Tools

1. Sample Funding Proposal

Here is a copy of the successful funding proposal for the Helping Skills project It was developed by Moyra Buchan, Executive Director of the Newfoundland and Labrador Division of the CMHA.

Building Helping Skills Executive Summary

1. Applicant

The Canadian Mental Health Association, Newfoundland Division. Established 1964, incorporated May 11, I 984.

Mission: To promote the mental health of all people, through public education, advocacy, service, research and community development.

2. Project Partners

CMHA will be working in collaboration with Community Health Boards in two health regions, partner agencies involved in the provision of mental health services (mental health units, public health nurses, social services offices. school guidance counselors) and with volunteers from various groups within communities (e.g. Women’s Institutes, displaced workers, parent-teacher associations, retired teachers) who are interested in becoming peer counsellors.

3. Purpose and Reason

To build partnerships between the formal and informal sectors in the area of mental health; via a mentoring and skill transfer process, to increase the knowledge, skills and involvement of community members in supporting their peers and addressing the health needs of their communities.

The health care restructuring process in Newfoundland is taking place at a time when many individuals, families and communities are under unprecedented stress as a result of the failure of the fishery. Community health boards are seriously under-resourced, existing helping services are stretched to breaking point, and there is an urgent need to develop alternative support networks.

4. Benefits

The "Train-the-Trainers" and skill transfer process will develop understanding of the basic human skills of helping and clarify areas where professional intervention is needed. By mobilizing and strengthening informal helping resources, professional helpers will develop a network of alternatives and increase the efficient use of scarce services. Peer helpers will expand the knowledge and skill base within the community, increase the sense of community responsibility for and participation in health issues, and enhance the community’s ability to identify and advocate for its needs. The process of collaboration between sectors will help to increase understanding on the part of all partners of the kinds of role shift required of them in the changing health care system.

5. Continuity

   The support network established among local professional and non-professional helpers in the course of the project will be self-sustaining by its completion and the continued involvement of the peer counselors and the repetition of the training program for new recruits as required. The model and Resource Manual will enable the process to be replicated in other regions.

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Sponsoring Organization

The Canadian Mental Health Association, Newfoundland Division, is a voluntary, charitable organization established in 1964, Registered Charity # 0008144-11. Its mandate is to promote the mental health of all Newfoundlanders through public education, advocacy, services, research and community development. It has local branches in Gander, Trinity-Conception and Labrador West which are represented on the 16 person provincial Board of Directors. Membership includes consumers, family members, service providers and members of the community.

The CMHA Division Office in St. John’s serves as a mental health resource centre which provides information and referral services for the province at large. Through special projects, CMHA carries out research and community development and pioneers new responses to mental health needs. In the present environment of rapid social and economic change in the province, the Division is working to develop new ways for people to cope with the stresses of daily living, such as unemployment, family problems and illness.

Since 1990, CMHA has developed a province-wide self-help network for consumers of mental health services and a support network for family members and caregivers; has sponsored self-help initiatives in other areas including gambling addiction and sexual abuse; has completed a Community Needs Assessment which gathered information about the effects of the fishery crisis on people in rural communities; and has published a Directory of Counselling Services and a Directory of Self-Help Groups for the St. John’s area.

The present proposal responds directly to information gained through the above activities. CMHA’s "Needs Assessment for Community Self-Help" (1994), an earlier project supported by the Health Promotion Contribution Program, documented the tensions and anxieties caused by the collapse of the cod fishery, the stresses of financial hardship and loss of occupation, the conflict within communities between those who are on "the package" and those who are not. We have heard from community members, professional and non-professional alike, about the need for social support networks and helping resources (see Appendix A). The lack of available, affordable counseling services has been demonstrated through the Directories we have compiled, as well as by many of the over 3000 inquiries received in the last year. As the restructuring of health care services progresses, the need for a range of community alternatives becomes increasingly urgent.

CMHA Newfoundland Division is well placed to sponsor an innovative response to these issues. The Division has had substantial experience in the development of the informal sector and the processes through which individuals become empowered to assume responsibility for their own health issues, through self-care, mutual aid and advocacy. The proposed project represents an extension of previous initiatives in that it aims to mobilize informal resources and facilitate skill development within communities to address the emotional and social problems that people are experiencing.

