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Implementing The Peer Support Specialist Role For Youth

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Implementing the Peer SupportSpecialist Role: ProvidingDirect, Individualized Supportin a Local ProgramThis information briefprovides an exampleof how one locally-initiatedprogram has implemented thePeer Support Specialist rolefor youth and young adultswith serious mental healthconditions. The brief coversaspects of training, coaching,supervision, role definitionand financing; and describeschallenges and solutions.Overview of the ProgramThe Youth Empowerment Support (YES!)Program provides opportunities and trainingsfor community and system transformation aswell as direct support, groups, and leadershipopportunities for young people at risk of, in,or emancipating out of system services. YES!began in 2007 in Auburn, CA. The programwas originally funded by a grant from theSubstance Abuse and Mental Health ServicesAdministration, but with the support of PlacerCounty, YES! was able to find more sustainablefunding through the Mental Health ServicesAct and Wraparound funding (state legislationknown as SB-163 and often referred to as the“millionaire’s tax”). The YES! program is part ofan organization named Whole Person Learning, which provides support and guidance inareas such as navigating policies, budgeting,grants, and human resources.YES! hires staff that are 18 years or older and:“.no longer receive any system services fromChildren’s System of Care, so that would belike child welfare or probation. We also state1

that they need to have a strong work ethic;be dependable, flexible, and able to adapt todaily changes and challenges. That’s mainlybecause of the atmosphere we work in and every day they come in and it’s something different. They also need to have knowledge of andability to learn positive youth development,strengths-based practice and cultural competence; the ability to work cooperatively anddecisively with individuals and groups with different educational, economic, cultural and racial backgrounds; and also must pass a criminal background check and drug screening.”supervise the Youth Coordinators. The use oftwo supervisors ensures a collaborative, teamapproach that provides support for differentaspects of the job.The youth referred to this program comefrom various sources. In the beginning, theyouth were referred through county services.As the program has gained a positive reputation, though, many youth are self-referring orreferring their peers. The youth served are12-26 years old. YES! is dedicated to providingindividualized services that do not replicatesupport that is already available within thecommunity.Currently, there are two full-time (includingthe Program Manager) and one part-time staff,all with lived experience. Staff are trained inMotivational Interviewing, suicide prevention,and cultural competency, and they also receivetraining from California’s Youth DevelopmentInstitute. Other training is provided as needed,and county and community partners provideaffordable trainings as well as online resources.YES! staff have prior experience with andknowledge of the various systems YES! workswith. These include experiences with the childwelfare, juvenile justice, and/or mental healthsystems. The Program Manager, along withthe Director of Whole Person Learning, co-“We try to find other resources to meet [theyouth’s] need and link that young person upwith [a resource], but if there isn’t a serviceor support in the community or county thatwould meet that need then we try to fill inthat gap. We’d also bring that informationback to the county and community throughvarious meetings that our coordinators are in,leadership meetings or system change projects, and so we’re constantly trying to loopour feedback from doing direct support in thecommunity and our own lived experience backto the county and the community to make improvement.”Role of Youth CoordinatorsYES! Youth Coordinators provide individualized support for youth in three phases. Thefirst phase, called the “intro phase,” involvesthe Youth Coordinator getting to know a youth,developing trust, becoming familiar with theyouth’s culture, and focusing on what the youthhopes to achieve during their time together.During this phase, the Youth Coordinator is ableto learn what resources will best suit the youthand what level of support will help the youthsucceed.The next phase, “intensive” or “periodic support,” really focuses on supporting youth andconnecting them with various community resources as well as assisting them in learninghow to navigate systems independently.“So for example if a youth comes into ourprogram and they’re homeless, and let’s saythey were adopted and they don’t qualifyfor certain programs or let’s say they neverentered the system but they bounce around,2

