Peer Support & WRAP as a Tool for Successful Implementation Presenter: Matthew R. Federici, M.S., C.P.R.P Executive Director [email protected]

Peer Support & Peer Support & WRAP as a Tool for WRAP as a Tool for

Successful Successful Implementation Implementation

Presenter: Matthew R. Federici, M.S., C.P.R.P Executive [email protected] 215-696-0319

Department of Veterans Affairs Peer Support Teleconference

February 25th 2010

1www.copelandcenter.com

Mission Statement:Mission Statement:The Copeland Center promotes The Copeland Center promotes

personal, organizational, and personal, organizational, and community wellness and community wellness and

empowerment through education, empowerment through education, training, and researchtraining, and research..


Copeland Center Copeland Center History:History: The Copeland Center for Wellness The Copeland Center for Wellness

and Recovery is named in honor and Recovery is named in honor of, and dedicated to, the memory of, and dedicated to, the memory of Kathryn Strouse Copeland of Kathryn Strouse Copeland (1912-1994)(1912-1994)•Recognizing her own need to talk with others, she began gathering patients together in small groups to share their experiences. •The hospital administration became uncomfortable with these meeting (the first peer support) and Kate was discharged at the age of 45. Kate went on from there to get a highly coveted job as nutritionist in an inner city high school. 3www.copelandcenter.com

Embedding Professional Peer Embedding Professional Peer Supporters in the VA System: Supporters in the VA System:

Survey of 110 administrators at three Survey of 110 administrators at three large VA clinics in Southern California:large VA clinics in Southern California:

1.1. Attitudes towards working with Peer Attitudes towards working with Peer ProvidersProviders

2.2. Barriers to future implementationBarriers to future implementation

3.3. If Peers could improve the system If Peers could improve the system

(Chinman, Young, Hassell, Davidson, 2006)(Chinman, Young, Hassell, Davidson, 2006)


Embedding Professional Peer Embedding Professional Peer Supporters in the VA System: Supporters in the VA System:

The concerns:The concerns: Discomfort with Peers having direct 1:1 Discomfort with Peers having direct 1:1

contact with “patients” away from traditional contact with “patients” away from traditional provider oversight provider oversight

May overly rely on their own experience May overly rely on their own experience versus formal trainingversus formal training

Not many veterans would applyNot many veterans would apply Require too much supervisory time, attention Require too much supervisory time, attention

and interventionand intervention Too much stress from the job for peersToo much stress from the job for peers How do we to recruit based on mental illness How do we to recruit based on mental illness Finding “stable” consumers for the roleFinding “stable” consumers for the role

(Chinman, Lucksted,Gresen,Davis, Losonczy, Sussner and (Chinman, Lucksted,Gresen,Davis, Losonczy, Sussner and Martone, 2008)Martone, 2008)


Experiences of Peers working Experiences of Peers working in the VA System in the VA System

Four Focus groups, 59 Peers and 34 Four Focus groups, 59 Peers and 34 supervisors:supervisors: ““Traditional- minded” staff had ongoing Traditional- minded” staff had ongoing

difficulty accepting the Peer Supporter on difficulty accepting the Peer Supporter on staffstaff

Peer reported role and expectation was Peer reported role and expectation was ambiguous for them, their colleagues, ambiguous for them, their colleagues, human resources and those they were to human resources and those they were to supportsupport

Paternalism and insensitivity from co-Paternalism and insensitivity from co-workersworkers


We Are Not Alone! We Are Not Alone!

Barriers in implementing Barriers in implementing Peer Supporters as a Peer Supporters as a valued Professional valued Professional perspective in the perspective in the broader community broader community behavioral health system behavioral health system have been the exactly the have been the exactly the same.same.


All levels of the Workplace All levels of the Workplace need attention:need attention:Service recipientsService recipientsPeer EmployeesPeer EmployeesOther mental health Other mental health

professionalsprofessionalsManagementManagement

-Consumers as Providers in Psychiatric Rehabilitation (1997), International Association of Psychosocial Rehabilitation Services

PEER SUPPORT SPECIALIST WORKPLACE CHALLENGES


Service Recipients Service Recipients Peer may reflect the societies'/system’s Peer may reflect the societies'/system’s

stigma and feels that only “regular stigma and feels that only “regular qualified” mental health professionals can qualified” mental health professionals can help them not people like themhelp them not people like them

Peers may view us differently once in a Peers may view us differently once in a paid rolespaid roles

Peers may have former relationships with Peers may have former relationships with us that confuse the boundariesus that confuse the boundaries


PEER SUPPORTERS WORKPLACE CHALLENGES


Peer Employee:Peer Employee:Multiple level role strain Multiple level role strain Fear of losing benefitsFear of losing benefitsUnclear expectations or job Unclear expectations or job

descriptiondescriptionSelf disclosureSelf disclosureValues conflict with co-workersValues conflict with co-workersBeing view through pathology Being view through pathology -Consumers as Providers in Psychiatric Rehabilitation (1997),

International Association of Psychosocial Rehabilitation Services

PEER SUPPORTERS WORKPLACE CHALLENGES


Management IssuesManagement Issues Employment practices (i.e. recruitment, Employment practices (i.e. recruitment,

hiring, pay scales…)hiring, pay scales…) Conflict managementConflict management Outdated policies Outdated policies Lack of information on role definitionLack of information on role definition Conflicting systems messages (i.e. Conflicting systems messages (i.e.

