Youth-guided Residential Practices that Support Positive

Outcomes – from Basic to

Advanced

Marvin Alexander, MSW, LCSWYouth Support Coordinator, Magellan Health Services of LouisianaPresident, Youth MOVE National Board of Directors National BBI Consultant on Youth-guided Care

Georgetown Pre-Institute Training ProgramEffective Residential Service InterventionsJuly 2012 Orlando, FL

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Youth Guided Care as a Value of Systems Transformation: Quick Lesson

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• People come with established values

• These values are constantly tested by situations that arise

• These values and the new ones formed are constantly shaped by the situations that play out

What is Youth Engagement?

•Youth engagement is the meaningful participation and sustained involvement of a young person in an activity, with a focus outside of him or herself.

Centre of Excellence for Youth Engagement web-site, at www.engagementcentre.ca

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More on Engagement

Engagement is empowering!Entails giving somebody power or authority and a greater sense of confidence or self-esteem.

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Embrace Youth-guided Care

Youth Guided means that young people have the right to be empowered, educated, and given a decision-making role in the care of their own lives.

This includes giving young people a sustainable voice and the focus should be towards creating a safe environment enabling a young person to gain self-sustainability in accordance with their culture and beliefs.

Through the eyes of a youth guided approach we are aware that there is a continuum of power and choice that young people should have based ontheir understanding and maturity in this strength based change process.

Youth guided also means that this process should be fun and worthwhile.

Youth MOVE National, Inc. (2008)

Level 1: Youth-Guided Individual Level

• Youth are empowered in their planning process from the beginning and have a voice in decision- making

• Youth receive training • Equal partnership is valued

Community Level • Community partners and stakeholders are open and willing to partner with

youth and have created safe spaces for young people

Policy Level • Youth are invited to meetings and training and support is provided• Youth can speak on their experiences • Adults value what youth have to say in an advisory capacity• Youth are voting members of all boards and committees

Level 2: Youth-DrivenIndividual Level

The young person is:• Telling his or her story• Building relationships with people who support them and making decisions in their care• Developing a deeper knowledge and understanding of the systems designed to serve and

protect them. • Not in a consistent period of crisis & basic needs are met

Community Level• Youth have positions and voting power on community boards• More youth advocates are involved and are recruiting other youth • Community members respect the autonomy of youth voice and spread the word on the

importance of youth voice

Policy Level• Youth understand the policy process Youth have understanding of the current policy issues

and speak their opinions• Youth opinions are heard and action is taken • There is increase of youth representatives and a decrease in tokenism

Level 3: Youth-DirectedIndividual Level

• The youth sets vision and goals for treatment with input from team• The youth is aware of options and is able to utilize and apply knowledge of resources • The youth is able to stand on his or her own and take responsibility for choices • Youth are mentors and peer advocates for other youth • Youth are giving presentations based on personal experiences and knowledge • The youth is making the transition into adulthood

Community Level• Community partners listen to youth and make changes accordingly • Young people have a safe place to go and be heard • There are multiple paid positions for youth in every decision-making group • Youth form and facilitate youth groups in communities • Youth provide training in the community

Policy Level• Youth are calling meetings and setting agendas in policy-making• Youth hold trainings on policy-making for youth and adults • Youth inform the public about current policies and have a position platform • Youth lead research to drive policy change

Elements of Youth Engagement

•evolving capacities •intergenerational equity•rights, voice and choice•youth-adult partnership•youth mainstreaming/ transitioning

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Factors that support youth engagement

•a supportive family background, mentors or role models

• involvement in cooperative activities• cultivation of intrinsic interest•awareness of moral and political issues • traits such as moral sensitivity and optimism• roles of adult support•a youth-friendly environment• the completion of meaningful tasks• learning and utilization of new skillsMichaelson, M. and Nakamura, J. (2001) Supportive Frameworks for Youth Engagement. Jossey-Bass; Checkoway, B.

and Gutie’rrez, L. (2006) Youth Participation and Community Change. Haworth Press.

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Barriers to Youth Guided Care

As Identified by Adults• Time• Funding• Staffing• Access to youth• Lack of training (in how to work

with youth)• Politics• Parents• Adult staff not empowered• Program evaluation requirements• Weak leadership• Racism

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As Identified by Youth• Ageism/Adultism• Money• Racism, sexism, homophobia• Stereotyping by appearance• Time• Transportation• Language• Lack of access to information• Lack of access to opportunities• Lack of support from adults• Few role models• Lack of motivation

Politz, B. (1996). Barriers to youth participation. Washington, DC: Academy for Educational Development. The Center for Youth Development.

12“ It is possible to teach youth to participate meaningfully in their education, treatment, or care planning. Doing that helps youth achieve better outcomes, and probably also helps the adults who work with the youth get better results as well.”

