Abstract
Scant research literature exists documenting the details of services rendered by peer support providers and their relative impact on children and families. The specific services delivered by peer providers, how the provision of such services are determined and tailored to the needs of individual families, and the tools used to gather services information are largely unknown. We examined how “parent advocates” in the state of Ohio conducted their work with families served through publicly funded children’s mental health services. In partnership with the National Alliance on Mental Illness (NAMI) Ohio, we qualitatively explored the services provided by parent advocates to families with children experiencing emotional and behavioral health challenges. We conducted semi-structured focus groups and individual interviews with 11 adult parent advocates operating in two metropolitan counties of Ohio. The findings include an account of the specific service activities in which the advocates engage with families, a description of how advocates plan and provide individualized and culturally responsive care to families, and advocates’ definitions of success. The study further resulted in the development of the Family Advocate Services Checklist (FASC), a tool to assist NAMI Ohio in gathering advocate services data. We discuss the findings with regard to grounding peer support provider approaches in theory (social support and empowerment), the juxtaposition of individualized and culturally responsive care for children and families through peer support providers, and how the FASC can be used to document advocate services and tie them to child and family outcomes in future studies.
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Bally, S. J., & Bakke, M. H. (2007). A peer mentor training program for aural rehabilitation. Trends in Amplification, 11, 125–131.
Barrera, M., Jr. (1986). Distinctions between social support concepts, measures, and models I. American Journal of Community Psychology, 14, 413–445.
Briggs, M. H. (1999). Systems for collaboration: Integrating multiple perspectives. Child and Adolescent Psychiatric Clinics of North America, 8, 365–377.
Briggs, H. E. (2009). The fusion of culture and science: Challenges and controversies of cultural competency and evidence-based practice with an African American family advocacy network. Children and Youth Services Review, 31, 1172–1179.
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and human design. Cambridge, MA: Harvard University Press.
Bruns, E. J., Walker, J. S., & The National Wraparound Initiative Advisory Group. (2008). Ten principles of the wraparound process. In E. J. Bruns & J. S. Walker (Eds.), The resource guide to wraparound. Portland, OR: National Wraparound Initiative, Research and Training Center for Family Support and Children’s Mental Health.
Bryant-Comstock, S., Huff, B., & VanDenBerg, J. (1996). The evolution of the family advocacy movement. In B. A. Stroul (Ed.), Children’s mental health: Creating systems of care in a changing society (pp. 359–374). Baltimore, MD: Brookes.
Cabral, R. J., Galavotti, C., Gargiullo, P. M., Armstrong, K., Cohen, A., Gielen, A. C., et al. (1996). Paraprofessional delivery of a theory based HIV prevention counseling intervention for women. Public Health Reports, 3(Suppl. 1), 75–82.
Carpenter, P. J., Vattimo, C. J., Messbauer, L. J., Stolnitz, C., Isle, J. B., Stutzman, H., et al. (1992). Development of a parent advocate program as part of a pediatric hematology/oncology service. Journal of Psychosocial Oncology, 10(2), 27–38.
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.
Davis, T. S. (2003). Viability of concept mapping for assessing cultural competence in children’s mental health systems of care: A comparison of theoretical and community conceptualizations. Doctoral dissertation, The University of Texas at Austin, 2003. Dissertation Abstracts International.
Davis, T. S. (2007). Mapping patterns of perceptions: A community-based approach to cultural competence assessment. Research on Social Work Practice, 17, 358–379.
Davis, T. S., Scheer, S. D., Gavazzi, S. M., & Uppal, R. (2010). Parent advocates in children’s mental health: Program implementation processes and considerations. Administration and Policy in Mental Health and Mental Health Services Research, 37, 468–483.
Evans, E., Armstrong, M. I., Dollard, N., Kuppinger, A. D., Huz, S., & Wood, V. M. (1994). Development and evaluation of treatment foster care and family-centered intensive case management in New York. Journal of Emotional and Behavioral Disorders, 2(4), 228–239.
Evans, M. E., Armstrong, M. I., & Kuppinger, A. D. (1996). Family-centered intensive case management: A step toward understanding individualized care. Journal of Child and Family Studies, 5, 55–65.
