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PEER PARENT SUPPORT SERVICESWHAT’S IT ALL ABOUT?

“You cannot truly understand another man completely until you have walked a mile in his moccasins.”

Native American Proverb

OBJECTIVES:

• Participants will learn why peer parent support is an important and critical service for families using the parent journey framework

• Participants will learn the essential qualifications for the peer parent support role and how and where peer parent support is delivered

• Participants will learn the benefits of peer parent support services

• Participants will be introduced to some of the research available on peer parent support across the county.

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Peer Parent

Support

System of Care Movement

• New ways to organize services & supports

• New ways to manage systems

Family Involvement Movement

• New roles for family members in system operations

• New roles for parents in service provision

Wraparound Movement• New ways to plan & organize

services and supports• Ability to connect support,

intervention, community resources and system services

Local Influences

ROOTS OF PEER PARENT SUPPORT

Adult Peer to Peer Support

Adult System

4 PEER SUPPORT MODELSDIFFERENT WORKFORCE QUALIFICATIONS AND

TRAINING

Parental Peer Support

Children’s System

Youth Peer Support and

Transition Age Youth Support

Children’s/Adult System

Adult Peer To Peer Support

Adult System

Adult Family Support

Adult System

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Jane Knitzer’s Unclaimed Children (1982)

• Children’s Mental Health Problems Poorly Identified and Diagnosed

• Ineffective Service Plans• Parents Blamed, Frustrated

Yet, Jane Knitzer also found:Despairing Parents, against all odds, remained committed to their children: • Parents fought, often heroically, for their

children• Parents were resilient, tenacious• Many of yesterday’s parents are now

leaders and mentors

A Little History

“ It is thought that families who receive consistent support will not only achieve higher community integration and well being but will also become less entangled and dependent upon formal services.”

Focal Point, Winter 2006Strengthening Social Support Research Implications for Interventions in Children’s Behavioral Health

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THE JOURNEY TO PEER PARENT SUPPORT

Becoming Defined by the Situation

Recognize that you’re part of a

system

Growing Realization that

you have to advocate for your

family

Understanding the meaning behind your experience

Commit to help others through your personal

experience

Patricia Miles

WHO PROVIDES PEER PARENTSUPPORT SERVICES?

Parent Peer Support Qualifications:For the purposes of Peer Parent Support Services,” parent, “ family,” and “caregiver” are defined as the person(s) who live with and provide primary care to the identified youth. This may include parents, guardians, other caregiving relatives and foster caregivers but do NOT include individuals who are employed to care for youth.• Experience navigating one or two child-serving systems• Uses strategic self-disclosure (ability to listen to and

strategically use their story in a way that is healing to the parent they are supporting)

• Has received specialized training and ongoing coaching and supervision

• In States billing Medicaid; meets the requirements for billing

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DEFINING PARENT PEER SUPPORT

Peer Parent Support Services are a critical and essential service component that can exist within any child-serving system:• Parent peer support is the instrumental, social and

informational support provided from one parent to another in an effort to reduce isolation, shame and blame, to assist parents in navigating child serving systems and provide other relevant life experiences

https://www.researchgate.net/publication/40690319_Family_Support_in_Children's_Mental_Health_A_Review_and_Synthesis

• Intentional peer parent support is the unrelenting focus on the parent/ primary caregiver(s), while other team members focus on the identified child and family

WHERE DOES PARENT PEER SUPPORT HAPPEN?

As part of ongoing services or systems:• Mental Health Agencies• Family Support Organizations• Schools• Child Welfare• Juvenile Justice• Division of Developmental Disabilities• Residential Treatment Facilities• Emergency Rooms• Integrated Care

In communities:

• Where families live, work and connect

In homes:

• Where families reside

Everywhere!

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BASIC FOUNDATION OF PARENT PEER SUPPORT

Grounded in lived

experience

Permanent relationship with

a child & seeking/sought

service

Experience navigating complex

behavioral health systems

Communicates Active

Acceptance

Ability to recognize &

manage own bias

Committed to working on

starting from a place of welcome

for all parents

Based on strategic self-

disclosure

Willing to share parts of your

personal story in helping parents

find their path to healing

Ability to build connections of

partnership

Partnered with rather than delivered to

parents

Ability to stay in a peer relationship

Support for support’s sake

rather than service sake

PPSP CODE OF ETHICS

• We tell our own story when it can help other families

• We support other families as peers with a common background and history rather than as experts who have all of the answers

• We acknowledge that each family’s answers may be different than our own

• We take responsibility for clarifying our role as Parent peer Support Partners and as a parent of a child with special needs

• We build partnerships with others including professionals who are involved with the care of our children

