Evaluation of a Train-The-Trainers Model for Family Peer Advocates in Children’s Mental Health

Abstract

Standardized training and credentialing is increasingly important to states and healthcare systems. Workforce shortages in children's mental health can be addressed through training and credentialing of professional peer parents (called family peer advocates or FPAs), who deliver a range of services to caregivers. A theory-based training program for FPAs targeting skills and knowledge about childhood mental health services (Parent Empowerment Program, or PEP) was developed through a partnership among a statewide family-run organization, state policy leaders, and academic researchers. Prior studies by this team using highly-experienced family peer advocates (who were also co-developers of the training program) as trainers found improvements in knowledge about mental health services and self-efficacy. In 2010, to meet demands and scale the model, a training of trainers (TOT) model was developed to build a cohort of locally-trained FPAs to deliver PEP training. A pre/post design was used to evaluate the impact of TOT model on knowledge and self-efficacy among 318 FPAs across the state. Participants showed significant pre-post (6 month) changes in knowledge about mental health services and self-efficacy. There were no significant associations between any FPA demographic characteristics and their knowledge or self-efficacy scores. A theory-based training model for professional peer parents working in the children's mental health system can be taught to local FPAs, and it improves knowledge about the mental health system and self-efficacy. Studies that evaluate the effectiveness of different training modalities are critical to ensure that high-quality trainings are maintained.

Strengthening care for children with complex mental health conditions: Views of Australian clinicians

“…[38,39] Peer-to-peer support by parents has been used successfully to support the child mental health workforce. [40] Peer support networks (either face to face or online) help parents navigate the system and advocate for their child. [41, 42] In addition, expansion of existing support structures to assist parents to navigate the health care system e.g.…”

Proposing a mechanistic model of clinician training and consultation.

“…In contrast, Train-the-Trainer models involve an EBT expert providing clinical training to a community-based clinician who in turn replicates that training with other clinicians in their organization. Although this approach is widely used (e.g., Hawkins & Sinha, 1998; Rogers, Cohen, Danley, Hutchinson, & Anthony, 1986) and is considered affordable and feasible (e.g., Hoagwood et al, 2018), the effectiveness of the model is not well understood. Within behavioral health, some studies have reported a “watering down” effect from consultants to staff (Shore, Iwata, Vollmer, Lerman, & Zarcone, 1995), whereas others have reported no differences (Martino et al, 2010).…”

Future Directions in Lay Health Worker Involvement in Children’s Mental Health Services in the U.S.

“…In one example of an auxiliary model, LHWs have been trained to increase engagement in Parent-Child Interaction Therapy by addressing barriers to care and promoting home practice of skills (Barnett et al, 2016(Barnett et al, , 2019. More broadly across mental health services, the Parent Empowerment Program trains family peer advocates to work with parents to address their children's mental health needs and overcome barriers to care (Hoagwood et al, 2018;Rodriguez et al, 2011). Limited evidence has established the success of these auxiliary models.…”