Congratulations

Welcome to your ENF leader training module. We are excited that you have committed to equip yourself to help families navigate mental health conditions with their loved ones.In this leader/facilitator training you will learn how:<ul><li>to successfully lead tough topic conversations in a group setting</li><li>to identify participants that are seeking Jesus and you potentially present to them the Gospel</li><li>to prepare to share applicable Scripture and feel comfortable presenting mental health information</li><li>to create a safe environment for participants to share their deep concerns and experiences</li><li>to express empathy and apply support principles during and after each session</li><li>to become proficient using Zoom or any other communication platform with all the tools available such as invitation calendars, attendance reports, whiteboards, breakout rooms, annotations, audio for video presentations, etc.</li></ul>

Leader Requirements Review

<ul><li>All leaders must be at least 25 years of age.</li><li>Leaders need to have experience leading small groups and have demonstrated traits like curiosity and empathy.&nbsp;</li><li>Must have lived experience with a loved one with a mental health condition and be in an advocacy stage.</li><li>All leaders must have submitted application, completed interviews and NPCC leader's training.</li><li>Before leading, leaders must become proficient using MS PowerPoint and Zoom platform.</li></ul>Once a leader has completed training:Sessions are led by two ENF leader facilitators that will divide the content between themselves. Leader’s should contact and interview one-on-one participants before the sessions begin. For info on interview questions please go to Preparation. If someone has registered that is suffering from a mental condition, this content will not be adequate for them, and you will need to find other resources for that person.&nbsp;Meet with your co-leader each week prior to the session to review what each one will be presenting and to pray for the session participants.&nbsp;All leaders are responsible for tracking attendance to sessions and debriefing after each session.&nbsp;<h2>Preparation</h2>Pray for your participants before the first session. Be aware that some attending may have experienced trauma when they first discovered what was happening to their loved one.Be sensitive and mindful that this may be the first time that a participant has talked about mental health concerns with strangers.Preliminary Interviews<ul><li>Once you have an interested participant, set up a short 15 min. Zoom interview with them at a time that works for both of you. This way you are testing their ability to log into Zoom as well as getting your information.</li><li>The interview should begin by thanking them for their interest and courage to sign up. You should ask them what their most immediate need is. This will take a few minutes.</li><li>Review the registration questions.&nbsp; We should know at this point, how does the participant categorize themselves in their faith walk: as a beginner, a returner, follower of Jesus or someone that is curious but not a believer yet. This is important to know because if the person seeking help is curious but not a believer, we should highly suggest they explore Starting Point.&nbsp;</li><li>Registration questions ask this but confirm here by moving on to ask for their loved one’s name/age/gender and if they have a diagnosis – take note of these on your roster because you will need to use this information for breakout rooms later.</li><li>Conclude with empathy and support saying they are in the right place, and we look forward to joining us. You can also assure them that they will learn some coping skills that will help with their situation.&nbsp;</li><li>NOTE: If you have an interview and you realize that the person is someone suffering from a mental health condition and does not have a loved one with a mental health condition, you will need to gently steer them to another resource. I would suggest a Peer-to-Peer NAMI support group or to investigate the NPCC Resources here <a target="_blank" rel="noopener noreferrer nofollow" href="https://northpoint.org/mental-health-resources">https://northpoint.org/mental-health-resources</a></li><li>You will conduct an interview with all participants prior to the first session. We suggest you use a roster template posted on Google Drive and accessed only by the two facilitators of the 8-weeks so that you can reference the information. The Excel roster template is provided as part of the leader’s guide. <a target="_blank" rel="noopener noreferrer nofollow" href="https://docs.google.com/spreadsheets/d/1ibtQMOlo1lG5Mf_Rgml9clBobKgWVO6t/edit?usp=drive_link&amp;ouid=113117015106823179389&amp;rtpof=true&amp;sd=true">https://docs.google.com/spreadsheets/d/1ibtQMOlo1lG5Mf_Rgml9clBobKgWVO6t/edit?usp=drive_link&amp;ouid=113117015106823179389&amp;rtpof=true&amp;sd=true</a></li><li>The Leader Guide provides the script and facilitator notes for each session.</li></ul>

