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Increasing access to mental health counseling for homeless youth: Peer2Peer Counseling Supports

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Increasing access to mental health counseling for homeless youth: Peer2Peer Counseling Supports

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Content PEER2PEER COUNSELING SUPPORTS 1
Increasing Access to Mental Health Counseling for Homeless Youth:
Peer2Peer Counseling Supports
Doctoral Capstone Project
by
Robin LaBarbera
Doctor of Social Work
Suzanne Dworak-Peck School of Social Work
University of Southern California
December 2020
PEER2PEER COUNSELING SUPPORTS 2

Executive Summary
Ensuring healthy development for all youth is one of the Grand Challenges of Social
Work that focuses on prevention efforts to facilitate child development and mental health
(Jenson & Hawkins, 2018). The aim of this grand challenge is to ensure that all youth grow up
to become healthy and productive adults (Jenson & Hawkins, 2018). There is a group of young
people, however, for whom opportunities to become independent, successful, and contributing
members of the community are seemingly unreachable goals—they are transition-age youth
(TAY) who are experiencing homelessness.
A significant number of homeless young people experience mental health problems – as
many as 80%, according to some researchers (Hodgson, Shelton & Van den Bree, 2014; Sample
& Ferguson, 2020; Shueller, Gover, Rufa, Dowdle, Gross, Karnik, & Zalta, 2019). Mental
health issues like depression, psychological distress, suicidality, post-traumatic stress, anxiety,
and behavioral problems are prevalent among homeless young people (Hodgson et al., 2014;
Sample & Ferguson, 2020; Schueller et al., 2019; Wright, Attell, & Ruel, 2017).
Cognitive behavioral therapy (CBT) has been identified in the literature as a best practice
for treating mental health disorders that occur frequently among individuals experiencing
homelessness (Taylor, Cunningham, Schultz, Jager-Hyman, Sposato, Evans, Beck, & Creed,
2016). Despite the availability of evidence-based mental health services, research indicates that
less than 20% of homeless young people seek supports from the mental health care system that
can improve their psychological functioning (Schueller et al., 2019) and that help interrupt the
cycle of chronic homelessness (Hughes, Clark, Wood, Cakmak, Cox, MacInnis, Warren,
Handrahan, & Broom, 2010), primarily due to mistrust of the mental healthcare field and fear of
judgment from providers (Winiarski, Rufa, Bounds, Glover, Hill, & Karnik, 2020).
PEER2PEER COUNSELING SUPPORTS 3
Together, these factors—the mental health challenges among homeless youth, the
evidence showing the effectiveness of CBT among homeless populations, and homeless youths’
reluctance to access professional mental health care services—reveal a unique opportunity for
innovative mental health service delivery. Working within the social work grand challenge to
ensure healthy development of all youth, I formed a non-profit organization called Peer2Peer
Counseling Supports (P2P), aimed at increasing access to essential mental health supports for
homeless youth.
P2P will change the way we deliver mental, emotional, and behavioral healthcare
services to homeless youth. The measurable outcomes used to accomplish this aim include: (1)
increasing the number of CBT-certified peer counselors who can provide mental health supports
to their homeless peers; (2) increase the number of homeless young people who access peer-
based mental health and well-being supports; (3) improved mental health/well-being among
homeless young people; and (4) improve housing stability. These intended outcomes, the
relevant conceptual framework, the problems of practice, and the innovative solution are detailed
in this paper.
Conceptual Framework
Statement of the Problem and Grand Challenge
One in 10 young adults ages 18-25 (transition age youth, or TAY) have experienced
some form of homelessness over a 12-month period in the United States, according to the 2017
Voices of Youth Count (Morton, Blondin, Chrisler, Pufpaff, Kull, Kugley, & Elliott, 2017). That
is 3.5 million young adults who slept in shelters, on people’s couches, or on the street (Morton et
al., 2017). Moreover, estimates report that at least 83% of TAY experiencing homelessness had
prior experiences with foster care or the juvenile justice systems (Morton et al., 2017). When
PEER2PEER COUNSELING SUPPORTS 4
youth age out of foster care or juvenile justice, they lose their safety nets overnight—they lose
access to the financial, educational, and social supports that were provided through the child
welfare system (Fowler, Marcal, Zhang, Day, & Landsverk, 2017). As a result, they fare poorly
compared to their non-homeless peers in terms of mental health problems, substance abuse, and
underemployment (Fowler et al., 2017).
Research has shown that high levels of depressive symptoms, psychological distress,
suicidality, mental illness, post-traumatic stress, anxiety, and emotional and behavioral problems
are prevalent among homeless youth (Hodgson et al., 2014; Sample & Ferguson, 2020; Schueller
et al., 2019; Wright et al., 2017). Yet, fewer than 20% of homeless young adults are reluctant to
access mental health services that can improve their psychological functioning (Schueller et al.,
2019).
Given the prevalence of mental health problems among homeless TAY, and their
reluctance to access the supports available to them, this problem falls under the social work
grand challenge of ensuring healthy development for all youth (Jenson & Hawkins, 2018). This
particular grand challenge is dedicated to reducing the incidence and prevalence of behavioral
health problems in youth from birth through age 24, and it appeals to providers to develop
effective interventions that serve young people (Jenson & Hawkins, 2018).
Environmental Context: Research and Practice
Chronic Homelessness
Chronic homelessness is used to describe people who have experienced homelessness for
at least a year, or repeatedly (National Alliance to End Homelessness, 2020). The National
Alliance to End Homelessness had this to say about people experiencing chronic homelessness:
“Once they become homeless—regardless of what immediately caused them to lose their
PEER2PEER COUNSELING SUPPORTS 5
housing—it is difficult for them to get back into housing and they can face long or repeated
episodes of homelessness” (2020, para. 3). And chronically homeless individuals consume more
than half of the resources in the homeless system—they are more likely to experience
catastrophic health crisis requiring medical intervention and a high number of contacts with law
enforcement (Homeless Hub, 2019). The longer young people are homeless, the more their
health and well-being declines, which further escalates the challenge to get off the streets and
reintegrate into the community (Homeless Hub, 2019).
Experiencing homelessness has several implications for young people. First, they
experience a limited support network (Wright et al., 2017), and without a stable support network
to address their needs, the opportunities for housing and employment stability are bleak
(Blakeslee & Best, 2019; Jones, 2019). Secondly, while it is true that a number of supports exist
to help youth who are experiencing homelessness, many youth are reluctant to access those
supports (Hodgson et al., 2014; Sample & Ferguson, 2020). Finally, a limited support network
and reluctance to access necessary supports dramatically increases the likelihood that they will
remain chronically homeless. The longer one is homeless, the more one’s health and well-being
declines, increasing the difficulty of getting off the streets and reintegrating into the community
(Homeless Hub, 2019).
Prevalence of Mental Health Problems
Researchers estimate that anywhere from 28% (Write et al., 2017) to 50% (Hughes et al.,
2010) of homeless young people meet the threshold for severe mental illness and/or drug
addiction problems (Hughes et al., 2010). The definition of “serious mental illness” offered by
the National Institute for Mental Health (NIMH) states it is “a mental, behavioral, or emotional
disorder resulting in serious functional impairment, which substantially interferes with or limits
PEER2PEER COUNSELING SUPPORTS 6
one or more major life activities” (NIMH, 2019). Individuals who experience homelessness
have high rates of mental illness and substance misuse, nearly twice as high as those among their
housed peers (Bender, Yang, Ferguson, & Thompson, 2015; Johnstone, Parsell, Jetten, Dingle, &
Walter, 2015; Schueller et al., 2019).
Young People experiencing homelessness exhibit disproportionately high rates of mental
health conditions, compared to their housed peers, including depression, anxiety, PTSD, suicidal
contemplation, substance use, dissociative behavior, emotion regulation, conduct disorder, and
trauma exposure (Bender et al., 2015; Homeless Policy Research Institute, 2019; Schueller et al.,
2019). Homeless youth in several reports met the criteria for major depression, bi-polar disorder,
schizophrenia, dissociative disorder, and anxiety, and they are more likely to contemplate and
attempt suicide than the general youth population (Homeless Policy Research Institute, 2019).
Researchers have documented the myriad of mental health problems that homeless youth
face, such as high levels of depressive symptoms, psychological distress, suicidality and suicide
attempts, mental illness, post-traumatic stress, anxiety, and emotional and behavioral problems
(Hodgson et al., 2014; Schueller et al., 2019; Wright et al., 2017). Social-emotional well-being
is also important for homeless young people. Social and emotional functioning refers to the “key
competencies, attitudes, and behaviors that equip a young person experiencing homelessness to
avoid unhealthy risks and to succeed across multiple domains of daily life, including school,
work, relationships, and community” (Morton et al., 2019, p. 8).
Well-being represents one’s capacity for functioning across day-to-day tasks and
activities, including those that would be required exit homelessness (Morton et al., 2019).
Without positive social-emotional functioning, young people will struggle to fulfill their
aspirations in the face of significant obstacles and cope well with challenges as they emerge
PEER2PEER COUNSELING SUPPORTS 7
(Morton et al., 2019). Moreover, experiencing homelessness can take a tremendous toll on
young people’s well-being, and if continued, could pose a serious threat to their long-term
resilience and housing stability (Morton et al., 2019).
Best Practices
Cognitive behavioral therapy (CBT) is an evidence-based practice that has demonstrated
widespread efficacy for disorders that occur frequently among individuals experiencing
homelessness including depression, anxiety, and substance use (Taylor et al., 2016). An
important advantage of CBT is that the psychological, emotional, and behavioral issues related to
homelessness can be addressed (Maquire, 2006).
There is a limited, but growing, body of research that has investigated the use of CBT
with homeless populations. Wang, Mott, Magwood, Mathew, Mclellan, Kpade, Baga, Kozloff,
Pottie, and Andermann’s review (2019), for example, delivered CBT-based therapy to homeless
youth and found improvements in percentage of days being housed, psychological distress, self-
efficacy, and substance abuse compared to control groups. Castano-Cervantes (2019)
implemented CBT with a group of homeless young girls, and found significant differences for
anxiety and depression symptoms, subjective well-being, and emotion regulation among
participants when compared to the control group. Castanos-Cervantes’ (2019) research results
were consistent with prior research with similar populations (Altena, Brilleslijper-Kater, & Wolf,
2010; Barker, Humphries, McArthur, & Thomson, 2012; Maguire, 2006; Speirs, Johnson,
Jirojwong, 2013).
Reluctance to Access Mental Health Services
Needs for mental health services are often high, but levels of usage tend to be low among
the homeless youth population (Hodgson et al., 2014; Sample & Ferguson, 2020; Tyler,
PEER2PEER COUNSELING SUPPORTS 8
Akinyemi, & Kort-Butler, 2012). Reasons such as lengthy waiting lists and mistrust of service
providers often prevent homeless young people from accessing mental health services (Black,
Fedyszyn, Mildren, Perkin, Lough, Brann, and Ritter, 2018; Winiarski et al., 2020).
Despite these acute mental health and well-being needs (Taylor et al., 2016; Wang et al.,
2019), young people experiencing homelessness can be reluctant to engage with mental health
services, primarily due to generalized mistrust of service providers (Black et al., 2018; Hughes et
al., 2010; Sample & Ferguson, 2020; Winiarski et al., 2020). For example, homeless youth in
Black et al.’s research (2018) reported that insensitive, impersonal, or unkind behavior from
service providers, or feeling judged, blamed, labelled, or not taken seriously kept them from
accessing services. Also, Brown et al. (2016) cited negative past experiences with service
providers as a factor among homeless young people.
As many as 83% of homeless youth have histories of foster care placements and juvenile
justice involvement (Morton et al., 2017). Many have been isolated from their families or other
sources of support, and some have never had stable, consistent, or safe caregivers (Hopper,
Olivet, & Bassuk, 2018). Hopper et al. believe that 79% of youth who are homeless have run
from abusive or neglectful home environments, they have been abused and rejected, and they
have experienced chronic stress, lack of a sense of security, loss of community and social
supports (2018). “Many have been involved with various systems, such as foster care, mental
health, and criminal justice systems, that have failed to meet their needs or provide an adequate
safety net” (Hopper et al., 2018, p. 46).
“Reaching out is not easy for many youth who have been abandoned, rejected, or hurt,
and who are reluctant to trust” (Kozloff, Bergmans, Snider, Langley, & Stergiopoulos, 2018, p.
78). Needs for mental health services are often high, but levels of usage tend to be low among
PEER2PEER COUNSELING SUPPORTS 9
the homeless youth population (Tyler, Akinyemi, & Kort-Butler, 2012), leaving their mental
health needs untreated, with significant consequences. It is understandable that homeless young
people who have been exposed to chronic or repeated deprivation, loss, and adversity would
have difficulty trusting and engaging with service providers (Hopper et al., 2018).
Without adequate psychological support, researchers estimate that as many as 50% of
homeless young people will continue to experience housing instability and/or homelessness into
adulthood (Hughes et al., 2010; Winiarski, et al., 2020). “These are tragic outcomes for