Evans, M. E., Armstrong, M. I., Kuppinger, A. D., Huz, S., & McNulty, T. L. (1998). Preliminary outcomes of an experimental study comparing treatment foster care and family-centered intensive case management. In M. H. Epstein, K. Kutash, & A. Duchnowski (Eds.), Outcomes for children and youth with behavioral and emotional disorders and their families: Programs and evaluation best practices (pp. 543–580). Austin, TX: PRO-ED.
Fogarty, L. A., Heilig, C. M., Armstrong, K., Cabral, R., Galavotti, C., Gielen, A. C., et al. (2001). Long-term effectiveness of a peer-based intervention to promote condom and contraceptive use among HIV-positive and at risk women. Public Health Reports, 116(Suppl. 1), 103–119.
Gielen, A. C., Fogarty, L. A., Armstrong, K., Green, B. M., Cabral, R., Milstein, B., et al. (2001). Promoting condom use with main partners: A behavioral intervention trial for women. AIDS and Behavior, 5, 193–204.
Haber, M. G., Cohen, J. L., Lucas, T., & Baltes, B. B. (2007). The relationship between self-reported received and perceived social support: A meta-analytic review. American Journal of Community Psychology, 39, 133–144.
Hardin, D. M., & Littlejohn, W. (1994). Family-school collaboration: Elements of effectiveness and program models. Preventing School Failure, 39, 4–8.
Heflinger, C. A., Bickman, L., Northrup, D., & Sonnichsen, S. (1997). A theory-driven intervention and evaluation to explore family caregiver empowerment. Journal of Emotional and Behavioral Disorders, 5, 184–191.
Hernandez, B., Hayes, E. A., Balcazar, F. E., & Keys, C. B. (2001). Responding to the needs of the underserved: A peer-mentor approach. SCI Psychosocial Process, 14, 142–149.
Hoagwood, K. E. (2005). Family-based services in children’s mental health: A research review and synthesis. Journal of Child Psychology and Psychiatry, 46, 690–713.
Hoagwood, K. E., Green, E., Kelleher, K., Schoenwald, S., Rolls-Reutz, J., Landsverk, J., et al. (2008). Family advocacy, support and education in children’s mental health: Results of a national survey. Administration and Policy in Mental Health, 35, 73–83.
Hogan, B. E., Linden, W., & Najarian, B. (2002). Social support interventions: Do they work? Clinical Psychology Review, 22, 381–440.
Jensen, P. S., & Hoagwood, K. E. (Eds.). (2008). Improving children’s mental health through parent empowerment: A guide to assisting families. New York, NY: Oxford University Press.
Joint Commission on Mental Illness and Health. (1961). Action for mental health: Final report of the Joint Commission on Mental Illness and Health. New York: Basic Books.
King, G., King, S., Rosenbaum, P., & Goffin, R. (1999). Family-centered caregiving and well-being of parents of children with disabilities: Linking process with outcome. Journal of Pediatric Psychology, 24(1), 41–53.
Knitzer, J. (1997). Service integration for children and families: Lessons and questions. In R. J. Illback, C. T. Cobb, & H. M. Joseph Jr. (Eds.), Integrated services for children and families: Opportunities for psychological practice (pp. 3–21). Washington, DC: APA.
Koroloff, N. M., Elliott, D. J., Koren, P. E., & Friesen, B. J. (1994). Connecting low-income families to mental health services: The role of the family associate. Journal of Emotional and Behavioral Disorders, 2, 240–246.
Koroloff, N. M., Elliott, D. J., Koren, P. E., & Friesen, B. J. (1996). Linking low-income families to children’s mental health services: An outcome study. Journal of Emotional and Behavioral Disorders, 4, 2–11.
Krippendorff, K. (2004). Content analysis: An introduction to its methodology. Thousand Oaks, CA: Sage.
Lakey, B., Adams, K., Neely, L., Rhodes, G., Lutz, C. J., & Sielky, K. (2002). Perceived support and low emotional distress: The role of enacted support, dyad similarity, and provider personality. Personality and Social Psychology Bulletin, 28, 1546–1555.