ENF Group Guidelines

Group Guidelines show leaders and participants how they are going to care for each other during group time. They provide mutual consideration, acceptance and protection.<ol><li>Start and stop on time</li><li>Absolute confidentiality</li><li>Be respectful</li><li>Be mindful of others; no interrupting or monopolizing time</li><li>Keep the conversation in the present</li><li>Empathize with each other's situation</li><li>Pray for one another</li></ol>

IDEA: Create some Loom video scenarios to kick off training

Training Scenario 1

<h4>Day 1: Checking In with Participants with Heavy Loads</h4>The trainee will demonstrate proficiency using the tough topics process. The ENF trainer will present a scenario where the trainee will navigate using the tough topic questions and the principles of support chart.The ENF trainer will present a tough topic with the entire group and select a trainee to apply the tough topic process with the entire group as a demonstration. Then the participants will be placed into two breakout rooms and asked to do the same with a tough topic presented in the breakout rooms.Example Tough Topics Statements:<ol><li>If I just had more faith and prayed more, this terrible illness would go away. I think God has forgotten me.</li><li>If God is so merciful, why would a good God allow this to happen to me? I am angry at God. I don't understand why He is allowing my child to suffer like this.</li><li>I am afraid of my son and his violent outbursts. Yesterday I came home and found him with a knife in his hand sitting next to my younger daughter.</li><li>My daughter keeps saying she doesn't want to continue to live like this anymore. I noticed she started cutting all over her arms and legs.</li></ol>

Training Scenario 2

<h4>Day 1: Believers and Unbelievers</h4>Assumption: The trainee has information about the faith journey of the group individuals per the group application.The trainee develops a statement at the beginning of each session that acknowledges the following:<ol><li>If you are a follower of Jesus, you will find that we lean on Him for everything in our lives including this journey.</li><li>If you are not a follower of Jesus, you will find emotional support and an opportunity to learn more about what it means to follow Jesus.</li></ol>Scenario: Non-believer, Seeker, Returner, New-believer statements<ol><li>How can you trust a God that allows so much evil in this world including these awful mental illnesses to happen?</li><li>My experience in church was that the pastor said that my daughter may be demon possessed because she was cutting her arms and legs and hearing voices.</li><li>How could I trust more that God is in control of all this?</li><li>I want to believe that Jesus is who He says He is but I have a hard time believing that he rose from the dead and is alive today.</li></ol>

The Gospel of Jesus Christ

“The kingdom of God has come near. Repent and believe the good news!” — Mark 1:15&nbsp;&nbsp;1. The Problem We’ve all sinned and fallen short (Romans 3:23). Sin separates us from God (Isaiah 59:2).&nbsp;&nbsp; 2. God’s Love and Solution Through Jesus, God showed His love. Jesus took our place and conquered death (John 3:16, Romans 5:8, 1 Peter 3:18).3. Our Response We’re invited to repent and believe. Salvation is a gift—not earned but freely given (Acts 3:19, Ephesians 2:8–9, Romans 10:9–10). 4. The Result We become a new creation, filled with divine purpose and eternal hope (2 Corinthians 5:17, Galatians 2:20, John 10:10). 5. The Invitation Jesus is knocking—will you open the door? Today is the day of salvation (Revelation 3:20, 2 Corinthians 6:2).

Training Scenario 3

<h4>Day 2: Participant Monopolization</h4>Each trainee will present a piece of the content assigned to them from session 4 on Suicide Prevention. <a target="_blank" rel="noopener noreferrer nofollow" href="https://lvl5.org/t/hgWR10kpU4TS/3">https://lvl5.org/t/hgWR10kpU4TS/3</a>The ENF trainer will role play as a participant that continues to monopolize the group discussion with their situation and demonstrates agitation in doing so.The trainee will apply the Emotional Responses chart and ask the audience to use principles of support. The trainee will demonstrate empathy, as well as ability to maintain control of the discussion.Note: The first trainee will present to the entire group and the following trainees will be split into two breakout rooms each with an ENF trainer.