• We commit to honesty with each other and all involved with the care of a child and expect the same from others

• We are committed to a non-judgmental and respectful attitude in our dealing with and discussions regarding families

• We are committed to non-adversarial advocacy in our roles within the system

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PEARLS Meta- Skills

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A GAME CHANGER FOR YOUR ORGANIZATION AND FOR THE

PEOPLE YOU SERVE

BENEFITS TO PARENTS• Common experience

• Appreciative ally- someone who stands in their corner

• Increased access to information increases the ability to make informed decisions

• Encouragement & support to bring out families strengths

• Creates an awareness of possibilities rather than reminding parents of their limitations

• Increased resilience

• Reduction of stress

• Increased hopefulness

• Increased social connectedness

• Increased engagement into services

• Increased awareness of importance of self-care

• Their presence influences agency culture

• Creates a conduit between treatment settings and family settings/cultures

• Sends a message to staff – Parents are valued

• A Trauma informed approach

• Interrupts bias and stigma, uses it as a teaching moment

• Utilizes their own story to create learning opportunities for staff

• Bridge-builder

• A partner who is relentless and persevering in their ability to keep trying

• Increases opportunities for family involvement activities within the organization

BENEFITS TO ORGANIZATIONS

BENEFITS TO HIRING PPSPS’

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BENEFITS OF PEER PARENT SUPPORT

For Children• Empowered parents who advocate on my behalf• Seeing my parent(s) in the driver’s seat• Knowledge that someone listens to and respects my

parent’s position• Comfort in knowing my parent is increasing parenting

capacity with skills that will help take care of our family

• Improves the quality of my life• Strengthens connections within our family• Potential for development of future advocates

WHAT PPSP’S CAN BRING TO THE TABLE

• Intentional and purposeful support

• A team member

• A different perspective

• Functional strengths of the family

• Focus on collaborative problem-solving

• Relational stance of respect and active acceptance

• Inspires Hope

• Connections to other parents and natural / informal supports

• Connection to resources in their local community

• Bridge- Builder

• Help families understand child-serving systems and mandates

• Time spent providing support to families between meeting, brings updates

• Emergence of any new needs as a result of using PPSP tools

• Recognizing and celebrating progress

• Create conditions for parents to be heard and understood

• Create conditions for professionals to hear the parent’s perspective

• Promote resiliency and recovery efforts

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INTENDED BENEFITS FROM PPSPSERVICES

• Building connection based on parent’s experience/story that builds safety and trusting relationship

• Leads to increased engagement in services and supports• Community based and culturally responsive• Parent peer support increases access, voice and ownership-

attributes of meaningful family involvement• Strives to build parent professional partnerships at all levels of the system• Practice that meets needs of families in obtaining positive outcomes• Future for families where they do not need to rely so heavily on formal

systems• System transformation that is persistent, enduring and even life long

KEY OUTCOMES OF PEER PARENT SUPPORT FOR FAMILIES

• Providing parents and children with a better understanding of the challenges and resources associated with children’s mental health concerns (Robbins et al 2008)

• Increasing the child’s early engagement with appropriate health resources (Koroloff , Friesen, Reilly & Rinkin1996)

• Reducing the rate of missed appointment and premature terminations from treatment (Davis-Groves, Byers, Johnson, McDonald 2011)

• Providing a workforce that is culturally aware of the needs of family members since they have similar experiences and come from the same community (Munson et al 2009)

• Reducing lengths of stay in foster care for out of home placements (Marcenko, Brown, DeVoy, & Conway, 2010) (Romanelli et al., 2009)

• Improving parents’ likelihood to be successfully reunified with their children (Anthony, Berrick, Cohen, & Wilder 2009)

• Supporting children staying in school rather than dropping out (Kutash et al., (2010)

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What Peer Support Workers Need from You

WHAT RESEARCH AND LITERATURE REVIEWS ARE SAYING ABOUT THE BENEFITS AND OUTCOMES OF

PARENT PEER SUPPORT

• Parent peer support programs help parents who have children with special needs find and become reliable allies for each other

• Parent-to-parent support programs are valued by parents and may improve the emotional functioning of parents who have children with disabilities and help them improve their coping skills

• Parents displayed a greater increase in hopefulness and were overwhelmingly satisfied with their experiences

• There is encouraging evidence of reducing child symptoms and improving child functioning as a secondary result of supporting the parent

• Evidence of some benefits to the parents and caregivers including a reduction of stress, improved mental health and well-being, perceived social supports and increased engagement into services

Honoring Innovations Report, 2014

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PARENT PEER SUPPORT INSURE MORE UNINSURED CHILDREN, IMPROVE ACCESS AND ELIMINATE

