TIPping Forward: Creating Your Own Path Transition to Independence Process

Introductions Warm Up Activity

Objectives To share one program’s experience in starting up and using the TIP model To overview some basic components of the TIP model and explore why it is unique To hear about the success of the TIP approach from both the people providing the service and the young people receiving the service To offer suggestions for implementing the TIP model in your programs

Comparison of Transition Domains Between the General Population and People with Emotional Disturbance The Need for Supports and Resources for Transition Age Youth: National-Level Studies, Legislation, and Trends National Network on Youth Transition

The Need for Supports and Resources for Transition Age Youth: Notable System Barriers Separate funding streams and criteria for adolescent and adult services Lack of coordination, planning, and understanding between the adolescent and adult serving systems Lack of expertise and focus on addressing the critical developmental needs of transition age youth in both the child and adult serving systems Lack of quality trauma treatment Lack of co-occurring mental health and substance abuse services Lack of affordable housing

The Need for Supports and Resources for Transition Age Youth: Local Needs and Trends Individual and group interviews with over 80 youth and young adults Individual and group interviews with over 60 professionals working with the Transition Age Youth population Focus group with nine Bucks County adults/community leaders currently providing young adults with informal community-based support Bucks County Transition Age Youth (TAY) Workgroup/Voice and Vision Community Needs Assessment – 2007

The Need for Supports and Resources for Transition Age Youth: Local Needs and Trends The power of peer support/social network/grouping young adults The strength that youth and young adults have found through personal connections (with staff/peers) The need for supportive and encouraging people in their life The need for transition age youth to have “normal teenage” experiences and test things out in a safe environment The importance of meeting youth and young adults “where they are” Bucks County Community Needs Assessment Findings

The desire to combat stigma surrounding mental illness The need for greater system flexibility The desire for increased mentoring/leadership development opportunities Practical skills training to help better manage one’s life/education and to get ahead Young people expect to be responsible citizens and to be held accountable but they also want their personal rights to be respected and safeguarded The Need for Supports and Resources for Transition Age Youth: Local Needs and Trends Bucks County Community Needs Assessment Findings

Two organizational platforms from which TIP can operate: Case Management Platform- where the young person is assigned to a TIP Facilitator Psychosocial Rehabilitation Platform: this platform encourages individuals to participate actively with others in choosing and reaching mental health and social competence goals TIP Platform Considerations

Reflects both adolescent and adult systems- did not need a waiver to support individuals under 18 Focuses on goals that are driven by the young person and a process that fully embraces self-determination Allows for less or more intense facilitation as needed BCM Platform Advantages

The Transition to Independence Process (TIP) Model System best practice for working with Transition Age Youth Developed by Hewitt B. “Rusty” Clark, Ph.D., BCBA University of South Florida Key elements:  Case Study Protocol for Continuing System Improvement - used to assist stakeholders in establishing a profile of the system’s areas of strength and weaknesses.  TIP System Guidelines - built on the underlying transition values that are critical for clinical programming or support provision

What Is TIP? TIP is….. Developed for working with youth and young adults with Emotional and/or Behavioral Difficulties A strengths based, futures planning process spanning five Transition Domains Rooted in seven Model Guidelines An empirically supported model Part of a county initiative to support Transition Age Youth

TIP’s Goals Support youth…  Through the transitional age period  In defining their own goals across the five Transition Domains  In becoming engaged in their own futures planning  Through Strengths Discovery and exploring their own interests  By breaking down their goals into more manageable, smaller steps, to make them more achievable

A Focus on Recovery and Resilience Self-Direction Individualized and Person-Centered Supports Empowerment Holistic Support Non-Linear Recovery A Focus on Strengths Peer Support Respect Responsibility Hope To help youth achieve these goals, TIP focuses on the Recovery and Resiliency principles:

Transition Domains

Educational Opportunities (Career-Track Training) Bachelor’s degree or beyond Associate’s degree Vocational or technical certification High school diploma or GED certificate Work place educational programs where placement is related to school/college/enrollment

Transition Domains Employment & Career Competitive or entrepreneurial employment site (e.g., apprenticeship with employee serving as coworker mentor) Supported employment (e.g., working with a job coach or mentor) Volunteer employment Job shadowing

Transition Domains Living Situation Independent residence Residing with natural, adoptive, foster, or other family Semi-independent living Supported living Group home or boarding home

Transition Domains Personal Effectiveness & Wellbeing Interpersonal Relationships Emotional & Behavioral Wellbeing Self-Determination Communication Physical Health & Wellbeing Parenting

Transition Domains Community-Life Functioning Daily Living Leisure Activities Community Participation

TIP’s 7 Model Guidelines Guidelines

Model Guideline 1  Engage the young people through relationship development, person-centered planning, and a focus on their futures. Use a strengths-based approach Build relationships Facilitate futures planning and goal setting Including prevention planning for high-risk behaviors and situations Engage young people in positive activities of interest Respect cultural and familial values and young persons’ perspectives

Model Guideline 2  Tailor services and supports to be: Accessible Coordinated Appealing Non-stigmatizing Developmentally appropriate

Model Guideline 3  Acknowledge and develop personal choice and social responsibility with young people. Encourage problem-solving methods, decision making, and evaluation of impact on self and others Finding a balance between: Maximizing the likelihood of the success of young people And Allowing young people to encounter natural consequences through life experience.

