Inclusion of Peer Support - Georgia Mental Health Consumer Network
Inclusion of Peer Support - Georgia Mental Health Consumer Network
Inclusion of Peer Support - Georgia Mental Health Consumer Network
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<strong>Inclusion</strong><strong>of</strong><strong>Peer</strong><strong>Support</strong>:Catalystto<br />
Recovery,TraumaInformedand<br />
Communityintegratedbasedservices<br />
MatthewR.Federici,MS,CPRP<br />
ExecutiveDirector<br />
CopelandCenterforWellness&Recovery<br />
dC Wll www.copelandcenter.com
<strong>Peer</strong><strong>Support</strong><br />
<strong>Inclusion</strong><strong>of</strong><strong>Peer</strong><strong>Support</strong> intentionally,inthe<br />
supportswe<strong>of</strong>ferpeopleinrecoveryisabout<br />
<strong>of</strong>feringnewrelationshipsbasedonexperientialnew relationships on experiential<br />
knowledge<strong>of</strong>whathasworkedandnotworked;<br />
VERSUS<br />
Traditionalhelperrelationshipsbasedonthe<br />
theoreticalandacademicexpertise<strong>of</strong>whatapersonand academic expertise <strong>of</strong> a person<br />
inrecoveryneeds.
NoOneShoe:<br />
• <strong>Peer</strong>Specialists/Coaches(i.e.trainedpersonin<br />
recoverytorolemodelandsupport.)<br />
• “<strong>Consumer</strong>”(ourcustomers)inputandadvisory<br />
di<br />
roles<br />
• Advocates(i.e.experiencewithnavigatingthesystem<br />
e eperiene ith na i atin the sstem<br />
anditsbarriers)<br />
• TherapeuticandCommunity<strong>Support</strong>sbasedonand on<br />
mutualityandequality,(i.e.use<strong>of</strong>disclosureand<br />
personcentered)
PositiveOutcomesAssociatedwith<strong>Peer</strong><strong>Support</strong><br />
Services:Howdoweknowthisworks<br />
– SelfHelpgroupsimprovesymptoms,increaseparticipants’<br />
socialnetworksandquality<strong>of</strong>life(Davidsonetal.,1999)<br />
– <strong>Peer</strong>providedServicesaseffectiveormorethanNon<strong>Peer</strong><br />
providedservices(SolomonandDraine,Chinman,Rosenheck<br />
etal.,2000)<br />
– Improvedsocialfunctioningandreducedsubstanceabuse<br />
and reduced substance abuse<br />
(Klein,Cnaanetal.,1998;Whitecraftetal.,2006)<br />
– Consistentfindings<strong>of</strong>decreasedhospitalizationorshortened<br />
length<strong>of</strong>hospitalstayforbothpeerproviderservices&peer<br />
h l t f id i providersthemselves(Solomon,2004)
EmploymentOutcomes<br />
• 82%CPSwereworkinginsomecapacity<br />
i i<br />
oneyearafterthetraining.<br />
• 77%wereworkingoneyearaftertraining<br />
inwhatweredefinedaspeerspecialist<br />
p<br />
positions.<br />
• 67%wereworkinginsomecapacity.<br />
working • Salzer,M.S.,Katz,J.,Federici,M.R.,Kidwell,B,&WardColosante,C.(2009)Pennsylvania<br />
Certified<strong>Peer</strong>SpecialistInitiative:Training,EmploymentandWorkSatisfactionOutcomes.<br />
and Satisfaction PsychiatricRehabilitationJournal,32,301305.
Ingredientsto<strong>Inclusion</strong><strong>of</strong><strong>Peer</strong>Specialists<br />
• Allstaffadoptanunderstandingandbeliefin<br />
recoveryvalues(e.g.stafforientation).<br />
• <strong>Peer</strong>Specialistarenotseeasspecialemployeesbut<br />
asspecialistinpeerandselfhelpapproaches<br />
• JobDescriptionsclearlyfocusonwellnessrole<br />
modelingandpeerrelationships/mentoringtasks<br />
• Supervisorsaretrainedinpeersupport<br />
relationships,selfhelpmodelsandperformance<br />
managementskills
RECOVRYBASEDLEADERSHIP=PROMOTINGPEER<br />
BASEDWORKPLACE<br />
• LEADERSHIP:<br />
– Constantlyfacilitatesandvalidatesthevalue<strong>of</strong>experiential<br />
knowledgeandcreatesasafeenvironmentfordisclosure.<br />
RecoveryStorytellingonmanylevelsbecomesthenorm<strong>of</strong><br />
conversation<br />
– Encourageandprovidesupportforallstafftousedirectiveand<br />
pp<br />
intentionalselfdisclosure(Egan,G.(2002)TheSkilledHelper:A<br />
ProblemManagementandOpportunityDevelopmentApproach<br />
toHelping.7 th editionBrooks/Cole.
