# Presentation: 038780

## Peer Support Training Curriculum

- Preparing Peers to Assist Peers in Preparing for and Recovering From Disasters

- _After The Crisis Initiative_

**Notes:**
*Trainers should read and/or print the following list to acknowledge ALL of the following people who were directly involved in creating this curriculum:

This training represents a collaborative effort of all of the numerous members of the After the Crisis initiative.  Several individuals and groups were instrumental in the development of this curriculum, including:

The CMHS National GAINS Center (Chanson Noether, Noel Thomas, Dan Abreu and Jackie Massaro)
Howie T. Harp Peer Advocacy Center (LaVerne Miller)
MHANYS (Helena Davis)
Boat People SOS (Nguyen Dinh Thang)
Meaningful Minds Louisiana (Debra LaVergne and Carole Glover)
Georgia Certified Peer Specialist Project (Beth Filson)
David Romprey (Consumer Advocate, Salem, OR)
Witness Justice (Helga West)
Pat Talbott (Consumer Advocate, Lancaster County, NE)
NYAPRS (Harvey Rosenthal)
The National Empowerment Center (Dan Fisher)
Mental Health Empowerment Project (Isaac Hayes and Peter Ashenden)
Consumer Organization & Networking Technical Assistance Center/WVMHCA (Carolyn Stuart and Kathy Muscari)
Louisiana State OMH, Office of Consumer Affairs (Margaret Mitchell)
Oklahoma Mental Health Consumers Council (Kaye Rote)
Mental Health Association of Southeastern Pennsylvania (Joseph Rogers)
The Sidran Institute (Esther Giller and Ruta Mazelis)
SAMHSA/CMHS (Susan Salasin)
Orleans Parish, LA Criminal District Court (Andree Mattix, Peter Brandt, Hon. Calvin Johnson)
NAMI Florida (Annette Popovich)

## Intended Training Audience

- This training is designed for use by organizations interested in organizing and training peers assists other peers preparing for disasters and to provide peer support crisis services to meet the needs of peer survivors, their families and communities following a disaster.
- It may be used as a stand alone training or incorporated into Forensic Peer Specialist, Peer Specialist and Peer Counselor trainings.

**Notes:**
Encourage trainees to think about potential opportunities to either incorporate training into existing trainings or have as stand alone training

## Introductions	

- Trainer/Facilitator
- Sponsoring Program/Agency
- Training Participants

## Preparing Yourself 

- Before committing yourself to this very challenging and rewarding endeavor, it is important to be sure that you are making the right choice, both for yourself and the people you will assist.
- You may want to poll trusted family members and friends, as well as care providers, to consider their opinions.
- Most importantly, you need to clarify your own thoughts.

## Preparation Exercise

**Notes:**
Preparation Exercise (courtesy of Helena Davis, MHANYS)

Time allotment:  30 minutes
Materials needed:  paper and pen or pencil
Directions:
1.  Consider each question carefully.  Write the most honest answers you can find.
Answering the following questions may assist you in making your best decision.
On a scale of 1 to 10, how solid is my recovery?  How long has it been that way?
What are my two greatest self-care challenges?  Can I surmount those challenges immediately after a disaster?  For the long haul?
How do I react to change and crisis in my life?
What are my motivations for wanting to do this work?
Under those motivations, what less obvious ones emerge?
What do I hope to gain from doing this work?
How do I react to being in the presence of someone experiencing and expressing great anger, anxiety, loss, and/or pain?
What unresolved issues do I currently have that might be triggered by these feelings in others?  What can I do if that occurs?
How do I respond when there is way more work to do than there is time allotted to do it?  What would I like to change about this response?
What is my pattern in asking for help when I need it?
Do I tend to see the cup as half full or half empty?
Inhale slowly and deeply.  Exhale through your mouth, slowly.  Repeat inhale and exhale three more times.
Notice what thoughts are going through your mind.  Write them down without editing.
Scan your body and notice what sensations you feel and where.  Write them down.
Notice what emotions are emerging.  Write them down.
Finally, in doing this exercise, what thoughts and feelings have you chosen to 
      ignore?  Write them down.
Repeat step #2.
Take a few moments and write down the following:
What it has been like to do this exercise? 
What have you learned?  
What is your next step?

