[Almost] Two Decades Deep: A Brief History of the Brenner Center

Long before the importance of prioritizing mental health across the lifespan snapped into sharp focus—by increasing access and reducing stigma—Samuel J. Moncata ,PsyD had a vision, one that hinged on creating an assessment center to meet the growing need among underserved populations in marginalized communities. What began as a small-scale teaching tool in the late 1990s, in the days before Obamacare provided health insurance for all, eventually took shape with support from President Nicholas A. Covino and the Board of Trustees. In December 2005, the stars aligned: A group practice was launched at the Massachusetts School of Professional Psychology (now William James College) using seed money from the College coupled with a gift honoring the memory of one founding faculty member with a special passion for psychological assessments—which, he believed, stood to play a central role in the training of sophisticated clinicians. For almost twenty years, the Dr. Leon O. Brenner Center for Psychological Assessment and Consultation has preserved its namesake’s commitment to clinical training and providing expert psychological consultation to those in need.

Humble Beginnings 

 “We had a dedicated space in West Roxbury, accessible by public transportation, and we began testing people across the lifespan,” says Moncata of folks from largely marginalized populations, most of whom were uninsured. The initial goal was to provide pro bono psychological assessments for children from low-income families. In their inaugural year, the small-but-mighty team at the Brenner Center received 17 testing referrals— all of which were administered by Moncata and Mina Panayoutou PsyD, a postdoctoral fellow and MSPP alumna. In July 2006, Lionel Joseph came on board as administrative director and Moncata assumed the role of clinical director. The potential for pre-doctoral training in conjunction with direct service was immediately made clear and led to the recruiting of three interns and a second Brenner Fellow—Sandra Dixon PsyD—whose Fellowship led to her subsequent appointment as a faculty member. By 2013, referrals had grown exponentially—to the tune of 276 that year alone—due to a single, staggering factor: Growing community awareness of a Boston-based assessment center that provided underserved, marginalized clients with the highest quality testing regardless of their ability to pay.

“We have such a long waiting list because, for many, we were the only game in town,” says Moncata who underscores quicker than normal turnaround (when compared with other assessment centers) as another benefit. Over the years, neither the clientele nor the mission has changed. In fact, two decades following its inception, the Brenner Center remains the only testing site in the Commonwealth to regularly accept MassHealth — a game changer for folks living at or below the poverty line. 

Amidst an institutional move to Newton (August 2016) and a rebranding to William James College (May 2015), a decision to consolidate myriad administrative activities into a single, full-time position led to Kelly Casey PhD, who was named Executive Director of the Brenner Center in 2014. After a decade spent working in the Juvenile Court Clinics (JCC) in Suffolk county (now operated by William James College under an agreement with the Massachusetts Department of Mental Health and the Trial Court of Massachusetts) and a stint at the Harvard University Hospital system, Casey arrived on campus to oversee a growing team of licensed psychologists, post-doctoral fellows, and pre-doctoral interns and their work in neurocognitive assessment. As to her elevator pitch for the Center? 

“We're an assessment center that will see people across the lifespan—from two years of age to 99-years-old - for a variety of different referral questions. As a training institute, we are motivated to meet the need that’s there, which equates to serving underserved populations. So we can provide a thorough, comprehensive, and specialized assessment for each person that comes to us.” she explains. 

The Brenner Center Today

Over the past two decades, the Brenner Center has evolved into a world-class training site serving the needs of interns, doctoral and postdoctoral students. In an effort to welcome and serve the whole community, the Center offers all people high quality, culturally responsive services while honoring race, religion, national origin, ethnicity, age, sex and fluidity of gender, sexual orientation, disability, socio-economic, immigration, or veteran status. Deemed an American Psychological Association Internship Consortium site in 2014, the Brenner Center currently conducts psychological assessments in a dozen different languages. By the numbers, the Brenner Center has seen approximately 3,200 cases since opening its doors—a whopping 2,200 of which have been since 2013.

“So much of our work is trauma informed, because so many of our clients have significant trauma histories,” says Moncata, emphasizing one of the Center’s enduring assets: Understanding what trauma looks like, how it impacts the brain, and—by extension—how it impacts the kind of data collected.

“As mental health has become less and less stigmatized, more and more healthcare providers are recommending psychotherapy and psychological assessments,” says Moncata in a nod to a pair of historically underutilized resources. Once word got out, the tide changed and folks of all ages began asking questions of the Brenner Center surrounding ADHD, anxiety and depression—a trend that’s only increased in the wake of the pandemic. 

Chief among the barriers to access is cost followed by time and transportation. “We will meet people where they are—from residential placements and DSS to prison—and for those who come to us, we bring them back as many times as needed to get a proper evaluation,” Casey adds, underscoring that testing an uncooperative child for only a finite amount of time on a challenging day can not only skew results but also make them largely unhelpful in the long run.

Since the beginning, clinicians have prioritized integrating across domains so reports come alive. “We work hard to avoid jargon and [instead] use language that’s accessible in order to deliver our findings in ways that are easily digestible,” says Moncata.

