Discussion Notes
Reach One, Teach One:
The Peer Educators Project in Action

Where individuals with a psychiatric condition come together to share experiences, strength, hope, coping skills, and resources.
Written by: Jennifer Tripp Massachusetts
Behavioral Health Partnership

What is the Peer Educators Project?

The Peer Educators Project is a state-wide effort to reach out and offer non-traditional support to individuals with serious mental illness and co-occurring disorders. This project was launched as a collaboration of the consumer leadership of Vinfen Corporation (a major provider of psychiatric rehabilitation services in Massachusetts) and the Massachusetts Behavioral Health Partnership (a managed behavioral health organization and a General Partnership of ValueOptions). The goal of the project is to recruit and develop Peer Educators throughout the Commonwealth to teach others about the recovery process by facilitating peer educators' groups, thus expanding the recovery community.

The value of peer education and support has been recognized by the Massachusetts Behavioral Health Partnership and its clients, the Massachusetts Division of Medical Assistance and Department of Mental Health, who have established specific contractual performance goals for developing and enhancing peer support throughout the Commonwealth.

Why This Video Was Made

There are two major reasons why this video was made:

1. To help educate consumers, families, clinicians, and policymakers about the purpose and value of peer education
2. To help train mental health consumers to facilitate peer educators' groups for others

What are Peer Educators Groups?

Since the 1970's, people with psychiatric conditions have formed self-help groups as a way to support and learn from each other. Too often, traditional mental health treatment fails to address the consumer's need to learn how to manage and live with his or her illness. Acting as peer educators, mental health consumers have been able to teach others who struggle with a psychiatric condition. Based upon their shared experience of mental illness, they provide inspiration and hope to their peers. Peer educators can make a significant contribution to the quality of life experienced by other consumers and to the effectiveness of the services they receive by teaching consumers to:

• Understand their illness
• Explore various coping skills
• Access and share information about community resources
• Become more effective self-advocates and partners with service providers
• Engage more fully in their own recovery

Showing the Videotape to Others

Before Viewing the Video

You may want to include some of the following information in your introduction to the tape:

In this video, you will see two models of peer education for people with psychiatric conditions. One is based on the Recovery Workbook and the other model is Double Trouble in Recovery. The Recovery Workshop groups are based on coping with the trauma of having a mental illness and are centered around principles of psychiatric rehabilitation. The Double Trouble in Recovery groups are 12-step groups for people coping with a psychiatric condition and alcoholism/addiction. At the end of the video, policymakers discuss why peer education groups like these are important components of a mental health services system.

After Viewing the Tape

Don't force a discussion too soon. Your group will probably want a quiet moment of contemplation. Then we suggest you begin with a short, open question. Below are examples of questions you may pose to get a discussion going, along with some possible responses.

Discussion Questions

1. What does recovery mean to you (or people you know)? How does it play out in people's lives?
   Examples:
   • Recovery is the ability to lead a rewarding and stimulating life
   • Recovery is a path or journey that people take to adjust their attitudes, feelings, beliefs, and goals in life
   • Recovery means different things to different people
     
     
2. What coping strategies are helpful in the recovery process?
   Examples mentioned in the video include:
   • Humor
   • Prayer/spirituality
   • Doing three things for yourself each week
     
     
3. How are peer educators' groups different from therapy groups? How are they similar?
   Differences demonstrated in the video include:
   • The peer educators groups are facilitated by individuals with a psychiatric disability
   • The peer educators share their own personal struggles and successes with the group members
   Similarities demonstrated in the video include
   • The groups may cover similar topics covered (coping skills, relapse prevention, etc.)
   • Some group members may participate more than others
     
     
4. How is the Double Trouble in Recovery (DTR) group different from Alcoholics Anonymous or other 12 step groups? How is it similar?
   Differences mentioned in the video include:
   • DTR's unique focus on having both a psychiatric condition AND an addiction
   • DTR groups accept that some people need to rely on medication
   Similarities demonstrated in the video include:
   • Both use 12-steps and encourage people to trust in a higher power
   • Both are self-help models
     
