RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Family Involvement
Family Involvement
in Transitions to
Adulthood
February 23-24, 2012
Presented by Johanna Bergan, Eileen Brennan,
Pauline Jivanjee, Claudia Sellmaier, Corinne Spiegel.
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FUTURES
POSITIVE FUTURES
TO POSITIVE
PATHWAYS TO
ON PATHWAYS
CENTER FOR
TRAINING CENTER
& TRAINING
RESEARCH
RESEARCH &
Introduction:
Johanna Bergan
Eileen Brennan
Youth M.O.V.E. National
Iowa
Pathways RTC, Portland State
University
Pauline Jivanjee
Claudia Sellmaier
Pathways RTC, Portland State
University
Graduate Research Assistant,
Pathways RTC, Portland State
University
Corinne Spiegel
Jewish Family and Child
Services, Family Member
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Family Involvement Objectives
• Articulate the value to young people of having family
members involved in services
• Navigate the legal and policy contexts of families
involved in the transition years
• Call upon Family Support Organizations and Parent
Advocates to support families in transition
• Involve families engaged in services in productive
ways, while supporting full community integration.
• Engage with diverse families
Presenter: Pauline Jivanjee
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
The Family Journey
• Parents losing control
• The natural pulling apart of adult
family members and youth as
youth become more
independent
• Forced disconnection within the
treatment system between
young adults and families
• System not conducive to
collaboration
Presenter: Corinne Spiegel
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Relationships with Providers
• Families are a resource
and generally want to be
helpful
• Youth in crisis may not see
what families have to offer
•
•
•
•
Recognize social and
emotional supports,
including siblings
Financial help (housing, bills, access to health care)
Treatment
Education
Presenter: Corinne Spiegel
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Relationships with Providers
•
Providers should be prepared
to speak about the value of
involving families
•
Recognize isolation, fear, and
loss of control in parents
•
Parents initially feel confident,
albeit worried, but service
providers who undermine
their expertise and good judgment by questioning and
marginalizing what they offer leads to feelings of
inadequacy.
Presenter: Corinne Spiegel
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Implications for Practice with Families
• Professional language can
create a gap
• Families need to be talked to
with clarity and without
jargon
• Providers must be willing to
answer questions and
provide access to information
Presenter: Corinne Spiegel
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Implications for Practice with Families
• Support families in the balancing
act between families wanting to
protect their child and needing to
let them make mistakes
• Don’t condemn families if their
child makes mistakes
• Get families involved in Family
Support Organizations and link
them with Family/Parent
Advocates
Presenter: Corinne Spiegel
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Your challenges and strategies
• What are the major challenges you have
faced in obtaining and maintaining family
involvement?
• What have been your strategies to
promote family involvement?
Presenter: Corinne Spiegel
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Family Community Integration
• Includes physical space in which families are
located, relationships, and resource accessibility
which affect a family’s ability to participate fully
in community life and roles.
• Clearly linked to having a social ecology which
successfully supports the young person in
transition and the family.
• A key part of community integration is
participation in the workforce.
Presenter: Eileen Brennan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Family Work-Life Integration
• Work-life integration is the degree to which
a person is able to successfully combine
paid work with the rest of life (Lewis, Rapoport,
& Gambles, 2002).
• Overcoming barriers through effective
strategies allows family members to
achieve some measure of work-life
integration.
Presenter: Eileen Brennan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Work-Life Integration: Challenges
•
Major challenges to work-life integration for parents
include:
– employment adjustments
– inadequate educational resources,
– few resources to help with home management,
– lack of community-based supports and services
– courtesy stigmatization at work and other
community settings (Corrigan & Kleinlein, 2005).
• Employment is necessary due to the high cost of
raising a youth with mental health challenges
(Brennan & Lynch, 2008).
Presenter: Eileen Brennan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Employment Barriers
• Barriers to adequate employment of family
members include:
– insufficient workplace support
– lack of relevant community-based resources
– limited flexibility
– personal stress
• Despite high levels of work-based flexibility
and workplace support, the majority of
parents are dissatisfied with their level of
work-family fit.
Presenter: Eileen Brennan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Employment Supports: Strategies
• Work strategies for securing employment to fit
with care include:
–
–
–
seeking jobs in family-friendly organizations
restructuring career and employment
disclosure about young person’s mental health
status
– reciprocity negotiation with supervisors and
co-workers
• Supervisor and co-worker relationships are
critical to flexibility.
