Peer Support Training Curriculum

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Peer Support Training Curriculum
After The Crisis Initiative

• Preparing Peers to Assist Peers in Preparing for
  and Recovering From Disasters

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Intended Training Audience

• This training is designed for use by
  organizations interested in organizing and
  training peers assists other peers preparing for
  disasters and to provide peer support crisis
  services to meet the needs of peer survivors,
  their families and communities following a
  disaster.
• It may be used as a stand alone training or
  incorporated into Forensic Peer Specialist, Peer
  Specialist and Peer Counselor trainings.

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Introductions

• Trainer/Facilitator
• Sponsoring Program/Agency
• Training Participants

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Preparing Yourself

• Before committing yourself to this very
  challenging and rewarding endeavor, it is
  important to be sure that you are making the
  right choice, both for yourself and the people
  you will assist.
• You may want to poll trusted family members and
  friends, as well as care providers, to consider
  their opinions.
• Most importantly, you need to clarify your own
  thoughts.

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Preparation Exercise
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Core Values of the Training
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Core Values of Training

• Peer Support Principle Peers have unique
  experiences and skills that are particularly
  valuable in helping other peers cope with and
  recover from disasters
• Avoid Pathologizing Response Normalizing the
  experiences and responses to disaster
• Peer support services should be integrated into
  all aspects of disaster planning, implementation
  and service delivery to assure that the needs of
  peers are met
• Encourage self-care and mutual support for peers
  providing these services

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Training Goal

• To provide reliable resources and supports to
  people with mental illness and CODs in the event
  of an emergency or disaster.

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Training Objective

• Prepare peers with histories of mental illness,
  substance abuse and or involvement in the
  criminal justice systems to assist peers in
  preparing for disasters and to provide peer
  crisis support in the aftermath of a disaster

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Adaptation of Training

• Peers are the targeted population for the
  services described in this training. However,
  the After the Crisis Project encourages trainers
  to incorporate information and activities that
  reflect the unique characteristics and needs of
  the their communities.
• This includes but is not limited to incarcerated
  peers,
• peers living in institutional settings such as
  state hospitals and adult homes, peers residing
  in rural communities, non-English speaking peers
  and peers with additional disabilities.

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Recruitment of Trainees

• Trainees should reflect the communities that they
  will be working in and the individuals that they
  will be providing services to.

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Learning Objectives

• Peers attending this training will
• Understand the roles that peers can play in
  assisting in preparing for disasters
• Understand roles that peers can play in providing
  peer support crisis services following a disaster
  
• Understand the goals of peer support crisis
  services and how to use them to promote recovery
• Understand the different stages of a
  disaster/emergency and the different needs of
  survivors, families and communities
• Understand the impact that a disaster or
  emergency has upon individuals,groups and
  communities

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Learning Objectives Continued

• Understand the impact that culture has upon an
  individuals response to traumatic events and how
  culture can promote recovery
• Learn strategies that promote engagement,trust
  and resiliency
• Learn basic assessment and referral techniques
• Understand the need for documenting contacts and
  record

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Learning Objectives Continued

• Learn strategies for self-care and staff support
• Learn strategies for leveraging additional
  opportunities for peer support services in your
  community
• Learn strategies for having peer services
  included in your local and state disaster plans
• Learn strategies for collaborating with local and
  national disaster relief agencies
• Learn about FEMA Crisis Worker Certification
  Training and other resources

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Training Ice Breaker

• You are are notified that you have five minutes
  to leave your home due to rising flood waters and
  you are told that you can only take one personal
  item with you when you leave, what would you take
  and why?

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Getting Started
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What About Your Experiences Make You Uniquely
Qualified to Provide These Services?
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Getting Started

• What is a disaster or emergency?
• How is a disaster or emergency different from
  other events or occurrences?
• Who or what decides whether an event is an
  emergency?
• Why should peers be trained to provide these
  services?

