A psychometric analysis of Project Liberty's adult enhanced services referral tool.

Objectives: Project Liberty was the first federally funded crisis counseling program to offer evidence-informed treatments to crisis counseling recipients in need of more intensive clinical intervention. The Adult Enhanced Services Referral Tool was developed as a screening instrument for making and monitoring referrals to enhanced services. This study aimed to examine how well the tool functioned for identifying persons who would perceive a need for professional treatment.

Effectiveness of two methods of obtaining feedback on mental health services provided to anonymous recipients.

Objective: The authors examined alternative methods for obtaining feedback from people receiving anonymous mental health services via Project Liberty, an initiative that provided free counseling to residents of the New York City area after the 2001 attacks on the World Trade Center.

Methods: Counselors offered all English-speaking and Spanish-speaking adults who used Project Liberty crisis counseling services the opportunity to evaluate Project Liberty via a telephone interview (eight sites) or a brief questionnaire (four sites).

Results: A total of 107 service recipients provided feedback via a brief 32-item questionnaire, and 153 gave feedback via a 45-minute telephone interview.

Use of clients' self-reports to monitor Project Liberty clinicians' fidelity to a cognitive-behavioral intervention.

Objective: This study examined outcomes associated with clinicians' fidelity to key elements of a cognitive-behavioral treatment intervention developed for Project Liberty's enhanced services counseling program.

Methods: In telephone interviews 60 individuals reported how often their clinicians provided six components considered central to the intervention by the intervention developers. Respondents received services at sites where some (25 to 50 percent) or all clinicians had received training in the intervention.

Clients' satisfaction with Project Liberty counseling services.

Objective: Satisfaction with 11 aspects of service quality and four domains of effectiveness was assessed for counseling services offered through Project Liberty after the September 11, 2001, attacks on the World Trade Center.

Methods: A total of 607 Project Liberty service recipients completed anonymous questionnaires, telephone interviews, or both. The 11 aspects of quality were counselor respect for client, willingness to listen, cultural sensitivity, speaking the same language as the client, amount of counseling time, convenience of meeting time and location, information received, whether the service would be used again, whether the service would be recommended to friends or family, and overall quality of service.

Characteristics of Project Liberty clients that predicted referrals to intensive mental health services.

Objective: The authors describe characteristics of Project Liberty crisis counseling recipients that predicted referral to more intensive professional mental health treatments over the two-year period after the terrorist attacks on the World Trade Center.

Methods: Random-effects ordinal regression models were applied to data from 684,500 logs of Project Liberty service encounters for individual counseling sessions.

Results: Overall, about 9 percent of individual counseling visits ended with a referral to professional mental health services.

Did Project Liberty displace community-based medicaid services in New York?

Objective: This study analyzed how the introduction of Project Liberty services after the September 11, 2001, terrorist attacks affected agencies' provision of community-based Medicaid mental health services in the New York metropolitan area.

Methods: Provision of Medicaid mental health services was tracked between January 2000 and June 2003 for provider agencies participating in Project Liberty (N=164) and for a comparison group of mental health provider agencies that did not participate in this program (N=94).

Results: Overall, participation in Project Liberty did not significantly affect the volume of Medicaid services provided.

Impact of a media campaign for disaster mental health counseling in post-September 11 New York.

Objective: After the September 11, 2001, terrorist attacks on the World Trade Center, the New York State Office of Mental Health (NYOMH) initiated a three-phase multifaceted, multilingual media campaign that advertised the availability of counseling services. This study evaluated the association between patterns of spending within this campaign and the volume of calls received and referred to a counseling program.

Methods: Spending on television, radio, print, and other advertising was examined, as was the corresponding volume of calls to the NetLife hotline seeking referrals to counseling services.

Outcomes of enhanced counseling services provided to adults through Project Liberty.

Objective: Project Liberty provided brief crisis counseling to 753,015 residents of New York City and surrounding counties after the attacks on the World Trade Center. Most regained predisaster functioning after counseling. For those who did not, Project Liberty provided enhanced services by specially trained, licensed mental health professionals.

Screening for complicated grief among Project Liberty service recipients 18 months after September 11, 2001.

Objective: The authors surveyed a sample of Project Liberty crisis counseling recipients approximately 1.5 years after the terrorist attacks on September 11, 2001, to determine the proportion of respondents who screened positive for complicated grief, a recently identified condition marked by symptoms of continuing separation distress and accompanying bereavement-related traumatic distress.

Methods: A total of 149 service recipients drawn from eight high-volume providers responded to a telephone survey that included questions to screen for complicated grief.

The road back: predictors of regaining preattack functioning among Project Liberty clients.

Objectives: This study determined the likelihood and predictors of Project Liberty counseling recipients' reporting their return to satisfactory life functioning 16 to 26 months after the September 11, 2001, attacks.