Presenter: Eileen Brennan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Risks and Benefits of Disclosure
• Disclosure of young person’s mental
health status at work comes with risks
and benefits (Rosenzweig et al, 2011).
• Benefits include greater support, such as
social support or formal supports such
as flexibility, and in some cases
protection from job loss.
• Risks include negative reaction from
supervisors or coworkers and the
potential of job insecurity or job loss.
(Rosenzweig & Huffstutter, 2004).
Presenter: Eileen Brennan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Conclusions for Practice
• Families care for youth in a context of
inadequate resources, and paucity of family,
workplace, and community supports.
• Service providers need to ask questions about
the important systems that affect the family’s
ability to support their young person ( e.g.
school, transportation, employment, family
support).
• New service approaches need to be developed
in a context of increasingly diverse families
and the rapidly changing workplace.
Presenter: Eileen Brennan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Supporting Community Integration
• What types of questions have you asked
family members to find out about the
challenges they face?
• What supports have you offered employed
family members to promote their
integration in the community?
Presenter: Eileen Brennan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Youth Perspectives
• Some young people may be
grateful for support that family
members offer them as they work
toward recovery and independence
(Preyde, Cameron, Frensch, & Adams, 2011)
• Other young people may want to
strike out on their own and not
want other family members in their
business (Arnett, 2000)
• Youth may not have the option to choose between
adulthood and childhood when navigating systems
Presenter: Johanna Bergan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Family Preparation for Transitions
Mental health issues for family discussion:
• Is the young person able to discuss her/his condition with
significant people?
• Can the young adult articulate her/his MH and other needs?
Does s/he know how to access health/MH information?
• Does the young person know how to access community
resources and agencies?
• Does the young person understand when to discuss her/his
condition?
• Can the young person advocate for her/himself? (Holmbeck et al, 2010)
Presenter: Johanna Bergan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Implications for Practice with Young People
• Listen, treat young people with
respect and dignity
• Offer information to young people
and a voice in decisions
• Create opportunities to use
experiences for growth, increased
skills, self-esteem
• Encourage supportive relationships
with family, friends, and others
Presenter: Johanna Bergan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Implications for Practice with Young People
• Support involvement in groups such
as youth activities, clubs, faith
communities
• Promote autonomy, personal
agency, empowerment, social
inclusion (Osgood, Foster & Courtney, 2010)
• Create opportunities to give and
receive peer support
• Involve families (Federation of Families for
Children’s Mental Health, 2001)
Presenter: Johanna Bergan
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Legal and Policy Issues
• Becoming an adult doesn’t
happen on a birthday
• Individual and Family
developmental changes
happen gradually
• Institutional transitions are
mediated by bureaucratic and
legal rather than cultural or
natural guidelines
Presenter: Corinne Spiegel
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Institutional Transitions
• Eligibility criteria: Different definitions of
serious emotional disturbance in special
education versus mental health
• Funding streams: Local taxes for education
versus state and federal funding for child
welfare
• Different culture: punitive versus
rehabilitation
Presenter: Corinne Spiegel
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Legal Issues: 4 C’s and a G
Consent
• Shift of legal responsibility
• Age of consent varies by state
Confidentiality
• According to HIPAA – Health Insurance
Portability & Accountability Act of 1996
(PL 104-191) providers cannot discuss
health information with a parent unless
the youth specifically grants permission
Competency
• When a young adult is clearly not competent to make independent
health care decisions, a parent may petition the court to become
their child’s guardian, generally completed before age 18.
Presenter: Corinne Spiegel
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Legal Issues: 4 C’s and a G
Conservator
• A conservator is appointed by court to make decisions about
property and assets
Guardianship
• A guardian is appointed to arrange care of a person
• Requires an attorney, filing for a petition, having a court visitor
interview the young adult to be sure it is in their best interest
• The protected person must be willing to sign the consent, or be
served to appear in court to show cause why
• No universally accepted definition of competence
Terms and conditions vary state-to-state.
Presenter: Corinne Spiegel
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Diverse Families
• Young people live in many different
family structures
• As a service provider, do I know
who the young people I work with
define as family and what are their
preferences for family involvement
in services?
