In September, the American Psychological Foundation (APF) awarded Alan Bellack, PhD, its $20,000 Alexander Gralnick Research Investigator Prize. The biennial prize recognizes a psychologist for exceptional research and mentoring accomplishments in the areas of schizophrenia and other serious mental illnesses.
Bellack, a professor at the University of Maryland (UMD), Baltimore and longtime schizophrenia researcher, is well known for using behavioral interventions to improve social functioning in people with schizophrenia.
More recently, he has broadened his focus to include research on people with the dual disorders of serious mental illness and substance abuse. With the award, he plans to develop studies to investigate recovery from schizophrenia and other serious mental health disorders.
"Psychology can play a key role in the science of understanding these illnesses and treatment development, and in terms of clinical applications," says Bellack.
Bellack has forged diverse research relationships since receiving his clinical psychology doctorate from Penn State University in 1970. As a professor at the University of Pittsburgh in the department of psychology and psychiatry from 1972 to 1982, he teamed with University of Pittsburgh Medical Center clinical psychologist Michel Hersen, PhD, to pioneer behavioral therapy interventions for people with schizophrenia--at the time an underserved population among people with serious mental illness.
"It was really propinquity," Bellack says. "It was a convenient group to study, and the more I worked with that group the more I became interested in schizophrenia."
In 1982, Bellack left the University of Pittsburgh to work at the Medical College of Pennsylvania, where he remained for 13 years. Bellack then moved to the UMD, Baltimore, where he is also director of the Veterans Affairs Capital Health Care Network Mental Illness Research Education and Clinical Center at the Baltimore Veterans Administration Medical Center. In this role he oversees investigators who work with UMD, investigating schizophrenia and serious mental illness.
He also continues his early research on behavioral interventions to help people with schizophrenia overcome the cognitive impairments that come with the disease. Such impairments affect people's community functioning, such as their ability to work, marry or have a positive social life, says Bellack. In one intervention, Bellack uses an educational software program for people with schizophrenia that teaches reasoning and problem-solving strategies while improving attention and memory skills.
Because of the prevalence of patients with both serious mental disorders and substance abuse in Philadelphia and Baltimore, Bellack has recently expanded his research focus to include studies of behavioral treatments for dual-disorder populations. He's focused on illegal street drug users, but also studies abusers of legal drugs such as alcohol and cigarettes.
"It's very difficult to get people with dual disorders engaged in treatment, but our intervention is very effective with those we do get involved," he says.
In fact, with a five-year grant from the National Institute on Drug Abuse, awarded in 2004, Bellack and Melanie Bennett, PhD, have developed a behavioral treatment program for patients with dual disorders called Behavioral Treatment for Substance Abuse in Schizophrenia (BTSAS) that in part aims to establish a personal bridge for patients by involving their families or friends in the treatment program. The six-month program, which includes motivational interviewing, regular urinalyses and social skills training, also features a psychoeducational intervention for the patient's family members or significant others.
In addition to teaching the family member about particular problems involved with co-morbidity, Bellack and his colleagues invite the partner to become a support person in the treatment. Bellack says preliminary studies show the family or partner intervention component increases a patient's rate of engagement in BTSAS.
Bellack was inspired to turn his research toward recovery from mental illness following the release of a report by the President's New Freedom Commission on Mental Health in 2003. The commission emphasized that recovery is a process--not an outcome--of positive adaptation to a mental illness. Bellack chaired a task force to see how the VA system could adopt a recovery-oriented stance.
"For many people with mental illness, the illness defines their life. Recovery is not simply in elimination of symptoms but in helping people to develop a more adaptive, normalized quality of life that extends beyond the fact they have a chronic illness," he says.
Bellack is considering using some of his Gralnick Award money to initiate studies that identify problems, target interventions and evaluate outcomes related to recovery and to develop measures to assess it--work of great value to the field, says APF Director Elisabeth Straus. "Alan Bellack is an outstanding researcher on the psychosocial aspects of schizophrenia and is seminal in the field," she says. "He has devoted his career to this work and will undoubtedly continue to enrich our understanding of schizophrenia and ability to treat it for years to come."
From his years of professional experience with people with schizophrenia, Bellack has found that one way to increase feelings of hope and efficacy in a person with a mental illness is to give them more say in their treatment.
"We don't usually ask people with serious mental illness to make choices about their treatment," he adds. "We tell them what to do, then when they don't do it, we blame them for being noncompliant. We want them to have a more active role, and to be in partnership with mental health professionals, rather than in a one-down, doctor-patient relationship."
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