homeless persons and their families; burdens on healthcare, social service, and corrections
systems; and costs to taxpayers” (National Coalition for the Homeless, 2020, para. 3).
Peer-Based Supports
There is a small but growing body of knowledge that highlights the efficacy of peer-
based interventions. Peer support is defined as those services that are delivered by individuals
who have common life experiences with the people they are serving (Barker & Macquire, 2017).
Because of their own experiences with recovery and resilience, peer mentors/supporters can offer
understanding and encouragement that someone without a similar background could not (Eddie,
Hoffman, Vilsaint, Abry, Bergman, Hoeppner, Weinstein, & Kelly, 2019). Typically, however,
peer support staff at youth-serving agencies serve as liaisons to the mental healthcare system by
providing referrals to outside providers (Winiarski et al., 2020).
Peer support can help reduce distrust or minimize the time to develop trust, according to
the literature (Barker, Maguire, Bishop & Stopa, 2018). Peer support refers to a process whereby
individuals with lived experience of a particular phenomenon provide support to their peers by
explicitly drawing on their unique experience of this situation (Miller, Carver, Foster, & Parkes,
2020). By virtue of their lived experience, peer supporters are “often perceived as more credible
PEER2PEER COUNSELING SUPPORTS 10
and understanding of youth concerns compared to adult providers and may help alleviate the
chronic difficulties of engaging youth in mental health treatment (Gopalan, Lee, Harris, Acri, &
Munson, 2017 p. 89).
Their lived experience enables peer supporters to genuinely empathize and connect with
mutual understanding when relating to the clients they serve (Barker & Maquire, 2017; Barker et
al., 2018; Kidd, Vitopoulos, Frederick, Daley, Peters, Clarc, Cohen, Gutierrez, Leon, &
McKenzie, 2019; Miller et al., 2020). Peer supporters have the capacity to bond with clients
“because they both have membership to a group that has endured marginalization—they have
experienced and survived the ‘different world’ of homelessness…thus, it becomes an
engagement tool to help break the cycle of homelessness (Barker et al., 2018, p. 220).
There is evidence to support the effectiveness of peer support services in terms of
mitigating emotional and behavioral health difficulties in a variety of settings. Peer-delivered
interventions can decrease mental health symptoms and increased hope, expanded social
networks, self-esteem, empowerment, self-efficacy, self-management of difficulties, and
treatment engagement among youth and young adults experiencing emotional and behavioral
health challenges (Gopolan et al., 2017). However, peer support services are typically limited to
coaching, mentorship, emotional support, facilitating social interactions, finding housing
opportunities, advocacy, connecting to available resources, case management, and referring
clients to professional providers (Barker & Maquire, 2017; Barker et al., 2018; Miller et al.,
2020; Storm, Fortuna, Brooks, & Bartels, 2020). There have been no reports describing the role
of peer supporters who participated in counseling functions in the literature (Kidd et al., 2019).
Their role is “explicitly a non-clinical one, which does not involve treatment, assessment or
evaluation” (Jacobson, Trojanowski, & Dewa., 2012, p. 2).
PEER2PEER COUNSELING SUPPORTS 11
Problems of Practice and Innovation
Research tells us that homeless youth are in greatest need of mental health services—as
many as 50% of homeless youth are thought to have serious mental health and/or drug addiction
problems (Hughes et al., 2020). We also know that those who seek mental health services are
more likely to exit homelessness and reach residential stability compared to those who do not
seek help (Hodgson et al., 2014; Sample & Ferguson, 2020). Yet, despite the ever-worsening
cycle of dysfunction, poverty, and homelessness (National Coalition for the Homeless, 2020),
fewer than 20% of homeless youth report engaging in the mental health services that can
improve psychological functioning (Schueller et al., 2019), primarily due to mistrust of the
system that is intended to support them (Black et al., 2018; Brown, Rice, Rickwood, & Parker,
2016; Hodgson et al., 2014; Sample & Ferguson, 2020; Schueller et al., 2019; Winiarski et al.,
2020).
Practices that do not take into consideration the perspectives of homeless youth, services
that are not tailored to their needs, and staff who are not trauma-informed (Hopper et al., 2018)
are aspects of the social norm that keeps this problem in place. Therefore, as service providers
look to create systems of support for young people experiencing homelessness, it is vital to
understand the needs of this group, specifically as it relates to mental health-specific services.
Opportunity for Innovation
Without psychological support, researchers say an estimated 50% of homeless TAY will
continue experiencing housing instability and/or homelessness into adulthood (Winiarski et al.,
2020). A better understanding of the barriers to engaging with mental health care among
homeless young people who are most in need of such services is essential for helping them exit
homelessness and reach residential stability (Hodgson et al., 2014; Sample & Ferguson, 2020;
PEER2PEER COUNSELING SUPPORTS 12
Taylor et al., 2016; Tyler et al., 2012; Winiarski et al., 2020). Peer support has been shown to
have a positive impact on outcomes for homeless people (Barker & Maquire, 2017; Kidd et al.,
2019), however, the impact could be even greater with new innovations in peer-based services
that allow for a new kind of service delivery.
The practice landscape reveals a unique opportunity to address homeless youths’
reluctance to engage with professional providers. By equipping peer counselors with lived
experience to implement CBT-based practices, thereby increasing access to peer-based mental
health and well-being supports for homeless young people, P2P emerges as an innovative
strategy for addressing the mental health/well-being needs of homeless young people that are not
being met under the current system of youth services.
There is nothing like P2P available in the current mental, emotional and behavioral
healthcare system, and with this innovative service delivery model, we believe we can improve
mental health and well-being for homeless young people and interrupt the cycle of chronic
homelessness. Strategies for measuring P2P’s success in achieving the intended intended
outcomes will be discussed under the “Project Structure” section of this paper.
Type of Innovation
Satell described four types of innovation, which he called “sustaining,” “breakthrough,”
“basic research,” and “disruptive” innovations (2017a). He defined a “breakthrough” innovation
as when we run into a problem that is very difficult to solve, we explore unconventional skill
domains to help reach a solution (Satell, 2017a). Traditionally, the way to address mental health
and well-being issues has been through licensed providers, who many homeless youth are
reticent to trust (Barker & Macquire, 2017; Eddie et al., 2019; Winiarski et al., 2020). “Clearly,
to solve really tough problems you have to cast your net far and wide to find the one elusive
PEER2PEER COUNSELING SUPPORTS 13
piece of the puzzle that does not lie in a conventional domain” (Satell, 2017b, p. 48). So, instead
of looking to improve licensed provider practices in our attempts to align services with the needs
of homeless youth, we would tap into a different kind of service delivery, or cast a wider net, by
training peers with lived experience of homelessness. If we considered a different, innovative
way to solve the problem, by training peer counselors with lived experience to implement CBT
with their homeless peers, this would appear to be “breakthrough” innovation according to
Satell’s definition (2017).
Alignment with the Grand Challenge
Ensuring healthy development for all youth is a grand challenge of social work that seeks
to address the mental, emotional, and behavioral problems youth face, so that we can help them
grow up to become healthy and productive adults (Hawkins, Jenson, Catalano, Fraser, Botvin,
Shapiro, Brown, Beardslee, Brent, Leslie, Rotheram-Borus, Shea, Shih, Anthony, Haggerty,
Bender, Gorman-Smith, Casey, & Stone, 2015). The call of this grand challenge is to promote
policies, programs, and funding to promote behavioral health for all young people from birth
through age 24, reducing behavioral health problems in this population through the power of
prevention (Hawkins et al., 2015). Given that this capstone is focused on addressing
behavioral/mental health problems in an underserved population of young people, and that it also
focuses on interrupting/preventing long-term homelessness, it aligns with the grand challenge of
ensuring healthy development for all youth.
Logic Model and Theory of Change
The theory of change that guides the development of this project states that, “If we train
young adults with lived experience of homelessness for meaningful, well-paying jobs as peer
counselors who can support their homeless peers using a cognitive behavioral approach, we
PEER2PEER COUNSELING SUPPORTS 14
increase access to mental health and wellness supports for homeless youth, and we are more
likely to interrupt the cycle of chronic homelessness.” See Appendix A: Logic Model for a
graphic representation of the logic model.
Clearly, the evidence suggests that there is a need for innovative solutions related to the
problem that homeless young people are reluctant to engage in supports that help improve their
psychological functioning and the ability to exit homelessness. The primary aim of this capstone
project is to ensure that homeless youth, who are reluctant to engage in traditional counseling
supports, feel more comfortable accessing peer-based mental health supports, which will
ultimately interrupt the cycle of chronic homelessness.
Project Structure
Capstone Components
The capstone, a program called Peer2Peer Counseling Supports (P2P), is a peer counselor
certification program that trains young adults with lived experience of homelessness to
implement a cognitive behavioral therapy framework with their homeless peers, and it is
comprised of four components: (1) Unique service delivery: Peer counselors with lived
experience of homelessness will be equipped to incorporate the foundational principles of
cognitive behavioral therapy in their conversations with their unhoused; (2) Engaging
curriculum: Engaging curriculum that teaches peer counselors to utilize a CBT approach in their
conversations; (3) Internship: A supervised experience under the guidance of a licensed mental
health provider; and (4) Certification process: A series of steps requiring completion of the
training modules, a supervised internship, and a final exam to earn a certification that allows peer
counselors use a CBT framework with their unhoused peers.
PEER2PEER COUNSELING SUPPORTS 15
One can see from Appendix B: Capstone Components that CBT is the innovative theme
represented in all four components. Using young people with lived experience of homelessness
to implement CBT principles is innovative. The curriculum that teaches the principles of CBT
represents an innovative peer support training model. A supervised internship that helps ensure
that trained young people can implement CBT principles with fidelity is innovative. And finally,
the certification process that equips young people with marketable skills that lead to meaningful,
well-paying jobs is innovative.
All of the capstone components can be accessed on a website developed for the program,
https://www.p2psupports.org, where prospective students can apply for enrollment, pay tuition,
and access the curriculum once they are enrolled. There is also a page for prospective donors
that explains our non-profit status and how to make a secure donation online.
Addressing Problems of Practice
Clearly the practice landscape reveals a distinctive opportunity for innovation. The
capstone project, P2P, addresses mental health because of research indicating that 50-80% of
homeless youth have serious mental health and/or drug addiction problems (Hughes et al., 2020;
Winiarski et al. 2020), yet fewer than 20% access available services (Schueller et al., 2019).
Without psychological support, homeless TAY will likely continue experiencing housing
instability and/or homelessness into adulthood (Hodgson et al.,2014; Sample & Ferguson, 2020;
Taylor et al., 2016; Tyler et al., 2012; Winiarski et al., 2010). P2P utilizes a CBT counseling
framework because it is an evidence-based practice that has demonstrated widespread efficacy
for disorders that occur frequently among individuals experiencing homelessness (Altena et al.,
2010; Barker et al., 2012; Castano-Cervantes, 2019; Maguire, 2006; Taylor et al., 2016; Spiers et
al., 2013; Wang et al., 2019).
PEER2PEER COUNSELING SUPPORTS 16
Because unhoused youth often demonstrate reluctance to engage in supports provided by
the formal mental healthcare system (Black et al., 2018; Hopper et al., 2018; Hughes et al., 2010;
Sample & Ferguson, 2020; Winiarski et al., 2020), P2P trains peers with lived experience of
homelessness to use a CBT framework in their counseling. P2P utilizes engaging training
curriculum to teach CBT principles because it meets the needs of the current generation of
learners who are less interested in reading a textbook or attending long lectures or completing
workbook pages on their own. P2P requires a supervised internship to ensure that candidates
implement the principles of CBT with fidelity. Finally, P2P certifies peer counselors because,
when trained counselors are certified to approach counseling from a CBT framework, they are
equipped to gain meaningful, well-paying employment as a peer counselor.
Together, four components of the overall capstone project address the problem that
unhoused youth are reluctant to engage in traditional mental health services that are available
(Barker & Maguire, 2017; Eddie et al., 2019; Winiarski et al., 2020). If we can address homeless
youths’ reluctance to engage with professional mental healthcare services in an innovative
service delivery format, we are more likely to interrupt the cycle of chronic homelessness
(Hodgson et al., 2014; Sample & Ferguson, 2020; Taylor et al., 2016; Tyler et al., 2012;
Winiarski et al., 2020).
Project Methods
Interested candidates can complete an application, pay tuition, enroll in the program, and
access the curriculum on P2P’s website. The only prerequisite is that they have completed high
school. If they have not already done so, any time prior to completion of P2P’s online CBT
training curriculum, candidates should also identify a fieldwork supervisor, who is a licensed
mental health provider, to oversee and evaluate their internship. Tuition is $250.00 for the entire
PEER2PEER COUNSELING SUPPORTS 17