• How can I find information and advice about the racial and ethnic
diversity of families I am encountering and how can I develop
skills in providing culturally responsive services?
• Am I tuned in to the over-representation of youth of color in more
restrictive settings and the challenges facing families who want to
participate in their children’s treatment?
Presenter: Pauline Jivanjee
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Working with Diverse Families
• Service providers working with African American young
people recommend long-term resilience-oriented
strategies that include activities where youth can
experience success
• For example, Self-Enhancement, Inc. in Portland, OR
provides after-school and school enrichment programs,
and relationships with mentors planned with family
involvement
• Protective factors include strong kinship ties (Joe, 2006)
• Involvement of community supports such as churches can
be valuable, although not all families want this (Lindsey et al.,
2006)
Presenter: Pauline Jivanjee
27
RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Interventions with Diverse Families
• Do I seek to connect Native
American youth and families to
culturally-specific agencies that
use holistic approaches rooted in
traditional teachings?
• Interventions at programs such as
NAYA Family Center in Portland
incorporate cultural
activities and the development of positive cultural identity
• Families are encouraged to draw from traditional culture and
spiritual teachings to guide their relationships with young
people (Cross et al., 2007)
Presenter: Pauline Jivanjee
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Immigrant Families
• As of 2010, 24% of youth in the U.S. are from
immigrant families, with higher rates of anxiety,
depression, PTSD, and suicidality
• For effective work with immigrant families, am I
thinking about protective factors such as respect,
loyalty to family, and the development of
biculturalism?
• Do I focus my interventions on promoting a strong
sense of positive cultural identity to reduce the
depressive effects of discrimination?
Presenter: Pauline Jivanjee
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Working with Immigrant Families
• Helping relationships for Latino
adolescents are oriented to
health promotion involving
family, friends, peer supports,
and other community supports
that young people trust (Garcia &
Saewyc, 2007)
• In my work with Latino families, do I seek ways to facilitate
youth-family communication to build understanding and
appreciation of strengths? (Chapman & Pereira, 2005)
• Do I reach out to community resources and engage in
advocacy on behalf of vulnerable families?
Presenter: Pauline Jivanjee
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Youth who Identify as LGBTQQIA2-S
• Families with a youth who identify as
LGBTQIQ2-S may experience varying levels of
acceptance and support when using mental
health services
• Do I use asset-based approaches to promote
LGBTQIQ2-S resiliency through building
positive identity, reducing stigma, and
promoting strong relationships with peers,
supportive families, positive role models,
and adult allies? (Gamache & Lazear, 2009)
• Example of the Sexual & Gender Minority Youth Resource Center
(SMYRC) in Portland: Drop in center and developmentally
appropriate programming
Presenter: Pauline Jivanjee
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Practice Guidelines
• Am I aware of families’ different cultural beliefs about
mental health and have I clarified their expectations of
treatment outcomes?
• Do I respond with humility and reflection and seek clarity
where I don’t understand?
• Do I know where to seek culturally relevant and specific
services and supports?
• Am I working to support the development of positive
ethnic and cultural identity as a protective factor?
• Have I sought mentors to bring knowledge of youth
culture to adult family members?
Presenter: Pauline Jivanjee
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Your experiences
• What are your experiences working with
diverse families?
• What has worked well for you?
Presenter: Pauline Jivanjee
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Family Support Organizations (FSO)
• A national network of FSOs advocates for
the rights of children and youth with
mental health challenges and their
families, and provides training and
technical assistance (Gyamfi et al, 2010)
• FSOs provide whatever it takes for families to achieve the balance
they need, including support groups and parent advocates in the
context of systems of care (Koroloff & Friesen, 1991; Kutash & Rivera, 1996)
• FSOs certify Parent Advocates
• Allies in advocating for change
• Help providers evaluate acceptability services
Presenter: Claudia Sellmaier
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Parent Advocates—Their Contributions
• Help other parents navigate the system and access
traditional and non-traditional services
• Translate the content and process of meetings with
service provider (Munson et al., 2009)
• Work to empower parents and youth so that their voices
are heard in service systems
• Serve as networking agents to link parents with others
with similar experiences
• Bring their valuable personal experiences to bear, and
offer hope (Hoagwood, 2005; Munson et al., 2009, Robbins et al, 2008)
Presenter: Claudia Sellmaier
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
National Family Support Organizations
• National Federation of Families for Children’s Mental
Health
http://www.ffcmh.org/
• National Alliance for the Mentally Ill (NAMI)
http://www.nami.org/
• Parents, Families and Friends of Lesbians and Gays
(PFLAG) has over 500 chapters nationwide and provides
community-based support and advocacy for families
http://community.pflag.org/
Presenter: Claudia Sellmaier
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Transition-serving Programs
• Self-Enhancement, Inc. http://www.selfenhancement.org
•
A Portland, OR nonprofit organization helping at-risk African-American urban
youth. SEI provides family resource services such as counseling, parenting classes,
energy assistance and housing programs, and other useful training.