Training Scenario 4

<h4>Day 2: Presenting Mental Health Information in breakout rooms</h4>Each trainee will demonstrate proficiency using Zoom tools to present a video, whiteboard discussion and a breakout room for further detailed discussions.Each trainee will present and discuss with the audience the following:<ol><li>Topic 1: Empathy Exercise with debriefing (Session 2)</li><li>Topic 2: Treatment Option Video presentation and discussion (Session 4)</li><li>Topic 3: Mental Health Conditions Overview (Session 3 - pick two)</li><li>Topic 4: Communication Skills I-statements and Reflective Responses (session 6)</li><li>Topic 5: Guided discussion in small breakout group (Session 7) <a target="_blank" rel="noopener noreferrer nofollow" href="https://lvl5.org/t/6UzmFrqtrJ1O/9">https://lvl5.org/t/6UzmFrqtrJ1O/9</a></li><li>Topic 6: The Invitation to follow Jesus. (Session 8)</li></ol>

Celebration and Prayer

<h4> Celebration, prayer and preparation </h4>Trainees will take time to pray for one another and thank the Lord for the opportunity to serve others in this capacity. All trainees that become ENF leaders will continue to stay in touch with each other via GroupMe or in person.

ENF Leader Training 

ENF Leader Training Assignments and Practice

Strategies for when a group member mentions a traumatic event such as suicide, violence, arrest, restraint, involuntary commitment or traumatic loss.

Facilitator Guide: ENF Tough Topics Process

**The tough topics process allows the facilitator to address traumatic events.Follow these steps and script when addressing a traumatic event in a group.<ol><li>Direct the conversation with empathy: This is really hard.. Let's talk about this.</li><li>Own tough topics yourself. "I've had similar experience of ...."</li><li>Tune the whole group into the subject by asking for a show of hands. Start a discussion: "How many of you have experienced or felt something similar? Pause - Let's talk about this.</li><li>Ask the person dealing with the crisis what his or her specific needs are right now: What do you think you need right now?</li><li>See what the group can do to help that is practical and constructive. How can we help you meet this need?</li><li>Use the Principles of Support Chart and ask the entire group which Principle of Support they found most helpful in getting through their own difficult time. Example: I'd like to ask the group: Can you tell me what Principle you found most helpful in getting through your own difficult times?</li><li>Ask the person dealing with the trauma, what Principle of Support might help? Can you tell us what Principle might help you right now?</li><li>Finally, underline strength and close on the subject on a positive note. The principles of Support help us to focus on hope when times are tough. We recognize the courage and determination of each of you for getting through traumatic events like this.</li></ol>

**ENF Principles of Support Chart

<ol><li>We will see the person first, not the illness.</li><li>We recognize that mental illnesses are medical illnesses that may have environmental triggers.</li><li>We understand that mental illnesses can be traumatic events.</li><li>We aim for better coping skills.</li><li>We find strength in sharing experiences.</li><li>We reject stigma and do not tolerate discrimination.</li><li>We wont judge anyone's' pain as less than our own.</li><li>We ask the Lord for forgiveness, we forgive ourselves and reject placing guilt on others.</li><li>We seek prayer from other believers.</li><li>We accept we cannot solve all problems and that we need to trust the Lord for the outcome. </li><li>We know that our future is in the Lord's hands.</li><li>We will never give up hope.</li></ol><blockquote>The Principles of Support represent what we are striving for as we struggle to come to terms with mental illness.</blockquote>

Strategies for ENF Leaders

We go to the emotional stages of recovery when a group member has intense feelings such as confusion, anger grief, and is overwhelmed. Emotional stages are important to normalize overwhelmingly intense or painful feeling in order to help the person determine what they need and how to get it.

**Facilitator Guide: Emotional Stages of Recovery

<ol><li>Move the person to the Emotional Stages Chart and say: Let's take a moment to look at the Emotional Stages Chart (see below).</li><li>Describe the chart. This chart describes a series of emotional reactions to the trauma of mental illness that are absolutely normal and predictable. Since our experiences may be cyclical, we can fluctuate among the stages as things change.</li><li>Ask the person to identify where they are on the chart and talk about that briefly. Where do you think you are in the chart?</li><li>Ask the group members about their needs. Where you are on the chart may help determine what you need. Can some one tell me what they needed when they were in this same stage?</li><li>Ask the person about his or her needs. What needs can the group help you with right now?</li><li>Ask the group how this person might het this need met by coming up with concrete, practical resources that will help that person right now. What do we know that would help [name of person] to meet this need?</li></ol>IMPORTANT<ul><li>Never tell a person where they are on the chart</li><li>Always move the group to what a person needs in that stage</li></ul>