course, which can be paid directly by the candidate, by the organization that sponsors the
candidate (e.g., Covenant House), or through scholarship funds from P2P.
P2P requires a supervised internship experience under the guidance of a licensed mental
health provider who can helps ensure compliance with CBT principles of therapy. In their
internship, candidates spend 50 hours developing and practicing CBT skills by counseling their
unhoused peers, under the supervision of their identified licensed provider. The internship
provides candidates with the opportunity to demonstrate implementation fidelity and their
competency to use basic cognitive behavioral therapy skills to influence human behavior.
Intern evaluation forms and instructions are provided for supervisors on P2P’s website.
Completion of the training modules, a satisfactory internship experience evaluation, and passage
of the final exam provides evidence that candidates have a working knowledge of CBT-based
counseling and allows participants to earn a Peer2Peer Counseling Supports certification.
Expected performance on all assessments (module knowledge checks, internship, and final
exam) is set at 80% or better, a standard of proficiency based on National Assessment of
Educational Progress guidelines (NAEP, 2020). NAEP provides standards that allow students to
demonstrate solid academic performance and competency with challenging subject matter
(NAEP, 2020).
Prototype
Prototype Purpose
The aim of P2P is to train peer counselors with lived experience of homelessness to
utilize a CBT framework in their conversations with their unhoused peers, to increase the
likelihood that their unhoused peers would access mental health supports. Therefore, I chose the
curriculum as my prototype because it is the means by which peer counselors become equipped
PEER2PEER COUNSELING SUPPORTS 18
to have CBT-based conversations with their peers. The curriculum is the material designed to
enable accomplishment of this intended aim, and it is instrumental to the project’s
implementation. The prototype is also useful for presentations with potential funders, partnering
organizations, and students, as it provides evidence that CBT skills are the foundation of P2P’s
certification.
Prototype Design
Cognitive Behavioral Therapy. Taylor et al. (2016) and other researchers have
established that using a CBT framework shows promise for improving services for people
experiencing homelessness. While professionally trained counselors are key for the most
effective treatment that uses cognitive behavioral therapy to help clients understand the
relationship of their own thoughts and behavior, the P2P project utilizes peer-based counseling.
Peers can use their own experiences to form an emotional connection with clients to help guide
them in overcoming their problems, and training for the current project adapted the CBT
framework to accommodate peer counselors’ strengths and needs. The content of P2P’s
curriculum is CBT-informed, it is grounded in CBT principles. Readers should note that this
project is in no way meant to replace therapy offered by a licensed professional.
The curriculum is a compilation of material largely based on Miechenbaum’s work,
Roadmap to Resilience (2012), and is also compiled from additional sources designed for
practitioners (e.g., Beck, 2021; Tolin, 2016) and laypeople (e.g., Gillihan, 2018; Tull, Gratz, &
Chapman, 2016; Wallace, 2017), as well as my personal experiences over 10 years under the
mentorship of a licensed psychologist. The interactive curriculum emphasizes CBT tools that are
appropriate for identifying thinking errors and basic cognitive restructuring, similar to the Taylor
PEER2PEER COUNSELING SUPPORTS 19
et al. (2016) study where bachelor’s level case managers were trained in CBT principles to guide
their clinical interactions with people experiencing chronic homelessness.
Personal experiences. This project was born out of my personal experiences with
trauma. As a child raised by a twice-divorced mother with a personality disorder, I witnessed
extreme domestic violence (my mother shot her second husband in my presence), I experienced
neglect and abandonment, I was taken by child services in the middle of the night, I spent four
years in foster care carting all my belongings around in one suitcase, and one house where I lived
in my foster care years was destroyed by a tornado, rendering us homeless. I have firsthand
experience with being marginalized, tossed aside, forgotten, and traumatized. These and other
traumatic experiences shaped and strengthened me, and the resilience I developed as a result
served to inspire the creation of P2P and the contents of the curriculum. The case studies
presented in each module are drawn from the deep wellspring of personal experiences with
trauma.
Cross-cultural experience. In my professional career as an educator (eight years as an
elementary special education teacher and 15 years as a professor and chair of the special
education credential department, I have had many opportunities to make content culturally
relevant and approachable to cultures other than my own. My eight years as a special education
teacher were spent in Watts, California to a mostly African American population. I have been an
invited speaker and educator in Papua New Guinea, Lebanon, Vietnam, India, South Africa,
Uganda, and Guatemala, primarily to train teachers and medical staff to educate students with
autism.
Principles of active learning. The prototype draws upon research that indicates what
“today’s learner” expects from a learning experience. Learners look for curriculum that is
PEER2PEER COUNSELING SUPPORTS 20
engaging and interactive, rather than passive reading or viewing long lectures (Cundell &
Sheepy, 2018). They prefer the flexibility of completing assignments anytime and in any place,
and the ability to interact with the content in ways that promote critical thinking (Cundell &
Sheepy, 2018). And they look for meaningful curriculum that has relevant learning objectives
and content that clearly enables the achievement of those objectives (Cundell & Sheepy, 2018).
A high level of engagement with the material is important for the best online learning
experience. There are 15 modules in the curriculum, all of which are structured to promote
active skill building, problem-solving, and critical thinking skills (Budhai & Skipworth, 2017).
Passive learning activities commonly found on Blackboard or Canvas learning management
systems, both of which I have used for over 15 years in my experience as a university professor,
typically ask learners to read or watch a lecture/presentation and respond in written form, which
is considered passive learning in the literature (Budhai & Skipworth, 2017). However, based on
the principles of active learning highlighted in Budhai and Skipworth (2017), P2P modules
include opportunities for the learner to engage with a great deal of content in smaller, more
manageable chunks, such as clicking a “card” to reveal a definition on the reverse side, or
clicking a “tab” to reveal more details about a particular topic, or following a timeline of steps
revealed one at a time, or sliding cards on a “carousel” to reveal smaller chunks of information.
(See Appendix C: Sample Module for an illustration of these active learning strategies. The
prototype is comprised of all 15 modules, and a sample module is provided for illustration in
Appendix C. This sample module, Module 6, introduces candidates to CBT.
Module structure. The curriculum used in this capstone is comprised of 15 modules.
(Please see Appendix E: Module Descriptions for a description of each module). Modules one
through five introduce candidates to the skills of a peer counselor, which includes strategies for
PEER2PEER COUNSELING SUPPORTS 21
questioning and listening effectively. The remaining modules introduce cognitive behavioral
therapy and then they teach candidates how to help their clients identify and break negative
thought patterns that influence our emotions and behavior.
All modules in the curriculum have the same structure. Modules open with a brief
introduction, followed by a list of the learning objectives for that module, content related to the
learning objectives, and 8-10 “knowledge check” questions that assess the level at which
candidates have met the learning objectives for the module. Candidates can take each
knowledge check a total of three times, to earn the required score of 80% or better. Most
modules also include a case study, or realistic scenarios where candidates can apply their
learning.
Field testing. After the first module was developed and uploaded to the course authoring
platform, I invited a sample of 12 users, ranging in age from 17-65, to view the module and
provide anonymous feedback. I was interested in testing whether the module contained too
much information for the average young adult learner, or too little; whether the graphics were too
busy or distracting; whether the module felt interactive and engaging for the user; whether they
considered the modules user friendly; and the extent to which they felt the knowledge checks
adequately assessed the learning objectives and the content of the module. See Appendix D:
Field Test Survey and Results to view the feedback form and sample remarks from field testers.
This feedback was then used to revise Module 1 and to inform the structure of the remaining
modules.
Instructional Design
While robust learning management systems (LMS) like Blackboard and Canvas have
helped streamline the process of translating content into the online environment, providing the
PEER2PEER COUNSELING SUPPORTS 22
type of engagement to match learner interest can present challenges (Budhai & Skipworth,
2017). Building courses that encourage deeper learning requires the use of a separate course
authoring tool. I conducted extensive research on what is considered the best course authoring
tool for eLearning that allowed for the creation of effective, engaging learning experiences—one
that had the quickest learning curve, for the most reasonable fee, with the best technical support.
My research led me to discover a tool called “dominKnow.” This tool, according to the
developers, allows instructional designers to “create more kinds of responsive content”
(dominKnow, 2020, para. 1). The “learning curve” was not as short as I imagined, and even with
my extensive experience teaching online content, it required a great deal of technical support.
However, having moved closer to mastering dominKnow, I am in a better position to achieve
program implementation. To date, I have created eight sample learning modules on
dominKnow, and uploaded the content to a cloud-based platform (SCORM cloud) that could
then be uploaded to the LMS I have chosen, which is Matrix. SCORM stands for “sharable
content object reference model” (SCORM.com, 2020). I chose Matrix as the LMS, after an
extensive amount of research, because it is SCORM compatible.
I have designed all 15 modules of the curriculum, and 8 have been uploaded to SCORM
cloud. To view all eight modules, click
https://cloud.scorm.com/sc/InvitationConfirmEmail?publicInvitationId=c8175b0b-0066-4c10-
a0ca-953360eb2969. As the project’s director, I have over 15 years of experience as an
instructional designer and professor of online learning at the university level, I have written
curriculum for at least 15 graduate courses for the School of Education where I was the director
of special education credentialing, and I have written and published three books (one textbook on
educating students with autism, one special education handbook, and one elementary school
PEER2PEER COUNSELING SUPPORTS 23
English language development curriculum). I also have a rich history of academic research and
publication, and local and international speaking/training experience. The amount of time
devoted to learning how to design and implement P2P’s website and engaging curriculum should
also provide convincing evidence that I have the capacity to bring the project to completion.
Market Analysis
We know that young people will seek out their peers with lived experiences, whereas
they are less interested in putting their trust in traditional service providers (Jacobson et al.
2012), and that recipients of peer support look to their provider as someone who has “been there”
and survived (Barker et al., 2018). Peer support can be provided in different settings as an
integral part of professional care, and it “provides mechanisms for people with lived experience
of mental illness to engage with those whose need for support is high, but who are often
alienated from traditional health services (Puschner, Repper, Mahlke, Nixdorf, Basangwa et al.,
2019, p. 2). There is a great deal of research literature demonstrating the far-reaching impact of
peer support, in terms of improved empowerment, quality of life, hope, self-esteem, better
functioning, engagement with care, and improved social networks (Puschner et al., 2019).
Evidence for the effectiveness of peer support abounds.
Typical peer support services are limited to social support, advocacy, preparing for
mental health care visits (referrals), coordination of services, locating housing, etc. (Barker &
Maquire, 2017; Barket et al., 2018; Kidd et al., 2019; Miller et al., 2020; Storm et al., 2020). A
number of organizations are utilizing peer support models to coordinate care and improve service
delivery, yet none directly involve peer supporters in any kind of clinical capacity (Jacobson et
al., 2012). A glance at Appendix F: Competitive Analysis Template will reveal greater detail
about organizations that provide services to the homeless population. With so many
PEER2PEER COUNSELING SUPPORTS 24
organizations serving those experiencing homelessness, it is surprising that none of these
organizations deliver research-based mental health/well-being supports via a peer-based model.
It appears that there is a gap in mental health services to homeless young people, and that
peer supporters are an under-used resource (Puschner et al., 2019). Where staff shortages in low-
resource setting are severe (Puschner et al., 2019), and young people are reluctant to put their
trust in traditional providers (Jacobson et al., 2012), leveraging the unique expertise of people
with lived experience of homelessness to provide mental health services represents a significant
opportunity in the market to improve service delivery.
Financial Plans
P2P is an established non-profit, under the fiscal sponsorship of Kingdomworks SDG
Foundation. With non-profit status, we have the capability of soliciting donations to support
P2P’s work. Moreover, P2P is supported by a reasonable financial plan. The program’s
operation will be closely monitored for financial efficiency and program effectiveness, and the
narrative provided in Appendix G: Financial Summary and Budget will show how the program
can be delivered with a positive bottom line.