• FosterClub http://www.fosterclub.com/
•
FosterClub is the national advocacy network for young people in foster care. Their
website includes a section for “grownups,” which includes information and
training for foster families and a supportive message board for adults.
• El Programa Hispano
http://www.catholiccharitiesoregon.org/services_latino_services.as
p
•
El Programa Hispano provides academic support, advocacy, skill building,
mentoring, tutoring and recreation to Latino students; as well as family
engagement services to Latino parents in Multnomah County school districts.
Presenter: Claudia Sellmaier
37
RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Transition Serving Programs
• Native American Youth and Family Center http://www.nayapdx.org/
•
NAYA provides educational services, cultural arts programming, and direct support
to reduce poverty to the Portland metropolitan area's American Indian and Alaska
Native community. NAYA Family Center provides family services to strengthen
family and community ties. Family services include Healing Circle, Foster Care
Support Program, Positive Indian Parenting, and Elders services.
• Sexual & Gender Minority Youth Resource Center
http://www.smyrc.org
•
SMYRC provides a safe, supervised, harassment-free, and alcohol- and drug-free
space for sexual minority youth 23 and younger. SMYRC also provides free family
counseling services to sexual minority youth and their families. SMYRC provides
the only drop-in resource center for sexual minority youth in Oregon. Youth
gather to participate in positive activities like art, music, community organizing,
youth development, education, peer support, support groups, case management,
counseling, and job readiness preparation.
Presenter: Claudia Sellmaier
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RESEARCH & TRAINING CENTER ON PATHWAYS TO POSITIVE FUTURES
Resources
• Community mental health program directors for Oregon counties
http://www.oregon.gov/OHA/mentalhealth/cmhpd-list.pdf
• Programs for young people between 14 and 30 in the Portland,
Oregon metropolitan area
http://www.pathwaysrtc.pdx.edu/pdf/projPTTCPortlandTransitionResources10-10-11.pdf
• The Early Assessment and Support Alliance (EASA)
http://www.oregon.gov/OHA/mentalhealth/services/easa/brochure.
pdf
•
The purpose of EASA is to identify youth with symptoms of psychosis as early as
possible, and to provide the most effective support and treatment so they can be
successful
Presenter: Claudia Sellmaier
39
FUTURES
POSITIVE FUTURES
TO POSITIVE
PATHWAYS TO
ON PATHWAYS
CENTER FOR
TRAINING CENTER
& TRAINING
RESEARCH
RESEARCH &
Question and Answer Session
Q&A
Presenter: Pauline Jivanjee, Oregon
40
FUTURES
POSITIVE FUTURES
TO POSITIVE
PATHWAYS TO
ON PATHWAYS
CENTER FOR
TRAINING CENTER
& TRAINING
RESEARCH
RESEARCH &
Additional Questions
If you have additional questions
or feedback, please contact us
Eileen Brennan, Co-Principal Investigator: brennane@pdx.edu
Pauline Jivanjee, Co-Principal Investigator: jivanjee@pdx.edu
Claudia Sellmaier, Graduate Research Assistant:
csellmaier@pdx.edu
Our project website
www.pathwaysrtc.pdx.edu/proj-trainingcollaborative.shtml
Presenter: Pauline Jivanjee
41
Acknowledgments/Funders
The development of the contents of this presentation were supported by funding from the National
Institute of Disability and Rehabilitation Research, United States Department of Education, and the
Center for Mental Health Services Substance Abuse and Mental Health Services Administration,
United States Department of Health and Human Services (NIDRR grant H133B090019). The content
does not represent the views or policies of the funding agencies. In addition, you should not
assume endorsement by the Federal Government.