**Dealing with Catastrophic Events

I. Dealing with Catastrophic Events - crisis/chaos, shock, denial, normalizing, despair, detachmentNeeds: support, comfort, empathy for current situation, help finding resources, crisis management reassurance, empathy for pain, permission to be numb, hope

**Learning to Cope

II. Learning to Cope: Anger, Guilt, Resentment, Recognition, GriefNeeds: To vent feelings, education, self-care, networking skills training, to let go, learning the system, hope

**Moving into Advocacy

III. Moving into Advocacy: understanding, Acceptance, Advocacy and actionNeeds: To restore balance in life, Responsiveness from the system, to find meaning, a sense of empowerment, activism, hope

Emotional Stages of Recovery 

<h4>This strategy is used when a participant continues to state that they are stuck on the same problem and keeps trying the same failed strategies.</h4><h3>Problem-solving skills</h3>All relationships experience challenges, or problems, from time to time. Mental health conditions can make navigating these challenges more difficult. Today, we’re going to talk about a few skills that can help with solving problems related to mental health conditions.We’ll learn to define the issues creating the difficulties, explore alternatives and identify possible solutions — ideally, solutions everyone agrees on.When you have a specific approach and tools you know how to use, problem solving can be less overwhelming. We’ll share some basic strategies that can make our challenges easier to manage.Most solutions aren’t permanent or may only work for a short period of time. As situations change, the approaches we use need to change too. Having a problem-solving process your whole family knows how to use can help you adapt to these changes.We call this approach to problem solving “POW.”POW stands for past experience, options and what if. <h3>It involves three basic steps:</h3>Step 1: Defining the problemStep 2: Solving the problem (POW)Step 3: Setting limitsOften, the hardest step is the first one, defining the problem. When we identify what the true issue is, the next steps can be much easier.

Step 1: Defining the Problem

Step 1: Defining the Problem<ul><li>Select only one program (the most urgent one)</li><li>State it specifically</li><li>Consider your emotions – decide if the emotions you are feeling may actually be the real problem</li><li>Seek agreement from other family members about the problem to work on</li></ul>

Step 2 - Solving the Problem (POW)

Step 2 - Solving the Problem (POW)P – Past experienceO – OptionsW – What if the first solution doesn’t work?Be specific:<ul><li>Who?</li><li>What?</li><li>When?</li><li>Where?</li><li>How?</li></ul>

Step 3 - Setting Limits

Establishing healthy boundaries involves telling your loved one what you will do to protect your own well-being. One example of a healthy boundary is that if they yell at you, you will leave the room. Another example is that you will talk with them about serious issues over the phone, but not through text messages. It usually means describing the limits of what you’re willing to do in various situations.Consider what your own personal boundaries are. In situations that make you somewhat uncomfortable, what are your limits? What situations will you remove yourself from?What other ways will you prioritize your own well-being?Once you understand what your boundaries are, you need to communicate them to your family. Everyone involved should understand what the baseline level of behavior that they expect from each other is. Having clear expectations, even if not everyone likes them, can help people feel more secure because they know what to expect in certain situations.What do you think of these suggestions?&nbsp;How do you manage limit setting with your loved one?The goal of setting realistic expectations for ourselves and others is to remain aware that while there are aspects of mental illness that are responsive to problem solving, there are other aspects that are difficult to solve. Our message of hope is that we must never give up working together to find strategies and solutions.

Problem Solving Process

Diagnostic Questions

<ol><li>Have you come to a place in your spiritual life where you know for certain that if you were to die today you would go to heaven or is this something you're still not sure?</li><li>Suppose you were to die today and stand before God and He were to say to you, "Why should I let you into Heaven?" What would you say? What comes to your mind?</li></ol>Good News Transition: The Gospel<ul><li>Grace - Heaven is a free gift</li><li>It is not earned or deserved</li><li>Man is a sinner and cannot save himself</li><li>God is merciful therefore He does not want to punish us</li><li>God is just therefore HE must punish sin</li><li>Jesus Christ - the infinite God-Man - God in the flesh</li><li>Faith - Trusting in Jesus Christ alone for eternal life.</li><li>Commitment: This is the greatest offer ever made by the greatest person who ever lived. Would you like to receive this gift of eternal life today?</li></ul>