Medical necessity and licensing Medical necessity and licensing requirements and push for recovery requirements and push for recovery orientation) orientation)

PEER SUPPORT SPECIALIST WORKPLACE CHALLENGES



Essential Ingredients To Essential Ingredients To Implementation Implementation

1.1. Systems Orientation and EngagementSystems Orientation and Engagement: : National Speakers; analysis of local National Speakers; analysis of local barriers and identifying action steps barriers and identifying action steps which includes all systems stakeholderswhich includes all systems stakeholders

2.2. Forming local Planning Teams:Forming local Planning Teams: developing developing ownership of change process which ownership of change process which includes your key service recipients includes your key service recipients

3.3. Facilitating Peer Resource Sharing:Facilitating Peer Resource Sharing: between planning teams. i.e. “macro level between planning teams. i.e. “macro level peer support” peer support”

4.4. Orientation & Continued Education:Orientation & Continued Education: Supervisors, administrators and human Supervisors, administrators and human resources personnel resources personnel


WRAP As A Tool for WRAP As A Tool for Systems TransformationSystems Transformation

WRAP provides an orientation for all stakeholders on WRAP provides an orientation for all stakeholders on key concepts of recovery from research with people key concepts of recovery from research with people who were struggling with metal health challenges.who were struggling with metal health challenges.

Provides a structure that can be used for an Provides a structure that can be used for an individual’s recovery and groups looking to transform individual’s recovery and groups looking to transform their system.their system.

WRAP can be used by anyone regardless of a WRAP can be used by anyone regardless of a diagnosis and therefore creates a culture of peer diagnosis and therefore creates a culture of peer support for everyone.support for everyone.

Provides a tool for people in recovery to stay well in Provides a tool for people in recovery to stay well in peer support roles as well as non-peer provider roles peer support roles as well as non-peer provider roles to stay well despite work place stress. to stay well despite work place stress.


WRAP Facilitators WRAP Facilitators CourseCourse

Copeland Center Advance Level Facilitators Copeland Center Advance Level Facilitators offer a five day course for VA Peer Counselors offer a five day course for VA Peer Counselors and other supporters to facilitate Wellness and other supporters to facilitate Wellness Recovery Action Planning for those the VA Recovery Action Planning for those the VA serves.serves.

Participants of this are grounded in core Participants of this are grounded in core values and ethics that will foster relationships values and ethics that will foster relationships and environments that promote recovery and and environments that promote recovery and peer support:peer support:

Counters stigma Counters stigma Strengthens the value of peer support and its role Strengthens the value of peer support and its role

in service delivery.in service delivery.

www.copelandcenter.com 14


Utilizing WRAP to Strengthen Peer Support Groups

Five day course:

1.Develop individual Wellness Recovery Action Plans2.Develop and WRAP for your peer support group 3.Define your groups mission

Organizational WRAPOrganizational WRAP

Copeland Center Advance Level Facilitators Copeland Center Advance Level Facilitators who are also systems leaders can work with who are also systems leaders can work with your VISN or VA group to develop an your VISN or VA group to develop an organizational WRAP to guide your services organizational WRAP to guide your services and team toward it’s wellness goals.and team toward it’s wellness goals.

Developing and organizational WRAP also Developing and organizational WRAP also parallels a familiar process and language for parallels a familiar process and language for working through challenges that translate working through challenges that translate directly to the individual recovery experience.directly to the individual recovery experience.


ADVANCE LEVEL ADVANCE LEVEL FACILITATORS TRAININGFACILITATORS TRAINING

Once the VA has trained WRAP Facilitators who have Once the VA has trained WRAP Facilitators who have experience facilitating the development of WRAP for experience facilitating the development of WRAP for others they may be able to become Advance Level others they may be able to become Advance Level Facilitators Facilitators

Advance Level Facilitators become key stakeholders of Advance Level Facilitators become key stakeholders of the Copeland Center who are empowered to mentor the Copeland Center who are empowered to mentor others in the core values and ethics in order to have others in the core values and ethics in order to have more facilitators for WRAP.more facilitators for WRAP.

With VA Employees who are Advance Level Facilitators With VA Employees who are Advance Level Facilitators we can partner in ways that are cost effective and we can partner in ways that are cost effective and yield long tern resources to offer WRAP to Veterans yield long tern resources to offer WRAP to Veterans


Documents

Peer Support & WRAP as a Tool for Successful Implementation Presenter: Matthew R. Federici, M.S., C.P.R.P Executive Director [email protected]