The Division is grounded in the principles of community development that are needed in a mentoring and skill transfer process. As well, it is known for its work in self-help development, and will be a credible facilitator for a cooperative effort between the formal and informal sectors.

Because of its limited resources and the wide range of issues and concerns that come within its mandate, collaboration is a basic mode of operation for Newfoundland Division. It has a web of working partnerships with other organizations and agencies in both the formal and informal sectors, which enable resources to be maximized and duplication of effort avoided (e.g. Coalition of Mental Health Partners, CMHA Coalition for Families, Women’s Health Network). CMHA is thus attuned, from hands-on experience, to the key concepts governing the restructuring of health care services.

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Issues To Be Addressed

The restructuring of health care services is taking place in the context of particular needs in Newfoundland and Labrador. The shift to a community-based, health promotion perspective is happening in the midst of a painful transition resulting from the cod moratorium and the reduction in transfer payments. This pain is felt at every level - individual, family, community, region and province.

The community health boards charged with the responsibility to implement the health promotion mandate are seriously under-resourced. In the area of mental health, the coordinators recently appointed in three regions are reporting social and emotional distress in communities to which they have no means of responding. Affordable counseling services are desperately lacking in this province and are virtually non-existent in rural areas. The priest, the family doctor and the public health nurse are the local overstretched resources, and people wait up to a year to see psychiatrists and other mental health professionals.

There is an urgent need to develop the capacity of communities to respond to their immediate needs and in so doing identify the issues which have to be addressed at a systemic level. When people have an opportunity to deal with their immediate distress, it becomes possible to mobilize energy to address the larger advocacy issues.

Isolated Newfoundland communities have historically been extraordinarily resourceful in dealing with their own human problems and survival issues. Helping skills, indeed, are natural human abilities possessed by many individuals and readily recognized by those who turn to them for support. In recent decades, however, such skills have been defined and taught by professions such as social work, psychology and nursing, and developed to a high level of sophistication by psychotherapists and counselors. This "professionalization" of helping, and the placing of ultimate trust in the expert, have in many ways undermined the role of informal resources. There exists a kind of mystique about professional counseling that engenders lack of confidence for many people in their own helping abilities. As a result there is great anxiety about the changes in service structures and reduced access to institution-based services.

Just as, at the macro level, institutions are returning to communities the responsibility for maintaining health, so at the micro level individuals will have to reassume some of the knowledge and control over their health issues that have been vested in professionals and "experts". The purpose of this project is, therefore, via a mentoring process, to regenerate and develop the informal human resources existing within communities for peer helping and supportive counseling.

Project Rationale

Rural communities are facing unprecedented challenges in dealing with the emotional and social problems people are experiencing as a result of the fisheries disaster and the consequent stresses on their finances, relationships and morale.

The helping resources that exist are limited and overburdened -TAGS employment counselors, public health nurses, social services workers, school guidance counselors. Many of these helpers are feeling overwhelmed by the range and intensity of the personal and family problems that people are bringing to them, and they need additional human resources and a network of support.

Effective supportive counseling involves skills which can be taught and learned. Within Newfoundland communities, there are individuals with the time and interest, along with a natural aptitude and experiential knowledge, who can be recruited as peer counselors - for example, retired teachers, former fisheries workers, volunteers with the Women’s Institutes. Local helping professionals have the background, together with knowledge of the current situation, which provide a strong basis for modeling helping skills and passing these skills on to potential peer- counselors. The process of skill transfer also provides the basis for the development of a support network and access to informal helping resources for those providing the front-line response to social and emotional needs.

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Project Description

Over an 18 month period, this project will establish a corps of community trainers in two health regions, and provide training, consultation and guidance to these individuals in developing and sustaining a network of peer counselors within their regions. Using a process of skill transfer and mentoring, the project will create and pilot a model for skill development in the informal sector, and will also build networks of support for those involved in dealing with emotional and social problems in communities where few other resources exist.

The project will be divided into three phases. In the first six months, contacts will be established with the Community Mental Health Co-ordinators and candidates sought from partner agencies in the region which will be asked to commit a portion of their employee’s time to this project. Consultation will be carried out with the Co-ordinators as well as with the ten counsellors selected as trainers regarding their learning needs. The training program will then be prepared, along with a Resource Manual for the trainers’ use. The ten trainers will spend two weeks in full-time learning with the consultant. They will then return to their regions and, over a period of ten weeks, recruit interested and appropriate people from the community to become peer counselors. Teleconferences will be held twice during this recruitment period for consultation and discussion of issues arising.