Assessment of Impact
Performance measurement helps an organization better understand and improve their
program. According to the recommendations of Chapin Hall (Morton et al. (2019):
In the work to end youth homelessness, there is general agreement that young people
need stable housing, permanent connections, education and/or employment, and an
overall sense of well-being to succeed and thrive—and to make sure they never
experience homelessness again (p. 3).
The project’s outcomes and the metrics used to assess them are discussed below.
PEER2PEER COUNSELING SUPPORTS 25
Among the outcomes P2P will measure are the number of certified graduates who have
received CBT training, increased access to peer-based mental health services, improved mental
health and well-being, and housing stability. Outcomes on P2P’s logic model and their relevant
measures are included here:
(1) Graduates are certified for jobs to deliver CBT counseling supports. The number
graduates who are eligible for meaningful, well-paying jobs, will be measured by
counting the number of people who receive training, complete their internship, and
successfully pass the final exam. This data will be collected through P2P’s LMS.
(2) Increase the number of homeless young people who access peer-based mental health
services. This will be measured by the daily logs that count the number of clients that
peer counselors serve.
(3) Improved mental health/well-being of unhoused youth. The Mental Health
Continuum-Short Form (Keyes, 2009) will be used to measure mental health and
social-emotional well-being, administered pre- and post-therapy. This 14-item valid
and reliable measure, appropriate for youth and young adults ages 12 to 26, assesses
emotional, psychological, and social aspects of well-being in order to classify
respondents’ mental health, and is typically read aloud by the administrator for
respondents to indicate their feelings over the past month (Keyes, 2009). See
Appendix H: Mental Health Measurement for more information.
(4) Housing stability. Knowing whether housing situations can be characterized as stable
requires looking at a person’s housing situation over a period of time (Morton et al.,
2019). This can be measured through a brief interview with a young person by phone
or self-administered through a brief survey, which could be sent via text. This
PEER2PEER COUNSELING SUPPORTS 26
measure can capture young people’s experience of housing stability during a one-
month period. There is one item with eight response options, asking respondents
“have you experienced any of the following sleeping situations because you didn’t
have a safe or permanent place to stay?”, and choices include sleeping outside, in a
vehicle, in a hotel/motel, couch surfing, or none of the above (I have not experienced
any housing instability during the last 30 days) (Morton et al., 2019).
Stakeholder Engagement Plan
The stakeholder engagement plan includes a number of different elements. First is the
relationship established with a Foundation who has agreed to serve as a Fiscal Sponsor to P2P.
Please see Appendix I: Fiscal Sponsorship for the project proposal, PowerPoint presentation, and
the resulting fiscal sponsorship agreement signed by officers of the Foundation. I will engage
potential donors by identifying grant making organizations/foundations that might be a good fit
for P2P’s mission and submit grant proposals. See Appendix J: Costco Grant Proposal for a
sample grant that was submitted to Costco Foundation.
I will also intend to continue cultivating the relationship that I have established with
Covenant House California CEO Bill Bedrossian, an early adopter who will champion P2P’s
work with homeless young people in their new Orange County location. He is an influential
thought leader in the field of services to those experiencing homelessness and has established
relationships with many celebrities and philanthropists who may also support the work of P2P as
they see its impact among youth who are involved with Covenant House California.
In addition, I have an established relationship with the university where I am professor
emerita, Biola University. I am in the process of fulfilling an agreement to develop a mini
course about Autism Spectrum Disorders through Biola LEARN, that is available to the public
PEER2PEER COUNSELING SUPPORTS 27
without the need to enroll in the university. I believe I can leverage this relationship to develop a
mini course to promote P2P and drive traffic to the website.
One way I will attract end users (peer counseling certification candidates) is to offer a
free sample module through P2P’s website, where interested parties can try out one module
before committing to enrollment in the full program. Another way to generate interest is through
additional strategic partnerships, like I have with Covenant House, they may have potential
certification candidates they wish to sponsor. This would allow P2P to scale to other
organizations like substance abuse treatment centers, churches, ministries, universities, etc.
Communications Strategy
Other forms of marketing P2P is to continue my established record of professional
publications, conference presentations, and other networking events to promote P2P. Social
media appeals are also planned, as I have established pages on Twitter
(https://twitter.com/p2psupports ), Facebook (https://www.facebook.com/p2psupports ), and
LinkedIn (https://www.linkedin.com/in/dr-robin-labarbera-a2a59810/ ) that are devoted to
promoting P2P, all of which use the hashtag #InterruptHomelessness. I have attention-getting
plastic business cards and sticky notepads for P2P (see Appendix K: Marketing for images of the
card and notepad). Another social media strategy is to acknowledge celebrity support. I have
received permission from The Piano Guys to use their song, “Holding On” in promotional videos
for one year, and they have indicated their support of the project in an email. See Appendix L:
The Piano Guys Support for a copy of the email correspondence.
Ethical Considerations
It is possible that homeless youth might continue their distrust of mental health providers
in general, even those supports delivered by their peers. The barriers that prevent homeless
PEER2PEER COUNSELING SUPPORTS 28
young people from accessing mental health supports may remain in place despite P2P’s efforts.
There might also be concerns about implementing CBT practices with fidelity and
confidentiality, given that P2P-trained counselors are not fully licensed practitioners. However,
since they will be under the supervision of licensed providers, concerns about fidelity and/or
confidentiality are mitigated. It is also possible, given that homeless young people and their peer
counselors are peers from approximately the same age group, the professional relationship line
between them might be blurred.
Conclusions
Practice Context
The high prevalence of mental health concerns among homeless young people, and their
reluctance to access supports provided by formal mental healthcare systems, creates a unique
opportunity to address these concerns in an innovative service delivery model. Mental health
supports from P2P-trained peer counselors can remove barriers to access. And with the support
of an early adopter, Covenant House, P2P’s innovative service delivery model can make a
significant difference in the lives of countless homeless young people as they work toward their
goal of exiting homelessness. As evidence about P2P’s effectiveness is disseminated, interest in
the program will grow.
P2P’s innovative delivery method for providing mental health supports to homeless peers
appears promising. “Peer support has increasingly been incorporated as an integral component
of the behavioral health service delivery system to promote recovery, wellness, and resiliency”
(National Association of State Mental Health Program Directors, 2020). As more organizations
seek to improve services to homeless youth, P2P training and certification represents a viable
option for increasing the number of peer providers who are available for employment.
PEER2PEER COUNSELING SUPPORTS 29
Potential Obstacles
Integrating peer counselors in the homeless youth services system allows for increased
access to mental health supports that are critical for interrupting the cycle of chronic
homelessness (Hodson et al., 2014; Sample & Ferguson, 2020; Taylor et al., 2016; Tyler et al.,
2012; Winiarski et al., 2020). However, one potential obstacle to using peer counselors is that
those who oversee their work (e.g., licensed providers) might be reticent to integrate peer support
in mental health services to homeless youth. It may be that trained peer counselors who work in
these positions will feel under-valued in such an organization. Surely, a new method of service
delivery may be met with some challenges.
Limitations to implementing peer-based CBT among the population of homeless young
people include fidelity of implementation. Peer counselors are not licensed professionals, and as
such, they must be carefully supervised and provided with mentorship by professional providers
so that no harm is caused to their peers inadvertently. The structured nature of CBT and its
clearly defined principles make it relatively easy to train practitioners, but like any form of
therapy, CBT is not without some risk of unwanted adverse effects (Taylor et al., 2016;
Weintraub, 2018). Awareness and recognition of potential adverse effects will benefit patients
and improve the therapy process (Weintraub, 2018). It is therefore critical that peer counselors
be closely monitored during their internship and beyond.
The availability of technology could potentially impede P2P’s implementation.
Candidates need access to a computer, iPad, or smart phone to complete the training modules.
The vast majority of respondents (94%) in Rhoades, Wenzel, Rice, Winetrobe and Henwood’s
research (2017) owned a cell phone, and 85% currently owned a smart phone. In addition,
VonHoltz, Frasso, Golinkoff, Lozano, Hanlon and Dowshen’s research suggest that homeless
PEER2PEER COUNSELING SUPPORTS 30
young people are able to access the internet with relative frequency (2018). While experiencing
homelessness, 86% of participants in their research were able to access the internet at least once
a week and 56% were able to access the internet at least once a day (VonHoltz et al., 2018). The
high rates of cell phone ownership and internet usage among people experiencing homelessness
that has been established in the literature suggests that technology-based training programs are
viable for this population. We can reasonably assume candidates will have access to P2P’s
curriculum.
Despite these potential obstacles, the implementation of P2P’s program represents
tremendous benefits. More homeless youth would have the opportunity to engage in counseling
than they would have under the traditional mental health system. We know that without adequate
psychological support, as many as 50% of homeless young people will continue to experience
housing instability and/or homelessness into adulthood (Hughes et al., 2010; Winiarski, 2020).
We also know that peers are in the best position to build relationships based on their shared
experiences of homelessness that can be a catalyst for positive changes in their lives (Barket et
al., 2018). Peer supporters are commonly used in the substance abuse treatment and recovery
field, but too few organizations that serve homeless young people have adopted this model
(Barker et al., 2018). Therefore, P2P is uniquely positioned in the field of homeless services to
provide a breakthrough innovation.
P2P’s trained peer counselors benefit from the program as well. Employment is
particularly important to young people with lived experience of homelessness, as it contributes to
their sense of well-being and provides income that facilitates economic self-sufficiency and
independent living (Ferguson, Bender, Thompson, Maccio, & Pollio, 2012). Low educational
levels, combined with limited work histories, can hinder homeless and formerly homeless young
PEER2PEER COUNSELING SUPPORTS 31
people’s success in obtaining and maintaining competitive employment and places them at risk
of returning to homelessness (Ferguson et al., 2012). Being equipped with marketable job skills,
via P2P’s certification program, increases the likelihood of gaining competitive employment and
maintaining their housing status.
Recommendations for the Future
Immediate plans include completion of the remaining eight training modules, and the
Intern Supervisor component on P2P’s website. My extensive experience teaching, creating
engaging online curriculum, and leading accreditation efforts at the university level should
provide convincing evidence of my ability to accomplish these tasks in the proposed time frame.
With eight modules completed, the project is implementation ready. As candidates begin work
on the first eight modules, I have the capacity to complete the remaining eight just ahead of
them.
The project is ready for implementation at any time. The next immediate action will be
training a group of peer counselors at Covenant House’s Orange County location, with plans to
extend services to approximately 12 additional sites in the U.S. in the first year of operation.
Data will be collected throughout the implementation process to inform program improvement
and marketing efforts. In addition, a video campaign called #InterruptHomelessness for P2P has
been created and disseminated through social media outlets such as Twitter, Facebook, and
LinkedIn. See Appendix M: #InterruptHomelessness Campaign for a description of this
campaign. Immediate plans are to make ongoing improvements to the video.
As an extra measure of implementation fidelity, efforts to assess peer counselors’
acquisition of CBT skills using self-report measures will be added to the evaluation plan, based
on the recommendations of Taylor et al. (2016). P2P currently has in place knowledge checks
PEER2PEER COUNSELING SUPPORTS 32
for each module, field supervisor evaluations of candidate performance, and a final exam.
However, an additional assessment will be added to evaluate counselors’ perceived readiness to
implement the skills in a pre-test, and perceived effectiveness in a post-test at the end of their
internship.
Given the prevalence of the mental health problems that homeless young people
experience, and their reluctance to access professional services, it is important to engage in
innovative ways to reach this particularly vulnerable population. Without psychological
services, homeless young people are more likely to experience long-term homelessness. It is an
urgent priority to improve access to mental health supports and identify strategies for engaging
hard-to-reach individuals.
PEER2PEER COUNSELING SUPPORTS 33
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PEER2PEER COUNSELING SUPPORTS 43
Appendix A: Logic Model

