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The evidence based Cornerstone Method of Reflective Network Therapy has passed some important and scientific study thresholds. These include service feasibility, prospective, consecutive, controlled and comparison treatment research. Two other factors we hope to add soon from a Harvard Medical School based project in Cambridge, Massachusetts are random assignment and further verification of cost benefits based on random assignments. We plan to randomly assign and have independent study of Cornerstone outcomes versus other methods such as ABA, Floortime, Psychopharmacologic, and regular special education: Feasibility. Cornerstone is possible to carry out in locations as varied as day care centers, private therapeutic nurseries, mental health clinics, Head Start projects and shelters for homeless families, as well as public school special education classes. Prospective. Cornerstone has been studied by forward-looking studies of outcomes, as well as and in contrast to backward-looking studies of archives. Consecutive. A study of outcome included a series of children with no omissions. Controlled. A study included reasonably well matched untreated same age, race and gender children with the same diagnoses in the same school system. Comparison-treatment. Results with Cornerstone treated children were compared with results with children given other treatments, such as supportive-expressive group therapy, and individual psychotherapy. Another factor necessary in scientifically based therapies is replicability. Our replication manual is a vital tool for further replication. Also essential for replication are the use of training videos and observation. Two ongoing laboratories for training in the technique (one at the Ann Martin Center, near Oakland, California, and one in Buenos Aires, Argentina) supplement the archives of training and research videos from our older New York and California projects. Psychologists will readily recognize the importance of significant gains among Cornerstone children’s IQ scores, as these measures usually change very little over time. After decades of studying Cornerstone work and its feasibility in various settings, we are convinced that extraordinary IQ gains will continue to be produced and this measure will remain robust in other settings as the Cornerstone method is more widely used. The easily and objectively measured increase in the standardized intelligence quotients of so many Cornerstone children is compelling in its statistical proof of one of the good effects of Cornerstone. Usually an individual’s IQ test varies by only a few points when it is repeated after a patient is treated by other methods (Siegel 1986). Thus, our results showing IQ growth with Cornerstone treatment are generally surprising. But they are even more surprising sources for therapeutic optimism about children with severe developmental disorders on the autism spectrum. One study discussed in Early Childhood Psychotherapy In The Classroom (Kliman, G. 2009) deals with 10 out of 10 such children (an uninterrupted series) all of whom benefited. Our overall follow-up group of 58 children, including those ten could simply not be predicted to grow this much in their intelligence. GRAPHS AND CHARTS CONCERNING OUR RESULTS In this section, a variety of data concerning our evidence-based Method is presented with brief explanations.
MULTI-SITE STUDY OF CORNERSTONE RESULTS: TWICE TESTED CHILDREN The meta-analysis [statistical assembly of an accumulation of comparable studies] of data collected over a forty year span now leads us to state that Cornerstone psychotherapy is an evidence-based method. Thanks are due to Michael Acree, Ph.D., of San Francisco for this meta-analytic statistical analysis. It shows the results are extremely unlikely to be due to chance. The statistical significance is better than a P= .001 level. The Cornerstone Method of Reflective Network Therapy has passed many scientific evaluation thresholds: Manualization, replicability, feasibility in multiple settings (day care, therapeutic nursery, public special education, homeless shelters), use by many teams other than the original team, use by many therapists other than the original therapist, effectiveness in another language in another culture, blind study, controlled and comparison study. RNT been delivered very effectively to preschool children with Pervasive Developmental Disorders, as well as to other diagnostic categories of serious emotional disturbances. It works in public school special education preschool classes as well as in a mental health agency. For a fuller discussion of this study, click on this link to excerpts from Chapter 7 of Early Childhood Psychotherapy In The Classroom: The Cornerstone Method of Reflective Network Therapy (Kliman, G. © 2009) 
PROSPECTIVE STUDY OF REFLECTIVE NETWORK THERAPY IN A PUBLIC SCHOOL Objective raters (defined as professionals who were not involved in any of the children’s treatment) found an average IQ increase of one to two standard deviations. That translates to an increase of 14 to 28 points on full-scale IQ scores. This rise occurred only among Cornerstone children. No IQ rise occurred at all among the children with similar disorders treated with other methods and none among the untreated control children. All of the Cornerstone children with Pervasive Developmental Disorder whose IQ’s were tested twice showed show an IQ rise upon retesting, At this writing, only one of the entire group of 58 twice-tested Cornerstone-treated children treated for all other diagnoses failed to show an IQ rise upon retesting.
