National Wraparound Initiative's Wraparound Blog
Innovations Institute Unveils PEARLS: A New Model for Parent Peer Support
September 24, 2023 | NWI
By Kim Coviello and Toni Donnelly
Peer-led services and supports have become a well-established component of systems of care for all types of individuals with complex needs. This trend has only accelerated as more and more research is published showing just how effective peers can be at promoting positive outcomes – and in response to the serious workforce crises confronting health and behavioral healthcare.
Parent peer support partner (PPSP) programs are a critical component in the comprehensive service array within a youth- and family-serving system of care. However, as for many other types of evidence-based practices, PPSPs must be trained, coached, supervised, and supported to provide support that is of high quality and based on principles of effective peer support.
The Frameworks that Support the PEARLS Model for Parent Peer Support Partners
The PEARLS PPSP model was developed by the Innovations Institute at UConn School of Social Work, in collaboration with Pat Miles. The model articulates and supports the work of PPSPs through comprehensive training and coaching. PEARLS outlines authentic and purposeful parent peer support based on two frameworks:
The first framework is the parent journey that focuses on and builds from each parent’s unique experience rather than from a system perspective.
The second framework consists of six core meta-skills that form the acronym PEARLS. These core meta-skills are demonstrated in each interaction with a parent for high quality PPSP work to occur:
- P: Establish a Peer-Based Relationship: A PPSP finds ways to establish, nurture and maintain relationships with parents that are based in the spirit of peer principles. This means that the PPSP works to understand each story while finding unique ways to build a strong connection based on strategic self-disclosure and shared experience. The PPSP is responsible for establishing that relationship. The highly skilled PPSP can establish that relationship with each individual parent they are supporting, even when this is challenging. The PPSP understands the parent journey framework and uses this tool to “meet the family where they are,” and can estimate the right fit and match of support in conversation with the parent/caregiver. The skilled PPSP is able to demonstrate the six guiding principles of a trauma-informed approach in all relationships with families.
- E: Encourage Parents to Grow in their Own Decision Making: The PPSP is concerned about building connection rather than forcing change. A PPSP is not a parent corrector or responsible for communicating to parents in a way that cause them to change. Instead, a skilled PPSP takes responsibility to understand the parent’s position and empower the parent to understand their own position. By providing purposeful and strategic support, the PPSP can empower the parent to make changes they want to make, rather than convincing them to make changes that others may want the parent to make.
- A: Active Acceptance: PPSPs communicate a sense of active acceptance to, and about, the parent, even when they find personal choices to be challenging. This sense of active acceptance becomes critical as the parent moves through their system journey. If the parent’s experience is grounded in shame or a sense of being judged, they are unlikely to experience a sense of empowerment. PPSPs communicate active acceptance and recognize the difference between acceptance and agreement.
- R: Respect: PPSPs build skills to continually hold the parent they are supporting with a sense of respect. This occurs in interactions with the parent, and also occurs in interactions about the parent. For example, a PPSP may find themselves participating in staff reviews with others working with the family. During those interactions, the PPSP works to communicate that sense of holding the parent in respect when interacting with others. This establishes a relational stance of respect from others to the parent. The PPSP also works to establish that sense of respect in the parent themselves, about their own choices and sense of identity. Building capacity for respect of self is a key responsibility of a highly skilled PPSP.
- L: Link with Others in Collaboration and Problem Solving: Parent peer support always happens in the context of other services. The PPSP may be the only person who has a primary focus on the parent while other service providers are concerned about the child/youth. This can result in the parent being viewed as secondary to the concerns of the child/youth. Most parents are quite comfortable with this as they search for resources and resolution for their child. The work of PPSPs involves not only focusing on the parent but recognizing that for the parent to maximize their sense of wellbeing, they will need to actively interact with others involved in providing care and service to their family. Working together establishes a sense of family wellness and recovery, rather than simply managing or eliminating symptoms. A skilled PPSP recognizes that effective parent peer support will work better when in a cooperative, solution-focused environment.
- S: Suspend and Interrupt Bias and Blame: Bias about parents exists in communities and in systems. An anti-parent bias is evident in many child- and family-serving systems. In some cases, this bias can be traced to a genuine concern about the well-being of the child. Even when the source of the bias is grounded in a positive frame such as concern for a child’s well-being, the skilled PPSP works to interrupt bias and blame. A highly skilled PPSP will interrupt that bias and blame as a learning experience, rather than simply shutting it down. This assures that the bias does not simply become hidden but instead is removed as a barrier to building strong connections.
The PEARLS Training and Coaching Certification Program
The PEARLS training and coaching certification program is designed to leverage these two central concepts to provide the parent peer workforce with the skills needed to deliver high quality, purposeful support to parents/primary caregivers of children/youth receiving services.
To date, the PEARLS coaching certification has been implemented by the Innovations Institute in several sites and communities, as well as statewide in Maine via their new Center of Excellence. In Maine, individuals with lived experience as a parent of a child/ youth with emotional, behavioral, and/or mental health needs who have received services for their child/youth will be hired as coaches and will participate in the PEARLS coaching/training certification program.
In Maine and beyond, the goal will be to help ensure that the parent peer workforce is well trained in best practices and supported to achieve sustainability of parent peer support across the state. We look forward to reporting back to the NWI community on progress with PEARLS, and evaluation results aimed to continually improve this new model.