PEER2PEER COUNSELING SUPPORTS 44

Appendix B: Capstone Components

PEER2PEER COUNSELING SUPPORTS 45
Appendix C: Sample Module
Module 6 - Overview of Cognitive Behavioral Therapy (CBT)
(For modules one through eight online, click:
https://cloud.scorm.com/sc/InvitationConfirmEmail?publicInvitationId=c8175b0b-0066-4c10-
a0ca-953360eb2969)

PEER2PEER COUNSELING SUPPORTS 46

PEER2PEER COUNSELING SUPPORTS 47

PEER2PEER COUNSELING SUPPORTS 48

PEER2PEER COUNSELING SUPPORTS 49

PEER2PEER COUNSELING SUPPORTS 50
Appendix D: Field Test Survey and Results

Survey

Results
A total of 12 reviewers evaluated the sample module (Module 1), and eight respondents
provided anonymous feedback on the SurveyMonkey tool. I also interviewed one respondent in-
PEER2PEER COUNSELING SUPPORTS 51
depth to gain additional insights. Results from the field test were then used to refine Module 1
and to inform the development of the remaining modules.
Representative feedback. Feedback used to refine the module is provided here. In
response to the question, “Which topics do you wish were more in depth or had more follow-up,”
one respondent said, “A clear definition of a peer counselor’s job description at the beginning
would be helpful. I remember reading why a peer counselor is best in some situations, but there
was an assumption that I knew what the job entailed.” One hundred percent of respondents
agreed that the quiz (Knowledge Check) at the end of the module asked relevant questions that
aligned with the learning objectives. Regarding page layout/graphics, one respondent said, “I
LOVED the way the pages were set up. Each page had a clean look without an overwhelming
amount of language. Yet, when you click the tables, each page actually had quite a bit of
information. This made viewing very digestible and engaging. It gave the feeling of discovery,
similar to playing a game.” One hundred percent of respondents rated the quality of the module
as “very high quality” and “high quality.”

PEER2PEER COUNSELING SUPPORTS 52
Appendix E: Module Descriptions

PEER2PEER COUNSELING SUPPORTS 53

PEER2PEER COUNSELING SUPPORTS 54
Appendix F: Competitive Analysis

COMPETITOR 1 COMPETITOR 2 COMPETITOR 3 COMPETITOR 4 COMPETITOR 5
Direct Competitors Indirect Competitors
Company
Profile

Company
Highlights
Encompass
Community Services
(Santa Cruz, CA)
My Friend’s Place
(Los Angeles, CA)
Covenant House Los Angeles
Homeless Services
Authority
Step Up
Key
Competitive
Advantage
Provides services in
behavioral health,
mental health
counseling,
substance use
recovery, well-being,
independent living
support, peer
support, outreach
A drop-in resource
center serving over
1,400 homeless
youth ages 12-25
Shelter and care for
homeless and
trafficked youth; the
largest privately
funded agency in the
Americas, providing
shelter, food,
immediate crisis care,
and other services.
Overall model:
“LAHSA supports
and creates
solutions to
homelessness in
Los Angeles
County by
providing
leadership,
advocacy,
planning, and
management of
funds.”
Outreach services
- to engage
homeless adults,
refer to services
Provides individuals
affected by serious
mental health issues
and who are
experiencing
homelessness with
permanent
supportive housing
Target
Market

Market
Information
TAY, families with
pre-school age
children; former
foster youth; HIV
diagnosis; adults
Youth ages 12-25 TAY (13-24) in 31 cities
across 6 countries
Homeless adults,
with the goal of
referring them to
services and
housing (short-
term housing or
shelters).
Individuals
experiencing serious
mental health issues
and homelessness
(adults, TAY,
veterans)
Market Share The largest
community-based
non-profit with
Serves nearly half
of homeless youth
in Los Angeles; $3.5
Operates in 31 cities
across 6 countries,
reaching 88,633 youth
6,634 people
contacted by
outreach workers
Staff of over 200
serving 650
permanent
PEER2PEER COUNSELING SUPPORTS 55
about 40 programs
in the county, $29
million budget
million assets; $2
million budget
in 2018. Since 1972,
helped more than a
million homeless,
runaway, and
trafficked youth;
$132,000,000 national
budget
supportive housing
developments in
Santa Monica,
Hollywood, West
Hollywood, Beverly
Hills, Pasadena, and
in Orange, Riverside,
San Bernardino
Counties; Georgia and
Florida
Marketing
Strategy
Market to all ages,
via website, word of
mouth: Services are
delivered with
dignity and respect
for each individual
and a commitment
to their right of
choice; “changing
lives, building
community.”
Market to TAY via
website, blog, word
of mouth, annual
benefit event,
marathon teams:
Primary goal is to
lower traditional
barriers to service
and provide
homeless youth
with the
opportunity to
improve
psychological,
intellectual, and
physical capacity to
reach their
potential.
Website, social media,
local “sleep outs” to
raise awareness and
financial support,
benefits/galas;
strategic plan includes
opening at least 6
more shelters
Outreach contacts
(for the outreach
services)
Website, blog, social
media, word of
mouth, benefit events
Products &
Services