During the second six months, the focus will be on the transfer of skills by the trainers to the peer counselors within their area. This will be accomplished through 20 weekly group sessions, using the teaching and mentoring methods modeled by the consultant in Phase I. Back-up will be provided by the consultant throughout this period via teleconferences, individual contact as required, and two visits to each of the ten areas to attend a group session. In the final month of this phase, the ten trainers will again spend three days full-time with the consultant, to evaluate the training process and plan ahead for the monitoring and maintenance of the peer counseling network.

In the final six months, the peer counselors will receive referrals from various sources, including self-referrals. Consultation will be carried out via monthly support meetings, facilitated by the trainers. During this time the project consultant will be available for problem-solving and guidance, and will make two further visits to each area. At the end of this period a comprehensive assessment of the effectiveness of the skill transfer process will be carried out by an independent evaluator.

Participation Of Target Population

The project will involve the building of active partnerships between the formal and informal sectors in the area of mental health. The cooperation of agencies in the areas of health, social services and education will be enlisted to commit a portion of selected employees’ time to being community trainers of peer counselors. Volunteers from the community at large will be recruited as peer counselors. At the project’s completion, there will be five trainers and fifty peer counselors active in each participating region.

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Project Goals And Objectives

Goals:

• To create a model for developing informal helping resources
  
  
• To build partnerships between the formal and informal sectors in the area of mental health
  
  
• Under the direction of an experienced mental health professional, to pilot a training program and learning process involving mentoring, skill transfer and consultation; to establish a corps of trainers who are helping professionals in two health regions; and to develop a network of rural peer counselors with the skills to appropriately refer or otherwise assist people with serious emotional or social needs
  
  
• to develop a network for support, referral and on-going consultation for helping professionals and peer counselors

Objectives:

• To develop and pilot a "train the trainers" program for a selected group of professional. To develop and pilot a "train the trainers" program for a selected group of professional counselors from two health regions, which will enable them to facilitate the learning of effective counselors from two health regions, which will enable them to facilitate the learning of effective helping skills by peer counselors helping skills by peer counselors
  
  
• To use, and teach how to use, a mentoring model in transferring learned skills in the following areas:

• recognizing and dealing with people’s anger, frustration and despair
  
• helping people express their feelings in a way that prevents them from getting "stuck"
• helping people to keep moving on emotionally so that they can make appropriate decisions for themselves
• dealing with the lack of other helping resources
• dealing with "casualties"
• making conscious use of one’s own responses in helping others

• To provide support and consultation during the skill transfer period and develop a network for on-going support and consultation, addressing issues such as:

• dealing with the counselor’s own anger and feelings of helplessness
• creating a safe environment in which counselors can get and give support to each other and reduce burnout

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Work Plan

Method

Mentoring is a process whereby a person with expertise and experience enables others to learn through a combination of direct teaching, modeling behaviour and providing support to the learners in their development. In this case, a professional counselor with extensive experience in teaching the skills of helping to non-professionals, will share the modeling and skill-transfer process with the group of trainers, including the struggles, risks and difficulties, and provide support to the trainers in carrying through this process.

The Project Consultant will work with a group of approximately ten counselors (five from each of two regions) who will be selected by the Community Health Board Mental Health Co-ordinators on the basis of demonstrated aptitude for the skill transfer process. The issues the counselors are facing will be identified through group discussion. They will then identify and practice skills in responding to these issues, using a combination of role-playing, observation, feedback, modeling, case consultation, and group and individual problem-solving.

Skills focused on will include:5

• active listening;
• reaching for feelings;
• sitting with discomfort ;
• problem solving:
• partializing (breaking problems down into components that can be tackled);
• reaching for strength;
• recognizing and trusting people’s ability to get through setting mutual boundaries of responsibility;
• confronting effectively;
• self-care.

The training program will also deal with:

• the process of assessment and referral;
• how to use the range of resources available:
• recognizing and avoiding "rescuing";
• recognizing and avoiding "victimizing";
• how to make helping contracts;
• how to deal with the pressure to find solutions in a situation where there are no solutions.