Model Guideline 4  Ensure a safety-net of support by involving a young person’s parents, family members, and other informal and formal key players. Involve parents, family members, and other informal and formal key players Support key players in understanding this transition period Assist in mediating differences Facilitate an unconditional commitment to the young person among his/her key players Create an atmosphere of hopefulness, fun, and future focus

Model Guideline 5  Enhance a young person’s competencies to assist them in achieving greater self-sufficiency and confidence. Utilize information and data from strength discovery and functional assessment methods Teach meaningful skills Use in-vivo teaching strategies Develop skills related to self-management, problem-solving, self-advocacy, and self-evaluation of the impact of one’s choices and actions on self and others

Model Guideline 6  Maintain an outcome focus in the TIP system at the young person, program, and community levels. Focus on the young person’s goals and the tracking of his/her progress Evaluate the responsiveness and effectiveness of the TIP system Use process and outcome measures for continuous TIP system improvement

Model Guideline 7  Involve young people, parents, and other community partners in the TIP system at the practice, program, and community levels. Maximize the involvement of young people, family members, and other informal and formal key players, and relevant community representatives Tap the talents of peers and mentors Partner with young people, parents, and others in the TIP system governance and stewardship Advocate for system development, expansion, and evaluation – and for reform of funding and policy to facilitate implementation of responsive, effective community transition systems for youth and young adults and their families

Our Experiences with TIP

What Makes TIP Different? A Matter of Focus

What Makes TIP Different? Focus 90% of your time on solutions and 10% Of your time on problems. -Anthony D’Angelo

What Makes TIP Different? TIP vs. Treatment Person Centered Goals based on desired personal outcome – Functional goals and treatment goals connected to personal outcome Relationship driven Based on assessment of problem Goals based on reducing symptom(s) – Focus often on treatment w/ idea that functional and personal goals will follow Role driven

What Makes TIP Different? TIP vs. Treatment Practice skills in live environment Stays with level of internal motivation – Engages ambivalence, resistance – Helps anticipate natural consequences Sometimes practiced in treatment environment, w/ goal to generalize External effort to increase motivation – “righting reflex” – External consequences

What Makes TIP Different? TIP vs. Treatment Measures work against personal outcome in a domain Generating self- sufficiency is built into the approach – Developing the “DIY” muscles – Developing supports Measures work in terms of improvement or progress Might be part of the process; not required

What Makes TIP Different? Role-Play Exercise

What Makes TIP Different? “Things don’t go wrong so that you can become bitter and give up. They happen to break you down and build you up so that you can be all that you were intended to be.” -Charles “Tremendous” Jones

Who Do We Serve? Serving Youth ages in Bucks County Youth who have Emotional and/or Behavioral Struggles (Axis I diagnosis) Youth who have Medical Assistance – All referrals are reviewed in partnership with Bucks County Behavioral Health, Bucks County Department of Mental Health/Developmental Programs, and Magellan Behavioral Health of PA.

TIP Facilitators Facilitators will support approximately 9-12 youth Have a Bachelor’s in Human Services Work in the home, school, and community settings Can function as a coach to guide youth through planning and goal-setting processes Work to build continuity between services and supports and encourage youth’s goals to be the focus Facilitators utilize in-vivo teaching Can be reached via 24/7 Crisis Phone

Certified Peer Support Specialist All youth will also have access to our Certified Peer Support Specialist CPSS will partner with the Transition Facilitators to support the youth, act as a peer mentor WRAP Certified Support youth with advocating for themselves and making their voice heard Participates in MYLIFE, etc. Currently growing our CPSS capacity

New Transition Handbook Transition of Youth and Young Adults with Emotional or Behavioral Difficulties: An Evidence- Supported Handbook by Hewitt "Rusty" Clark, Ph.D., and Deanne K. Unruh, Ph.D. If you have any questions regarding NNYT or the TIP model, please contact: Hewitt B. “Rusty” Clark, Ph.D., BCBA, Nicole Deschênes, RN, M.Ed.,

Research Findings on the TIP Model Guidelines & Practices For summaries of progress and outcome studies, please visit website: Theory & Research Button on the TIP website – Some Additional Resources: Transition to Independence Process –– TIP website: – TIP System Development and Operations Manual TIP Manual – Personnel Training Modules/Personnel Modules – Theory and Research Basis for TIP System National Center on Youth Transition –– NCYT website: – Building Site Capacity