Product
Information
For TAY: provides
counseling, skills-
building, drop-in
center (help
obtaining jobs,
registration for
Three program
areas: Safe Haven
(day shelter
offering basic needs
and referrals, a
“point of entry into
Outreach (provide
sandwich, information
about shelters, gain
trust, and get the
youth to the crisis
shelter); educate the
Outreach services
(building trust,
referrals to
shelters/ housing,
access to mobile
shower and
Permanent
supportive housing,
vocational training
and placement, and
member-driven
supportive services.
PEER2PEER COUNSELING SUPPORTS 56
college, budgeting
skills, workshops),
subsidized
supportive housing
(rent subsidies,
counseling, obtaining
ID cards, driving
permits, workshops
on money
management, finding
independent
housing, obtaining
financial aid for
college, rewards
program for youth
pursuing their
education);
transitional vouchers
(Section 8).
higher commitment
programming);
Transformative
Education (focus on
life skills, creative
arts, teaching youth
how to connect
with resources to
improve self-
sufficiency); Health
& Well Being (case
management, crisis
intervention,
coping skills,
counseling, medical
care, health
assessments,
pregnancy &
parenting program,
advocacy)
community on issues
of teen homelessness;
toiletries, help to
medical
appointments);
transitional
housing managed
by LAHSA provides
up to 36 months
of stable housing
for youth with
access to
supportive
services
Psychiatrists,
transportation,
weekly support
groups, money
management,
creative activities (art
and writing),
computer learning
center, parent
support groups; job
placement assistance;
Daniel’s Place for
transition age youth.
Pricing Free Free Free Free Free
Distribution
Channels
Outreach
(relationship building
and referrals); drop-
in centers,
transitional housing,
Drop-in centers Outreach (relationship
building and bring to
shelters), drop-in
centers, transitional
housing, long-term
residences
Outreach efforts,
collaborations,
advocacy work,
grants, and others
Permanent
supportive housing
Strengths
SWOTT
Information
Largest such
organization in the
county; established
1973 (TAY program
established 2003);
outreach to adults
experiencing
Large number of
volunteers (800);
integrate trauma-
informed care into
interactions with
youth; embraces a
strength-based
Open accountability
(financials, annual
report available on
website); fundraising
(raised over
110,600,000 in
contributions,
850 outreach
workers in LA
County; overall
organization has
sizeable budget;
provides funding,
program design,
Peers with lived
experience on staff;
weekly member
advisory councils for
feedback and
problem solving;
members volunteer;
PEER2PEER COUNSELING SUPPORTS 57
homelessness by
building relationships
and making referrals;
educates downtown
merchants/business
community, law
enforcement, county
behavioral health;
build on talents,
strengths, coping
ability, inherent
worth of every
individual; empower
youth in making
healthy transition
into successful
adulthood; as part of
a collaborative
project team,
received $2.2 million
multi-year HUD grant
to prevent/end
youth homelessness
in 2017;
comprehensive
website; skilled
leadership; public
relations.
approach to
preserve dignity
and empower
youth; work to
lower the barriers
to entrance
(minimize
psychological,
physical, social
barriers); thorough
information on
website/
communications;
equips youth with
marketable skills
(primarly creative
arts – writing,
acting,
drawing/arts)
through
Transformative
Education Program;
offers life skills
training, GED
assistance,
computer training,
resume writing, job
search strategies,
internship
opportunities
32,000,000 in
government grants,
16,400,000 in special
events revenue);
skilled staff; reputation
outcomes
assessment,
technical
assistance to 100
nonprofit partner
agencies that
assist homeless in
achieving
independence and
housing stability;
coordinate
support services
and housing
resources across
LA County to
connect homeless
individuals to
services and
housing;
administers
funding to service
providers; primary
goal is to connect
to effective
services; conducts
greater LA
homeless count;
Homeless
Engagement Team
(HET) provides
direct outreach to
link to resources;
educate public
about services
programs for TAY
(intervention,
education, mental
health care, service
coordination, linkages
to housing); 264
service recipients
employed in 2018;
2,200 homeless
engaged in mental
health services in
2018; California
nonprofit of the year
in 2018
PEER2PEER COUNSELING SUPPORTS 58
available; detailed
website visually
appealing;
information
hotline; last year,
the homeless crisis
response system
helped 21,631
people move into
permanent
housing (40%
above last year’s
count); outreach
workers contacted
34,110
Weaknesses Majority of services
offered to families
and adults (some
TAY services, 23
housing voucher
slots); outreach links
adults to appropriate
resources (does not
deliver counseling
through outreach);
financial limitations
(fundraising);
shortage of skilled
staff at physical
locations (current job
openings = 42);
reliance on
volunteers; limited
number of vouchers
Limited number of
beds/facility size;
budget relies
entirely on
donations;
communications
weakness (website
is “busy,” has tiny
print, and has
limited visual
appeal); 100%
privately funded
(fundraising efforts
are required); does
not provide
outreach
counseling
supports; Safe
Haven shelter open
Outreach business
model rests
entirely on
referrals to
housing that have
lengthy waiting
lists; lengthy
questionnaire
required to get
services from
LAHSA;
performance
indicators
measure only how
many people get
housing;
Members must
complete initial
screenings offered
8:30am-1pm Mon. –
Thur. only at Santa
Monica location; TAY
services are drop-in
only, with referrals
and help to
permanent housing;
serve only those with
mental health
diagnosis/issues;
employee
dissatisfaction
PEER2PEER COUNSELING SUPPORTS 59
to disperse (30 youth
on wait list for
housing); resource
center only open 2
days per week;
develop outcome
measures; staff
burnout
only during daytime
hours
Opportunities “Epidemic” number
of young people
leaving foster care
system without a
place to live and
without basic
independent living
skills (emerging need
for services);
outreach to those
youth on the waiting
list who cannot
access supports; few
competitors of
similar size and
community impact;
press/media
coverage of their
services; more TAY
eligible for Medi-Cal;
building
collaborative
relationships with
similar organizations;
expanding services
Offering something
that other
organizations do
not (outreach to
those who can’t
access the drop-in
center by providing
counseling
supports);
community
education
campaign around
homeless TAY;
social marketing
(advertise on social
media); fundraising
events; make
website less “busy”
and more visually
appealing;
matching grant
incentives; growing
TAY homeless
population in Los
Angeles; emerging
need for more
Increasing target
population
homelessness;
expansion
opportunities; offer
more customized
services, extend
services to non-
residential youth;
increase mental health
and addition supports
through community
partnerships;
strengthen life skills
workshops; support
health and well-being;
expand employment
and job training
options through
community
partnerships; in-house
job training programs;
increase public
awareness; expand
funding sources;
increase organizational
Developing an app
to provide
outreach workers
with real-time
information about
availability of
shelter beds;
significant media
coverage; 2019
Request for
Proposal
announcement
issued to provide
grants for centers
for transition age
youth
Few facilities offer
supportive
permanent housing
exclusively for
mentally ill homeless
population; social
media presence; blog
news coverage;
training staff in
trauma-informed
care; expand
infrastructure;
expand community
partnerships; rise in
mentally ill homeless
population
PEER2PEER COUNSELING SUPPORTS 60
to TAY (i.e.,
transitional housing)
supports and
services
capacity; strengthen
advocacy work;
evidence-based
research and
evaluation; expand
mental health/well-
being supports to
outreach;
Threats Social environment
that prohibits
building expansion
(“not in my
community”);
regulation/law
changes; stigma;
government funding;
financial risks
(grants, foundation
limitations); budget
constraints;
increased
competition for
funding
opportunities;
increased operating
costs; limited follow-
through for supports
with TAY
Reliance on job
development
partnerships
(employers who
provide
opportunities for
youth
employment);
reliance on
volunteers; reliance
on private
funding/grant
development;
competitors
(Covenant House);
societal attitudes
toward homeless
population;
supports and
services available
only in “drop-in”
delivery model.
City approval for
expansion (community
protests, lawsuits
prohibit building
occupation); public
resistance to
expansion; limited real
estate assets; public
awareness; increasing
sex-trafficking
awareness/prevention;
human
resources/staffing;
government support;
finding and sustaining
volunteer staff
Insufficient
housing
opportunities;
long wait lists;
unpaid shelter
workers tasked
with providing
information about
availability of
shelter beds (for
the app); regional
housing
affordability crisis
continues to drive
thousands into
homelessness
each year; limited
shelter beds
(“around 31,500
people are in the
system, have been
assessed by case
managers, and
have said yes to
housing-but are
awaiting a place to
Fundraising; staffing;
real estate/housing
difficult to find and
gain approval for
developing; public
awareness/education;
social acceptance;
revenue streams;
human resources;
governmental
regulations; political
support; relationships
with vendors,
partners, suppliers;
residents don’t seek
out opportunities for
housing; lack of
available facilities;
rising costs of
facilities; public
resistance to
expansion; worsening
economy
PEER2PEER COUNSELING SUPPORTS 61
call home due to
shortage of
affordable housing
stock and rental
subsidies.”)
Trends In Santa Cruz area,
2,167 are homeless:
Housing affordability
crisis; increase in
homelessness;
longer waiting lists
for supports and
services; chronic
homelessness
percentage increase;
increase in youth
(under 25)
homelessness; two-
thirds of homeless
are male, 60% are
over 25, 39%
physical or mental
disability, 30%
drug/alcohol use;
increasing lack of
affordable housing;
increase in family
and veteran
homelessness;
trends in
collaboration across
agencies
Increase in former
foster youth who
are homeless;
homeless youth are
vulnerable to sexual
exploitation;
disproportionate
percentage of
LGBTQ youth.
Homeless youth in
Hollywood: 75% are
18-25, 60% male,
42% African
American, 24%
Latino, 14 years is
mean age when
youth first left
home/were
removed/ were
forced out, mean
time homeless was
2.8 years, 27%
experienced hate
crimes, 53% do not
have high school
diploma, 49% met
criteria for clinical
depression, 18%
for PTSD, 40% had
In 2018, of the 88,000+
youth they served,
36% had criminal
justice history, 35%
mental health history,
30% foster care
placement history,
20% domestic violence
history. Over 10,000
served in residential
programs, over 3000
enrolled in job
readiness programs,
almost 2000 slept in a
CH bed each night,
over 1600 obtained
employment, 3500
enrolled in on-site
education programs,
4000 placed in stable
housing, 400 obtained
high school
diploma/GED, 26,000
on-site medical visits,
11,000 served in drop-
in programs; expand
mental health/well-
being supports beyond
the walls of their
City of LA
approved
temporary
moratorium on
“no cause”
evictions for some
housing units;
2019 homeless
count show 12%
rise in
homelessness
(58,936 people in
LA County
experience
homelessness);
23% of
unsheltered
people
experiencing
homelessness for
the first time last
year, 53% cited
economic hardship
as the cause; small
decrease in
veteran homeless
population;
Black/African
American continue
Social media;
PEER2PEER COUNSELING SUPPORTS 62
been removed from
home by CPS
facility
(mobile/outreach);
governmental and
organizational dollars
earmarked for facilities
expansion; increasing
costs for facilities
development
to be
overrepresented
(33%); youth
homelessness rose
24%; chronically
homeless numbers
increased 17%;
California has the
highest number of
people living in
poverty of any
state, LA County
has the highest
poverty rate
(24.3%)

PEER2PEER COUNSELING SUPPORTS 63
Appendix G: Financial Summary and Budget
Peer2Peer Counseling Supports (P2P) is an innovative nonprofit organization that trains
young adults with lived experience of homelessness to deliver CBT counseling to their unhoused
peers. A foundation has agreed to serve as a fiscal sponsor, which allows P2P to function as a
nonprofit under their 501(c)3 umbrella for a minimal annual administrative fee.
P2P is supported by a reasonable financial plan, discussed more fully in the narrative
below. The project’s operations will be closely monitored for financial efficiency and program
effectiveness, and the narrative below will show how the project can be delivered with a positive
bottom line. Read further for these financial details and for information about how the project
can be sustained and scaled when the time is right.
Start-Up
The three-month start-up phase requires $17,847 in expenses, to be supported by $36,250
in revenue. In the start-up phase, the capstone will be implemented one Covenant House
location in Orange County with approximately 5 peer counselor candidates. Three private
donors have committed to providing a combined total of $20,000 in start-up funds, and a
foundation has committed to funding a $15,000 start-up grant. Major expenses will include
curriculum development and finalization, the instructional design tool and the learning
management system, and data collection to be used for program evaluation. Other miscellaneous
expenses are listed on the attached budget.
First Full Year of Operation
In the first full year of operation, P2P’s training will be implemented at 12 of the 23
Covenant House Locations in the United States (with approximately 5 candidates per location).
In that year, revenues are expected to include $50,000 in private donations, $150,000 in
PEER2PEER COUNSELING SUPPORTS 64
foundation grants, and $15,000 in tuition/course sales. Expenses of $49,997 are expected for the
first full year, and they are discussed more fully in the narrative below.
Expenses
P2P will operate under the umbrella of a Fiscal Sponsor, Kingdomworks SDG
Foundation. This foundation has agreed to cover all insurance and professional fees, therefore
those expenses are not be reflected on the attached start-up or full fiscal year budgets. Health
insurance will be covered under the Executive Director’s family policy rather than as a P2P
expense. The Executive Director recently retired from her role as a full-time professor, and she
relies on retirement benefits from that position, therefore no other benefits expense is required of
P2P.
Personnel Costs
The Executive Director (Robin LaBarbera) will be the sole employee. The Executive
Director has earned two doctoral degrees, one in Education, and another in Social Work, making
her an ideal fit as director of a peer counseling certification program. Robin will take no salary in
the start-up and first year of operations. The Director’s experience as an educator (eight years as
an elementary special education teacher and 15 years as a university professor) adept at
curriculum development, training and education of the participants in the peer counseling
certification program, research, program evaluation, and communication and/or publishing
results at professional conferences and in academic journals warrant a significant salary,
however, she will take no salary until such time as the organization becomes financially able to
accommodate such a significant expense. When the time is right to expand the program to
additional Covenant House sites and/or to organizations beyond Covenant House that desire to
PEER2PEER COUNSELING SUPPORTS 65
train TAY to be peer counselors after the first year of operation, income is expected to support
the Director’s salary.
Any other staff who participate in the program implementation will be employees of
Covenant House or any other organization that contracts with P2P to implement the program and
are therefore not reflected on the start-up or year one budgets. Therefore, graduates of Covenant
house who participate in training and community engagement (selected because they have lived
experience and can relate well to the community of unhoused TAY), directors of mental health at
Covenant House who will oversee the program implementation and supervision of fieldwork, or
any other Covenant House staff who participate in program implementation will not be included
as personnel expenses on P2P’s budgets.
Other Operating Costs
Two areas—data collection, analysis, and publication of results ($24,000), and program
evaluation ($5,700)—represent the most significant expenses on the start-up and first year
budgets. Ongoing curriculum development ($4,000), and the annual fees for dominKnow ($997)
and Matrix LMS (5,000) are the next largest expense categories. Data collection, analysis, and
communication of results at $24,000 represent a rather significant expense. This budgeted
amount is commensurate with the researcher’s experience and time spent analyzing data and
writing documents that communicate results (which can be used in P2P’s and Covenant House’s
marketing efforts).
In the expense category, there are several items that represent fixed costs, and several that
indicate variable costs. Fixed costs include the instructional design tool (dominKnow) and the
LMS (Matrix), data collection, website hosting/internet, which do not fluctuate with the number
of candidates enrolled or the number of sites in which the project is implemented. Variable
PEER2PEER COUNSELING SUPPORTS 66
costs, then, include office supplies, fundraising/marketing, communications, and other
miscellaneous expenses, as they vary as the number of candidates and implementation sites
increase.
What is not reflected on either the start-up or year one budgets is office space expense.
For the foreseeable future, the ED will be the sole employee/operator of the organization, and
she will work from her home office.
Revenues
Revenue projections to cover P2P’s three-month start-up period will be provided by
individual donations and foundation grants at approximately $35,000 and course sales of $1,250.
Individual donors have been identified who are willing to provide the initial $20,000, and a
foundation has agreed to fund a $10,000 start-up grant. In the first year of operation, revenues of
$215,000 are anticipated. Fundraising and marketing efforts will continue to solicit individual
donations of at least $50,000 per year.
Government and Foundation Grants
Government grants could be a source of funding for nonprofits but applying for
government grants can be an arduous process. Moreover, especially during the start-up and year
one of operation, P2P has not established a track record of delivering robust programs in the
community. In addition, government grants require short lead times, they offer increased
oversight and monitoring of how funds are spent, and they are often slow to reimburse
(Stombaugh, 2019). Government grants also look for evidence that your organization has a
successful history of grant seeking, and a history of successful outcomes (Stombaugh, 2019), and
it is unlikely that these opportunities will be available to a new nonprofit. When the time is right,
PEER2PEER COUNSELING SUPPORTS 67
after P2P has been in operation for several years and has established a successful track record,
we may well pursue government funding.
In the area of homeless services, there are likely a number of government grants
available; however the most appropriate revenue source to help accomplish the mission of P2P
seems to be foundation grants. We’ve identified several potential foundations that offer grants to
organizations such as P2P that can provide the $150,000 in budgeted revenue. The Citi
Foundation Pathways to Progress Youth Workforce Fund
(https://www.citigroup.com/citi/foundation/programs/youth-workforce-fund.htm) supports
nonprofit organizations to connect low-income youth to a range of employment opportunities,
and P2P’s peer counseling certification program fits that description. The Citi Foundation would
potentially provide a $50,000 grant for P2P.
The California Wellness Foundation (Advancing Wellness Grants Program)
(https://www.calwellness.org/money/what-we-fund/) is an especially good revenue source for
P2P, as they promote opportunities to employ and build resilience in transition age youth who
are or who have exited foster care or homelessness. The California Wellness Foundation would
potentially provide a $50,000 grant for P2P.
A foundation known to the ED has committed to providing a $15,000 grant for start-up
efforts. We anticipate expending efforts to maintain an ongoing relationship with this foundation
for continued revenue streams. In addition to the foundations identified above (California
Wellness Foundation and Citi Foundation), there are several other foundations we have
identified that appear to be an appropriate revenue source to provide ample support for the
remaining expenses.
PEER2PEER COUNSELING SUPPORTS 68
Individual Grants
Three individual donors have committed to providing $20,000 in start-up funds. The ED
also has an extensive network of individuals who can be potential donors as the organization
proceeds to year one and beyond. Donor retention efforts will be ongoing, hence the $2,000
fundraising expense listed on the budget, and will include thank you calls, donor-appreciation
dinners, continued engagement in networking events, and the like. A typical strategy for
generating additional donors is via social media (Facebook, Twitter, Instagram, LinkedIn,
Website and Blogs). P2P maintains pages on each of those venues with an increasing number of
followers, and social media appeals will continue.
Please see P2P’s startup and first full year of operation budgets below:

