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Cost and Benefits: A PhD Student’s Research

By Jamie McCrary


When Sarah Hornack started her doctorate at AU in 2008, she was on a mission. “Going into grad school, I had been working in a small, community-based clinic in North Carolina where families sometimes drove two hours for weekly therapy appointments,” she says. “I wanted to learn how to make the delivery of services more efficient so that more people could receive the mental health treatment they needed.”  

A clinical psychology PhD candidate, Hornack is also a researcher at AU’s Program Evaluation Research Lab (PERL). Her focus in on intensive, in-patient substance abuse programs, specifically gender-sensitive programs that address the needs of women. “Historically, substance abuse treatment has been designed with the male client in mind. Women are presented with a host of obstacles to treatment, including sexual abuse, physical abuse, and spousal abuse,” she says. “Often they’re the primary caregivers in the family, too, which prevents them from coming to treatment because they can't just leave their kids behind.”  

Working with professor and mentor Dr. Brian Yates, Hornack is following 15,000 women enrolled in intensive, gender-sensitive programs. She will evaluate whether participation in these programs affects the rate at which women used services afterwards compared to beforehand. “Dr. Yates and I have spent a lot of time thinking about what services in particular are helping them to become better functioning members of their family, as well as society,” she says. “We want to know what the costs and benefits are of providing those services. Are women getting jobs? Are they using health services more or less? Are they relapsing and entering substance abuse treatment again?” 

Yates always hoped to have students like Hornack in PERL. "Collaborating with Sarah on her thesis and dissertation research continues to inspire me,” he says. “I had always hoped that PERL would attract and retain graduate students such as Sarah, adding to their clinical training the quantitative and qualitative skills in improvement of human service programs that can be gained through evaluation research. She has led the way for four other doctoral students in clinical psychology to join PERL in subsequent years.”  

Hornack’s colleagues at PERL are asking similar questions through their own cost-assessment research. PERL is dedicated to evaluating human services programs that address issues such as mental health and substance abuse. Current doctoral students are researching topics including drug abuse, seasonal affective disorder, and eating disorders, each evaluating different programs. “A lot of labs are focused on specific medical or psychological conditions, whereas as evaluators, we look at many different issues,” says Hornack. “When we all get together we have entirely different things to share about our research and ideas.”  

Despite their varying focus areas, all PERL researchers share a common goal: to help programs evaluate their cost, effectiveness, and benefits so they can be stronger, more efficient, and more impactful in their communities. Though collecting and evaluating so much research data is a challenge, Hornack is confident that working at PERL will help her meet her goals. “Dr. Yates has given so much support,” she says. “He’s provided so much structure and guidance that I feel confident in producing this dissertation project and entering the workplace in a research-oriented setting. It's a great environment to work in because he's very willing to foster your development as a professional.”  

As she continues to evaluate the costs and benefits of women-focused substance abuse programs, Hornack hopes to leave her mark on the field—both in the literature available to researchers and in the families and communities she’s working with. “At the heart of it, I think the extent to which women are able to rejoin their families and rejoin society is what makes it impactful for me,” she says.