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Youth Empowerment Youth Empowerment Pennsylvania


									Embracing Youth Empowerment

        Gordon R. Hodas MD
           Jake Vandall
            Alex Knapp
            October 10, 2012
  20121 Pennsylvania Community
Provider Association Annual Meeting
         Seven Springs, PA
• Gordon R. Hodas, MD
• Jake Vandall
• Alex Knapp

Roles & Disclosures

         Gordon R. Hodas MD

• Member, AACAP Systems of Care Committee
• Statewide Child Psychiatric Consultant, PA Office of
  Mental Health and Substance Abuse Services
• Child Psychiatric Consultant, Bucks County
  Behavioral Health System
• No involvement with pharmaceutical companies
• No other conflicts of interest

                Jake Vandall

• Certified Peer Specialist, Family Services of Western
• Member, AACAP Systems of Care Committee’s
  Youth Coalition
• Young adult member of Pennsylvania Youth and
  Family Training Institute (for statewide High Fidelity
  Wraparound implementation)
• No conflicts of interest

                Alex Knapp

• Youth Involvement Specialist, PA System of Care
• No conflicts of interest

             Workshop Theme

Youth empowerment is consistent with sound mental
  health treatment and the provision of strengths-based
  human services. We all can embrace this concept
  and practice at multiple levels.

              Workshop Goals
Our Goals For Today
• Consider antecedents of youth empowerment, going
  back to family empowerment movement of 1980’s,
  moving forward.
• Clarify what youth empowerment entails and why
• Provide snapshot of youth empowerment at
  systems/policy level.
• Provide insights on youth empowerment at individual
  and family treatment level.
            Family Empowerment
History Repeating Itself Can be a Good Thing
• Youth empowerment builds on caregiver/family
  empowerment of the 1980’s.
• Many elements contributed to family movement:
   –   Being blamed.
   –   Being overlooked.
   –   Being disqualified.
   –   Having experience and expertise ignored.
   –   Sometimes, needing to give up child custody to get MH Rx.

          Family Empowerment
Concerns of Providers at the Time
• “Our training and expertise will be irrelevant.”
• “The need for political correctness will take over.”
• “We’ll be bullied by families.”
• “What’s the point of going to graduate/medical
• “If families know so much, then how come they’re in
• “Should we just give them what they want and remain

           Family Empowerment
Understanding What was at Issue
• Help-giving based then based on a vertical model:
   – Professional with knowledge and expertise.
   – Family as a “recipient of service,” needing to embrace and
     follow professional expertise.
• At its best, services respectful & compassionate, but
  true reciprocity absent, and relationships unequal.
• Provider concerns about being harmful, or irrelevant.
• Horizontal model, with sharing of power/collaborating,
  starting to emerge, but its benefits not yet clear.
          Family Empowerment
What Families and Family Advocates Learned
• Their contributions are essential.
• Their “lived experience” and expertise matters.
• Advocacy, like everything else, requires training,
  supervision, and acquisition of skill sets.
• There is benefit in working with providers, not in
  adversarial relationships.
• Active participation is intrinsically empowering.

          Family Empowerment
What Smart Professionals Learned
• Collaboration is invigorating, and synergizes &
  amplifies possibilities of change.
• Families have unique expertise based on experience.
• Drawing upon this expertise improves Rx and Rx
  planning, does not undermine the professional.
• Active families are more engaged & more resilient.
• Meaningful conversation & disagreements possible.
• Professionals still have important roles – providing
  expertise and promoting dialogue/consensus.
           Family Empowerment
Definition of “Family-Driven Care”
• Family-driven care “means families have a primary
  decision-making role in the care of their own children
  as well as the polices and procedures governing care
  of all children in their community, state, tribe, territory,
  and nation “ (Osher, Osher, Blau).

             Family Empowerment
Some Legacies of the Family Movement
• Commitment to serve youth with, or at risk of, serious
  emotional disturbance, often in multiple child-serving
  systems, & their families – complex, often overlooked
• Support for CASSP Principles, including “child-
  centered, “family-focused,” “culturally competent.”
• Further growth and evolution of core concepts:
   –   “Family-driven” care.
   –   “Youth-guided” care.
   –   “Systems of care,” & high fidelity wraparound, practice model
   –   Emergence of youth empowerment movement.

           Youth Empowerment
Youth Empowerment and National Leadership
• Gary Blau, Child and Family Branch, Center for
  Mental Health Services (CMHS) in SAMSA.
• Formation of YouthMOVE National.
• YouthMOVE National now part of Federation of
• State & county chapters.
• American Academy of Child & Adolescent Psychiatry:
   – 2009 AACAP Policy Statement, “Youth and Family
     Involvement in Clinical Decision-Making.”
   – AACAP Systems of Care Youth Coalition; CMHS support.
          Youth Empowerment
Youth Empowerment in Pennsylvania
• Grass-roots organizations, over the years.
• Youth on Children’s Advisory Committee to OMHSAS
• Youth Subcommittee, OMHSAS Advisory Committee.
• YouthMOVE Chapters, Philadelphia and Allegheny.
• PA’s Youth and Family Training Institute (YFTI), with
  unique composition.
• PA’s System of Care Partnership, with youth
  recruitment, engagement, and leadership structure.

           Youth Empowerment
Youth Empowerment – “déjà all over again”
• Potentially, same concerns as with family movement,
  except more welcoming climate now, fewer concerns
• Potentially, benefits of same magnitude as with family
• Additional issue – developmental maturity and
  readiness of some youth, especially younger ones.
• Awareness: Youth need own voice, parents cannot
  fully advocate for them. Also, youth differentiation.

           Youth Empowerment
Definition of “Youth-Guided Care”
• Youth guided means “to value youth as experts,
  respect their voice, and to treat them as equal
  partners in creating system change at the individual,
  state, and national level” (YouthMOVE National).
• PA morphing “youth-guided” into “youth-driven.”
  What does this entail?

 Video of AACAP Youth Coalition

This brief video involves youth members of the AACAP
  Youth Coalition talking about their personal recovery
  and key aspects of a positive helping relationship
  with child and adolescent psychiatrists. The video is
  not currently available for distribution, but will
  eventually be posted on the AACAP website

                 Bottom Line
Where We Need to Go
• We need holistic, integrated treatment and care that
  involves caregivers, youth, providers, planning
  partners, and community resource partners as part of
  a cohesive team.
• “Voice and choice” empower the overall process, not
  just specific participants.

      Appendix: FFCMH Family
       Involvement Principles
• Families define themselves and their own culture.
• Families require culturally competent services
  and supports reflecting their race, ethnicity,
  gender orientation, language, socio-economic
  background, and family structure.
• Families have their basic needs met.
• Families have access to information and training.
• Family identified priorities and concerns drive
  policy and practice.

      Appendix: FFCMH Family
       Involvement Principles
• Families share power to make decisions and
  responsibility for outcomes.
• Families & their system partners know their
  individual strengths, limitations and fears.
• Families have their own independent organization
  to speak with a collective voice for system
• Families and their organizations get both respect
  and protection from their system partners.


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