National AgrAbility Project Peer Support Douglas B. Carmon National AgrAbility Project Manager 2007 National AgrAbility Training Workshop November 15, 2006 Jackson, MS

DEFINITION PEER n. –A person who has equal standing with another, such as in age, gender, disability and life experiences.

A peer is someone who may or may not be like us in obvious ways, but is someone with whom we share a basic humanity, uniqueness, or experience DEFINITION

All people share universal human experiences By virtue of this shared humanity, we are all peers DEFINITION

SUPPORT –verb 1. to undergo or endure, esp. with patience or submission; tolerate 2. to sustain (a person, the mind, spirits, courage, etc.) under trial or affliction: They supported him throughout his ordeal 3. to maintain (a person, family, establishment, institution, etc.) by supplying with things necessary to existence; provide for: to support a family –noun 4. a person or thing that gives aid or assistance

System of giving and receiving help founded on key principles of respect, shared responsibility, and mutual agreement of what is considered to be helpful Provided by people with disabilities to people with disabilities PEER SUPPORT

Has been recognized as an invaluable and effective adjunct to professional health services Peer support work is based on a recognition that peers could understand feelings and personal issues concerning disabilities better than non-disabled professionals, certain areas of service were pinpointed as pertinent to peer involvement; these areas included information and referral, skills training, emotional support, self-exploration, problem identification, goal setting, action planning, and goal attainment monitoring. (NIHR 1984) PEER SUPPORT

Mutual respect Optimistic outlook Empowerment of the client –Understanding that the client has the solutions to his/her own problems and does not need your advice or direction Genuineness –being oneself –authenticity CHARACTERISTICS

Acceptance of differences –does not mean agreement, but acceptance based on respect Empathy –allowing oneself to feel with another person Intention to be of service to another CHARACTERISTICS

Designed to bring answers and support to people with newly acquired disabilities, as well as people who have had disabilities for some time PEER SUPPORT PROGRAM

Besio and Mahler (1993) cite a number of benefits of utilizing consumers/survivors as service providers, including empathy and understanding, tolerance of unusual behaviors, ease of relating to service recipients, knowledge of available resources, positive role modeling and a strong sense of responsibility for clients. They also emphasize that peer support provides a level of care not available by professionals. PEER SUPPORT PROGRAM

An individual who has adjusted well to their disability, and wants to assist others in similar situations to do the same. PEER VOLUNTEER

Meet with participants with similar disabilities and share information about adaptive equipment, family and marital issues, transportation, employment and education Sharing experiences & information –Emotionally –Physically –Psychologically PEER VOLUNTEER

Increases feeling of self-worth and accomplishment—contributing to help another & the community “Inspiring” others often inspires the peer volunteer Improves interpersonal and communication skills PEER VOLUNTEER BENEFITS

Provides opportunity to achieve a greater level of independence and self-sufficiency through role modeling and encouragement Participant is often encouraged to take sensible risks –Peer Volunteers can often accomplish this better than professionals PEER RECIPIENT BENEFITS

Peers can often motivate people to do things previously thought as impossible Development of better coping skills –Community –Red tape –Attitudes –Modifications –Adaptations PEER RECIPIENT BENEFITS

Often receive emotional support and new techniques for managing problems Learn self-advocacy skills Have a role model to follow to enhance self-worth, a sense of identification by reduction of isolation and separation PEER RECIPIENT BENEFITS

The benefits to the clients is clearly identified by whom state that through developing and drawing on social support, clients can gain knowledge and skills to assist their integration into the community. Clients can more easily relate and communicate with someone with whom they can identify, and they can gain a sense of hope and inspiration through interactions with peer support workers. (Besio and Mahler 1993) PEER BENEFITS

Why Identified need Other peer support programs National initiative

How SRAP workgroup Compilation of resources –CO AANNPST –SRAP workgroup –Public & private organizations –PPT, handouts, role playing

How Workshop program 1.Welcome & Intro 2.AgrAbility Overview and PS Training Goals 3.Peer Support, Supporters, and Supported 4.Coping with Disability 5.Effective PS Volunteer Methods 6.Volunteer Standards of Conduct 7.Pulling it All Together PPT, handouts, Peer Helper’s Pocketbook, & role playing

How Pilot tested with KS AgrAbility

Next Steps Resource release Assist SRAPS in launching their own peer support program Quarterly PS teleconferences Establish the National Peer Support Network(NoPerSoNalone)

Help where help will be accepted Enable self directed solutions Referrals Do no harm –Be safe to self and others BOTTOM LINE

National AgrAbility Project

Promoting Independence in Agriculture AANNPST (Rev b) Colorado AgrAbility Project— Peer Support Train-the-Trainer Training Jackson, MS By Robert J. Fetsch, Extension Specialist & Director, Colorado AgrAbility Project, Human Development & Family Studies Colorado State University

Promoting Independence in Agriculture History— AgrAbility Neighbor-to-Neighbor Peer Support Train the Trainer Training —We visited with AgrAbility Staff: Bill Field, Paul Jones, Paul Leverenz, Mary Yearns, Dan Robbins, Cheryl Skjolaas, and others.

Promoting Independence in Agriculture History— AgrAbility Neighbor-to-Neighbor Peer Support Train the Trainer Training —We found in the research literature 10 stages from denial to joy of life.

