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Family Peer advocate Training and Credentialing initiative Ruth Fennelly, Wayne M. Gurnick, Anne D. Kuppinger NYS coalition for Children’s Mental Health Services Staff Development Training Forum . December 1, 2010. A Partnership of…. Families Together in New York State Columbia University

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Family Peer advocate Training and Credentialing initiativeRuth Fennelly, Wayne M. Gurnick, Anne D. KuppingerNYS coalition for Children’s Mental Health Services Staff Development Training Forum

December 1, 2010


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A Partnership of….

Families Together in New York State

Columbia University

NYS OMH Division of Children and Families

Family and Clinical Partner PEP Training Teams

Family Support Programs and Provider Organizations

COLUMBIA UNIVERSITY


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Family Peer Advocacy and Support in NYS

  • NYS Office of Mental Health - DCF

    10 Parent Advisors in 5 OMH Regions

  • FTNYS - Statewide Family Organization

    10 Regional Chapters

  • Over 100 Family Support Provider Organizations

  • 400+ Family Peer Advocates in MH System alone

  • Commitment to Training, Evaluation, and Research

  • Growing Family Peer Advocacy in all ‘systems’


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Implemented in a Variety of Settings

  • Independent Family Run Organizations

  • Family Support Programs Within Provider Agencies

  • Family Support Embedded in Residential and Inpatient Programs

  • Clinics

  • Wraparound, CCSI, SPOA, HCBS Waiver

  • Funded System of Care Communities

  • Schools, Child Welfare, Juvenile Justice


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FPA Training and Credentialing: A Workforce Development Initiative


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Principles of Family Support

Family-Driven * Youth-Guided * Culturally Competent


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Evolving Practice of Family Support

Services traditionally known as Family Support Services. These might include (but are not limited to): individual advocacy, support groups, skill building, parenting education, respite, home-visiting, warm-line, psycho-education, referral, system navigation support. Very often provided by a peer.

Family Peer Advocates work with families is focused on increasing self-efficacy, developing natural supports, modeling self-advocacy skills, engaging the family in the planning process (and in treatment and with the system), system navigation and linkage.

Hopefully govern all aspects of service planning and delivery regardless of the provider or system.



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PEP Training of Trainers

New York State PEP Trainers

  • Behavioral Health Services North

  • Parsons Child and Family Services

  • BryLin Hospital

  • The Resource Center

  • The Pederson-Krag Center

  • Nassau County DMH

  • The Guidance Center

  • SCO Family of Services

  • Family Ties of Westchester

  • Institute for Family Health

  • Families CAN of Erie County

  • Families Together in Albany County

  • Orange County System of Care

  • Nassau County No Wrong Door

  • Family Services League/LIFT

  • Vanderheyden, Inc.

  • Families Together in New York State

  • Family Services (Diane Lang)

  • Montefiore School Health Program

  • North-Country Regional Center for Independent Living (NRCIL)

  • Onondaga Case Management


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Family Peer Advocate: A Unique Role

  • Empower

  • Promote resiliency

  • Navigate

  • Advocate

  • Engage

  • Increase knowledge, skills, and self-efficacy

  • Promote effective, constructive self-advocacy

  • Foster partnerships

  • Achieve positive outcomes as defined by the family, the youth, the system, and the community

  • Articulate lessons learned from lived experience

  • Inspire hope


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Parent Empowerment Training

  • 100 trained 2003 - 2009

  • 175 trained in 2009- 2010 by New York Training Teams

  • Upcoming trainings: Long Island (March 2011) and Central New York (May/June 2011)

  • Submit Training Need Form for advocates waiting for training.

  • In development: PEP Partnership Training for Advocate/Supervisor/Clinical Partner Teams


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Family Peer Advocate Credentialing

  • Credentialing Agency: Families Together in New York State

  • Expected Launch Date: Winter 2011

  • Advisory Group: Family Peer Advocate Training and Credentialing Workgroup has representation from OMH, Regional Parent Advisors, Provider Organizations, Family Support Programs, Advocates, NYCDMH, Counties, Columbia University


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An Attainable, Credible, Evolving Credential

  • Goal is to develop a Credential that is reasonably attainable yet valuable due to its ‘rigor’.

  • As the need for new competencies arises, we can address this through adaptation in the training and through continuing education requirements.

  • Continuing education should be flexible (approved local trainings), right amount, and continue to have statewide aspects.


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Benefits of Credentialing

  • Respect and recognition of the value of competencies

  • Potential for advancement

  • Clarifying role and responsibilities

  • Assures hiring agencies a foundation level of training

  • Potential for improving outcomes

  • Opportunities for continuing education and the development of communities of practice

  • Basis for the development of a professional association

  • May open up reimbursement possibilities


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Proposed New York Family Peer Advocate Credential Requirements

  • Successful Completion of PEP Training including six months of consultation calls*

  • High School Diploma, GED or equivalent skills

  • Lived Experience

  • Ongoing self-assessment of professional strengths and needs

  • Work or volunteer experience as a family peer advocate

  • Three letters of recommendation

  • Resume

  • Code of Ethics

  • Recertification and Continuing Education

  • Others to be defined by FPA Training and Credentialing Workgroup


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What about the FFCMH Certification? Requirements

  • The requirements for the FFCMH National Credential have not been finalized. We are working closely with the FFCMH through this process. For more information, go to www.ffcmh.org

  • Our goal is to align the requirements so that we can achieve reciprocity (ideally) or at a minimum sufficient alignment that advocates credentialed in New York will have fulfilled the majority of requirements for national certification.


