What Family Support Specialists Do: Examining Service Delivery

Abstract

This study describes services provided by family support specialists (FSS), peer advocates in programs for children with serious psychiatric conditions, to delineate differences between recommended components of FSS services and services actually provided. An analysis of qualitative interview and observational data and quantitative survey data from 63 staff at 21 mental health programs in New York identified that FSS and other staff have generally similar ideas about FSS services, and that these perceptions of activities are generally congruent with what FSS actually did. Implications of findings are discussed in the context of developing competencies and quality indicators for FSS.

An ARC-Informed Family Centered Care Intervention for Children’s Community Based Mental Health Programs

“…Common among programs serving children and families with complex needs, the frontline providers in Waiver endorsed limited competencies and low self-efficacy around effective practices both clinically (e.g., crisis management) and organizationally (e.g., how to run a meeting and team building skills). Such endorsement is consistent with data on providers within these programs; while Waiver program directors typically have professional credentials, frontline providers were less formally educated and less likely to be credentialed (Wisdom et al 2014). The FCC and ARC interventions thus provided targeted competencies that served to increase both team and individual provider self-efficacy, increasing the likelihood that providers have the tools necessary to effectively engage families in shared decision making during care delivery.…”

“…At the time of study recruitment, there were 33 HCBS Waiver programs located within New York State, each embedded within a larger human service agency. HCBS Waiver program staff generally include at least: (a) Agency Administrators, usually the CEO or designee of a large mental health agency that oversees several programs including the HCBS Waiver program; (b) Program Director, usually a master’s level clinician who is responsible for the overall management of the program; (c) Individualized Care Coordinator, who conducts intake and screening, assessment of needs, service plan development, monitoring of goals, and consultation; (d) Parent Peer Specialists, who are peer providers of services with experience as a parent of a child with mental health needs and who provide advocacy and support for parents of children with mental health issues; (e) Skill Builders, who assist the child in acquiring, developing, and addressing functional skills and support, both social and environmental; (f) Respite Workers, who provide a break for the family and the child to ease stress at home and improve family harmony; (g) Crisis Response Workers, who implement activities to stabilize occurrences of child/family crisis, and who provide intensive interventions in the home when a crisis response service is not enough (Olin et al 2014a, b; Wisdom et al 2014). …”

“…Moreover, if new practices such as family-centered care challenge currently held shared values and beliefs that underlie clinical practice, resistance can be doubly difficult to overcome. Recent studies document these challenges, which include variability in the roles and responsibilities of parent peer specialists vis a vis families and other providers on the team (Kutash et al 2014; Rodriguez et al 2011; Salzer et al 2010; Wisdom et al 2014), variability of service quality across programs (Olin et al 2014a, b), and the impact of social organization context in inhibiting or facilitating high quality parent peer services (Olin et al 2014a, b). Clearly, training of parent peer specialists alone is insufficient.…”

Increasing Mental Health Engagement From Primary Care: The Potential Role of Family Navigation

“…Therefore, an important next step is to standardize navigation implementation and research definitions, measures, and protocols. 89,90 Rigorous research (eg, RCTs), particularly within mental health-focused pediatric navigation literature, is limited. Few studies have examined mechanisms of change, specifically which components of a program or characteristics of a navigator are most important.…”

The Tasks and Characteristics of Supportive Support Brokers

“…Whereas the support broker role was totally new, we can see from quite different interventions which aimed to support participants who needed acute as well as long term supports such as the Social/Health Maintenance Organization or early Medicare home care experiments in upstate New York and Pennsylvania that participants were much more apt to be satisfied with their supports and services if they could name their case manager (Leutz & Capitman, 2007), and an affiliation with a disease management-health promotion nurse intervention helped to integrate long-term services and supports with acute care needs Meng et al (2009). Research in New York State on family support specialists, a somewhat analogous position, working with children with serious psychiatric conditions (Wisdom et al, 2014;Olin et al, 2014) point to the advantages of developing quality indicators. Our research on participant and caregiver perceptions on support brokers can be a first step in this direction.…”