## Core Values of the Training

## 	Core Values of Training

- _Peer Support Principle_:  Peers have unique experiences and skills that are particularly valuable in helping other peers cope with and recover from disasters
- _Avoid Pathologizing Response_:  Normalizing the experiences and responses to disaster
- Peer support services should be integrated into all aspects of disaster planning, implementation and service delivery to assure that the needs of peers are met
- Encourage self-care and mutual support for peers providing these services

## Training Goal

- To provide reliable resources and supports to people with mental illness and CODs in the event of an emergency or disaster.

## Training Objective

- 	Prepare peers with histories of mental illness, substance abuse and or involvement in the criminal justice systems to assist peers in preparing for disasters and to provide peer crisis support in the aftermath of a disaster

## Adaptation of Training

- Peers are the targeted population for the services described in this training.  However, the After the Crisis Project encourages trainers to incorporate information and activities that reflect the unique characteristics and needs of the their communities.
- This includes but is not limited to incarcerated peers,
- 	peers living in institutional settings such as state hospitals and adult homes, peers residing in rural communities, non-English speaking peers and peers with additional disabilities.

**Notes:**
Emphasize the importance of adapting the curriculum to the needs of the targeted community

## Recruitment of Trainees

- Trainees should reflect the communities that they will be working in and the individuals that they will be providing services to.

## Learning Objectives

- Peers attending this training will:
- Understand the roles that peers can play in assisting in preparing for disasters
- Understand roles that peers can play in providing peer support crisis services following a disaster
- Understand the goals of  peer support crisis services and how to use them to promote recovery
- Understand the different stages of a disaster/emergency and the different needs of survivors, families and communities
- Understand the impact that a disaster or emergency has upon individuals,groups and communities

## Learning Objectives Continued

- Understand the impact that culture has upon an individuals response to traumatic events and how culture can promote recovery
- Learn strategies that promote engagement,trust and resiliency
- Learn basic assessment and referral techniques
- Understand the need for documenting contacts and record

## Learning Objectives Continued

- Learn strategies for self-care and staff support
- Learn strategies for leveraging additional opportunities for peer support services in your community
- Learn strategies for having peer services included in your local and state disaster plans
- Learn strategies for collaborating with local and national disaster relief agencies
- Learn about FEMA Crisis Worker Certification Training and other resources

## Training Ice Breaker

- You are are notified that you have five minutes to leave your home due to rising flood waters and you are told that you can only take one personal item with you when you leave, what would you take and why?

**Notes:**
Trainers should decide the format that works best for this exercise, given the characteristics of the group being trained.  This exercise could be done in pairs, small groups or with the entire group as a discussion.  Allow time at the end of the exercise for processing and discussion.

## Getting Started

## What About Your Experiences Make You Uniquely Qualified to Provide These Services?

**Notes:**
Here the trainer should ask participants to take a small amount of time (3-5 minutes) to reflect upon their own experiences that have lead them to participate in this training.  Participants should be encouraged to write down responses on a piece of paper and save for future reference.  This exercise may be done individually or in the same combination as used in the previous exercise.  At the end of the exercise, each participant should be instructed to choose one item to share with the group.  Time should be allowed at the end of the exercise for processing and discussion.

## Getting Started

- What is a disaster or emergency?
- How is a disaster or emergency different from other events or occurrences?
- Who or what decides whether an event is an emergency?
- Why should peers be trained to provide these services?

**Notes:**
This slide should be presented as an instructor lead discussion and brainstorming session.  Participants’ responses should be recorded and posted somewhere in view of the training participants.  These responses should be referred back to by the trainer as appropriate throughout the training.