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How Does PEP Training Fit in? Requirements

  • Successful completion of PEP Training will satisfy ONE core credential requirement, but there are additional requirements.

  • For 8 months following the initiation of the FPA Credential process, applicants may use their Family Development Credential or successful completion of any version of PEP training to satisfy the core training requirement. After this ‘grandfathering’ period, PEP Basic Training will be required.



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Parent Empowerment Program (PEP) Training Empowerment

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A core requirement for the FPA Credential

Developed by researchers and family advocates

Designed around core competencies for role of family advocate.

Teaches specific framework and strategies with an outcomes focus

40 hours plus 12 consultation calls over 6 months

Emphasis on promoting parent-professional partnership and parent empowerment

Family advocates report that it helps them focus on empowerment vs. ‘fixing’; on listening to families; and, practicing non-adversarial advocacy.


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Shared Commitment to Equality Empowermentand Partnership

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PEP is based on a paradigm shift that holds that there can be and should be equality and collaboration between family members and providers in the delivery of service and in training. Jim Rodriguez


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Modules in 40-hour training Empowerment

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PEP Conceptual Framework

Listening and Engagement Skills

Priority setting

Boundary Setting Skills

Group management skills

Mental Health System

Working with Schools


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The PEP Framework: EmpowermentA Model for Working with Families

Parents as Agents of Change

Model

Principles of

Family Support

Goal: The overarching framework for PEP brings together what we know from the parent support field and behavioral science, and combines them into a strategy for helping parents.

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Model of Change Empowerment

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Principles of Family Support Empowerment

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Family-Driven * Youth-Guided * Culturally Competent


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COMMUNITY PROVIDERS: Lack expertise, resources, already high caseloads, safety concerns

OMH: Wants shorter LOS based on research demonstrating positive outcomes

1

p

RESIDENTIAL PROVIDER: Can’t do it all by themselves; concern abut recidivism

PARENT: Concerned about safety; doesn’t know how to handle child’s behavior

POSITIONS

CHILD: Just wants to be home, see friends and go to own school

POSITIVE OUTCOMES

OMH

Parent/

Caregiver

Provider

Child

Shorter Lengths of Stay (LOS)

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2

  • PARENT:

  • Wants their child to have the skills to be successful.

p

INTERESTS

POSITIVE OUTCOMES

Shorter Lengths of Stay (LOS)

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  • PARENT:

  • Wants their child to have the skills to be successful.

INTERESTS

Family Peer Advocate

Parent

Provider

POSITIVE OUTCOMES

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Engaging Parents: Objectives caseloads, safety concerns

Develop an appreciation for obstacles parents face in getting help

Provide a framework and strategies for engaging vulnerable families

Integrate strategies and practice communication skills to engage families


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Steps to Engage and Empower Parents caseloads, safety concerns

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Clarify your role

What can parents expect?

Clarify need

What do you think your child needs?

What are the benefits of addressing the need?

Increase parent investment and efficacy

Give them credit for taking the step to come in. Strengthen their sense of self, by showing your belief that they can take the necessary next steps, one by one, and when the time is right


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Continued…. caseloads, safety concerns

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Identify potential obstacles (e.g. personal and concrete)

How do you feel about this?

Do you have any concerns?

Will child care, time or transportation be a problem?

Previous experience with systems of care?

What do others think?

ADDRESS BARRIERS!!!


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PEP in Action in caseloads, safety concernsSuffolk County, Long Island


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Family Advocates: caseloads, safety concernsEssential Members of Our Team:

  • Family Support Services Program

  • Home & Community Based Services Waiver Program

  • CIRCLE Family Based Treatment Program

  • Setauket Community Residence

  • Dix Hills Community Residence

    10 -13 Family Advocates (FTEs)

    Some Pederson-Krag employees; others contracted


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Buy-in of Partnership Approach At All Levels caseloads, safety concerns

  • Family

  • Advocate

  • Staff

  • Program Leadership

  • Administration

  • Ideally – The System of Care

    PEP Strategies more powerful if

    Family Support Principles practiced by all staff at all levels.


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Mutual Interest = caseloads, safety concernsFamilies remaining together. Children functioning in their homes, schools, and communities.