Throughout the training the emphasis will be on modeling and teaching these skills to peer counselors without the same professional background. The community trainers will be provided with a resource manual, consistent follow-up and consultation as they implement the training with peer counselors in their areas.

Roles and Responsibilities

The project consultant will be responsible for orienting partner agencies to the project and developing the "Train-the-Trainer" program and Resource Manual in response to learning needs identified. This person is the pivot of the learning and skill transfer process.

The community trainers will be responsible for recruiting peer counselors, for implementing the skill-transfer process over a series of 20 sessions, and for facilitating follow-up support sessions for the peer counselors.

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Model

The project would serve two health regions in the province via the following model, with a view to replicating the process in other regions of the province or country:

Timetable

PHASE I: TRAINING THE TRAINERS

Month 1

• Contact with Mental Health Co-ordinators and partner agencies (Mental Health Units, Social Services Offices, Guidance Counseling Program)
  
  
• Selection of trainers
  
  
• Consultation re: learning needs

Month 2-3

• Preparation of Training Program and Resource Manual

Month 4

• 2 weeks full-time "Train the Trainer" program
  
  
• (20 half-day units)
  
  
• teleconference follow-up

Month 5-6

• Recruitment and orientation of Peer Counselors
  
  
• Two teleconferences and individual consultation as needed
  
  
• Evaluation of Phase 1

PHASE II: TRANSFERRING THE SKILLS

Months 7- 12

• 20 weekly group training sessions (trainer and ten peer counselors)
  
  
• One teleconference per month for trainers with consultant; individual contact and consultation as needed
  
  
• Two visits to each area by consultant; attend group consultation sessions; individual sessions with trainers
  
  
• Evaluation of Phase II
  Three day planning session (consultant and trainers)

PHASE III: MAINTAINING THE NETWORK

Months 13 - 18

• Peer counsellors in action
  
  
• Monthly support sessions with trainer
  
  
• Monthly teleconferences (consultant and trainers) and individual contact as needed
  
  
• Two visits to each area by consultant Comprehensive evaluation

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Opportunities For Collaboration

This project provides the opportunity for innovative partnerships between different parts of the formal sector involved in responding to mental health needs (hospital mental health units; school guidance counselors; social services, etc.) and individuals with various backgrounds in the community women’s Institutes, churches, service groups, parent-teacher associations, etc.) Mental Health Advisory groups which bring various agencies together already exist in several areas, and with the support of the Regional Mental Health Co-ordinators, these would be an avenue for securing the involvement of local professionals in the project. This will also be an arena where commitment to involving members of the community in meeting health needs could be developed and engaged.

Dissemination Of Results

The Final Report and evaluation of the skill transfer model will be circulated to all health boards and their mental health advisory bodies within all five health regions of the province, and to all Ministries of Health and CMHA Divisions across the country. The Resource Manual will be made available to jurisdictions wishing to replicate the process of developing the informal sector.

Evaluation

The evaluation will address the following components:

1. Training Program
2. Trainers evaluation of skill transfer process
3. Peer Counselors evaluation of skill transfer process
4. Consumers response
5. Community response
6. Partner agencies perspective

The evaluation will take the form of questionnaires and personal interviews, administered to the trainers at the end of Phase I and to the trainers and peer counselors at the end of Phase II. The questionnaires will address both content and process. There will also be an oral evaluation during the three-day meeting at the end of Phase II. In the final months of Phase Ill, information would be gathered from all participants, including consenting consumers, members of the community and partner agencies about the overall effectiveness of the skill development process and the use of peer counseling resources in rural communities.

The responsibility for administering the evaluation would be sub-contracted.

Project Consultant

The Project Consultant will be Susan McConnell M.S.W. Ms. McConnell is a practicing psychotherapist with many years of experience in counseling, teaching and consulting on a wide range of social/emotional issues. She has extensive experience of teaching helping skills to people who do not have a formal background in counseling, and served as consultant and trainer for a CMHA project on self-help for survivors of sexual abuse. Ms. McConnell’s resume is attached.

The position will be full-time for a total of 20 weeks (eight weeks for consultation and development of training program and resource manual; two weeks for training program; ten weeks travelling, covering five visits each to two regions and five areas within each region). Follow-up consultation and teleconferences are estimated to require an average of six hours per week for the other 58 weeks of the project’s duration.

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