Adding Peers to the Workforce

October 31, 2007
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What to keep in mind when you train peer employees—and your existing staff

The 2003 report of the President's New Freedom Commission on Mental Health gave us a wonderful vision of recovery, and urged the strategic and systematic inclusion of peers and family members in the behavioral healthcare workforce. Since then training programs have cropped up across the country to prepare peers and family members, such as "parent partners" (see our June 2007 column), to work alongside professional staff members, adding their hard-won expertise to promoting recovery for those who use our services.

If your organization is about to take this step, we want to assure you that you can do a lot to maximize the effectiveness of peer/family training programs and guarantee positive outcomes. It just takes a little thought and planning before you jump into hiring trainers.

We've looked back over our collective successes, as well as our "unsuccesses," to give you the benefit of what we've learned about training peers and parent partners to join the behavioral healthcare workforce. This way you can avoid some of the potholes we've fallen into and can arrive at a successful outcome without breaking a sweat. Well, maybe you'll have to sweat a little, but less than you would if you hadn't read this column.

Choose a Solid Curriculum

One of the first decisions that you'll probably make is whether to use an existing training curriculum or develop your own. Several good training programs are on the market; they have been tested over and over and proven to be effective. We recommend that you review what's available and choose the training program that best fits your needs. This way you can save the energy you would have invested in curriculum development for your implementation phase.

When looking for a curriculum that best matches your needs, find one with a strong recovery focus that trains students in their unique role as peers, not as junior case managers or junior clinicians. The training material should help them understand and articulate their own experience of recovery and prepare them to share it in ways that help others recover. Avoid less creative, highly clinical curriculum packages. They reflect the mistake that peers need to know how to do the things professionals do, but not to do them. This can confuse peers and parent partners trying to understand their new roles.

If you're looking at a curriculum heavily laded with information on diagnostic criteria, medications and their side effects, symptoms, and so on, keep exploring your options. Peers and parent partners may need to know the basics of some of these factors, but most of their training should focus on the discipline of skillfully being in a mutual partnership.

Most of the tried-and-true curriculum packages take about 70 to 80 hours to complete. This provides enough time to cover the basics of recovery and peer support, as well as enough time to train students in the key areas of skill development. There is often flexibility in how the training can be scheduled so it is most absorbable. Also, since recovery has a strong focus on strengths and accomplishments, be sure the training includes a bang-up graduation party and suggests inviting everyone remotely connected to the training. This is a great way to acknowledge the students' successes.

Note: If you work for a civil service organization, with a lot of red tape and departments that need to get involved in writing job descriptions and so forth, you may want to consider a pilot peer employee program. Start by contracting with a training program that has a strong track record. This might allow you to skip bureaucratic barriers and get a peer employee training program off the ground. Once you have established your program, you can use it as evidence that this approach works, and then begin to replicate it in other locations if that is part of your long-term plan.

Consider Your Post-Training Plans

When behavioral healthcare organizations realize how effective peers and parent partners can be, and how they can complement the existing workforce, they usually rush into implementing training programs without thinking through some of the logistics. It's great to start with a lot of enthusiasm but, before you get too far down the road, give some thought to how peers and parent partners will work in your organization after they complete their training. Consider the following before you schedule the training:

  • Where will peers and parent partners be employed? For example, will they be used in your outpatient settings, crisis centers, and residential settings? How about at your administrative offices?

  • If peers and parent partners will have benefits, how will you address the issues that arise around this? For example, peer employees often need to start part time to preserve disability benefits.

  • Who will write peers' and parent partners' job descriptions?

  • How will the positions be funded?

  • How will peers advance in their new careers?

  • What training will you provide existing staff members about peers' and parent partners' roles?

  • Who will supervise peers and parent partners? What kind of training will you provide managers so they can supervise skillfully?

Planning ahead will enable you to hire peers and parent partners right after they graduate from training programs. This allows you to maintain momentum and not lose students due to long waits for jobs. Below we go into detail in a few of these areas.

Job descriptions. Job duties clearly spell out what this new workforce will be doing on a day-to-day basis. Defining job duties will save you a lot of confusion and conflict when employment begins (more on this in a minute). It also will help other staff members know what to expect from these employees.

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