VA Peer Support David Hampton

LCSW, LPC, LADC&

Eric Gates, Peer Support Specialist

VAMC OKC

(405)-456-5583

Peer Support Role

“My role is to be a mentor, a role model, and an advocate for VETERANS!”

Duties (PD) of Peer Support Provider in VHA Mental Health Care

Serves as Recovery agent providing and advocating for effective Recovery services that will aid the Veteran in daily living.

Teach and engage Veterans in problem solving and conflict resolution to support in self-directed Recovery.

Assisting peers in articulating goals for Recovery.

Assisting Peers to learn and practice new skills, monitor progress coping based on Peer Support Provider’s own recovery experience.

Supporting Peers in advocating for themselves to obtain effective services.

Dedicated to Veteran-Centered Care.

Support and encourage Veterans to achieve self-determination and Self-empowerment.

Support Veterans to achieve Recovery goals that lead to independent living in the community.

Who are Peer Support Providers in the VHA?

Veterans who share their personal experience with MH/SA to inspire hope in Veterans served.

Peer Veteran’s perspective based on lived experience of recovery transformation & Military Cultural experience.

Eligible under 38 USC 7402 (b)(13) have spent a minimum of 1 year in personal recovery from DSM diagnosis SA/MI.

DO Facilitate peer support groups

Share own Recovery stories

Advocate for Veteran

Act as role models of Recovery

Provide crisis support

Communicate with Staff

Act as liaison for Veterans

Work on variety of teams

Provide outreach & educate VAMC

staff and Veterans about peer

support services

Don’t Do Provide psychotherapy

Assigned task’s or roles currently

performed by other Staff

Collude with Veteran consumers

against clinical staff

Cross Professional boundaries

Support Veteran consumers in

their self-destructive or illegal

behaviors

Fill other Vacant Positions

Approved Peer Support Activities

What Peer Support Specialists Do?

What PSS’s Do:Help others learn abouttheir strengths and challenges

What PSS’s Don’t Do:Diagnose or categorize them based upon a clinical label or what others have told them are

What PSS’s Do:Encourage people tomake their own choices on what will work for them. Walk side by side and honor each person’s diversity

What PSS’s Don’t Do:Provide clinical services or map out a recovery process for the person

What Peer Support Specialists Do?

What PSS’s Do:Support the development of personal responsibility, self efficacy, and self-advocacy skills. Help develop independency

What PSS’s Don’t Do:Make decisions for the people we serve; do things for them that they can do for themselves;’ makeVeteran dependent on us

What Peer Support Specialists Do?

What PSS’s Do:Create partnerships with people with a focus on mutual learning and mutual responsibility.

What PSS’s Don’t Do:Assume the expert roleor leader or tell otherswhat’s best for them.

What Peer Support Specialists Do?

What PSS’s Do:Listen and “be with” peers in an affirming way.

What PSS’s Don’t Do:Jump in and try to “fix”people, disallowing them space to feel their feelings or search for their own solutions.

What Peer Support Specialists Do?

What PSS’s Do:Validate peers’ painful experiences while expressing belief in a person’s abilityto be resilient and move on.

What PSS’s Don’t Do:Stay stuck on the negative or participate in the “blame game.”

What Peer Support Specialists Do?

What PSS’s Do:Talk through differences and resolve conflicts respectfully with people.

What PSS’s Don’t Do:Argue with people, gossip or “vent” to others about challenges with serviceproviders.

What Peer Support Specialists Do?

What PSS’s Do:Stay open to partneringwith our professionalcolleagues and shareour belief that mentalhealth systems canrecover too.

What PSS’s Don’t Do:Give up on systems that haven’t recovered yet or perpetuate hopelessness when people are experiencing challenges with the system and/or service providers.

What Peer Support Specialists Do?

What PSS’s Do:Observe peer supportethics responsibly.

What PSS’s Don’t Do:Act in ways that could potentially harm the people we serve orundermine trust in the value of peer support.