## Challenges Experienced By Peers Following A Disaster

- Lack of Information
- Separation from “family” and friends
- Difficulty accessing mental health services
- Fear of getting “sick again”
- Access to services

## Peer Support Disaster Services vs. Traditional Peer Support Services

- Peer Support Disaster Services
- Short term
- Emphasis on quickly assessing needs of survivors for referral to other resources
- Mobilized in response to a disaster

- Traditional Peer Support Services
- No time limits
- No or minimal emphasis on speedy assessments
- Designed to provide ongoing support to peers

## Common Ground: Crisis Counseling and Peer Support Disaster Services

-     Peer Support Disaster Services have a lot in common with Crisis Counseling Model used by traditional disaster relief programs:
- Recovery is possible
- Services are Person Centered
- Do not pathologize responses to events, “no you are not going crazy or getting sick again”
- Not mental health treatment
- Draws on the resiliency of individuals and communities in developing coping mechanisms
- Services “brought” to people
- Elimination of barriers to accessing counseling services and other support
- Whenever possible, assist individuals and families in returning to their communities

## Goals of Peer Support

- Assist peers in understanding that their responses are often “normal” responses to an “abnormal event”
- Crisis often creates opportunities for growth and change (Mead, 2001)
- Is your glass half empty or half full?

## Goals of Peer Support Continued

- Assist peers in talking about their experiences
- Educate peers about trauma and sources of strength and resiliency
- Assist peers in identifying their needs
- Assist peers in getting their needs met
- Assist peers in establishing or re-establishing contact with “family” and friends
- Assist peers in setting short and long term goals for their recovery

## Menu of Peer Support Services

- Individual Crisis Counseling
- Peer Support Groups
- Public Education and Outreach
- What other services can peers provide?

**Notes:**
Discuss what other services do peers provide? Emphasize peers can provide any service, depending upon their training and preparation.

## Services Funded by FEMA

- FEMA funds the following services, provided that they are provided by a “Certified” Crisis Counselor (more about this later)
- Crisis Counseling
- Support Groups
- Public Outreach and Education
- These services are free

## Levels of Preparedness

- National
- State
- Local
- Neighborhood/Community
- Self and Family

## Preparedness Pyramid

## Disaster Preparedness: Before the Crisis

- Studies show that most Americans do not have a “Disaster Plan” and therefore are unprepared when disaster strikes
- Peers can assist other peers and their families in developing personal “Disaster Plans”
- Effective planning can avoid some of the problems experienced by peers in the aftermath of a disaster

## Before the Crisis

- Preparedness=Empowerment

## Role of Preparedness in Facilitating Rebuilding and Recovery by Individuals and Communities

## Individual Preparedness

- Peers can assist peers in many activities:
- Creation of personal/family plans
- Storage of emergency items such as food, water, clothing and lighting
- Assembling and retaining personal information in a safe and accessible place

## Preparedness:  Keys to Recovery 

- We all respond better to difficult situations when we are prepared
- Preparedness can reduce some of the emotional,financial and destabilizing impact of disasters on individuals and communities
- Preparedness can facilitate more timely recovery/rebuilding process

## Insert Sample Plan Here

## Strategies to Encourage Personal Preparedness

- Convene a special event to complete plans
- Make the development of plans part of routine services provided to all peers in diverse settings, including hospitals, jails and prisons and adult homes

## Community Mobilization and Preparedness

- Peer support groups and other activities provide a unique opportunity for peers to work together and develop strategies to support each other in preparing for a disaster
- Your “community “ can work together to address issues of:
- 	Communication-Multiple means
- 	Transportation
- 	Temporary Shelter
- 	Care of displaced pets
- 	Meeting Places

**Notes:**
Trainer:  Ask group, “What else can your community work together on?”

## Community Mapping:  Creating Other Partnerships

- 	Disaster preparedness activities also create unique opportunities for peers and peer run programs to build bridges and collaborate with other community based organization in the area.

## Community Mapping Exercise

**Notes:**
In this exercise, using the diagram in the slide as a “jumping off” point, the trainer should lead participants through an exercise in which they brainstorm, identify and map resources, agencies, organizations, and tools available in the community that can be utilized by peers in responding to survivors of disaster.

## After the Crisis:  Peer Crisis Services

- Peers Supporting Peers

## Peer Support:  An Emerging Practice in Disaster Crisis Services

- First Responders- Police, Fire Department, Medical Personnel
- Consumers first trained as Crisis Counselors in 1995-1996
- 	Ventura Fires- 1995
- 	Oklahoma Bombing-1995
- 	World Trade Center Tragedy- 2001

## 	What is in the Name: The Role of Peer Crisis Counselor

- Crisis Counselor is the term used to define counselors specially trained to provide services and support to  survivors and communities impacted by a disaster.
- Peer Crisis Counselors are peers specially trained to provide services and support to peers and their communities.