Miles, P. (2008). Family partners and the wraparound process. In E. J. Bruns & J. S. Walker (Eds.), The resource guide to wraparound. Portland, OR: National Wraparound Initiative. Research and Training Center for Family Support and Children’s Mental Health.
Munson, M. R., Hussey, D., Stormann, C., & King, T. (2009). Voices of parent advocates within the systems of care model of service delivery. Children and Youth Services Review, 31, 879–884.
Murphy, C. A., Cupples, M. E., Percy, A., Halliday, H. L., & Stewart, M. C. (2008). Peer-mentoring for first-time mothers from areas of socio-economic disadvantage: A qualitative study within a randomized controlled trial. BioMed Central Health Services Research, 8 [on-line publication].
New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming Mental Health Care in America. Final report. DHHS Pub. No. SMA-03-3832. Rockville, MD. Available from: http://www.mentalhealthcommission.gov/reports/FinalReport/downloads/downloads.html.
Ohio Department of Mental Health. (n.d.). Access to better care initiative. Retrieved April 10, 2009, from http://www.mh.state.oh.us/what-we-do/provide/children-youth-and-families/access-to-better-care-initiative.shtml.
Padgett, D. (1998). Qualitative methods in social work research. Thousand Oaks: Sage.
Perkins, D. D., & Zimmerman, M. A. (1995). Empowerment theory, research, and application. American Journal of Community Psychology, 23, 569–579.
Quittner, A. L., Glueckauf, R. L., & Jackson, D. N. (1990). Chronic parenting stress: Moderating versus mediating effects of social support. Journal of Personality and Social Psychology, 59, 1266–1278.
Rappaport, J. (1987). Terms of empowerment/exemplars of prevention: Toward a theory for community psychology. American Journal of Community Psychology, 15, 121–148.
Romanelli, L. H., Hoagwood, K. E., Kaplan, S. J., Kemp, S. P., Hartman, R. L., Trupin, C., et al. (2009). Best practices for mental health in child welfare: Parent support and youth empowerment guidelines. Child Welfare, 88, 189–218.
Ross, L. T., Lutz, C. J., & Lakey, B. (1999). Perceived social support and attributions for failed support. Personality and Social Psychology Bulletin, 25, 896–908.
Strauss, A., & Corbin, J. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage.
Stroul, B. A., & Friedman, R. M. (1986). A system of care for children and youth with severe emotional disturbances. (Revised edition). Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.
Sullivan-Boylai, S., Grey, M., Deatrick, J., Gruppuso, P., Giraitis, P., & Tamboriane, W. (2004). Helping other mothers effectively work at raising young children with type 1 diabetes. The Diabetes Educator, 30, 476–484.
Systems of Care, Substance Abuse and Mental Health Services Administration. (n.d.). Center for Mental Health Services, U.S. Department of Health and Human Services. http://www.systemsofcare.samhsa.gov/headermenus/deffamilydriven.aspx.
U. S. Department of Health and Human Services. (1999). Mental health: A report of the surgeon general. Rockville, MD: U. S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health.
Vandenberg, J. E., & Grealish, E. M. (1996). Individualized services and supports through the wraparound process: Philosophy and procedures. Journal of Child and Family Studies, 5, 7–21.
Walker, J., & Schutte, K. (2005). Quality and individualization in wraparound team planning. Journal of Child and Family Studies, 14, 251–267.
Walter, U. M., & Petr, C. G. (2006). Lessons from the research on paraprofessionals for attendant care in children’s mental health. Community Mental Health Journal, 42, 459–475.
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 30–41.
Acknowledgments
The authors would like to thank the National Alliance on Mental Illness (NAMI) Ohio and the parent advocates for their support and contributions to this research. Funding for this research was provided by the Ohio Department of Mental Health.
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Davis, T.S., Gavazzi, S.M., Scheer, S.D. et al. Measuring Individualized Parent Advocate Services in Children’s Mental Health: A Contextualized Theoretical Application. J Child Fam Stud 20, 669–684 (2011). https://doi.org/10.1007/s10826-010-9443-y
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DOI: https://doi.org/10.1007/s10826-010-9443-y