they don’t have any family support and nowthey’re homeless. We would have to do a lotmore work with that individual than, say, withsomebody who comes in and maybe qualifies for a lot of services because they grewup in the system and emancipated out. So wewould link one person up with services thatwould be periodic, and the other homelessyouth – we would be trying to meet their basicneeds, working multiple days trying to meettheir needs.”their goals, and for celebration for what hasbeen accomplished.Youth Coordinators also sit in on meetings suchas Individual Education Planning, PlacementPlanning, and Family Team Meetings. In thesesettings, the Youth Coordinator provides information to the family members and the youthso that they are prepared and know what to expect. The Youth Coordinators encourage youthto advocate for themselves, but in instanceswhen perhaps the youth is not being heard oris not ready to speak up, they will support theyouth in whatever manner is most comfortablefor the youth. It is the hope of the Youth Coordinators that this modeling will further encourage the youth to advocate for themselves. TheYouth Coordinator is continuously working withthe youth to improve existing skills and buildnew ones.The final phase, the “transition phase,” involvesevaluating the services that have been provided and checking in with the youth to find outif they have achieved what they wanted duringtheir time at YES!. Also, the final phase is a timefor making sure the youth have the resourcesthey need to continue to move forward withChallengesthis system and they first take a job trying towork on system transformation, they come inwith their own bias and stigma towards thesystem so it goes both ways.”As with most programs with Youth Coordinatorroles, there have been challenges to creatingand sustaining the role. In the beginning, therewas quite a bit of stigma from adult professionals. Because YES! hires youth who have experience with systems such as child welfare, mentalhealth, and juvenile justice, some staff were notvery supportive of hiring them for professionalroles.Additionally, there is a need to support theYouth Coordinators during their own time oftransition into a professional role. The Youth Coordinators are valuable because of their experiences, but these experiences may also meanthe Youth Coordinators require extra supportfrom supervisors.“There’s a lot of stigma around our work andbreaking down those barriers in both ourcounty and community has been a challengeat times and I always say the only reasons wehave sustainable staff is because people cometo this job with the passion that they want tomake a change. The bad experiences you’vehad are going to come up in this job for surebecause you’re working with the county andseeing its flaws, but you also get to see thestrengths I think when people go throughThe YES! Program Manager and the Directorof Whole Person Learning emphasize the importance of providing a safe workplace thatencourages debriefing. They also encourageYouth Coordinators to participate in trainingsand community relationship building in order tobuild their skills and relationships and continuetheir growth as advocates and professionals.3

“Our staff – we come with our lived experienceand we may, to some degree, have work history we bring with us, but we’re not necessarily coming with a degree so I think it’s reallyimportant to have an employer who will findthose resources for you. I think that’s important – to have an employer who is willing tofind those things for your program and support you in that.“Future WorkMany of the youth who have received supportfrom YES! have voiced a desire to have a dropin center where they can socialize and accessa variety of resources in one place. YES! will belooking into possibilities to make this a reality.Currently, YES! will be launching a cloud plat-form where youth can store their vital documents and have them all in one safe locationcalled HealthShack. This is especially important for youth who move often or do not havestable housing.AcknowledgmentThanks to YES! for providing information about their program for this peer support case study.Funded byProject funded by National Institute of Disability and RehabilitationResearch, United States Department of Education, and the Centerfor Mental Health Services Substance Abuse and Mental HealthServices Administration, United States Department of Health andHuman Services (NIDRR grant H133B090019).Suggested CitationResearch and Training Center for Pathways to Positive Futures andYouth & Youth Empowerment Support Program. (2013). Implementingthe Peer Support Specialist Role: Providing Direct, Individualized Supportin a Local Program. Portland, OR: Research and Training Center forPathways to Positive Futures, Portland State University.www.pathwaysrtc.pdx.edu4