Methods: Using anonymous brief paper-and-pencil questionnaires or structured telephone interviews, 452 respondents provided retrospective ratings of their functioning in five life domains during the month before the World Trade Center attacks and the month immediately before the assessment. Information on demographic characteristics and exposure to risk during the World Trade Center attacks also was obtained and used in logistic regression models.

Service utilization and event reaction patterns among children who received Project Liberty counseling services.

Objectives: This study examined service utilization and event reaction patterns among children who used crisis counseling services provided under Project Liberty for 27 months after the September 11, 2001, terrorist attacks on the World Trade Center.

Methods: The authors analyzed logs of 681,318 service encounters submitted by Project Liberty counselors, paying particular attention to demographic characteristics and reported event reactions.

Results: Nine percent of service recipients reached by community-based Project Liberty providers were children, whereas census data for the 15 counties and boroughs served by Project Liberty indicated that children constituted 25 percent of the population.

Clusters of event reactions among recipients of Project Liberty mental health counseling.

Objective: This study aimed to determine a pattern in the frequency with which individuals who manifested distress reactions resembling diagnostic syndromes of posttraumatic stress disorder (PTSD) and major depressive disorder accessed services provided by Project Liberty.

Methods: Hierarchical cluster analysis was applied to 31 reactions to stress (event reactions) shown by 465,428 recipients of Project Liberty counseling, to determine how well event reactions mapped onto traditional diagnostic criteria. Service recipients were tracked when they first sought Project Liberty counseling during the 27 months after the attacks.

Use of Project Liberty counseling services over time by individuals in various risk categories.

Objective: The authors examined temporal changes in the rates at which people sought access to Project Liberty services after the attacks of September 11, 2001, according to risk category (family of missing or deceased, persons directly affected, uniformed personnel, other rescue or recovery workers, schoolchildren, displaced employed and unemployed workers, persons with disabilities, and the general population).

Methods: First visits to individual counseling services, as determined from logs of 465,428 service encounters, were proportioned among risk categories and plotted across 27 months.

Results: Individuals who lost family members accounted for 40 percent of visits in the first month but dropped to 5 percent or fewer visits by five months.

Demographic characteristics of individuals who received Project Liberty crisis counseling services.

Objectives: This article describes demographic characteristics of service recipients and their patterns of use of crisis counseling services provided under Project Liberty during the 27 months after the September 11, 2001, attacks on the World Trade Center. It also examines the extent to which service recipients reflected the demographic characteristics of their home communities.

Methods: A total of 753,015 service encounter logs submitted by 177 providers were analyzed to determine rates of use by different demographic groups and to evaluate patterns of use over time with goodness-of-fit and logistic regression models.

The kids oneida project: what happened to services when the payment rules changed.

Community-based systems of care may provide high quality, cost-effective alternatives to institutional care for children and adolescents. This report examines Kids Oneida (KO), a not-for-profit managed care entity established in upstate New York in 1998 to serve such children and their families. Changes in payment rules that established the program allowed KO to contract with a wide array of providers to provide and be reimbursed for non-traditional and formerly unreimbursable services, such as mentoring and supervision.

Using staff focus groups to refine a feedback process for people who used Project Liberty.

Project Liberty provided free counseling services to those affected by the September 11th attacks. Focus groups were conducted with Project Liberty provider staff to gain feedback on their participation in the process of evaluating Project Liberty individual crisis counseling services. Focus groups provided information regarding barriers to eliciting feedback from people who used Project Liberty services that informed planning for the next phase of the evaluation.

Treatment recommendations for the use of antipsychotics for aggressive youth (TRAAY). Part II.

Objective: To develop treatment recommendations for the use of antipsychotic medications for children and adolescents with serious psychiatric disorders and externalizing behavior problems.

Method: Using a combination of evidence- and consensus-based methodologies, recommendations were developed in six phases as informed by three primary sources of information: (1) current scientific evidence (published and unpublished), (2) the expressed needs for treatment-relevant information and guidance specified by clinicians in a series of focus groups, and (3) consensus of clinical and research experts derived from a formal survey and a consensus workshop.

Results: Fourteen treatment recommendations on the use of atypical antipsychotics for aggression in youth with comorbid psychiatric conditions were developed.

Project Liberty: a public health response to New Yorkers' mental health needs arising from the World Trade Center terrorist attacks.

The September 11th terrorist attacks had a dramatic impact on the mental health of millions of Americans. The impact was particularly severe in New York City and surrounding areas within commuting distance of the World Trade Center. With support from the federal government, state and local mental health authorities rapidly mounted a large-scale public health intervention aimed at ameliorating the traumatic stress experienced by residents of the disaster area.