DISPARITIES

This study, led by Medica Research Institute Distinguished Chair in Health and Policy Research Glenn Flores, was the first to asses the effectiveness of Parent peer Support in insuring uninsured minority children:

• Parent peer Support Partners are inexpensive costing $53/child/month

• Savings of $6, 045.22/insured child

• Six Million U.S children are uninsured and two-thirds to three-quarters of them are Medicaid/CHIP eligible

• Furthermore, racial and ethnic disparities exist in insurance coverage for U.S. children compared with a uninsured rate of 5% for white children, 12 percent of Latino, 8 % of African-American, and 8% of Asian/Pacific Islander children are insured

• Latino and African-American children comprise 57% of uninsured children, although constituting only 42% of children in the United States

• Among children in low income families, 84% are eligible for but not enrolled in Medicaid CHIP

Dr. Flores states “Our team previously found that Parent peer Support Partners were effective in improving outcomes for minority asthmatic children…”

http://pediatrics.aappublications.org/content/pediatrics/early/2016/03/16/peds.2015-3519.full.pdf

BENEFITS OF FAMILY YOUTH & PEER SUPPORT SERVICESLITERATURE REVIEW FROM CENTER FOR HEALTH CARE

STRATEGIES, INC .

• Peer support provides benefits of experiential learning and helps connect families to each other

• Peer support programs help parents who have children with special needs find and become reliable allies for each other

• Parent-to-Parent support programs are valued by parents and may improve the emotional functioning of parents who have children with disabilities and help them improve their coping skills

• Self-efficacy and empowerment of families can be enhanced by providing family support. This has been associated with a variety of improved outcomes such as service initiation and completion; increased knowledge about the youth’s conditions and relevant services; satisfaction; and youth functioning at discharge

• There is encouraging initial evidence of the value of family education and support in reducing child symptoms and improving child functioning

Furthermore, there is evidence of some benefits to the parents and caregivers; including a reduction of stress, improved mental health and well-being, increased self efficacy, perceived social supports and increased treatment engagement

https://www.chcs.org/media/FYPS_Literature_Review_FINAL.pdf

CHSC Family and Youth Peer Support Literature Review September, 2013

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BENEFITS OF FAMILY & YOUTH PEER SUPPORT SERVICESLITERATURE REVIEW FROM CENTER FOR HEALTH CARE

STRATEGIES, INC .

CHSC Family and Youth Peer Support Literature Review September, 2013

• The findings in the Family Experience Study suggest a need to increase contact with, and access of families in wraparound to other families who experience similar problems with their children

• Parents in the Parent Connectors group displayed a greater increase in hopefulness from baseline to follow-up than parents in the comparison group

• Use of formal peer support or advocates to increase family involvement in children’s mental health services seems to be increasing

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Toni is the Director of Training and Innovation at the Family Involvement Center. In her role Toni develops training curriculum and educational supports for family groups who have children with emotional, behavioral and mental health challenges. She is also responsible workforce development training and coaching for the Parent Peer support workforce both locally and nationally..After moving to Arizona in 2004,Toni served as a trainer for the Family Involvement Center. In 2005, Value Options hired Toni as the Children's Division Network Development Manager. In conjunction with a community collaborative, she was directly responsible for the creation and implementation of the Quality Management system for the evaluation of Child and Family Teams. This landmark effort paired family members with other behavioral health professionals in the evaluation processToni’s most important role has been raising three sons with emotional and behavioral health challenges. Toni and her family, has had personal life experience navigating both the public and private sector of behavioral health. Toni became actively involved in the family movement in Burlington County, New Jersey .Burlington County was awarded a SAMSHA grant in 2001 and her oldest son Michael, was involved in multiple child-serving agencies at the time. He was one of the first 180 youth that received services through the Care Management Organization, Partners for Kids and Families.Email Toni @Toni@familyinvolvementcenter.org . You may also reach her on her cell phone at 602-615-2510 or on her direct line at 602-412-4074

About the Trainer

REFERENCES

Center for Health Care Strategies, Inc., (CHCS). (2013). Family and youth peer support literature review. Retrieved from https://www.chcs.org/media/FYPS_Literature_Review_FINAL.pdf

Focal Point. (2006). Strengthening Social Support Research Implications for Interventions in Children’s Mental Health

Honoring Innovations Report. (2014). Family-to-family peer support: How can tribal communities join the growing movement? Retrieved from https://www.nicwa.org/wp-content/uploads/2016/11/2014_PeerSupportPrograms_Newsletter.pdfPediatrics article released on March 17, 2016