 CORNERSTONE ARGENTINA DATA - November 2007 IQ rises for children too retarded to be testable have occured using the Cornerstone Method at our Buenos Aires service site. One child's improvement upon retesting represents an unusual advance into the normal range for full scale IQ. 
Eleven out of twelve children treated at Cornerstone Argentina showed significant improvement in emotional health upon retesting. 
The Childhood Autism Rating Scale is used to test children 2+ years old. Cornerstone Argentina results indicate a consistent reduction of symptoms for children treated using the Cornerstone Method. 
IQ CHANGE BY TREATMENT MODALITY - CONTROL AND COMPARISON STUDY The IQ rise benefits of Cornerstone are particularly significant in light of a large literature showing the stability of IQ. It is not generally found in psychological studies of intelligence that children’s IQ’s change much over time. A recent study of 41 preschool children with PDD including childhood autism shows that when treated with “eclectic” means such as medication, behavioral management, and speech therapy, their IQ is stable, and developmental quotient also does not rise (Jonsdottir et al 2006). This contrasts with Cornerstone treatment findings, and provides a robust comparison group. Cornerstone’s IQ gains have been sustained over ten to thirty years as shown in anecdotal follow-ups; see Evelyn Urbano’s personal account of recovery from autism in this book for an example of this phenomenon. [Psychotherapy In the Preschool Classroom, Chapter 4, (Kliman, G., 2008]  IQ GAIN CORRELATES WITH NUMBER OF REFLECTIVE NETWORK THERAPY SESSIONS The graph below shows the IQ gains over time from twice-tested children and points out the direct correlation between the number of Cornerstone treatments and rises in IQ, highlighting the Cornerstone advantage in this regard. [Psychotherapy In the Preschool Classroom, Chapter 12 (Kliman, G., 2008]  CORNERSTONE ARGENTINA RESULTS (Buenos Aires) PRELIMINARY DATA CONCERNING 10 CORNERSTONE ARGENTINA PATIENTS As is the case with the following grouping, a high proportion of the children treated at Cornerstone Argentina are very severely autistic. MENTAL HEALTH GAINS IN ONE YEAR
 It is rare to see a child with a subnormal IQ climb into the normal range with any other treatment method we know of. This result is also showing up in Cornerstone Argentina where most of the children are severely autistic. The chart below shows one Cornerstone Argentina child’s IQ scores which climbed into the normal from the retarded range. 
COSTS OF SPECIAL EDUCATION ENHANCEMENT The Cornerstone Method of Reflective Network Therapy has been successfully tested in more highly varied educational and community based group settings than has the Lovaas method using one-on-one behavioral aides: public school special education classrooms, preschools, mental health clinics, private therapeutic preschools, homeless shelters, day care centers, Head Starts and has been successful in another culture. Cornerstone therapy is successful for children on the autism spectrum as well as for children having a full range of emotional and developmental disorders, while Lovaas is primarily viewed as a therapeutic response to ASD. Mental health and cognitive gains are produced faster by the Cornerstone method which reduces the treatment timeline and therefore the extension of all costs.
Cornerstone treatment eliminates the necessity for one on one aides in the classroom who have been previously assigned, and accordingly lowers the associated costs. Additional reduction of expenses for staff: (a) The Cornerstone method eliminates the costs of pull-out therapy: (b) Reflective network therapy achieves results using only 15-20 minutes per lassroom day of professional psychoanalytic therapist time with each child; and, the cost of individual psychoanalytic in-classroom therapy is included in the calculated cost savings. The chart includes start up costs for implementing Reflective Network Therapy in public schools, including teacher training. The calculation employs representative salary figures which will vary in different communities.