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Challenges Experienced By Peers Following A
Disaster

• Lack of Information
• Separation from family and friends
• Difficulty accessing mental health services
• Fear of getting sick again
• Access to services

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Peer Support Disaster Services vs. Traditional
Peer Support Services

• Peer Support Disaster Services
• Short term
• Emphasis on quickly assessing needs of survivors
  for referral to other resources
• Mobilized in response to a disaster

• Traditional Peer Support Services
• No time limits
• No or minimal emphasis on speedy assessments
• Designed to provide ongoing support to peers

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Common Ground Crisis Counseling and Peer Support
Disaster Services

• Peer Support Disaster Services have a lot in
  common with Crisis Counseling Model used by
  traditional disaster relief programs
• Recovery is possible
• Services are Person Centered
• Do not pathologize responses to events, no you
  are not going crazy or getting sick again
• Not mental health treatment
• Draws on the resiliency of individuals and
  communities in developing coping mechanisms
• Services brought to people
• Elimination of barriers to accessing counseling
  services and other support
• Whenever possible, assist individuals and
  families in returning to their communities

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Goals of Peer Support

• Assist peers in understanding that their
  responses are often normal responses to an
  abnormal event
• Crisis often creates opportunities for growth and
  change (Mead, 2001)
• Is your glass half empty or half full?

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Goals of Peer Support Continued

• Assist peers in talking about their experiences
• Educate peers about trauma and sources of
  strength and resiliency
• Assist peers in identifying their needs
• Assist peers in getting their needs met
• Assist peers in establishing or re-establishing
  contact with family and friends
• Assist peers in setting short and long term goals
  for their recovery

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Menu of Peer Support Services

• Individual Crisis Counseling
• Peer Support Groups
• Public Education and Outreach
• What other services can peers provide?

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Services Funded by FEMA

• FEMA funds the following services, provided that
  they are provided by a Certified Crisis
  Counselor (more about this later)
• Crisis Counseling
• Support Groups
• Public Outreach and Education
• These services are free

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Levels of Preparedness

• National
• State
• Local
• Neighborhood/Community
• Self and Family

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Preparedness Pyramid
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Disaster Preparedness Before the Crisis

• Studies show that most Americans do not have a
  Disaster Plan and therefore are unprepared when
  disaster strikes
• Peers can assist other peers and their families
  in developing personal Disaster Plans
• Effective planning can avoid some of the problems
  experienced by peers in the aftermath of a
  disaster

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Before the Crisis

• PreparednessEmpowerment

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Role of Preparedness in Facilitating Rebuilding
and Recovery by Individuals and Communities
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Individual Preparedness

• Peers can assist peers in many activities
• Creation of personal/family plans
• Storage of emergency items such as food, water,
  clothing and lighting
• Assembling and retaining personal information in
  a safe and accessible place

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Preparedness Keys to Recovery

• We all respond better to difficult situations
  when we are prepared
• Preparedness can reduce some of the
  emotional,financial and destabilizing impact of
  disasters on individuals and communities
• Preparedness can facilitate more timely
  recovery/rebuilding process

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Insert Sample Plan Here
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Strategies to Encourage Personal Preparedness

• Convene a special event to complete plans
• Make the development of plans part of routine
  services provided to all peers in diverse
  settings, including hospitals, jails and prisons
  and adult homes

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Community Mobilization and Preparedness

• Peer support groups and other activities provide
  a unique opportunity for peers to work together
  and develop strategies to support each other in
  preparing for a disaster
• Your community can work together to address
  issues of
• Communication-Multiple means
• Transportation
• Temporary Shelter
• Care of displaced pets
• Meeting Places

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Community Mapping Creating Other Partnerships

• Disaster preparedness activities also create
  unique opportunities for peers and peer run
  programs to build bridges and collaborate with
  other community based organization in the area.

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Community Mapping Exercise
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After the Crisis Peer Crisis Services

• Peers Supporting Peers

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Peer Support An Emerging Practice in Disaster
Crisis Services

• First Responders- Police, Fire Department,
  Medical Personnel
• Consumers first trained as Crisis Counselors in
  1995-1996
• Ventura Fires- 1995
• Oklahoma Bombing-1995
• World Trade Center Tragedy- 2001

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What is in the Name The Role of Peer Crisis
Counselor

• Crisis Counselor is the term used to define
  counselors specially trained to provide services
  and support to survivors and communities
  impacted by a disaster.
• Peer Crisis Counselors are peers specially
  trained to provide services and support to peers
  and their communities.

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Visualization Exercise

• Have you ever been in a disaster? What are some
  of the things that you felt or worried about
  immediately following the event and the days
  weeks and months and weeks that followed?

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Unique Risks Facing Peers

• Relapse
• Attributing normal physical and mental responses
  to onset of psychiatric symptoms
• Interruption of mental health services
• What else?