Start-Up First Full Year
Private Donations $20,000 $50,000
Foundations/Grants $15,000 $150,000
Course Sales ($250 per participant) $1,250 $15,000
Total REVENUE $36,250 $215,000
Personnel Expenses
Executive Director salary $0 $0
Other Operating Expenses
Curriculum Development $8,000 $4,000
Instructional Design tool (dominKnow) $997 $997
Learning Management System license (Matrix) $5,000 $5,000
Data collection, analysis, publication $2,000 $24,000
Supplemental resources for participants $150 $3,900
Office supplies $1,000
Fundraising/Marketing $1,000 $2,000
Program Evaluation $5,700
Webhosting, internet $400
Communications $1,000
Conferences, Conventions, Prof. Development $500 $1,000
Miscellaneous expenses $200 $1,000
Total EXPENSES $17,847 $49,997
$18,403 $165,003
EXPENSES
SURPLUS/DEFICIT
REVENUE
Peer2Peer Counseling Supports
Start-Up and Year One Budgets
Category
PEER2PEER COUNSELING SUPPORTS 69
Appendix H: Mental Health Measure

PEER2PEER COUNSELING SUPPORTS 70
PEER2PEER COUNSELING SUPPORTS 71
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PEER2PEER COUNSELING SUPPORTS 73

PEER2PEER COUNSELING SUPPORTS 74

Appendix I: Fiscal Sponsorship
Project Proposal, Presentation, and Fiscal Sponsorship Agreement

Project Proposal: Peer2Peer Counseling Supports

Executive Summary
Young people who exit the child welfare system are often ill-equipped to transition to
self-reliant adulthood, and many end up with no place to call home. Peer2Peer Counseling
Supports (P2P) addresses this problem by providing online certification using a Cognitive
Behavior Therapy (CBT) framework to train peer counselors with lived experience to support
young people who are experiencing homelessness in their journey toward self-sufficiency and
well-being. Through this certification, young people with lived experience are prepared for
meaningful, well-paying jobs as peer counselors, and their unhoused peers get the supports they
need to heal from trauma from trusted peers who have lived experience.
P2P is the only organization that provides a CBT-based training curriculum that
addresses the unique challenges faced by transition age youth who are experiencing
homelessness. With the support of trained peer counselors, we increase the likelihood that
homeless youth progress toward life goals in the area of safety, health and wellness, education,
employment, self-sufficiency, and stability. P2P plays a vital role in the lives of homeless young
people who are seeking safety, housing, and employment as they transition to adulthood.
P2P is seeking approval from the Board of Directors of Kingdomworks SDG Foundation
to operate the project under the Fiscal Sponsorship of KSDG.

Problem Statement:
One in 10 young people aged 18-24 in the united states have experienced homelessness at
least one night in the previous year. That’s 3.5 million young people who slept on the streets, in
shelters, ran away, were kicked out, or couch surfed, and 83% (just over 2.9 million) of them
have had foster care or juvenile justice system involvement. As a result, many are unprepared
and ill-equipped to live independent adult lives and studies suggest that without support, they are
at great risk for becoming chronically homeless adults (National Network for Youth, 2020). “As
a nation, we are missing opportunities to ensure that all young people can reach their full
potential and contribute to stronger communities and economies across the country” (Morton et
al., 2017, p. 1).

Cause. There is not a single reason for why youth experience homelessness. Their stories
and situations vary from person to person. Information on youth homelessness shows that some
young people lack housing because they ran away from an abusive household, relationship, or
foster home. Some are homeless because despite employment, they cannot afford rent and end
up living on the streets. Some have simply “aged out” of the system of care where they lived
until they turned 18 (e.g., foster care, group home care, juvenile justice), and they were left
without a place to call home.

Consequences. The 2.9 million homeless young people who have transitioned out of
foster care or a juvenile justice facility are often unprepared to enter adulthood. These young
PEER2PEER COUNSELING SUPPORTS 75
people are often left without adequate support and guidance to navigate their transition to
adulthood, and as a result, they experience higher rates of unemployment and lower educational
attainment, and homelessness. Homelessness is a devastating experience that has a significant
negative impact on an individual’s physical and mental health, well-being, functioning, human
development, and life trajectory” (Youth.gov, 2020).
Researchers and concerned individuals have questioned whether these youth had received
necessary and effective services while in the child welfare system to help them establish
sustainable living situations upon exit. Only one-fifth of participants in Bender et al. reported
having had full-time employment in the past 6 months, however, the majority reported
engagement in informal or dangerous means of income generation such as panhandling, dealing
drugs, and stealing. This suggests a high need for employment services that help these youth
identify their informal—often entrepreneurial—skills and transfer them to formal employment
settings” (Bender, Yang, Ferguson, & Thompson, 2015, p. 227). Through no fault of their own,
young people who exit the child welfare system have not been given the support that helps them
develop the life skills, well-being, and resilience they need to succeed in the adult world.
The majority of youth who emancipate from child welfare experience a low quality of life
and lack the personal and social resources to hold their own successfully. They face significant
barriers to obtaining and maintaining stable employment and housing. Once homeless and on
their own, these young adults face extraordinary challenges to joining the workforce and
transitioning from life on the streets to self-sufficiency.

Chronic homelessness. Homeless youth under age 25 are a priority for many
communities. There is evidence that for many chronically homeless individuals, their pathways
into homelessness began when they were youth and young adults. It makes sense, then, that
focusing on homeless young people, with age appropriate models of support, may be the best
strategy for preventing chronic homelessness (Gaetz, Gulliver-Garcia, & Richter, 2014). We
have learned much about how to end homelessness, which includes a shift from managing the
problem through emergency supports to strategies that emphasize prevention (Gaetz et al., 2014).
For this reason, P2P is dedicated to equipping and empowering young people to build lives of
well-being and self-sufficiency, so that we interrupt the cycle of chronic homelessness.

Proposed Solution: Provide online certification to train peer counselors with lived
experience to support young people who are experiencing homelessness.

Project. In the field of youth homeless services, Youth.gov (2013) believes that
recognizing the effects of trauma and understanding how to address trauma are fundamental in
treatment and recovery efforts. They recommend approaches that involve cognitive behavioral
therapies, emotion regulation therapies, relational-interpersonal therapies, and peer-to-peer
support programs that enhance well-being and resilience (Youth.gov, 2013). For these reasons,
P2P was established to use a cognitive behavioral therapy (CBT) framework to train peer
counselors with lived experience to provide counseling supports to young people who are
experiencing homelessness. The premise of P2P is that with the right supports, unhoused young
people can become and remain housed, thereby ending the cycle of chronic homelessness.
The Peer2Peer Counseling Supports (P2P) project will prepare young people with lived
experiences of homelessness for meaningful jobs providing evidence-based, trauma-responsive
PEER2PEER COUNSELING SUPPORTS 76
counseling supports to their unhoused peers. The project provides 18 online video modules, with
related activities designed to enhance the learning experience, plus with 50 hours in an internship
experience under the supportive guidance of a licensed mental health provider, followed by a
final exam. Together, these learning activities lead to a peer counselor certification that young
people can take to any youth-serving organization (e.g., homeless shelters, transitional living,
supportive housing, churches, schools) in their employment search. P2P’s certification prepares
young people for meaningful, well-paying jobs in the rapidly growing homeless services field.
The program increases the pool of trusted peer counselors with lived experience, which
allows unhoused young people to have their support needs met by peer counselors, instead of
being referred to outside agencies, potentially to be subject to lengthy waiting lists. Trusted peers
are often considered essential among community-based programs serving homeless youth. The
one-to-one relationship with someone who has experienced homelessness is essential to earn the
trust of young people and to help offer meaningful connection and guidance. This program pairs
a certified counselor who builds a trusting relationship with an unhoused peer to help them
achieve identified goals related to education, employment, financial stability, and well-being.
Establishing and maintaining connections with supportive individuals is integral to their success.