## Visualization Exercise

- Have you ever been in a disaster?  What are some of the things that you felt or worried about immediately following the event and the days weeks and months and weeks that followed?

**Notes:**
Include all the Elements of Activity Instructions
Time
Purpose
Set-up
Introduction
Materials
Instructions
Processing and Summary

I may have experienced one up close OR perhaps only from a distance. What if I haven’t experienced a disaster? The second question is a good brainstorming question for those who have. A visualization is usually a story where you ask people to imagine something and then the storyteller fills in the images.

## Unique Risks Facing Peers

- Relapse
- Attributing normal physical and mental responses to onset of psychiatric symptoms
- Interruption of mental health services
- What else?

## Emotional Charting

| Feelings Directly After Event | Feelings During the Following Days and Weeks |
| --- | --- |
|  |  |
|  |  |
|  |  |
|  |  |

## Phases: Responses to Disaster

- Honeymoon Phase
- Inventory Phase
- Disillusionment Phase
- Rebuilding Phase

## Emotional Characteristics of Each Phase

| Honeymoon | Shock and Denial |
| --- | --- |
| Inventory
 | Fact seeking, piece together what happened, reality sets in |
| Disillusionment | Frustration, anger, trying to find meaning |
| Rebuilding | Acceptance, desire to move forward |

## Needs During Honeymoon Phase

**Notes:**
This is an exercise in which participants should be asked to think about what needs they think might be faced during this phase.  Participants should spend approximately 2-3 minutes thinking about this question.  Afterward, the trainer should lead the group through a facilitated discussion of the needs that were identified by the training participants.  Participants’ responses should be recorded on easel paper or some other format in which responses can easily be posted for the remainder of the training. 

## Needs During Inventory Phase

**Notes:**
This is an exercise in which participants should be asked to think about what needs they think might be faced during this phase.  Participants should spend approximately 2-3 minutes thinking about this question.  Afterward, the trainer should lead the group through a facilitated discussion of the needs that were identified by the training participants.  Participants’ responses should be recorded on easel paper or some other format in which responses can easily be posted for the remainder of the training. 

## Needs During Disillusionment Phase

**Notes:**
This is an exercise in which participants should be asked to think about what needs they think might be faced during this phase.  Participants should spend approximately 2-3 minutes thinking about this question.  Afterward, the trainer should lead the group through a facilitated discussion of the needs that were identified by the training participants.  Participants’ responses should be recorded on easel paper or some other format in which responses can easily be posted for the remainder of the training. 

## Needs During Rebuilding Phase

**Notes:**
This is an exercise in which participants should be asked to think about what needs they think might be faced during this phase.  Participants should spend approximately 2-3 minutes thinking about this question.  Afterward, the trainer should lead the group through a facilitated discussion of the needs that were identified by the training participants.  Participants’ responses should be recorded on easel paper or some other format in which responses can easily be posted for the remainder of the training. 

## Community Responses Mirror Individual Responses

- Communities exhibit similar responses to disasters.  What behaviors may be observed in communities impacted by a disaster during the following phases:
- Honeymoon
- Inventory
- Disillusionment
- Rebuilding

**Notes:**
Trainer should spend about 5-10 minutes here discussing with the group how community responses mirror some of the individual responses discussed in the four preceding slides.  Participants should be encouraged to share their personal experiences within their own community as appropriate.

## Caution!!!!

- Not everyone or every community goes through all of the phases
- Not everyone goes through the phases in the order presented
- Let survivors describe how they are feeling and what their immediate concerns are

## Trauma Informed Peer Disaster Support Services

- Disasters are traumatic events that cause emotional and physical responses in most survivors
- Survivors with trauma histories such as histories of physical and emotional abuse may be “re-traumatized” by the disaster
- Many peers report histories of prior traumatization and this may impact on engagement strategies used by peers

## People respond very differently to disasters 

- These differences may be due to such things as:
- 	Previous trauma history
- 	Current living situation
- 	Access to resources
- 	Access to information
- 	Pre-existing support system
-      Gender
- 	“Culture”

## What is “Culture” and How is it Transmitted?

- Expansive definition of culture
- How is culture developed?
- What role does may culture play in how we respond to a crisis?
- How may our views about different cultures impact on our ability to support peers?
- What impact may culture have on the development of particular coping skills?