Implementing the Peer SupportSpecialist Role: Youth PeerSupport in WraparoundThis information brief provides an example of how one state hasimplemented and supported the Peer Support Specialist role foryouth with serious mental health conditions. The brief covers aspectsof training, coaching, supervision, role definition and financing; anddescribes a series of challenges and solutions.Overview of the Programto the HFW workforce. Counties that elect toimplement the HFW process for youth andfamilies currently provide start up funding forthe agencies. HFW in Pennsylvania is fundedby Medicaid using the Joint Planning Teams,which are administrative activities of the Behavioral Health Managed Care Organizations.The population of focus is 8-18 year olds andtheir families who have complex behavioralchallenges; involvement in multiple systems,such as juvenile justice, child welfare, mentalhealth, addiction services and education; andrisk of placement, or current placement in, outof-home facilities.The Youth and Family Training Institute (YFTI)was created in 2007 to bring the High FidelityWraparound (HFW) Planning Process to Pennsylvania. YFTI is funded by the Office of MentalHealth and Substance Abuse, Community CareBehavioral Health and the University of Pittsburgh/Department of Psychiatry of WesternPsychiatric Institute and Clinic. YFTI is responsible for training, coaching, credentialing andcontinuous quality improvement of the HFWprocess for county contracted agencies whosupport the HFW workforce. The training,coaching, credentialing and continuous qualityimprovement is provided by YFTI at no cost1

Development of the YSP Role in PennsylvaniaYoung people who were involved in the processof developing the Youth and Family TrainingInstitute participated in a discussion regardingstaffing. At that time, staffing for HFW consistedof a Coach, a Facilitator and a Family SupportPartner. When the youth heard about the roleof the Family Support Partner they wantedsomething similar for themselves and otheryouth – someone to support them, advocatewith them, help them find their voices, and helpthem connect to others. As a result, youth werepart of the development of the original role ofYouth Support Partner (YSP). Over the next fewyears, YFTI, along with early HFW implementercounties and workforce members, developedthe training around skills essential for a YSPwithin the PA model. YSPs are now working inall but one of the HFW implementer counties!Youth Support Partners are coached and supervised by the agency in which they are hired.YFTI has recently hired a Youth Support PartnerSpecialist to assist in coaching, training andcredentialing the HFW workforce within thecounty provider agencies. In addition, the YouthSupport Partner Specialist has quarterly checkin calls with the YSPs to discuss strengths withinthe work, issues, concerns or suggestions. Thiscall also allows for coaching support if needed.YFTI provides ongoing learning in several formats, including webcasts, online trainings andyearly HFW Workforce Day.Role of Youth Support PartnersYouth Support Partners offer a range of supportto youth. Similar to the Family Support Partner,the YSPs meet youth to engage them in the HFWprocess, gather information from the youthabout their strengths and challenges, preparethem for team meetings and help them connectwith other youth and with natural and community supports. The YSP supports youth in findingand expressing their voice and sharing their experiences. In preparing for team meetings, theyouth and the YSP will discuss what to expect,who should be there and how the meeting willwork. At times the YSP may speak for youth orco-present with them until the youth are readyto do it on their own. In situations where youthmay feel outnumbered or be reluctant to speakabout their needs, the YSP is there to add another youth voice and advocate on their behalf.want to share their voices, they don’t want tojust sit there silently. They want to be able tocommunicate what they need, but they don’tthink anybody would want to listen. The youthsupport partners help them see that others dowant to listen and are ready – and they willsupport them if people aren’t listening, too. So,it’s an added voice to support and strengthenthe voice the youth have. Not every kid wantsto do it, not every kid is ready for that. But,many of them respond. It’s amazing. Amazing. It’s one of the strongest elements of thismodel: the peer support.”The goal is to help the youth develop their ownabilities to advocate effectively for themselves,both in meetings and in the community.The YSP will also work with the youth and helpthem find community resources that they mayhave been unaware of beforehand or disconnected from in the past. The YSP can accompany the youth as they navigate the communityand various service systems, leading to confi-“[Youth Support Partners] help youth to thinkthrough what they want to say and practicewhat they want to say and help them find theirvoice so that they can share it in a meaningful way. It’s surprising how many kids actually2

