensively or offensively," Singer says. "When people don't feel threatened, they are more likely to agree to talk to professionals like trauma counselors, youth counselors, and mental-health counselors."

PAR is attracting attention nationally and internationally with a number of requests for consultation from other cities and overseas. This past year, the Begun Center hosted 13 criminal justice students and two professors from Vrije University in Amsterdam, The Netherlands.


Although Singer's role as Interim Director of the Begun Center ended after five productive years, he continues to lead research and training projects and to collaborate with the Center's new full-time Director Daniel Flannery, PhD, who joined the Mandel School on July 1 as the Dr. Semi J. and Ruth W. Begun Professor.

Flannery fits right into the Begun Center philosophy and approach. Like Singer, he has a clinical background. He also takes a multidisciplinary and multi-systemic approach to his work, collaborating with researchers and community leaders and practitioners in law enforcement, criminal justice, youth and family services, and public health, among others. He currently has over $6 million in funded research, evaluation, and training projects and is bringing many of them to the Begun Center. Sources of funding for Flannery's current projects include federal agencies such as the Center for Disease Control and Prevention (CDC), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the U.S. Department of Justice, as well as the Ohio Department of Mental Health (ODMH), county agencies, and local foundations. He has published widely in professional journals in multiple disciplines.

Flannery also brings to the Mandel School a multidisciplinary team of 20 researchers, evaluators, consultants, and trainers who have master's- and doctoral-level training in social work, anthropology, education, sociology, psychology, law, nursing, and criminal justice. He also brings the Center for Innovative Practices (CIP), a State of Ohio Coordinating Center of Excellence initiative, that disseminates mental-health interventions for youth. CIP is directed by Patrick J. Kanary, MEd.

Among Flannery's current projects is the continuation of Project Tapestry, a system-of-care demonstration and research project in Cuyahoga County funded by SAMHSA. This project is examining the facilitators and barriers of intersystem collaboration and how violence prevention and intervention services might influence changes in youth and family behavior over time. Flannery's team provides the evaluation of the program.

Another project is the Fugitive Safe Surrender Program, initially funded by the United States Marshall Services (USMS). Flannery helped start the program in northeast Ohio in 2005. It has been replicated in 21 different cities throughout the United States with over 35,000 people having surrendered non-violently nationwide. Flannery's team develops and administers surveys at these events and provides evaluation of the data.


Ask Flannery and Singer to explain what lies at the core of the problem of exposure to violence, and they will remind you that the obvious consequences are physical trauma and medical conditions. Yet, there are also not so- obvious psychosocial conditions which not only harm individuals and families but neighborhoods, schools, and communities as well.
For example, violence and the threat of violence activates the survival instinct, releasing hormones like adrenalin and cortisol, which contribute to intense, emotionally charged fight, flight, or freeze responses. This lightning fast process often suppresses higher-level brain functions that would otherwise transform impulses into observation, reflection, and language. In other words, the survival instinct increases hyper-vigilance and hyper-reactivity and reduces opportunities for constructive social interactions like verbal communication, negotiation, and learning. The instinct also reduces the body's ability to fight infection. Medical research has associated high levels of stress hormones like cortisol with suppressed immune-system functioning and chronic health conditions such as cardiovascular disease.

"You cannot discount the impact of everyday events over time on physical health, mental health, and well-being," Flannery says. "Chronic exposure to violence impacts brain development, brain functioning, temperament, mood, and coping skills."

The health and mental-health disparities are topics that the Begun Center will continue to explore, especially among children and adolescents. Youth violence is presently a significant public health problem. Recent studies show that between 50 to 96 percent of youths living in urban areas like Cleveland are exposed to violence.


The high levels of youth violence, Flannery and Singer emphasize, typically occur in the context of significant poverty, educational disadvantage, and segregation. Therefore, the Center is collaborating on a number of projects that address these conditions. The first is the Academic-Community Partnership Plan (ACP), a three year planning project in greater Cleveland, funded by the National Institute of Child Health and Human Development (NICHD). The community partner is Mr. Michael Walker, executive director of the Partnership for a Safer Cleveland.

The goal of this project is to create The Greater Cleveland Consortium for Youth Violence Prevention, which will address health disparities among children and adolescents exposed to violence. The Consortium will be comprised of a partnership of businesses, schools, nonprofits, faith-based organizations, cultural organizations, and government agencies in the greater Cleveland community. The Consortium aims to develop a research agenda and to develop proposals for additional funding for research and training in youth-violence prevention.

Another project recently funded by the US Department of Justice is the Cuyahoga County Children Exposed to Violence initiative. Participants will develop a comprehensive strategic plan that will enable Cuyahoga County to improve prevention, intervention, and response systems for children most at risk and exposed to violence from birth through 17 years of age. The collaboration includes individuals with a background in program planning, development, and evaluation, which will ensure that short-term outcomes are measured and reported and a comprehensive information collection and management system is established. 

Paul M. Kubek, MA, is director of communications at the Center for Evidence-Based Practices at Case Western Reserve University, a partnership between the Mandel School of Applied Social Sciences and Department of Psychiatry at the Case School of Medicine.