## Impact of Culture on Disaster Responses

- Group Exercises

**Notes:**
Being the Stranger in a Strange Land (2 Exercises) – Courtesy of Helena Davis, MHANYS

Exercise #1:  Open and Shut Case (25 minutes)
Set up:   Divide the group into pairs
Instructions:
In round 1, the speaker will begin telling a story about something exciting that has recently happened.  Duration:  3-5 minutes
The listener will participate by silently judging and noticing negatives but at the same time, responding politely.
Facilitator asks speakers what the experience was like for them.
How easy was it to share?  How did you feel about the listener?
How did they feel about yourself?  Would you be willing to share your thoughts with the listener again?
Listeners, what was this like for you?
In the second round, the speaker will tell the same or another story
about a time he or she felt excited.
The listener will try to hear and notice all the positives about the speaker and his or her story.
Facilitator will once again ask the questions:  How easy was it to share?  How did you feel about the listener?  How did you feel about yourself?  Would you be willing to share your thoughts with the listener again?
Listeners, what was this experience like for you?  How would you compare it to the first time?
If time permits, roles can be reversed
Facilitator asks participants to write the answers to two questions:
What have you learned from this exercise?
What is one behavior you will be sure to do when supporting peers?
Facilitator asks a few participants to share their answers with the     group.

Exercise #2:  Discussion or Reading

NOTE TO TRAINER:  This is an exercise for which you can prepare the materials ahead of time and distribute as a “takeaway” or “homework” exercise for training participants.

If this is the first time you have ever experienced a community disaster, you will have a lot to learn and little time to learn it.  Hopefully, you will have 30 minutes to do some quick reading on the local population, history, and cultures or you may need to find someone who is familiar with the area who can tell you what perspectives, beliefs, and traditions drive the way things are done.  If all else fails, you will have to learn as you go.

When you are in learn-as-you-go mode, it is like crash landing on another planet.  If you are going to survive and succeed, you will need to understand the inhabitants as quickly as possible.  

Curiosity and awe will be your greatest assets; assumptions and judgments will be your greatest enemies.  How do we know this?  When we are curious or awe-struck, our minds are open.  When we make assumptions, 99.9% of the time they are incorrect.  We are making guesses with closed minds.  When we pass judgment about what we see or hear, we are closing our minds to learning and understanding.

Here is an example:  I spent a year living in an Asian county and discovered, much to my annoyance, that people lied as easily and as frequently as they told the truth.  I have always felt angry with liars.  I took their dishonesty personally.  After a week or two of feeling upset in this Asian country, my common sense took over and my thoughts changed to”  “Hmmmm.  I wonder what has happened that makes them feel okay about lying?”  I began to read as much about the history of the country as I could.  It did not take long to figure out that people here lied for two reasons:  1) it is considered very impolite to say something that might cause displeasure to someone in a social or political station and 2) because the country has a centuries-long tradition of iron-fisted rulers with lots of spies who are frequently overthrown,
lying became a tool for survival.  If I had allowed myself to stay angry instead of becoming curious, I would have spent a year being miserable.  I would have made enemies rather than friends!

Our job after disaster is to help people adapt to their new, very challenging environment, to survive, and ultimately to recover.  In order to succeed at our job, we will need to earn trust.  After a disaster, people will be feeling many negative emotions:  fear, anxiety, anger, shame, grief, and guilt.  They will need to feel our openness in order to trust us.  Disaster survivors will need to trust us if they are to accept our support.  
Part of our job in providing support is to be able to see the positives, the resources, the strengths, and the hope when survivors cannot do so.  We must be able to see the survivors’ strengths and reflect them when the survivors can only feel loss and hopelessness.  We will need to hold these hopes and strengths until the survivors can take them back from us.  We must be able to meet our peers where they are in order to lead them to a different 
place.

Summary
To successfully support your peers after a disaster, you will need to do the following:
Be curious, be amazed
Be a learner as well as a teacher at all times
Look and listen for strengths and positives
Meet people where they are and get to know them before you try to lead them to a new place

## Taking an Observant and Asking Stance

- We all know what happens when we make assumptions!
- Positive assumptions about an individual or group of individuals may be as harmful to them work as having making negative assumptions about an individual or group?  Why?
- What are some popular held assumptions about peers or different groups of peers in your community?

