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The Role of Peer-to-Peer Services: Facilitating Personal Growth

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Title: The Role of Peer-to-Peer Services: Facilitating Personal Growth


1
The Role of Peer-to-Peer Services Facilitating
Personal GrowthAdvancing Recovery
Reneé Kopache Hamilton County Mental Health and
Recovery Services Board Angela
Ostholthoff Recovery Center of Hamilton
County March 28, 2008
Cincinnati VA Medical Center and Northern
Kentucky University
2
Agenda
  • Overview of peer support
  • Matching services peer support to stages of
    recovery
  • Integrating peer support
  • The lived experience

3
What is Peer Support
  • Relationships built and nurtured through shared
    experiences. People who have liked experiences
    can better relate and can consequently offer more
    empathy and validation. (Sherry Mead)
  • Grew out of early advocacy efforts (history)

4
Purpose of Peer Support
  • Strengthen advocacy
  • To utilize shared experiences as a means to
    foster the recovery of other individuals with a
    mental illness
  • Engage consumers who otherwise may not be willing
    to receive services
  • To provide a more relaxed relationship
  • Advance recovery

5
Evidence Effectiveness of Support
  • Peer support and peer provided services are
    considered promising practices
  • Peers do as well as non-peers on most outcomes
    (no significant differences)
  • ACT teams with peer specialists have experienced
    better outcomes
  • Working as a consumer provider fosters
    empowerment, self-esteem, and a shift in meaning
    and purpose

6
Matching Services to Stages of Recovery
7
Stages of Recovery
ODMH (1999) Emerging Best Practices in Mental
Health Recovery. Stages in parenthesis are from
the Village Integrated Services, Inc. Long
Beach. CA
8
Hope
  • Provider Agency
  • Acute, intense clinical services
  • Case management
  • Medical somatic
  • Focus on increasing the consumers level of
    awareness regarding illness, health, basic needs,
    and medications. Connect to/provide services to
    address basic needs.
  • Consumer Agency/ Community Supports
  • When appropriate, involve family in treatment.

9
Empowerment
  • Clinical services emphasizing stability
  • Case management
  • Medical somatic
  • EBPs
  • Day/Psychosocial programs
  • Skills development (basic)
  • IMR
  • Peer support
  • 12-step programs
  • Focus on stability and helping consumers gain
    independence (do with instead of for).
  • Consumer Agency/ Community Supports
  • Continue family involvement
  • Introduce peer support

10
Self Responsibility
  • Clinical services emphasizing growth
  • Reduced medical somatic
  • Transition out of case management
  • Therapy
  • Vocational services
  • Supported housing/education
  • Transition out of day/psychosocial programs
  • Focus on self-esteem and continued empowerment
  • Consumer Agency/ Community Supports
  • Add social/community support to family support
  • Peer support shifts to consumer-operated agencies
  • Recovery groups
  • Self-help/peer support groups
  • Education (formal/informal)
  • Advanced Skill Development (computer training,
    resume writing, serving on committees/ boards,
    etc.)
  • May work as peer supporter in agency or in a job
    in the community
  • May advance formal education

11
Meaningful Role
  • Provider Services
  • Medical somatic only services
  • Safety net for other services should the need
    surface
  • Focus on utilization of natural supports and,
    for some, transition from mental health services.
  • Consumer Agency/ Community Supports
  • Employed as peer supporters and/or transition
    from peer support at consumer agency to natural
    supports in the community
  • Fulfilling a meaningful role in community
    (employment, volunteer, neighbor, friend, clubs,
    etc).

12
Matching Peer Support to Stages of Recovery
What Helps When and How?
13
Hope
  • Peer support is informal
  • Interactions in treatment settings
  • (the result of being at the same place at the
    same time)
  • Focus is often on mental illness rather than
    recovery
  • Clinical and family support is often as important
    as peer support at this stage

14
Empowerment
  • Peer support becomes more formal
  • Often occurs at agencies/hospitals
  • day programs, groups, peer-to-peer classes
  • Focus begins to shift from mental illness to
    advocacy and recovery
  • While clinical support is still critical in this
    stage, peer support takes on increasing importance

15
Self Responsibility
  • Peer Support takes on an equal, if not more
    important role than clinical and/or family
    support.
  • Peer support is more likely to occur outside the
    formal treatment environment
  • People in recovery begin to give back.they
    become volunteer or paid staff.
  • Peer support begins to occur in the community
    rather than the mental health system.

16
Meaningful Role
  • Peer support occurs in the natural environment.
  • At this point, some individuals graduate from
    the system and seek support though non-consumer
    relationships.
  • If remaining a part of the consumer culture,
    individuals at this stage are the givers of
    supportthey receive their support elsewhere.
  • Providing support becomes a meaningful role!

17
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18
Support that Hinders Recovery
  • Support that doesnt match the needs and desires
    of the individual
  • e.g. providing peer-to-peer classes to a person
    who has acute clinical needs is far less
    effective than having a peer available for that
    individual to talk to.
  • Support that doesnt encourage and facilitate
    growththat doesnt help an individual establish
    and reach his/her goals
  • e.g. doing things for a person that they are
    capable of doing for themselves, or learning to
    do for themselves.

19
Support that Hinders Recovery
  • Support that doesnt end
  • Avoid the Hotel California syndrome
  • when peer support is no longer necessary and/or
    beneficial, the person should be encouraged to
    transition to something else (i.e. natural
    supports in the community).
  • Support that is controlling
  • If the relationship is hierarchical, theres a
    problem
  • Support that is stigmatizing
  • We cant criticize mental health professionals
    and the community for stigmatizing those with a
    mental illness if we also do it!

20
Integrating Peer Support
Recovery is the mending process that reweaves
Human Beings back into the fabric of our
society And Peer Support is a critical
ingredient of recovery.
21
Environments with Peer Support
  • Consumer-operated agencies
  • Peer-run agencies/programs
  • Psychosocial and other programs/services at
    agencies
  • ACT teams
  • Hospitals, crisis centers and emergency rooms
  • Jails

22
Role of Consumer Staff
  • Foster hope and self-determination
  • Mentor/role model
  • Engage
  • Teach
  • Support
  • Research
  • Combat stigma

23
Training for Peer Providers
  • Train the trainer method
  • Peer support specialists
  • Collaboration with community colleges
  • Recovery Centers
  • Organizational certification
  • Consultants/technical assistance centers

24
Challenges
  • Dual roles (role confusion)
  • Loss of own support system
  • Illness/symptoms
  • Inadequate training
  • Boundaries
  • Rural (one agency) communities
  • Job titles

25
Challenges
  • Perceptions of other employees that peer staff
    receive favorable treatment
  • ADA (accommodations), extended illness/symptoms
  • Employing consumers are providers without having
    a culture that supports recovery-oriented
    services
  • Ethical standards for licensed professionals
  • Supervision

26
The Lived Experience
  • Coe
  • Susan
  • Angela

27
Resources
  • Pathways to Recovery
  • BRIDGES
  • WRAP
  • Wellness, Management Recovery
  • Peer Support Specialists training
  • Self-determination series
  • DBSA (dbsa.org)
  • www.mentalhealthpeers.com
  • National Association for Peer Specialist
    www.naops.org
  • The Institute for Recovery and Community
    Integration www.mhrecovery.org

28
QA and Contact Info.
  • Renee Kopache
  • reneek_at_hamilton.mhrsb.state.oh.us
  • www.mhrecovery.com
  • Angela Ostholthoff
  • aostholthoff_at_gcbhs.com
  • www.recoverycenterhc.org
  • This presentation will be available online
  • http//mhrecovery.com/presentations.htm
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