     
5. In the video, Melanie talks about her experience of discrimination by others (in her case, it was the police) when they learned that she had a psychiatric condition. Have you or someone you know encountered discrimination due to having a psychiatric disability?
   Examples of discrimination include:
   • Barriers in finding housing or employment due to discrimination
   • Your primary care doctor's not taking your concerns seriously
     
     
6. What did you learn about how to facilitate a peer educator's group? What would you like to learn more about next?
   Examples demonstrated in the video include:
   • Paying attention and listening carefully to what each person says
   • Reinforcing what others say by saying things like "That's sad" or "Great idea"
   • Validating what others say by repeating the gist of what they said in different words
   • Encouraging people to get involved in the conversation
     
     
7. What are some ways that mental health consumers can help get peer educators groups started?
8. What role can policymakers, family members, and provider staff play?

Suggestions on Facilitating a Peer Educators Group

Through peer educators' groups, individuals who have successfully coped with a psychiatric condition and/or addiction teach others about how to cope with their symptoms, advocate for themselves to get the services they need, prevent relapses, find resources in the community, and get support from others. The primary role of peer educators is to educate others. Peer educators are not considered peer counselors. To become peer educators, individuals first need to learn as much as they can about the recovery process.

• Facilitators: Peer educators' groups should be facilitated by one or two people with a history of a mental illness and/or substance abuse disorder. Facilitators often arrive 30 minutes early to help set up and stay 30 minutes late to talk with people individually.
• Confidentiality: Peer support groups offer confidentiality to the individuals who participate. Generally, group participants are discouraged from spreading rumors or sharing personal information about each other with people outside the group.
• Location: Peer educators' groups may be held at clubhouses, group homes, places of worship, mental health centers, hospitals, and other settings in the community. The groups should be held at a consistent time and place each week in order to make it easy for people to remember and attend.
• Refreshments: Light refreshments are a good way to encourage people to attend the groups and make them feel welcome.
• Structure: The structure of the peer educators groups is nontraditional, if you compared it to a therapy group. For example, people may leave the groups at any time to take a break and then return to the group. Some people may arrive late or leave early. Some people may sleep (or appear to sleep) during part of the group.

Tips for Facilitating Recovery Workshop Groups

Overview: The Recovery Workbook: Practical Coping and Empowerment Strategies for People with Psychiatric Disability was developed at Boston University's Center for Psychiatric Rehabilitation by Dr. LeRoy Spaniol, Martin Koehler, M.S. and Dori Hutchinson. It is designed to help individuals with psychiatric disabilities to understand their recovery process and develop practical skills needed to help them rebuild their lives. At the end of the series of groups, the facilitator should give participants certificates for completing the Recovery Workbook.

The Recovery Workbook is designed to help people in six areas:
1. To become aware of the recovery process
2. To increase knowledge and control
3. To become aware of the importance and nature of stress
4. To enhance personal meaning
5. To build personal support
6. To develop goals and a plan of action

• Structure: The facilitator asks a participant to read an excerpt from the Recovery Workbook, and then asks others to respond. "Did anything jump out at you in this excerpt?" The facilitator starts a general discussion about the excerpt from the Recovery Workbook and offers bits of guidance to the participants.
  
  
• Length and frequency of the group: The Recovery Workbook groups are often 12 week groups that meet once a week, although some may meet more than 12 times. Each group lasts 1 to 2 hours. Attendance is open and flexible. Some people may attend one group or may attend many of the groups, or all of the groups. Remain welcome and flexible to all people who wish to attend whatever their level of commitment. Just keep teaching the Recovery Workshop and encouraging people to keep coming.
  