Promoting Independence in Agriculture We found in the research literature 10 stages from denial to joy of life. Denial & Shock Mourning & Withdrawal Anger & Blame Bargaining Depression

Promoting Independence in Agriculture We found in the research literature 10 stages from denial to joy of life. Reassessment & Reaffirmation Coping & Mobilization Dialogue Self-Acceptance & Self-Esteem Joy of Life

Promoting Independence in Agriculture History— 10 stages –It’s not a linear process. –It’s a dynamic process. –Family members too. –Let’s be vigilant and refer.

Promoting Independence in Agriculture History— —We asked questions: –How long is realistic to expect farmers/ranchers to take off from work to learn about peer support? –What are the core skills that peer support advocates need to learn to provide effective peer support?

Promoting Independence in Agriculture 33 What Are the Core Skills? 1.Connect well. 2.Listen actively. 3.Problem-solve. 4.Spot signs of high stress, anger, depression, and suicidal thinking. 5.Make effective referrals to appropriate professionals.

Promoting Independence in Agriculture 34 3 Keys to Effective AANNPST Training: 1)Screen Well! 2)Teach Well! 3)Assess Well!

2003 U. S. Suicides - by State Deaths Per 100,000 Population

Suicide rates per 100,000 population by state and US Source: Retrieved October 24, 2006 from

Suicide rates per 100,000 population by state and US Source: Retrieved October 24, 2006 from

National Institute of Mental Health Current Suicide Rates in U. S.

Promoting Independence in Agriculture 39 We use practical handouts and resources. We provide science-based information. We are conducting an evidence-based program effectiveness study of what works in peer support programs with farmers and ranchers with disabilities.

Promoting Independence in Agriculture 40 How do we teach? 3 ways. Lecture/cognitive learning. Role play/experiential learning in dyads/triads. Self learning on one’s own.

Promoting Independence in Agriculture 41 From previous research, what do we now know? That high-dosage training programs work well and are effective with non- farm/ranch groups.

Promoting Independence in Agriculture 42 From previous research, what do we not know? Whether a 1-2 day peer support trainings are effective with groups of farmers/ranchers with disabilities and caregivers. CO and OK are poised to find out! Won’t you join us?

Promoting Independence in Agriculture 43 How many workshops since inception? 7/15/2004 AgrAbility Neighbor-to- Neighbor Peer Support Program Training, Denver, CO—7 CO farmers & ranchers with disabilities and caregivers.

Promoting Independence in Agriculture 44 How many workshops since inception? 5/10-11/2005 AgrAbility Neighbor-to- Neighbor Peer Support Program Train- the-Trainer Training at the request of Doug Carmon and Cheryl Skjolaas, Kansas City, KS—19 AgrAbility staff participants from CA, CO, DC, IA, IL, IN, KS, MI, NE, OK, PA, and SD.

Promoting Independence in Agriculture 45 How many workshops since inception? 4/18-19/2006 AgrAbility Peer Advocate Training at the request of Carla Wilhite and Linda Jaco, Stillwater, OK—7-9 OK farmers and ranchers.

Promoting Independence in Agriculture 46 What feedback did we get from participants?

Promoting Independence in Agriculture 47 What are some challenges and successes of running this program?

Promoting Independence in Agriculture 48 What are our future plans, e.g. helping other SRAP’s launch their program?

Promoting Independence in Agriculture 49 Thank you very much!

Kansas AgrAbility Experience Kansas AgrAbility Experience Jackson, MS Kerri Ebert Promoting Success in Agriculture for People with Disabilities and their Families

51 When and why did we decide to start a Peer Support Program? When  2003 discussed by Advisory Committee  2005 Hosted multi-state training in Kansas City  Included in plan of work for new grant application submitted in 2005 Why  Need articulated, but reservations about “getting in over my head”  Add dimension to services offered by AgrAbility Project  Fill a perceived need

52 Initial Peer Support Training July 2006 –Two, half days – afternoon through noon – including group dinner 12 invited farmers – 8 RSVPs – 4 showed 2 part-time participants 3 AT Ag Specialists participated

53 Feedback Farmers were enthusiastic Desire to give back to the Project and to serve fellow farmers “I had help and I want to give something back.” “I would like to help someone if I can, within my boundaries.” “I want to be able to tell and show people that anything is possible. Where there’s a will there’s a way.”

54 Resources Initial training partner = National AgrAbility Project –We agreed to pilot test training materials –We were challenged to find in-state experts for presenters Presenters –Charlie Griffin, Kansas Rural Family Helpline Assistant Professor of Family Studies and Human Services Background in rural mental health, chemical dependency counseling, stress management, crisis intervention, and biofeedback training; formerly private practice marriage and family therapist An established KAP partner in outreach to rural Kansans –NAP & KAP Staff

55 Challenges / Opportunities Challenges  Identifying peer supporters  Encouraging farmers to access our trained peer supporters  Continuing education and support for trained peer supporters Opportunities  Promote greater awareness of Project  Add depth to services offered by Project  Meet a need in the agricultural community

56 Unintended Outcomes  Our AT Ag Specialists gained a greater understanding of the Project and the possibilities of Project participation  Helped our AT Ag Specialists expand their network of resources

57 Future Next training in Fall 2007 Explore training for children with a parent who has a disability Continue to develop in-state network and cooperate with surrounding states and NAP Incorporate Colorado survey tool to help populate that database