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Emotional Charting
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Phases Responses to Disaster

• Honeymoon Phase
• Inventory Phase
• Disillusionment Phase
• Rebuilding Phase

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Emotional Characteristics of Each Phase
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Needs During Honeymoon Phase
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Needs During Inventory Phase
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Needs During Disillusionment Phase
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Needs During Rebuilding Phase
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Community Responses Mirror Individual Responses

• Communities exhibit similar responses to
  disasters. What behaviors may be observed in
  communities impacted by a disaster during the
  following phases
• Honeymoon
• Inventory
• Disillusionment
• Rebuilding

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Caution!!!!

• Not everyone or every community goes through all
  of the phases
• Not everyone goes through the phases in the order
  presented
• Let survivors describe how they are feeling and
  what their immediate concerns are

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Trauma Informed Peer Disaster Support Services

• Disasters are traumatic events that cause
  emotional and physical responses in most
  survivors
• Survivors with trauma histories such as histories
  of physical and emotional abuse may be
  re-traumatized by the disaster
• Many peers report histories of prior
  traumatization and this may impact on engagement
  strategies used by peers

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People respond very differently to disasters

• These differences may be due to such things as
• Previous trauma history
• Current living situation
• Access to resources
• Access to information
• Pre-existing support system
• Gender
• Culture

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What is Culture and How is it Transmitted?

• Expansive definition of culture
• How is culture developed?
• What role does may culture play in how we respond
  to a crisis?
• How may our views about different cultures impact
  on our ability to support peers?
• What impact may culture have on the development
  of particular coping skills?

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Impact of Culture on Disaster Responses

• Group Exercises

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Taking an Observant and Asking Stance

• We all know what happens when we make
  assumptions!
• Positive assumptions about an individual or group
  of individuals may be as harmful to them work as
  having making negative assumptions about an
  individual or group? Why?
• What are some popular held assumptions about
  peers or different groups of peers in your
  community?

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Taking an Observant and Asking Stance Continued

• Be Proactive! Listen,observe and ask questions
• Be curious, be amazed
• Be a learner and a teacher at all times
• Look and listen for strengths and positive coping
  strategies
• Meet people where they are and get to know them
• Make sure to familiarize yourself with the
  community you will be working in

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Establishing Rapport

• Mission Not Impossible Creating a safe and
  nurturing environment under difficult
  circumstances.
• Flexibility Adapt to your working
  environment
• Introduction Prepare an introduction that you
  will use when first meeting a survivor (Dont
  assume that people will know who you are or why
  you are speaking with them)
• Listen Actively listen, listen actively

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Tools of Engagement Successful Communication
Skills

• Active Listening
• Non-Verbal Cues
• I Messages

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Active Listening

• Active listening is listening to the speaker with
  both ears, our mind, our heart and our eyes
• We are not only listening to the speakers words
  but are also listening between the line to hear
  the feelings behind the words
• When are ready to respond to the speaker, we
  reflect back the feelings we heard between the
  lines

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Active Listening in Action

• Survivor I cant take this anymore. Every time
  I need something I have to stand in line and tell
  my whole story all over again and then tell me
  that they cant give me what I need.
• Peer Sounds like you are very frustrated!
• You got that right!

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Active Listening Exercise

• Think of a time when you had something really
  important to say and someone listened to you,
  what did the listener do that made you feel that
  you were being heard?
• Think of a time when you had something important
  to say and you did not feel that you were being
  heard?

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Non-Verbal Cues

• Communication can also be non-verbal
• It is important that your non-verbal cues convey
  your interest in the person, what he/she is
  saying and your desire to help

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Non-Verbal Cues Exercise

• What are some non-verbal cues that promote
  engagement?
• What are some non-verbal cues that discourage
  engagement?

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I Messages

• Statements used to communicate concern
• Helps the listener remain open to hearing you
• Non-judgmental
• How can I messages be helpful to you in you in
  your work as a counselor?