  
• Materials: The Recovery Workbook: Practical Coping and Empowerment Strategies for People with Psychiatric Disability costs $29.95 and significant discounts are available for consumers, family members, and group purchases. To order, please contact:

  Center for Psychiatric Rehabilitation
  Sargent College of Allied Health Professions
  Boston University
  940 Commonwealth Avenue
  Boston MA 02215
  Phone: 617-353-3549
  FAX: 617-353-9209

Tips for Facilitating Double Trouble in Recovery Groups

Overview: Because addictions (both process addictions, like gambling, and substance addictions) are common for many individuals with mental illnesses, the Peer Educators Project uses a proven program, Double Trouble in Recovery. This model was developed by Howard Vogel of Double Trouble in Recovery, Inc. based in Albany New York. This program is a 12-step variation which was designed to address the special needs of persons recovering from mental illnesses.

According to the Double Trouble in Recovery (DTR) Basic Guide, Double Trouble is "a fellowship adapted from the 12-Step program of Alcoholics Anonymous and is founded upon equality, one dually-diagnosed person sharing and talking with, never down to, others. Many of us with substance abuse problems and mental dis-orders have followed the Steps and traditions of other programs that address either alcoholism or drug addiction. We needed a program that dealt with both alcoholism/drug addiction and mental dis-orders." (page 5-6)

• Structure: The groups follow a 12-step meeting structure. At the beginning of each meeting, individuals are asked to introduce themselves. Then the 12 steps and the philosophy of Double Trouble in Recovery are read aloud. Members then discuss their experiences in maintaining sobriety and coping with a psychiatric condition. At the end of the meeting, the participants say the Serenity prayer together.
  
  
• Length and frequency of the group: Double Trouble in Recovery groups meet weekly for one to two hours at a time, are ongoing, and are held in the community.
  
  
• Materials: How to Start and Run a Double Trouble in Recovery Group, by Howard S. Vogel, CSW, CASAC., and the Double Trouble in Recovery Basic Guide, cost around $7 each. To order, please contact:

  Double Trouble in Recovery Inc.
  261 Central Avenue
  Albany NY 12206
  Phone: 518-434-1393 or 1-800-MEHP-INC

For More Information

For general questions about the Peer Educators Project, please contact:

Naomi Pinson, Co-Founder
The Peer Educators Project, Vinfen
10 Laurel Street, Suite 6
Cambridge MA 02139
Phone: toll-free 1-877-2VINFEN (1-877-284-6336)
or 617-491-2457
Email address: PinsonN@shore.net

Moe Armstrong, Co-Founder
The Peer Educators Project, Vinfen
PO Box 390-812
Cambridge MA 02139
Phone: toll-free 1-877-2VINFEN (1-877-284-6336)
or 617-864-7203
Email address: moea@pop3.shore.net

For questions about administration, funding, and outcomes evaluations of the Peer Educators Project, please contact:

Jennifer Tripp, Manager
Prevention, Education and Outreach
The Massachusetts Behavioral Health Partnership
150 Federal Street, 3rd Floor
Boston, MA 02110
Phone: toll-free 1-800-495-0086 ext. 4049
or 617-790-4049
FAX 617-790-4185
Email address: jennifer.tripp@valueoptions.com

To request additional copies of the Reach One, Teach One video, please contact:

The Mental Illness Education Project Videos
22-D Hollywood Avenue
Hohokus, New Jersey 07423
Phone: toll-free 1-800-343-5540
Website: www.miepvideos.org

Who provided the support to make this videotape possible?

The following organizations provided significant support and resources to the production of this videotape:

Massachusetts Behavioral Health Partnership, a General Partnership of ValueOptions: A managed behavioral health organization under contract with the Massachusetts Division of Medical Assistance to manage mental health and substance abuse services for many people who have MassHealth (Medicaid) insurance.

Massachusetts Division of Medical Assistance: This state agency manages the MassHealth (Medicaid) program, which provides health care benefits to low income families and individuals living in the Commonwealth of Massachusetts.

The Mental Illness Education Project: This not-for-profit organization seeks to improve the care and prognosis of people with psychiatric disabilities through video-based programs for those with disabilities, their families, mental health professionals, students, and others.

Vinfen: A private, non-profit human service organization that provides a wide array of programs and facilities to help people with disabilities live independently and with pride. Vinfen serves thousands of consumers each year through acute care, residential, respite, day programs and crisis intervention services.

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