INTERESTS

Family Peer Advocate

Parent

Provider

POSITIVE OUTCOMES


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Key to Success in Achieving Mutual Interests: Families & Providers as Partners in Care

  • Families, youth and staff share decision making and responsibility for outcomes

    Collaborative Service Planning

  • Families and youth share in program development

    Family Bonds Advisory Board

    WAVE Youth Leadership Organization

  • Peer Support Activities

    Family-Led Support Groups, LI Coalition Events

  • Cultural Competence/Sensitivity Trainings

  • New Relationships

    Project Adventure, Family Bonds Annual Retreat


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Family Bonds Team Providers as Partners in Care


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Organizational Culture Shift Providers as Partners in Care

Family Advocates Training of Staff

  • Family Engagement (McKay)

  • Family Support Principles/Family Driven Care

  • Parent Empowerment (Brickman)

  • Family Development (Cornell Cooperative)

    Parent Advisory Board Mission Statement

    “To create a platform for encouragement, healing, and hope for the future while empowering parents (ourselves and others) to collaborate with Pederson Krag on policies and procedures affecting our children”

    Family Directed Support Groups – Families as Experts


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Family Advocate: A Unique Role Providers as Partners in Care

  • Have walked in similar shoes – empathy and hope

  • Demonstrate that families have expertise

  • Address Barriers to access through engagement

  • Mitigate provider historical perspective of resistance and family dysfunction – focus on strengths

  • See parent as agent of change: knowledge & skill = power

  • Active Role throughout all program phases - continuity

  • Connections to community and larger Family Support Network

  • Development of families healthy self-reliance


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PEP Training Provides Providers as Partners in Care

  • Knowledge

  • Research-based strategies

  • Strategies to put values into practice

  • Strategies to get to outcomes

  • Role definition


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Transforming Family Support Practice: PEP Skills in Action Providers as Partners in Care

  • Her interactions with the parents are more partnering, empowering, supporting…she is more of an active listener…assisting the parents in coming up with their own ideas or solutions to the challenges at hand.

  • PEP assisted her in being more mindful of the cultural differences often faced when providing support for families….

  • Training has assisted her in providing parents a “cost-benefit” analysis in terms of strategies in managing her child’s behavior.

  • Principles of Family Support

  • Active Listening

  • Priority Setting

  • Problem-solving

  • Cultural Competence

  • Setting Priorities

  • Developing Action Plan

  • PAC Model


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Transforming Family Support Practice Providers as Partners in Care

  • More goal oriented but still provide the emotional support parents need – someone to vent to.

  • Take a more active role in modeling (through role-play) effective behavior for the parents [with professionals]

  • Family Support workers have the ability to truly empathize with the parents as well as understand and work through the parents’ concerns…in some cases, parents that were ‘unwilling’ to give up waiver services, fearful at the thought of not having Waiver in their lives are willing to transfer to other services.

  • Parents as Agents of Change Model

  • Active Listening

  • Engagement

  • Role Rehearsals

  • Strategies to Empower

  • Self Advocacy


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The Smith Family Providers as Partners in Care

  • 9 year old girl in FBT with a diagnosis of mood disorder, NOS, a history of psychosis and ADHD. Five prior hospitalizations in the year prior to admission into FBT. Her 8 year old brother has a diagnosis of Bipolar Disorder. They are cared for by their grandmother who has very few social supports.

  • She was referred because of aggression toward her grandmother and brother, property destruction, suicidal ideation and gestures and anxiety among other things.


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Family Advocate’s Work Providers as Partners in Care

  • Engage in Support Group, Family Bonds Events, Family Support Coalition Events & Parent to Parent Support

  • Develop informal social supports (call other parents)

  • Prioritization of Needs; Establishment of Goals

  • Advocate led the way to connecting with informal support network to reduce isolation and get help: connect to NYC friends, going to church, out to lunch with her sister.

  • Facilitate engagement with providers, reinforce team approach, encourage active participation in team meetings

  • Exploration of diagnoses and social/behavioral implications

  • Parenting skills & positive approaches. Sharing what advocate learned, confidence in parenting

  • Special education info., prep for and support at CSE meetings

  • Assistance in accessing clinic services for grandson


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Family Empowerment Scale Providers as Partners in Care

At discharge, Mrs. Smith chose ‘very often’ as the rating for 12 measures of self-efficacy and empowerment. Including:

  • I feel confident in my ability to help my child grow and develop

  • When dealing with my child, I focus on the good things as well as the problems

  • I feel I am a good parent.

  • I am able to work with agencies and professionals to decide what services my child needs

  • I have a good understanding of the service system that my child is involved in.

    Source: Research and Training Center, Regional Research Institute for Human Services, Portland State University)


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The Smith Family Providers as Partners in Care

  • Discharged 6/25/10 to CCSI (In home service)

  • Ongoing member of Family Bonds and local family support network. Attended annual retreat in Oct. 2010.

  • Inspiration of success and hope for other families new to residential programs!


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Integral to Other Initiatives and Objectives Providers as Partners in Care

  • Children’s Plan Initiatives

  • Clinic Restructuring

  • Clinic Plus

  • Family Support Outcomes and IT

  • Promotion of Evidence-Based Practice

  • Research and Evaluation

  • Cross-Systems Approaches

  • Cost-Effectiveness and Sustainability

  • Federation of Families for Children’s Mental Health Peer Support Provider Initiative


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Questions and Discussion Providers as Partners in Care


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Presenter Contact Information Providers as Partners in Care

Ruth Fennelly

[email protected]

Wayne Gurnick

[email protected]

Anne Kuppinger

[email protected]


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