What Peer Support Specialists Do?

What PSS’s Do:Exercise good judgmentin situations in which thebest thing is not always clear, always consultingwith our supervisor if we are in doubt about our work.

What PSS’s Don’t Do:Avoid consulting withour supervisor orcoworkers when consultation is needed.

What Peer Support Specialists Do?

What PSS’s Do:Understand how trauma can affect the way people act, relate with others, and perceive of themselves.

What PSS’s Don’t Do:Characterize a person’s response to trauma as “something wrong with” that person.

What Peer Support Specialists Do?

What PSS’s Do:Share parts of our storywith the people we assist -- the parts we feel will help each person move forward.

What PSS’s Don’t Do:Share “war stories” or commiserate around problems.

What Peer Support Specialists Do?

What PSS’s Do:Believe in people. Hold the hope that all can recover from mentalillness and addictions.carry the belief that recovery is the expectation, not the exception.

What PSS’s Don’t Do:Doubt a person’s dreams and goals. Hold a belief that some people can never recover. Carry lowexpectations for others.

What Peer Support Specialists Do?

What does research say about the benefits Peer Support Services?

Empathize

Focus on strengths & desires

Tolerant, flexible, patient and persistent

Inspire hopefulness by sharing our recovery story

Inspire Veterans involvement in their own care

"Who then can so softly bind up the wound of another as he who has felt the same wound himself?"–Thomas Jefferson

Research shows challenges both in & out of VHA:

Role confusion:

Lack of clarity of duties

Staff resistance:

Less supervision & support

Exclusion from treatment team discussions

Unequal Treatment:

Relegated to grunt work

Question reasonable accommodations

Why should we hire Peer Support Staff?

2003- President’s New Freedom Commission on MH Report:“Because of their experiences, consumer providers bring different attitudes, motivations, insights, and behavioral qualities to the treatment encounter

(p.45).”

VHA now requires Peer Support staff within Mental HealthVHA Handbook 1160.01 Uniform MHS in VAMC VHA Handbook 1162.02 MH Residential Rehab ProgramsVHA Handbook 1163.05 Psychosocial Rehab and Recovery Centers . . “must design Peer Support Services” (p.8)

On August 31, 2012, President Obama signed an executive order instructing the VHA to hire 800 peer support counselors for mental health care.

Compassionate Energy Rewires your Brain!

Flores, Philip J. (2004). Addiction as an Attachment Disorder. Lanham, Maryland: Rowman & Littlefield Publishing Group, Inc.

Common misperceptions about Peer Support Staff?

Cannot work full-time

Cannot fulfill valuable roles in the treatment of Veterans

Peer Support staff will relapse

Peers will cause harm that other staff will have to undo

Peers cannot handle administrative demands of the job

Goals for using Peer Support Staff on the Treatment Team

Help Veterans get most from VA services.

Consult with Veterans to develop a supportive

relationship.

Help Veterans connect with community resources.

What is appropriate Peer Support Training?

The PS supervisor include training for:

PS’s role and responsibilities

Opportunities for continuing education based on the

PS’s skill set, interest level, and job demands.

Promote professional development to obtain

certifications

(e.g. Certified Psychiatric Rehabilitation

Practitioner; Wellness Recovery Action Plan facilitator;

Wellness Coach; etc).

Promote participation in VHA Leadership Effectiveness

Accountability Development training).

Training for Peer Support Providers

Training for Peer Supports with Facility Recovery Coordinator

Peers meet weekly each Friday 1430 – 1600 to train from the VA Peer Specialist Training Manual. There are ten competencies and assessment tests that cover the following knowledge domains:

•Recovery Principles•Peer Support Principles•Cultural Competence•Communications Skills•Group Facilitation Skills•Managing Stigma•Understanding Different Illnesses•Recovery Tools•Professional Development & Workplace Skills•Managing Crises and Emergency Situations

Additional training & help!

