Based on a presentation at the ICCCPO Conference in Geneva, Switzerland, Sept 2006

Background

This report will describe progress to date with a training programme for Family Support Workers that has recently been implemented by the Child Cancer Foundation in New Zealand.

New Zealand is a long narrow country made up of 2 main islands. There is a population of around 4 million, with a large percentage of the population living in the North Island. The Child Cancer Foundation is the only organisation that provides support specifically for children and families affected by childhood cancer. It is a national organisation made up of 4 Divisions, which in turn support 23 Branches. The mission of the Child Cancer Foundation is:

      “No child or their family walking the cancer journey ever feels alone”.

The main focus of the Child Cancer Foundation is the provision of Family Support to children and families affected by childhood cancer, as well as support to the health professionals who care for them.  Family Support encompasses a range of emotional, practical and financial support as well as social activities with opportunities to meet families who also walk this journey. The key providers of Family Support are:

    1) Family Support Coordinators in the Divisions.

    2) Family Support Workers in the Branches.

The Family Support Coordinators come from a range of backgrounds including parents of children who have had cancer, counsellors, social workers and teachers. They are located at the Family Places which are close to the treatment centres. There is a dual focus of their role:

    1) Providing support to families while they are at the treatment centre

    2) Providing training, supervision, mentoring and support to Family Support Workers in the Branches

The Family Support Workers are in a mix of volunteer or paid roles depending on the requirements of their particular Branch for family support. They also come from a range of backgrounds including parents, counsellors and social workers. They provide support to families when they are at home in their Branch. Many of the Family Support Workers have been in their roles for a long time. They started before the Foundation developed an orientation programme so have not had any formal induction or training to their roles provided by the Foundation but may have attended a variety of different courses in the community. As a result, although it was recognised that they had a wide range of skills and experience, it was also necessary to introduce a training programme which would ensure the safety of:

1) Family Support Workers who are providing support to families

2) families receiving family support and

3) the Child Cancer Foundation as the provider of  Family Support services.

This training programme would establish a common baseline of knowledge and skills which is required by Family Support Workers.

Implementation – challenges

There are some logistical challenges which we have faced in New Zealand in establishing a training programme for Family Support Workers.

These have included the fact that Family Support Workers are located in Branches throughout New Zealand, covering a wide geographical area. Family Support Workers also have varying levels of availability to attend training as many are volunteers and carry out this work around family commitments and other employment. Of those who are employed their roles are generally part time.  This led to the question of how to ensure consistency in training across Divisions as it is not realistic to bring Family Support Workers to one central point on a regular basis.

Other factors that needed to be considered were how to carry out the baseline training programme, where to provide it and who would provide it as well as the potential cost of such a programme.

Potential Benefits

Balanced against the challenges was a consideration of the potential benefits. These included improving the support we offer to families and increasing the knowledge and skills of those delivering family support which would then increase their level of confidence in supporting families. There was also the potential to support parents who are volunteers with training which may assist them in developing a career pathway if they so desired. As well as this there was the opportunity to break down a sense of isolation of Family Support Workers, who may be the only support person in their Branch which in many cases can also be quite remote. As well as creating a sense of being part of a Family Support team there was also the potential to help foster peer support across branches which were in close proximity to each other.

The Training Programme

After consultation with the Family Support Coordinators and Division Managers a national training progamme consisting of eighteen modules was agreed upon. It was anticipated that the modules would be delivered as part of a 2 day training programme which would occur twice a year in each Division. Each module has an outline of the training content to be delivered and the expected outcomes. The Training Programme will be coordinated by the Family Support Coordinator for the Division with the support of the Division Manager and the national Family Support Manager. The training modules may be provided by a variety of people including the Family Support Coordinator, the Division Manager and the National Family Support Manager as well as health professionals or contracted specialists where necessary.

The Training Modules

The Training Programme consists of 18 modules which fall broadly into 6 categories as outlined below:

   Organisational:
        Foundation Structure
        Management Guidelines

   Family Support Worker
        The Family Support Worker Role
        Working in team/isolation

   Professional Standards
        Confidentiality
        Ethics
        Documentation
        Supervision

   Psycho Social
        Core Interpersonal/Counselling Skills
        Stress Management/Selfcare
        Grief and Loss
        Working with families affected by chronic illness
        Working with Families from an Empowerment/Strengths Based Approach
        Benefits and Entitlements

   Child/Young person
        Child Protection
        Childhood Cancer Information

   Cultural
        Bi culturalism and the Treaty of Waitangi
        Multi culturalism

Training Module Outlines
Examples of 2 of the training modules are given below:

Training Session Nine - Core Interpersonal / Counselling Skills

Presenter: This session would normally be facilitated by a social worker, counsellor or trainer with recognised skills in running experiential sessions with a high level of interaction

Topics Covered:

-    Exercise to consider own personal interactive style

-    Establishing rapport

-    Active listening skills

-    Empathy vs sympathy

-    Open vs closed questioning

-    Reflecting back

-    Summarising

-    Paraphrasing

-    Reframing

-    ‘Normalising’

-    Use of silence

-    Being non-directive

-    Dealing with anger, aggression

-    Use of body language

-    Self disclosure

-    Further topics could also include dealing with diversity e.g.

        > Working through an interpreter

        > Working with a family with little English

        > Incorporating cultural sensitivity into interactions

        > Communicating with a visually or hearing impaired person

        > Working with challenging situations or clients

Expected Outcomes:

-     The Family Support Worker will  demonstrate greater insight into the way he/she interacts with others

-    The Family Support Worker will develop  increased skills in interacting with families

-    The Family Support Worker will interact with families in an open, empathetic, non judgmental manner

-    The Family Support Worker will demonstrate the ability to deal with more complex interactions in a professional manner

Training Session Thirteen – Working with families from an Empowerment / Strengths Based Approach

Presenter:  This session would normally be presented by a counselor, social worker or trainer who is skilled in a strengths based/empowerment approach to working with families

Topics Covered:

-    Discussion about a strengths based/empowerment approach to working with families

-    Building resilience vs creating dependency

-    Working with family systems vs enmeshment in the family system

-    Discussion of case scenarios

Expected Outcomes:

- The Family Support Worker will be able to articulate key points regarding a strengths based/empowerment approach to working with families and demonstrate this in his/her work with families

-    The Family Support Worker will demonstrate through case studies, internal supervision and ‘live supervision’ sessions role clarity in his/her relationship with family systems

Progress

This is very much a work in progress. The Training Programme was signed off in March 2006 and two Divisions have already started implementing the programme, one of which will soon run its second training weekend. A third Division is planning its first training programme for late November and members of the fourth Division will be invited to this as there is a close link between these two Divisions.

Positives to Date

Implementation of the programme has so far been positive and enhanced the sense of being part of a Family Support team. It has strengthened the relationship between the Family Support Coordinators and the Family Support Workers and helped to break down a sense of isolation that some workers may feel. It draws on the knowledge and skills within the teams and it has been encouraging to see how open Family Support Workers can be in participating and sharing their perspectives.

It has also created the opportunity for the Family Support Workers to meet health professionals who are working with the families they support and to gain a better understanding of what happens while families are at the treatment centre. As well as this there is the opportunity to draw on and develop community networks.

The important role that the Family Support Workers play is also reinforced through this process and their contribution to family support is acknowledged during the sessions. Ultimately, we are all working together for our common goal of providing the best possible support to children and families affected by childhood cancer.