## Taking an Observant and Asking Stance Continued

- Be Proactive! Listen,observe and ask questions
- Be curious, be amazed
- Be a learner and a teacher at all times
- Look and listen for strengths and positive coping strategies
- Meet people where they are and get to know them
- Make sure to familiarize yourself with the community you will be working in

## Establishing Rapport

- _Mission Not Impossible_:  Creating a safe and nurturing environment under difficult circumstances.
-    	_Flexibility_:  Adapt to your working environment
- 	_Introduction_: Prepare an introduction that you will use 	when first meeting a survivor (Don’t assume that 	people will know who you are or why you are 	speaking with them)
-       _Listen_:  Actively listen, listen actively

## Tools of Engagement:  Successful Communication Skills

- Active Listening
- Non-Verbal Cues
- “I” Messages

## Active Listening

- Active listening is listening to the speaker with both ears, our mind, our heart and our eyes
- We are not only listening to the speakers words but are also “listening between the line” to hear the feelings behind the words
- When are ready to respond to the speaker, we reflect back the feelings we heard between the lines

**Notes:**
THERE ARE TWO ACTIVE LISTENING EXERCISES THAT CAN BE UTILIZED IN THIS SECTION:

Active Listening Exercise #1 (courtesy of Helena Davis, MHANYS)
What is Active Listening?  How is it different from everyday listening?

Usually, when we listen to someone, we are multi-tasking.  We are listening to the speaker with one ear and listening to our own internal dialogue with the other ear.  We are usually trying to think about our next statement in response to the speaker.  We may also be thinking about the time, what we want for lunch, etc., etc.
When we use Active Listening, we are listening to the speaker with both ears, our mind, our heart, and our eyes.  We are not only listening to the speaker’s words, but we are also listening “between the lines”, so to speak, to hear the feelings behind the words.  When we are ready to respond to the speaker, we do so by reflecting back the feelings we heard between the lines.  

Consider the previous example:
Speaker:  I can’t take it anymore!  Every time I need something I have to stand in line, tell my whole story, and then listen to why they can’t give me what I need!
Listener:  Sounds like you’re really frustrated!
Speaker:  You got that right!

Brainstorming Exercise
Time needed:
Materials:  Flip chart, pen
Directions:
Facilitator asks group to think of a time when they really had something important to say and someone really listened to them.  Ask participants to think of ways they knew they were really being heard.  Write these on the flip chart.
Some answers might include:  nodding, looking at me, leaning towards me, saying “um hm” or “I see”, asking clarifying questions, responses were about me, not him.
The facilitator now asks the group to think of a time they had something important to say and the listener didn’t feel heard.  Ask participants to think of ways they knew the listener wasn’t really hearing them.  Write these on the flip chart.
Some answers might include:  looking around, looking at watch, fidgeting, interrupting, responding about himself rather than about me, misunderstanding what was said.
Ask participants felt when they experienced the first kind of listening.  Write responses on the flip chart.
Ask participants how they felt when they experienced Active Listening.  Write responses on the flip chart.
Summary:  Active Listening is very important because it helps people feel heard, validated, understood, and important.  It makes them feel safe to continue exploring and expressing their feelings.  As this happens, speakers often get more clear about how they feel and what they need.  It often clears their heads and allows them to take their next steps.  At the very least, it relieves some of the stress.

Active Listening Exercise #2 (courtesy of Helena Davis, MHANYS)
Exercise:  Practice Active Listening
Time needed:  30 minutes
Directions:
Participants are directed to form dyads.
In this exercise, one person will be the listener and one will be the speaker
In the first round, the speaker will tell the speaker a story about a time that was scary.  The speaker will have 3 minutes.
During this time, the listener will use as many bad listening behaviors as possible
At the end of three minutes, as the listeners to share what it was like to tell their stories to a poor listener.
Next, have the speaker continue the story or tell another.  The speaker will have 3  minutes.
Direct the listeners to use Active Listening during this round.
At the end of the round, ask the speaker what it was like to tell their story when Active Listening was used.
Ask the listeners what it was like to use Active Listening.
Now, reverse the roles and repeat the exercise.
Bring the group back together so participants can share what they learned and how it would apply to doing peer support 

## Active Listening in Action

- _Survivor_: I can’t take this anymore.  Every time I need something I have to stand in line and tell my whole story all over again and then tell me that they can’t give me what I need.
- _Peer_:  Sounds like you are very frustrated!
- You got that right!