Teleconferences SAMHSA Resource Center to Promote Acceptance, Dignity, and Social Inclusion Associated with MHVHA Peer Support Lecture Series monthly webinars: Archived webinars VA Learning University-TMSVA Mental Health Services Peer Support Services SharePoint:Attend National Conferences (Annual) that focus on peer support and psychosocial rehabilitation practices:

* International Ass. Of Peer Supporters (iNAPS)* Depression & Bipolar Support Alliance (DBSA)* National Alliance on Mental Illness (NAMI)* US Psychiatric Rehabilitation Association

(USPRA) * New England MIRECC Peer Education Center trainings

America’s Freedom Warriors

I will facilitateWellness Groups,

be a Recovery Educator, and use

my lived experience to

inspire Hope & Recovery for

Veterans.

THANK YOU

QUESTIONS?

References

Chinman, M., Lucksted, A., Gresen, R., Davis, M., Losonczy, M., Sussner, B., & Martone, L. (2008). Early experiences of employing consumer-providers in the VA. Psychiatric Services, 29 (11), 1315-1321.

Chinman M., Shoai, R., Cohen, A.N. (2010). Using organizational change strategies to guide Peer Support Technician implementation in the VA. Psychiatric Rehabilitation Journal, 33, 269-277.

Cook, J.A., Copeland, M.E., Corey, L., Buffington, E., Jonikas, J.A., Curtis, L.C., Grey, D.D., Nichols, W.H. (2010). Developing the evidence base for peer-led services: Changes among participants following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives. Psychiatric Rehabilitation Journal, 34(2), 113-120.

Department of VA VHA. (2010). VHA handbook 1162.02. Mental Health residential rehab programs. Retrieved June 28,2012.

Department of VA VHA. (2011). VHA handbook 1163.03. Psychosocial rehab and recovery centers (PRRC). Retrieved June 28, 2012.

Chinman, M., Lucksted, A., Gresen, R., Davis, M., Losonczy, M., Sussner, B., & Martone, L. (2008). Early experiences of employing consumer-providers in the VA. Psychiatric Services, 29 (11), 1315-1321.

Chinman M., Shoai, R., Cohen, A.N. (2010). Using organizational change strategies to guide Peer Support Technician implementation in the VA. Psychiatric Rehabilitation Journal, 33, 269-277.

Cook, J.A., Copeland, M.E., Corey, L., Buffington, E., Jonikas, J.A., Curtis, L.C., Grey, D.D., Nichols, W.H. (2010). Developing the evidence base for peer-led services: Changes among participants following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives. Psychiatric Rehabilitation Journal, 34(2), 113-120.

Department of VA VHA. (2010). VHA handbook 1162.02. Mental Health residential rehab programs. Retrieved June 28,2012.

Department of VA VHA. (2011). VHA handbook 1163.03. Psychosocial rehab and recovery centers (PRRC). Retrieved June 28, 2012.

ReferencesDepartment of VA VHA. (2011). VHA handbook 1163.05. Psychosocial rehabilitation & recovery peer support handbook. Retrieved June 28, 2012.

Flores, Philip J. (2004). Addiction as an Attachment Disorder. Lanham, Maryland: Rowman & Littlefield Publishing Group, Inc.

Gates, L.B. & Akabas, S.H. (2007). Developing strategies to integrate peer providers into the staff

Harrington, S., Dohoney, K., Gregory, W., O’Brien- Mazza, D., & Sweeney, P. (2011). Department of VA peer specialist training manual-Instructor edition. Washington, DC: US Department of VA

Miya, K., Wilbur, S., Crocker, B., & Compton, F. (1997). Addressing and resolving role issues between professionals and consumer employees. Consumers as providers in psychiatric rehabilitation (pp. 334-346). Columbia, MD: International Assoc. of Psychosocial Rehab Services.

Simpson, D.D. (2002). A conceptual framework for transferring research to practice. Journal of Substance Abuse TX, 22 (4), 171-182.

http://www.dbsalliance.org/site/PageServer?pagename=wellness_peer_support_research