Embracing Youth Empowerment
Gordon R. Hodas MD
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
• Certified Peer Specialist, Family Services of Western
• Member, AACAP Systems of Care Committee’s
• Young adult member of Pennsylvania Youth and
Family Training Institute (for statewide High Fidelity
• No conflicts of interest
• Youth Involvement Specialist, PA System of Care
• No conflicts of interest
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.
Our Goals For Today
• Consider antecedents of youth empowerment, going
back to family empowerment movement of 1980’s,
• Clarify what youth empowerment entails and why
• Provide snapshot of youth empowerment at
• Provide insights on youth empowerment at individual
and family treatment level.
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.
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
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.
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
• Active participation is intrinsically empowering.
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.
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).
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 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 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
• PA’s System of Care Partnership, with youth
recruitment, engagement, and leadership structure.
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.
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
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
• 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
• 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.