## Active Listening Exercise

- Think of a time when you had something really important to say and someone listened to you, what did the listener do that made you feel that you were being heard?
- Think of a time when you had something important to say and you did not feel that you were being heard?

**Notes:**
Activities
Be sure to include for each activity:
Time
Purpose
Set-up
Introduction
Materials
Instructions
Processing and Summary

Trainer should spend a few minutes (5-10) facilitating a group discussion for those training participants who wish to share their responses.

## Non-Verbal Cues

- Communication can also be non-verbal
- It is important that your non-verbal cues convey your interest in the person, what he/she is saying and your desire to help

## Non-Verbal Cues Exercise

- What are some non-verbal cues that promote engagement?
- What are some non-verbal cues that discourage engagement?

**Notes:**
Activities
Be sure to include for each activity:
Time
Purpose
Set-up
Introduction
Materials
Instructions
Processing and Summary

Trainer should spend a few minutes (5-10) facilitating a group discussion for those training participants who wish to share their responses.

## 		“I” Messages

- Statements used to communicate concern
- Helps the listener remain open to hearing you
- Non-judgmental
- How can “I” messages be helpful to you in you in your work as a counselor?

**Notes:**
Activities
Be sure to include for each activity:
Time
Purpose
Set-up
Introduction
Materials
Instructions
Processing and Summary

Trainer should spend a few minutes (3-5) facilitating a group discussion for those training participants who wish to share their responses to the question.

## “Assessment” and Referral

**Notes:**
Introductory slide.

## Assessment and Referral

- _Caution_:  This is _not_ a mental health assessment
- The purpose of this assessment is to help survivors effectively communicate to you what their needs are and to assist them in having these needs met
- Mental health services may be one of these needs
- The agency that you work with will have established policies and practices regarding these types of referrals

## 	Referral Strategies

- Work with other peers to create a resource handbook of community resources
- Handbook should include but not be limited to the following information:
- Emergency Housing Information
- Food pantries
- Peer Support groups
- 12 Step-Programs
- Pharmacies
- Places of Worship

## Additional Referral Strategies

- Local benefits offices
- Post Offices
- FEMA, the Red Cross and other disaster
- relief agencies also have resource
- manuals and directories

## Making the Match

- Collaborate with survivor in locating resources that meet their needs, are culturally and linguistically competent and are accessible
- 	Always call to confirm hours of operation and what documentation is need to receive services or support

## Each Contact is an Opportunity to Educate Peers About Wellness and Recovery Tools

- In some communities, survivors may be unfamiliar with wellness and recovery tools whose value may extend beyond their recovery from the immediate disaster
- _Some suggested tools are_:
- Disaster Preparedness Kits
- WRAP Plan
- Advance Directives
- “Personal Medicine” Forms

## Documentation Requirements

- You will be required to document your contacts and provide basic demographic and referral information
- Generally speaking, different forms may be used to document different types of services
- Follow all confidentiality rules regarding the listing of names and other personal identifiers
- Become familiar with the forms you will be using
- In most cases these forms document services rendered for payment
- If you don’t record it, it didn’t happen

## 	Self-Care

- Disaster support work is very demanding and challenging
- Tips to assist you in maintaining your own recovery and to avoid the “burnout” that is frequently experienced by workers:
- Don’t over do it, stick to your assigned work schedule
- Maintain your personal wellness routine
- Eat healthy and get plenty of rest
- Have regularly scheduled debriefing sessions with your supervisors and peers
- Ask for help when you need it
- Create opportunities to joy and pleasure
- _Wellness tip_:  Create your own Wellness and Recovery Action Plan

**Notes:**
Trainer should first ask participants:

How many of you use a WRAP? 
What elements from your WRAP would be relevant to Self Care in this context? 

Then show slide as summary.