Leader and Participant Resources

<h2>Leader &amp; Participant Resources</h2>NAMI Northside Atlanta <a target="_blank" rel="noopener noreferrer nofollow" href="https://naminorthsideatlanta.org/">https://naminorthsideatlanta.org/</a>NAMI Dekalb <a target="_blank" rel="noopener noreferrer nofollow" href="https://www.namidekalb.org/">https://www.namidekalb.org/</a>&nbsp;NAMI Gwinnett <a target="_blank" rel="noopener noreferrer nofollow" href="https://namigwinnett.org/">https://namigwinnett.org/</a>&nbsp;NAMI Georgia <a target="_blank" rel="noopener noreferrer nofollow" href="https://namiga.org/">https://namiga.org/</a>&nbsp;&nbsp;NAMI Family Support Group Ongoing twice a month<a target="_blank" rel="noopener noreferrer nofollow" href="https://naminorthsideatlanta.org/support-and-education/support-groups/nami-family-support-group/">https://naminorthsideatlanta.org/support-and-education/support-groups/nami-family-support-group/</a>&nbsp;Northside Atlanta Resource Guide online<a target="_blank" rel="noopener noreferrer nofollow" href="https://naminorthsideatlanta.org/resources/nna-resource-guide/">https://naminorthsideatlanta.org/resources/nna-resource-guide/</a>&nbsp;&nbsp;NPCC Emotional and Mental Health&nbsp;<a target="_blank" rel="noopener noreferrer nofollow" href="https://northpoint.org/mental-health-resources">https://northpoint.org/mental-health-resources</a>&nbsp;

Gender Dysphoria (formerly Gender Identity Disorder)

In the DSM-5, gender dysphoria is diagnosed when there's a significant and persistent incongruence between a person's experienced gender and their assigned gender, causing significant distress. This distress is marked by at least six months of feeling a strong desire to be the other gender or another gender altogether, and this desire is accompanied by other feelings or behaviors that indicate this distress.&nbsp;Developmentally appropriate criteria: The DSM-5 includes separate criteria for children and adolescents/adults, recognizing that the expression of gender dysphoria may differ depending on developmental stage.&nbsp;<a target="_blank" rel="noopener noreferrer nofollow" href="https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria">What is Gender Dysphoria?</a>

ENF Resources 

Evaluate the delivery of topics using a 1 to 5 rating scale. Where 1=Strongly Disagree and 5= Strongly Agree

The session expectations were clearly outlined at the beginning and adhered to.

Evaluate the delivery of topics using a 1 to 5 rating scale. Where 1=Strongly Disagree and 5= Strongly Agree
 
The facilitator(s) were prepared for each session and demonstrated understanding of the content.

Evaluate the delivery of topics using a 1 to 5 rating scale. Where 1=Strongly Disagree and 5= Strongly Agree

The facilitator managed tough topics effectively applying the support principles and engaging the entire group. 

Evaluate the delivery of topics using a 1 to 5 rating scale. Where 1=Strongly Disagree and 5= Strongly Agree

The facilitator(s) treated participants with respect and were active listeners?

Evaluate the delivery of topics using a 1 to 5 rating scale. Where 1=Strongly Disagree and 5= Strongly Agree

The facilitator(s) demonstrated empathy and were credible and authentic.

Evaluate the content design using a 1 to 5 rating scale. Where 1=Strongly Disagree and 5= Strongly Agree

The sessions provided ample time for participants to express where they were in their faith journey and emotionally. 

Evaluate the delivery of topics using a 1 to 5 rating scale. Where 1=Strongly Disagree and 5= Strongly Agree

The facilitator demonstrated proficiency when a participant was distraught by engaging the entire group to focus on support principles. 

Evaluate the delivery of topics using a 1 to 5 rating scale. Where 1=Strongly Disagree and 5= Strongly Agree

The facilitator demonstrated proficiency navigating the communication platform (Zoom or other) by using all the tools available for engaging the audience. 

NPCC ENF Facilitator Training & Support Strategies