Walker and Child (2008)

What strategies have you used to ENGAGE youth touched by a

residential intervention?

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Strategies for Youth Engagement from the Research•Hire staff with expertise in this process.

•Use peers who are already living in the community to teach/model skills

•Have youth learn and use skills in their daily activities in residential care.

•Normative experiences should not be treated as privileges or withheld to manage behavior.

• Residential providers in remote areas should plan programs and housing to move older youth into the community with support.

Courtney (2007); Davis & Koyanagi (2005)

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Strategies for Youth Engagement from the Research

•Community schools should be used as much as possible.

•Maintain & build network of support. Youth connection with family/community support systems have correlation to how youth are doing 10 to 15 years after care.

•Family engagement may play a stronger role in the outcomes than the actual intervention program

•Services accommodate the critical role of peers and friends

Courtney (2007); Davis & Koyanagi (2005)

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Examples of Youth Guided Care for States/Counties/Cities

• choosing supports, services, and providers;

• setting goals;

• designing and implementing programs;

• monitoring outcomes;

• partnering in funding decisions; and

• determining the effectiveness of all efforts to promote the mental health and well being of children and youth.

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Examples of Youth Guided Care in Programs

• Opportunities to spend time with families in their homes is NEVER a privilege or something that has to be earned – IT IS ENCOURAGED & MADE POSSIBLE – EVERY WEEKEND & DURING THE WEEK - as often as possible ‘treatment’ occurs IN THE HOME AND HOME COMMUNITY

• Bonds w/ siblings and community friends strongly supported

• Phone calls are not restricted (e.g., 10 minutes max; from 6 to 8 p.m.) – youth are encouraged to call extended family members and an approved list of friends (approvals only if absolutely necessary)

• School: "Going to home schools is the most preferred - if consistent with youth's wishes; going to school in community is also preferred; IF must go to campus-based school - then focus is on ensuring strong connection to home school and ENSURING that youth keeps up w/ his/her classes so he/she moves up with his/her class in home school!!! (THIS IS A BIG ISSUE FOR YOUTH)

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Examples of Youth Guided Care in Programs

• Programs should CONTINUALLY strive to eliminate restraints/seclusion – use of individualized soothing/calming plans and focus on supporting self-regulation (i.e. sensory approaches) and staff understanding of trauma should all be strong components of program

• Focus on collaboration and empowerment not control and rules

• All public recognition for youth (i.e. awards/certificates) should be about normalizing activities (e.g., art work; sports; dance) – not for ‘most improved in behavior’ or ‘no restraints’

• Celebration activities/holidays are about supporting family traditions at home – not about long-term program traditions

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Examples of Youth Guided Care in Programs

• Youth provided training/support to lead own treatment team meetings

• Hiring of youth advocates (meaningful roles throughout the organization)

• Providing youth community mentors – preferably from home community

• Youth/youth advocates represented on agency Governing Body and/or youth advisory council reports to CEO

• Providing leadership training for all youth

• Needed skill training is relevant to INDIVIDUAL discharge needs (e.g., social skills based on family/community individual issues; bank account; public transportation; laundry) & occurs in community

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Examples of Youth Guided Care in Programs

• Youth individual strengths/talents/interests identified pre-admission & priority put on youth staying involved in activities that match these areas – preferably in the community w/ pro-social peers

• Youth have multiple daily opportunities for choices/taking control of their everyday lives – from time to get up (using their own alarm clocks) and time to go to bed to what activities they would like to participate in to food to spending time outside

• Group activities – which should be rare – involve family members (i.e. siblings/cousins go roller skating with youth); very little- IF ANY- residential-based activities involve residential youth only

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Youth Recommendations • “Every staff wants to talk to me about my problems. It gets so old.

Why don’t we just talk about what interests me?”

• “We can help each other as well, if not better, than staff can help us. They should promote ways of doing this.”

• “Just listen, truly listen – staff need to not be so obvious that they are waiting to say something.”

• “Make me smile and laugh; be there for me – not just there to remind me of rules.”

• “Nobody asks me about my dreams. They ask me about my behaviors.”

Authentic Youth Engagement

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Happens when…• the voice and actions of youth are valued.

• youth are utilized as a resource in the development of themselves and their community.

• Authentic youth voice is present, empowered and interwoven throughout your system and your organization.

• youth are valued for their experience and expertise (not as the problem).

• youth consumers are advocates and educators.

• youth members are on boards and committees.

• youth are decision makers.

• there is equal partnership and shared respect.

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“The world that we have made as a result of the level of thinking we have done thus far creates problems that we cannot solve at the same level at which we created them.”

- Albert Einstein

Contact Information

Marvin Alexander, MSW, LCSWYouth Support Coordinator, Magellan Health

Services of LouisianaPresident, Board of Directors

Youth MOVE National, Inc.Phone: 225-218-7698

marvincalexander@gmail.com