In the fall, the Brenner Center will welcome a cohort of 16 trainees— including postdoc, doctoral, and bachelors level students—the largest in the Center’s 20-year history. The large training cohort, coupled with five, full-time faculty members, is a boon for all. 

“We can manage a lot of cases, many of which are given to [Sam’s] class,” says Casey in a nod to a particularly popular pair. Moncata has been teaching Advanced Assessment: Integrated Team Clinic to groups of third and fourth year clinical psychology doctoral students since 2001. Testing real-life Brenner clients under his supervision hones their assessment skills, and makes them more attractive candidates in preparation for the 5th year APA internship application process. In 2014, he began offering an Assessment Seminar to the Brenner Center APA Internship Consortium participants. Additional cases are given to consortium interns who do not provide testing at their sites, of which there are a dozen in total. All the while, Casey’s personal goal remains to intervene as quickly as possible. 

“Anytime we can make a difference—and arm parents with the appropriate knowledge to advocate for their kids, especially in school—it is incredibly rewarding,” she says, underscoring an across-the-lifespan approach unique to the Brenner Center. Two decades on, expansion of services continues. A new partnership with the Department of Public Health and the State’s massFAS task force is providing evaluations for kids suspected of having Fetal Alcohol Spectrum Disorder (FASD). In Massachusetts, consistently ranked among the top five states when it comes to binge drinking, this work is more timely than ever. 

“These kids do have a neurodevelopmental disorder that impacts all facets of their development—just like autism or an intellectual disability would—but they are not getting diagnosed correctly, so they don’t receive the services they need,” says Casey pointing to another staggering fact: In Massachusetts, the Department of Developmental Services (DDS) does not currently recognize FASD in adults, unless it is accompanied by an intellectual disability. 

Casey’s current passion has been presenting to folks—from lawyers and other clinicians to Juvenile Court Clinics —to ensure these kids don't get missed. 

The Enduring “Why?”

Despite coming to the shared work of prioritizing mental health at different times and from different perspectives, both Moncata and Casey are equally invested in the Brenner Center’s success. The pair is also fueled by lived experience.

Moncata, who has always loved psychology, was drawn to the field on the heels of his own trauma history—the effects of which he didn’t fully understand until he was in graduate school doing his own therapy as part of the program. Over time, he developed an analogy likening engaging in therapeutic work to an oyster producing a pearl: “The genesis is an injury, an abrasion inside the flesh of the mollusk, and creating the pearl is part of its healing,” says Moncata of hard work over time that ultimately produces something that’s not only distinct but also of great beauty and value. 

 “Part of the way I think about my history, and how I healed myself, was trying to figure out how to turn my pain into something of great value and in service to others—that was my formula.” 

When reflecting on his career, Moncata has a point of pride for what he’s accomplished at William James College. “From establishing an assessment center and having it become an APA internship site to serving underserved populations—all of that will live on well after I retire. The Brenner Center is a wonderful jewel,” he says, sharing a sentiment with which Casey concurs. 

“A proper assessment can change the course of someone's life,” says Casey, the mother of a dyslexic child who, over the course of her career as a court clinician, saw kids get missed by the system time and again.

When asked what drives her in her work, Casey underscores a single factor: “Identifying what someone needs to reach their optimal potential, as early as possible, in order for them to function and to prosper,” she says, from helping an individual get the education that they deserve to providing the support needed to prosper in their respective community. Aside from her time spent working in the JCC, Casey’s career highlights hinge on the various individuals she’s met over the years who have touched her heart. 

“I once encountered an individual in prison, unable to get parole for years, due to an intellectual disability having gone undiagnosed,” says Casey pointing to a stark reality: If someone is in custody, being asked questions they cannot answer, who is there to advocate for them? (In this case, the individual was tested, diagnosed, and is awaiting a parole hearing.) Casey has been equally impacted by an affinity for teaching, a path she never imagined pursuing. 

“Training new interns to understand the importance of having a balanced client portfolio—complete with some pro-bono and MassHealth cases—coupled with teaching new clinicians to think in a way that will benefit the most people going forward, in a sort of systemic way, is the part of my job I like the best right now,” says Casey who, come fall, will oversee a staff of 20 including trainees; in her tenure at the Center, she’s provided supervision to approximately 80 individuals. Still, challenges remain. 

“Being aware that boys from underserved populations, for example, are less likely to be diagnosed with autism than white children from middle class families with parents who can advocate for them [is imperative],” says Casey, underscoring a pervasive disparity that can come with devastating consequences, given that these children often get diagnosed with other things first, like ADHD and ODD.

“Years often go by—where they could have been getting the services they need to bolster their development of neural pathways, to make the biggest difference—before anyone considers an autism diagnosis,” says Casey who, in her teaching, is keen on making sure students know these discrepancies still exist—in the way tests are normed as well as the way both behavior and results are interpreted. In short, awareness is not enough. 

“Future clinicians need to look for [these discrepancies], ask about them and make no assumptions.”

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