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Assessment and Referral
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Assessment and Referral

• Caution This is not a mental health assessment
• The purpose of this assessment is to help
  survivors effectively communicate to you what
  their needs are and to assist them in having
  these needs met
• Mental health services may be one of these needs
• The agency that you work with will have
  established policies and practices regarding
  these types of referrals

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Referral Strategies

• Work with other peers to create a resource
  handbook of community resources
• Handbook should include but not be limited to the
  following information
• Emergency Housing Information
• Food pantries
• Peer Support groups
• 12 Step-Programs
• Pharmacies
• Places of Worship

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Additional Referral Strategies

• Local benefits offices
• Post Offices
• FEMA, the Red Cross and other disaster
• relief agencies also have resource
• manuals and directories

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Making the Match

• Collaborate with survivor in locating resources
  that meet their needs, are culturally and
  linguistically competent and are accessible
• Always call to confirm hours of operation and
  what documentation is need to receive services or
  support

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Each Contact is an Opportunity to Educate Peers
About Wellness and Recovery Tools

• In some communities, survivors may be unfamiliar
  with wellness and recovery tools whose value may
  extend beyond their recovery from the immediate
  disaster
• Some suggested tools are
• Disaster Preparedness Kits
• WRAP Plan
• Advance Directives
• Personal Medicine Forms

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Documentation Requirements

• You will be required to document your contacts
  and provide basic demographic and referral
  information
• Generally speaking, different forms may be used
  to document different types of services
• Follow all confidentiality rules regarding the
  listing of names and other personal identifiers
• Become familiar with the forms you will be using
• In most cases these forms document services
  rendered for payment
• If you dont record it, it didnt happen

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Self-Care

• Disaster support work is very demanding and
  challenging
• Tips to assist you in maintaining your own
  recovery and to avoid the burnout that is
  frequently experienced by workers
• Dont over do it, stick to your assigned work
  schedule
• Maintain your personal wellness routine
• Eat healthy and get plenty of rest
• Have regularly scheduled debriefing sessions with
  your supervisors and peers
• Ask for help when you need it
• Create opportunities to joy and pleasure
• Wellness tip Create your own Wellness and
  Recovery Action Plan

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Self-Care Exercise
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Strategies for Systems Change in Disaster
Planning and Preparedness

• Integrating Peers in Disaster Planning,
  Preparedness and Disaster Service Delivery
  Activities

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Strategies for Inclusion in Your Local and State
Disaster Plans

• Your state and local government are required to
  have disaster/emergency plans
• Do not wait until a disaster to advocate for the
  inclusion of these services into state and local
  disaster plans
• Inclusion in your local and state plans creates a
  formal process assuring the utilization of peers
• Be proactive and organize!

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FEMA Funded Services
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FEMA Funded Services

• The Federal Emergency Management Administration
  funds two types of crisis counseling initiatives
  and crisis counseling training when the President
  officially declares a disaster.

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Immediate Services Program

• FEMA program allowing the state or local agency
  to respond to immediate mental health needs with
  crisis counselors, outreach and community
  networking services.

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Regular Services Program

• Provides up to 9 months of crisis counseling,
  community outreach and education services. State
  can request an extension of this time limitation.
• State must submit a proposal to FEMA and peer
  crisis services must be included as part of this
  submission.
• Programs and agencies are strongly encouraged to
  review previously successful applications
  submitted for peer crisis services (dont
  reinvent the wheel).

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Other Peer Services Funded by FEMA

• Peers have successfully received funding for such
  services as
• Warm Lines- Oklahoma and New York City

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Crisis Counselor Certification Program

• FEMA also offers a Crisis Counselor Certification
  Training Program
• Counselors must be certified for costs to be
  reimbursed
• States must formally request services and
  certification training

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FEMA Certification Training

• Benefits of FEMA Certification
• Strengthens your argument for inclusion state and
  local disaster plans
• Increases likelihood that you will be permitted
  to provide services in disaster relief shelters
  run by traditional relief agencies
• Eligible for payment for services

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Roadmap for Inclusion and Integration

• Speak with Peer groups with previous experience
• developing, implementing and evaluating peer
  disaster relief
• initiatives and develop strategic plan
  addressing
• Statement of Need
• Services provided
• Proposed outcomes-targeted community, numbers
  served
• Management of program
• Program Evaluation
• Training Outline and schedule

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Roadmap Continued

• Identify key players and schedule meetings
• Practice Your Presentation
• Advocate, Advocate and Advocate

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Leveraging Your Peer Crisis Counselor Program

• Peers have successfully leveraged the
• opportunities created during disasters to
• Organize our communities and establish mutually
  beneficial relationships with other new
  organizations
• Develop peer workforce
• Introduce concepts of peer support and recovery