dence in doing so independently. Youth SupportPartners work to introduce the youth to othersthat can assist during the transition from youthto adult services. However, this does not meanthat the YSP severs connections with the youthonce they reach a certain age. As the Director ofthe Institute states:Most importantly, perhaps, is the role modeling that goes on during these times. The YSPslearn to share their personal stories in a positivemanner that demonstrates how to successfullynavigate systems, work on recovery, and effectively advocate for and communicate needs.The youth are able to see the YSP as someonewho shares experiences with them, is a similarage, and is working to advocate for their success. Success becomes less of an abstract notion and much more tangible with a YSP. Youthmay be exiting from residential programs wheremany daily activities were done for them, suchas making a doctor’s appointment. This basicskill can seem overwhelming to youth who aremoving between services and possibly livingsituations, especially if they have never done itbefore. A YSP can work with the youth on gaining this skill, having experienced similar issues,without the youth fearing embarrassment.“There’s a lot of check-in that happens afterpeople transition out of the process. If theyouth wants it, the YSP can, and does, checkin by texting or by phone. You know, catch up,check in. You’re not just ‘done’ with the process unless you choose to be.”Youth Support Partners are also looking foryouth that may benefit from and be interestedin leadership development. The Youth SupportPartner Specialist and the Youth InvolvementSpecialists within the PA System of Care Partnership are developing training around this topic so that youth can become leaders at the localand state level as well.Challengesgrow older. The Institute is exploring ways toaward college credit for the trainings the YSPsparticipate in and to offer sustainable compensation. The experience and skills the YSPs gainare transferable to other jobs.For many YSPs, this is their first work experience.Qualifications for this position call for personalexperience in systems and being the general ageof a young adult. The stress of a first job, alongwith that of lived experience within the system,may need to be addressed. The YSPs may participate in creating their own wellness plan sothat their teams are aware of times when theymay need more support. This, as well as otheractivities, has decreased turnover within therole, as has meeting with the team membersand discussing ways to support and assist YSPsin succeeding in the workplace.Another challenge is that some candidates forthe YSP have a criminal history. Because theHFW teams work with youth who also havejuvenile justice histories, youth with justice involvement are especially needed. Current agency policies may prohibit hiring these youth dueto mandatory background checks. The Instituteis currently working with various counties andthe state to address this issue.The program is still relatively new, but successful. A question that is now coming up is what todo when a YSP ages out of the role. The agencies are looking at ways to support YSPs andhelp them move into other positions as theyThough many agencies and providers have integrated YSPs, the generational aspect still requires flexibility. Youth Support Partners areusually aged between 18 and 26 years old.3

Young people are gaining experience in a professional role that takes time to develop, andtheir colleagues must adjust to this learningcurve. Time management, professional dress,and professional communication are skills thatare learned on the job and with the assistanceof all team members.ConclusionAgencies have embraced the YSP position dueto the valuable insight and unique skill set YSPsbring to the team. These positions are seen asintegral to the success of the HFW team meetings as well as the success of the youth transitioning.eight facilitators, four family support partnersand two youth support partners. We quicklylearned that youth support partners are in demand, so as soon as people found out whatthey could do and what their role was on theteam, we had to up the ratio to be equal to thefamily support partner. It’s been a wonderfuladdition. I can’t imagine trying to do this process without it.”“When we first started, our ratio was for every one hundred families, you had one coach,AcknowledgmentThanks to the Youth and Family Training Institute for providing information about their program forthis peer support case study.Funded byProject funded by National Institute of Disability and RehabilitationResearch, United States Department of Education, and the Centerfor Mental Health Services Substance Abuse and Mental HealthServices Administration, United States Department of Health andHuman Services (NIDRR grant H133B090019).Suggested CitationResearch and Training Center for Pathways to Positive Futures andYouth and Family Training Institute. (2013). Implementing the PeerSupport Specialist Role: Youth Peer Support in Wraparound. Portland,OR: Research and Training Center for Pathways to Positive Futures,Portland State University.www.pathwaysrtc.pdx.edu4

the Youth Coordinator getting to know a youth, developing trust, becoming familiar with the youth’s culture, and focusing on what the youth hopes to achieve during their time together. During this phase, the Youth Coordinator is able to learn what resources will best suit the youth and what level of support will help the youth succeed.