– Setandcommunicatesstrategicgoal<strong>of</strong>atleast25%<br />
l<br />
expectationforworkforceandrolestobebasedon<strong>Peer</strong><br />
<strong>Support</strong>(i.e.selfhelp,recoverycoaches,familyadvocates,<br />
p y<br />
<strong>Peer</strong>Specialist)<br />
– PlansforServicesUsersonBoards,AdvisoryCouncils,and<br />
SpeakersBureaus<br />
– Proactivelyseeksservicerecipientsinputonquality<strong>of</strong><br />
servicesfrommultipleapproachesi.e.surveys,focus<br />
groups,exitinterviewsetc…
Boundaries,Ethics&<strong>Peer</strong><strong>Support</strong><br />
:<br />
• Largestperceived concern:<br />
– <strong>Peer</strong>sability tohandleconfidentialityandboundaries<br />
• (basedonliteraturereviewaroundimplementation<br />
concernswithconsumersasprovidersandfocus<br />
groupswithadministratorsandexistingagency<br />
workforce)<br />
• Reality<br />
Largestchallengeistheagencyandorganization’sability<br />
hll th i ti tohandleconfidentialityandboundariesbetween<br />
peopleasmembers<strong>of</strong>theircommunityandtheir<br />
workforce<br />
9
Boundaries,Ethics&<strong>Peer</strong><strong>Support</strong><br />
:<br />
• Thebiggestcontributingfactortoethicalandboundary<br />
tib ti t t thi b d<br />
problemsiswhentherolesarenotclearlydefinedand<br />
communicationisnotoccurring<br />
• Thisisnotonlytruewhenwetransitionfromone’sfriend<br />
inthehospitaltotheirpaidsupport,butalsowhenwe<br />
h it lt i id t t l h<br />
transitionfromtheircolleaguetotheirbossorsupporter<br />
tocolleague<br />
• Thecontexts<strong>of</strong>ourrelationshipsarefluidandnotstatic<br />
relationships<br />
10
RECOVERYBASEDLEADERSHIP=PROMOTINGPEERBASED<br />
WORKPLACE<br />
• BoundariesandEthics<br />
d – Needtobeflexibleandongoing discussionsingroupand1:1<br />
supervision(ethicalandboundarieschallengesshouldbeexpectedifwe<br />
aredoingcommunityintegration)<br />
– Dualrelationshipsarenotanissue<strong>of</strong>inclusion<strong>of</strong>currentandformer<br />
servicesrecipientsandpeersupporters,butanissue<strong>of</strong>ashiftfrom<br />
institutionalsupportstocommunitybasedprograms<br />
BasedonOldStandards,NewDilemmas:EthicsandBoundariesinCommunity<strong>Support</strong>Service<br />
byLaurieC.CurtisandMarthaHodge<br />
SelfDisclosureandItsImpactonIndividualsWhoReceive<strong>Mental</strong><strong>Health</strong>Services<br />
http://www.samhsa.gov/ / .Foraprintcopy<strong>of</strong>theCMHSmonograph,contactSAMHSA’s<strong>Health</strong><br />
Information<strong>Network</strong>at1877SAMHSA7(18777264727).RequestinventorynumberSMA08<br />
4337
Hiring<strong>Peer</strong><strong>Support</strong>ers,Recovery<br />
Coaches&<strong>Peer</strong>Specialists<br />
• Whenpeopleseeavalueonsharingwhattheknowtheywill<br />
on sharing the they will<br />
show.<br />
• Focusonwhatpeopleknowaboutrecoveryandwellness p not<br />
mentalillness.<br />
• It’saboutrecovery fromlife’sdifficultiesregardless<strong>of</strong>causeor<br />
diagnosis Abilitynotdisability.<br />
• Ifyoucanaskanyoneyoucanaskapotential.<br />
• Recoverystorytellersandeffectivetestimonials.<br />
tellers effective testimonials<br />
• Completion<strong>Peer</strong>CertificationCoursewhereeffectivesharing<br />
<strong>of</strong>onesexperiencewithinthesystem<strong>of</strong>mentalhealthservices<br />
isthecornerstone<strong>of</strong>thedemonstratedskills.
