APPLICATION FOR TRAINING LOUISIANA PEER SUPPORT SPECIALIST

Louisiana Family Peer Support Specialist Curriculum Training Facilitator Application

Louisiana Family Peer Support Specialist Curriculum

Training Facilitator Application

We are excited to announce that Louisiana peer programs are expanding! OBH (in partnership with The Extra Mile, local experts, and Master Trainers from Texas) has developed a Family Peer Support Specialist training curriculum.

We are now recruiting Louisiana experts in family peer support to join the team of Training Facilitators, to become trained on this this Family Peer curriculum, and then to deliver it to interested family peers seeking to become trained and recognized as Recognized Family Peer Support Specialists.

This is a preliminary application for a Family Peer Support Training Facilitator. When considering candidates for this training, preference will be given to candidates who have successfully completed training in Peer or Family/Parent Peer support, through the OBH-approved Peer Support Specialist training, training as a Parent Peer Support Specialist in the CSoC program, or other peer or parent/family peer training programs.
Before applying, please consider this requires a large time commitment. The person(s) selected will be expected to complete the following:
1. “Train the Trainer” 4 days in-person in Baton Rouge: Master Trainers will train Training Facilitators on the Family Peer Support Curriculum (February 20-23, 2024)
2. Training Facilitators will co-facilitate 5-day Family Peer Support training with coaching from Master Trainers (March 4-8, 2024). Training Facilitators will be on-site in Baton Rouge with the Master Trainers.
3. Following this training process, Training Facilitators will be expected to co-facilitate at least two (two) 5-day Family Peer Support Training sessions annually. Sessions may be presented live and virtually (via zoom), or in-person.

If interested in becoming a Family Peer Support Facilitator, please fill out this application. Please note, a response to ALL questions on the application is required. If a question does not apply, please answer “N/A”. Only completed applications will be accepted for review.

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Untitled

Are you at least 24 years of age?(Required)

Yes

Do you have at least one year of experience of functioning as a parent, guardian and/ or primary caregiver of a minor child with a behavioral health need who has received services for that need?(Required)

Yes

Do you have at least one year of experience navigating a child-serving system (behavioral health, child welfare, juvenile justice, special education) as a parent, guardian and/or primary caregiver?(Required)

Yes

Do you agree to disclose your personal lived experience as a caregiver of a child with a behavioral health need for the purpose of educating, role modeling and providing hope to others about the reality of recovery?(Required)

Yes

Have you previously completed a Peer or Family/Parent Peer Support Training?(Required)

Yes

If yes, please provide the year you completed Peer or Family/Parent Peer Support Training and with what program and/or trainer.

Current Employer Name(Required)

Current Employer Phone(Required)

Current Employer Email(Required)

Put Employer and dates employed here. Hit the Plus button to add more.(Required)

High School(Required)

High School/High School Equivalent

Diploma Earned

Vocational

Vocational/Technical

Diploma Earned

College

College/University

Diploma Earned

Other

Diploma Earned

(1) Three Professional References with Contact Infomration (No family or friends)(Required)

Name

Phone Number

(2) Three Professional References with Contact Infomration (No family or friends)(Required)

Name

Phone Number

(3) Three Professional References with Contact Infomration (No family or friends)(Required)

Name

Phone Number

Please list any special skills and/or certifications:

On a scale of 1-10, how would you rate your technology skills, including use of PowerPoint and Zoom video? Please explain.(Required)

Do you have experience facilitating groups?(Required)

Yes

If yes, please describe:(Required)

Are you able to commit to participating in the “Train the Trainer” training, and co- facilitating a 5-day Family Peer Training session with coaching from Master Trainers, as described on page 1 of this application?(Required)

Yes

If needed, add any comments or clarifications about your availability here:

If selected, are you able to commit to facilitating a minimum of two (2) Family Peer Support Specialist training sessions each year, with each training session lasting 5 days and delivered live and virtual (via Zoom)?(Required)

Yes

If needed, add any comments or clarifications about your availability here:

Why do you want to become a Family Peer Support Specialist Curriculum Facilitator?(Required)

What strengths and assets would you bring to the team of Family Peer Support Specialist Curriculum Facilitators?(Required)

What does Family Recovery mean to you?(Required)

What factors are important in family recovery?(Required)

What does Family Peer Support mean to you?(Required)

Do you think that it is important to share your story of family recovery stories as part of being a Family Peer Support Specialist Facilitator? Explain.(Required)

Please tell us about your lived experience as a caregiver for a child with behavioral health needs.(Required)

Please tell us about your lived experience navigating a child-serving system as a caregiver for a child with behavioral health needs.(Required)

Participating Trainees who do not have a conflict of interest will be financially compensated for their time participating in the training in accordance with the Trainee’s written agreement with The Extra Mile Region IV. Compensation will be based on a scale with compensating increasing once a Trainee has successfully completed the training, submitting all required documentation, and becomes a Louisiana Recognized Family Peer Support Specialist Curriculum Facilitator. Trainees will only be compensated for time worked. Further details of compensation will be shared with selected Trainees by The Extra Mile Region IV. By typing my name, I certify that my answers are true and complete to the best of my knowledge. If this application leads to an employment agreement, I understand that false or misleading information in my application or interview may result in any offer being rescinded.

Name

First Last

Louisiana Family Peer Support Specialist Curriculum Training Facilitator Application

Louisiana Family Peer Support Specialist Curriculum

THE EXTRA MILE REGION IV

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