## Self-Care Exercise

**Notes:**
Self Care Exercise (courtesy of Helena Davis, MHANYS)

Time needed:  15 minutes
Directions:  The facilitator will read the following story to the participants.

Self Care
“The Guardian of the Embers”
A shaman from one of the Indian tribes in the California desert shared this story with the young person he was training to take his place.
Long, ago, when our people first lived on Mother Earth, an ancestor visited the wisest elder in the tribe.  The ancestor appeared and announced her presence: “Behold, Wise Elder, I have brought a gift for you to share with your clan.  It will make your lives better in many ways.”
“This gift is called fire. It is both a gift and a challenge and that is why I entrust it to you, the wisest, for safekeeping.”
The ancestor set down the box in front of Wise Elder and opened it to display the contents.  Wise Elder felt the intense heat as she put her face close for a better look.  She noticed that the glowing embers appeared alive as they pulsated with light.  The ancestor
demonstrated how, like a small child, the embers could be made to grow by nurturing them with tinder and sticks and how they could be shared with the rest of the clan.  The ancestor demonstrated that the fire could be used to heat water and cook food, as well as keep the clan warm on chilly nights. She demonstrated how the fire could be used to light the way when hunters or warriors had to travel on cloudy nights.
Wise Elder thanked the ancestor for the gift and expressed her joy at all that the fire could do for them.
Before the ancestor left, she advised Wise Elder of the following:  “I have entrusted this gift to you to keep for the clan because you are the wisest.  You must always remember that even though you give the embers away to members of the clan who need them, you must always keep a few, yourself, and tend them so that the fire never disappears.  From now on, your name will be Guardian of the Embers.”
Discussion
What did you learn from this story?
How can it be applied to the job of Peer Support Volunteer?
What can you, personally, do to apply what you have learned from this story?

## Strategies for Systems Change in Disaster Planning and Preparedness

- Integrating Peers in Disaster Planning, Preparedness and Disaster Service Delivery Activities

## Strategies for Inclusion in Your Local and State Disaster Plans

- Your state and local government are required to have disaster/emergency plans
- Do not wait until a disaster to advocate for the inclusion of these services into state and local disaster plans
- Inclusion in your local and state plans creates a formal process assuring the utilization of peers
- Be proactive and organize!

## 	FEMA Funded Services

**Notes:**
Introductory slide.

## 	FEMA Funded Services

- The Federal Emergency Management Administration funds two types of crisis counseling initiatives and crisis counseling training when the President officially declares a disaster.

## Immediate Services Program

- FEMA program allowing the state or local agency to respond to immediate mental health needs with crisis counselors, outreach and community networking services.

## Regular Services Program

- Provides up to 9 months of crisis counseling, community outreach and education services.  State can request an extension of this time limitation.
- State must submit a proposal to FEMA and peer crisis services must be included as part of this submission.
- Programs and agencies are strongly encouraged to review previously successful applications submitted for peer crisis services (don’t reinvent the wheel).

## Other Peer Services Funded by FEMA

- Peers have successfully received funding for such services as:
- 	Warm Lines- Oklahoma and New York City

## Crisis Counselor Certification Program

- FEMA also offers a Crisis Counselor Certification Training Program
- Counselors must be certified for costs to be reimbursed
- States must formally request services and certification training

## FEMA Certification Training

- 		**Benefits of FEMA Certification**
- Strengthens your argument for inclusion state and local disaster plans
- Increases likelihood that you will be permitted to provide services in disaster relief shelters run by traditional relief agencies
- Eligible for payment for services

## Roadmap for Inclusion and Integration

**Speak with Peer groups with previous experience**
**developing, implementing and evaluating peer disaster relief**
**initiatives and develop strategic plan addressing:**
- Statement of Need
- Services provided
- Proposed outcomes-targeted community, numbers served
- Management of program
- Program Evaluation
- Training Outline and schedule

## Roadmap Continued

- Identify key players and schedule meetings
- Practice Your Presentation
- Advocate, Advocate and Advocate

## Leveraging Your Peer Crisis Counselor Program

- Peers have successfully leveraged the
- opportunities created during disasters to:
- Organize our communities and establish mutually beneficial relationships with other new organizations
- Develop peer workforce
- Introduce concepts of peer support and recovery