 CHART SHOWING FINANCIAL FEASIBILITY IN A PUBLIC SCHOOL: IN TERMS OF STAFF TIME The chart includes start up costs for implementing Reflective Network Therapy in public schools, including teacher training. The calculation is based on representative salary figures which will vary in different communities.   
HELPING CHILDREN HEAL PROJECT: 2006 PRELIMINARY RESULTS, TULANE UNIVERSITY SCHOOL OF MEDICINE Reporting Reduction in Symptoms of Post-Traumatic Stress Disorder in Middle School Children:
Displaced Victims of Hurricane Katrina Using Psychoanalytically Informed
Guided Activity Workbooks Developed by The Children’s Psychological Health Center ABSTRACT: A School-based Mental Health Recovery Effort Lawrence L., Viron M., Johnson J..E., Hudkins A., Samples G., Kliman G. (2006)
OBJECTIVE: On Monday, August 29th, Hurricane Katrina made landfall in New Orleans, causing extensive destruction and widespread flooding. The objective of this study was to decrease Post Traumatic symptoms in 6th – 8th grade children attending New Orleans West (NOW), School based in Houston, TX exclusively for children displaced from New Orleans. The student population is 100% African-American, the majority of whom were from impoverished areas of New Orleans; areas that were widely devastated by Katrina.
METHOD: The University of California at Los Angeles Child Post-Traumatic Stress Disorder Reaction Index (PTSD-RI) was administrated to the children prior to beginning work on the Hurricane Workbook and after approximately three months of working with the workbooks. My Personal Story About Hurricanes Katrina and Rita: A Guided Activity Workbook for Children by Gilbert Kliman, et al. was given to each child who worked on it for 30 minutes weekly for approximately three months.
RESULTS: For grades 6-8), post-traumatic stress symptom level scores declined compared with pre-assessment scores. See charts below. SUMMARY: My Personal Story About Hurricanes Katrina and Rita appears to have contributed to decreasing PTSD symptom factors in 6th– 8th graders attending NOW post-Hurricane Katrina.
 For the entire middle school (6-8), compared with earlier in the year (Nov.-Jan), the post-traumatic symptom level scores declined 18.75%, from a median of 32 to 26. This reduction was statistically significant (p=.0001). The intervention being monitored was the use of the Guided Activity Workbooks developed by The Children’s Psychological Health Center, Hurricane workbooks, but obviously, other factors such as classroom and home environment, counseling groups, individual support from teachers and family, and the passage of time all likely contributed to the reduction in symptom levels. For the entire middle school (6-8), statistically significant reductions were observed in the responses to the following assessment questions: 
An increase was noted in the response to the question “Do things make you think it might happen again?” (p=.0349) For the 6th grade, compared with earlier in the year (Nov-Jan), post traumatic symptom level scores declined 25% from a medial of 32 to 24. This reduction was statistically significant (p=.0719). The intervention being monitored was the use of the Hurricane workbooks, but obviously, other factors such as classroom and home environment, counseling groups, individual support from teachers and family, and the passage of time all likely contributed to the reduction in symptom levels. 
For the 6th grade statistically significant reductions were observed in the responses to the following assessment questions: 
For the 7th grade, compared with earlier in the year (Nov.-Jan.), post traumatic symptom level scores declined 18.75% from a medial of 32 to 26. This reduction was statistically significant (p=.0719). The intervention being monitored was the use of the Hurricane workbooks, but obviously, other factors such as classroom and home environment, counseling groups, individual support from teachers and family, and the passage of time all likely contributed to the reduction in symptom levels. 
For the 7th grade statistically significant reductions were observed in the responses to the following assessment questions: 
For the 8th grade, compared with earlier in the year (Nov.-Jan.), post traumatic symptom level scores declined 18.75% from a medial of 32 to 26. This reduction was statistically significant (p=.0008). The intervention being monitored was the use of the Hurricane workbooks, but obviously, other factors such as classroom and home environment, counseling groups, individual support from teachers and family, and the passage of time all likely contributed to the reduction in symptom levels. 
For the 8th grade statistically significant reductions were observed in the responses to the following assessment questions: 
The following is the latest 2008 report from Cornerstone Argentina. 
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Research