WRAP®=Recovery,<strong>Peer</strong><strong>Support</strong>&Trauma<br />
Informed<br />
• Peopleinsupportrolesandpr<strong>of</strong>essionalsupports<strong>of</strong>ten<br />
roles pr<strong>of</strong>essional supports <strong>of</strong>ten<br />
experiencesigns<strong>of</strong>“burnout…andincludeirritability,<br />
disturbedsleep,feelingoverwhelmed,feelingemotionally<br />
disconnectedtothingsthathavemeaninginlife…”<br />
<strong>Support</strong>ersthatrespondtocrisis<strong>of</strong>tenexperiencetrauma<br />
and/orvicarioustraumathatgoesunaddressedforlong<br />
that unaddressed periods<strong>of</strong>time.<br />
• EverybodyinCrisisResponseneedsthe“GreenRoom.”<br />
• “Unfortunatelymanypeoplerespondtoburnoutbytrying<br />
harderateverything,astrategythatisboundt<strong>of</strong>ail.”<br />
MaryEllenCopeland<br />
l
WRAP®=Recovery,<strong>Peer</strong><strong>Support</strong>&Trauma<br />
Informed<br />
• WellnessRecoveryActionPlanisforeveryoneandbased<br />
is everyone and onrecoveringourwellnesswhichisselfdefined.<br />
• “Itisasystemforselfmonitoring,reducingandeliminating<br />
g g<br />
uncomfortableordangerousphysicalandemotional<br />
difficulties.”–MaryEllenCopelandPhD<br />
• <strong>Peer</strong><strong>Support</strong>andrecoveryisseeninthecontext<strong>of</strong>non<br />
clinicalandnondiagnosticperspective<strong>of</strong>wellness.<br />
• Peoples’ challengesareseenasnormalresponsesto<br />
are seen as normal responses traumaticeventsandcircumstancesnotassymptoms<strong>of</strong>an<br />
illnessorresult<strong>of</strong>adisability.<br />
– Copeland,M.(2009)Value’sandEthics.<strong>Mental</strong><strong>Health</strong>RecoveryIncludingWellness<br />
RecoveryActionPlanCurriculum:FacilitatorTrainingManual
WRAP®=Recovery,<strong>Peer</strong><strong>Support</strong>&Trauma<br />
Informed<br />
• SeminarIDevelopingaWRAP®canbefacilitatedwithstaff,<br />
l ff<br />
servicerecipientsandpeersupportstogetherbreakingdown<br />
artificialbarriersbetweenthesegroups.<br />
• WRAPFacilitatorcoursesarebasedonlearningacoreset<strong>of</strong><br />
valuesandethicswherebypeersupportoccursand<br />
relationshipsarebasedonthecommonpursuit<strong>of</strong>wellness<br />
• WRAPFacilitatorsaredoinggroupstohelpindividualsachieve<br />
wellnessintheirsupportroles,holistichealthissues,<br />
support roles holistic health issues<br />
relationships,andgroupstodevelopteamandorganization<br />
WellnessRecoveryActionPlans.
WRAP®=Recovery,<strong>Peer</strong><strong>Support</strong>&Trauma<br />
Informed<br />
EffectiveLeaderscreateanorganizationalculturethatidentifies<br />
l d f<br />
andtriestolivebykeyvalues<br />
(AnthonyandHuckshorn,2008)<br />
WRAPFacilitatorValuesandEthicsweredevelopedbyagroup<strong>of</strong><br />
peerswhoaskedwhatisworkingwhenweshareourrecoverywith<br />
otherstocreate:<br />
• Hope<br />
• PersonalResponsibility<br />
• Education<br />
• SelfAdvocacy<br />
• <strong>Support</strong>…<br />
inthelives<strong>of</strong>thoseparticipating
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