Rationale. The most effective services for TAY who experience homelessness involve
not only assistance with housing, but also completing educational goals, securing employment,
and addressing mental health or emotional concerns. Advocates and providers agree that
vocational/occupational programs are a fundamental part of the transition from life on the streets
to mainstream society, and they recommend employment services that enable these young adults
to develop marketable job skills. Finding a job can help youth gain confidence in their abilities,
increase their sense of self-worth, and create independence through income generation.
Employment can be one of the most effective ways to support individuals as they move out of
homelessness and into permanent housing and independent living.

Competitive advantage. While there are several other peer support training programs in
existence, none are focused on supporting the unique needs of transition age youth by certifying
peers who have lived experiences with homelessness. A job training program that certifies TAY
to counsel and support their homeless peers was conceptualized because homeless services is one
of Los Angeles’ fastest-growing job sectors. With so many openings in this sector, agencies are
looking beyond social workers to those whose experiences are closely aligned with the people
they would be supporting. Those with lived experiences know the population they are serving
well, they know what it is like to struggle, and they know how to engage the population and
build trusting relationships. Homeless youth need to have someone who will listen, understand,
and be trustworthy. For these reasons, a peer counseling certification project that trains those
with lived experiences to offer support to peers was selected as the job training program.

Theory of change. If we offer a trauma-informed peer counseling certification program
to TAY who are living in transitional housing, we provide marketable job skills and give them
the tools they need for long-term stability and success, and TAY who are living on the streets get
the counseling supports they need to heal from trauma and begin their journey toward housing
stability. We help end the cycle of chronic homelessness through this community-level
intervention, so TAY don’t become permanently homeless adults.

PEER2PEER COUNSELING SUPPORTS 77

Goals and Objectives
The goal of the Peer2Peer Counseling Supports project is to enable unhoused young
adults to access support from trusted peers to the point where they can progress in their journey
toward self-sufficiency.
The main objectives include:
1. Increasing the number of young people with lived experience who receive certification
that prepares them for meaningful, well-paying jobs.
2. Increasing the number of certified counselors who gain employment as a peer counselor.
3. Increase the number of unhoused peers who get supports they need to heal from trauma
and progress in their transition to independent adulthood.
4. Increase the number of young people (certified counselors and the unhoused youth they
support) who find stable housing.
5. Facilitating the well-being of transition age youth.
• This will be measured by the Youth Thrive Survey, a research-informed measure
of the presence, strength, and growth of protective and promotive factors that
have been identified in research literature to advance healthy development and
well-being and mitigate the impacts of trauma and negative life experiences. The
factors measured include resilience, knowledge of development, concrete support
in times of need, and cognitive and social-emotional competence. (Measured pre-
and post-certification to demonstrate growth.)
6. In the long term, ending chronic homelessness.
• We will know we have ended youth homelessness when every young person who
is ejected from their home, runs away, or is homeless for any reason has
immediate access to youth-appropriate interventions and services that enable them
to grow and develop as a young adult and transition to adulthood and independent
housing with safety and with support.

Project Budget
The budget includes start-up revenue and expenses, as well as for the first full year of
operation for the project. This will provide training for five young people in the start-up period,
and 130 trainees in the first full year of operation. Also note that the Executive Director will
take no salary for the operation of the project.
Funding. Please note that P2P is seeking no financial compensation from KSDG.
Peer2Peer Counseling Supports will fundraise from grantmaking sources outside of KSDG.

Staff
Leadership. Dr. Robin LaBarbera, the Executive Director of P2P, has close to 25 years
in the field of education and 15 years in program development and curriculum design, and she
has a long history of research, publication, and speaking both locally and internationally. The
work of P2P combines her PhD in Education, her experience as a university special education
department leader, and her Doctorate in Social Work to lead this community-level social change
organization.
No other employees will join the organization until is made necessary by project
expansion.
PEER2PEER COUNSELING SUPPORTS 78

Conclusion
We must recognize that the circumstances that lead young people to homelessness are
different from adult homelessness. Many young people who are experiencing homelessness lack
the supportive structure they need to transition to adulthood with self-sufficiency. The goal of
P2P is to expand the pool of support for unhoused young people by providing certified peer
counselors who have lived experiences with homelessness. The support of a certified peer
counselor is key to preventing these young people from becoming chronically homeless adults.

Respectfully,

Robin LaBarbera, PhD, DSW-C
Executive Director
Peer2Peer Counseling Supports
PEER2PEER COUNSELING SUPPORTS 79
Appendix I
Board Presentation

PEER2PEER COUNSELING SUPPORTS 80

PEER2PEER COUNSELING SUPPORTS 81

PEER2PEER COUNSELING SUPPORTS 82
Appendix I
Signed Fiscal Sponsor Agreement

PEER2PEER COUNSELING SUPPORTS 83

PEER2PEER COUNSELING SUPPORTS 84
Attachment J: Costco Grant Proposal

To: Costco
Date: August 7, 2020

Kingdomworks SDG Foundation (KSDG) was founded July 27,1999 and was granted
IRS status 509(a)(1) as charitable organization (non-private foundation). Kingdomworks
SDG Foundation exists to build the capacity of organizations that promote and/or
perform acts of service to the community.

KSDG builds the capacity of community service organizations, through financial support
and/or strategic planning and consulting services. In 2019, Kingdomworks provided
financial support in the amount of $367,000 to over 16 entities that provided community
service, school programs for children with learning disabilities, universities, youth worker
development projects, churches, and home-building projects for impoverished
communities.

Peer2Peer Counseling Supports, described below, is a project of KSDG, for which we
are requesting $27,147 in financial support from Costco.

Project Description
Young people who exit the child welfare system are often ill-equipped to transition to
self-reliant adulthood, and many end up with no place to call home. Peer2Peer
Counseling Supports (P2P) addresses this problem by providing online certification
using a Cognitive Behavioral Therapy (CBT) framework to train peer counselors with
lived experience of homelessness to support young people who are unhoused in their
journey toward self-sufficiency and well-being.

The project increases the pool of trusted peer counselors with lived experience, which
allows unhoused young people to have their support needs met by peer counselors,
instead of being referred to outside agencies, potentially to be subject to lengthy waiting
lists. With the support of trained peer counselors, we increase the likelihood that
homeless young progress toward wellness, employment, self-sufficiency, and stability,
thereby interrupting the cycle of chronic homelessness.

How the funds will be used
Peer2Peer Counseling Supports is seeking a $27,147 from Costco to fund curriculum
development and course instructional design (dominKnow), licensing fees for the
learning management system (Matrix), participant stipends, and course materials that
will be utilized to train 130 participants nationwide in one full year of operation.

The funds will be used to develop 18 online certification modules and put them online to
make them available to the largest number of participants. Specifically, P2P is
requesting $4,997 for curriculum development and online instructional design, $5,000
for the learning management system licensing fees, $3,900 for supplemental
PEER2PEER COUNSELING SUPPORTS 85
resources/textbooks for course participants, 13,000 for participant stipends, and $250
for the Youth Thrive Survey data collection tool.
Please note that the Executive Director will take no salary. A grant from Change
Happens would be used to fund direct project expenses, and not for salary or overhead
costs.

Thank you for the opportunity to present this proposal.

Sincerely,

Robin LaBarbera
Executive Director, Peer 2 Peer Counseling Supports project
https://p2psupports.org
robin@p2psupports.org
562-833-4496

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PEER2PEER COUNSELING SUPPORTS 90

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Appendix K: Marketing

PEER2PEER COUNSELING SUPPORTS 94
Appendix L: The Piano Guys Support

PEER2PEER COUNSELING SUPPORTS 95

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PEER2PEER COUNSELING SUPPORTS 97

PEER2PEER COUNSELING SUPPORTS 98
Appendix M: #InterruptHomelessness Campaign

Why This Campaign Needed
Numerous studies have shown that the majority of homeless youth age 18-25 (transition
age youth, or TAY) struggle to access appropriate services that are designed to support their
mental health and wellbeing (Johnstone, Parsell, Jetten, Dingle, & Walter, 2015). While
unhoused youth are more likely to benefit from mainstream resources, such as shelters,
affordable housing programs, or mental health services available to the general homeless
population, they choose not to engage in such services for a number of reasons (Morton, Kull,
Chávez, Chrisler, Carreon, & Bishop, 2019). Common barriers impeding the help-seeking
process include poor mental health literacy, lack of knowledge about where to seek help,
negative attitudes toward professional help-seeking, fear of stigma, and confidentiality concerns
(Brown, Rice, Rickwood, & Parker, 2016). Other reasons youth report for rejecting formal
resources include strict rules, distrust of adults, and lack of physical or emotional safety in
shelter facilities (Morton et al., 2019). In a nutshell, homeless TAY do not trust the system that
was intended to support them.
Well-being, defined as overall satisfaction with life, which includes standard of living,
achievement in life, personal relationships, etc., is said to be a critical piece of transitioning out
of homelessness (Johnstone et al., 2015). In fact, evidence suggests that to break the cycle of
homelessness, policies must be in place that build upon a framework which has individuals’
well-being as the primary objective (Johnstone et al., 2015). Positive social support (perceived
emotional support related to acceptance and self-worth, perceived companionship, perceived
material and financial resources, perceived support to help understand and cope with
PEER2PEER COUNSELING SUPPORTS 99
circumstances) contributes successful pathways out of homelessness (Johnstone et al., 2015).
Together, well-being and social supports interrupt the cycle of chronic homelessness.
As the literature suggests, lack of availability, lack of awareness, and general mistrust of
traditional mental health and well-being support systems means lack of engagement with those
supports, which predicts poor outcomes for youth who are experiencing homelessness. These
issues underscore why a system that serves homeless youth should be centered on and responsive
to the needs, preferences, and voices of youth with lived experience (Morton et al., 2019).
Campaign Description
In order to increase access to mental health and well-being supports for unhoused youth,
thereby facilitating their transition to permanent housing, the current campaign will promote an
innovative solution. This innovation, called Peer2Peer Counseling Supports (P2P), involves
training TAY with lived experiences of homelessness to provide peer counseling to their
unhoused peers. P2P removes the barriers to accessing supports that are necessary for
transitioning out of homelessness.
Unhoused youth are reluctant to seek mental health and well-being supports for a variety
of reasons. Therefore, it is important to make services available that unhoused TAY will feel
more comfortable accessing. The campaign, which has the tagline, “The end of chronic
homelessness begins with P2P,” highlights the need for unhoused youth to access support from a
trusted peer to develop well-being and interrupt the cycle of chronic homelessness. The
campaign will be called #InterruptHomelessness.
The #InterruptHomelessness campaign will include a short-form video posted on
https://www.p2psupports.org, and on social media (YouTube, Facebook, Twitter, and LinkedIn),
to appeal to potential donors, with the goal of raising funds to support P2P. Communications
PEER2PEER COUNSELING SUPPORTS 100
will highlight celebrity affiliations with: (1) The Piano Guys, who have provided support through
the free use of their song, “Holding On,” which appears as background music in the video; (2)
The early adopter’s influence as an opinion leader in the field who has garnered the support of
numerous celebrities for Covenant House California.
Target Group
The #InterruptHomelessness campaign will be targeted towards donors and
philanthropists. Steiner (2018) stated, “Frankly, most people in the nonprofit world know more
about their projects and causes than about their prospective donors or how to approach them. In
my considerable experience, not knowing why Philanthropists give limits your ability and your
organization” (para. 10). He said that philanthropists give for a variety of reasons, such as a
family history or tradition of giving, and a desire to make a lasting impact for social good. Others
say that the key motives for their charitable giving include personal values or a sense of morality
and ethics, belief in a specific cause, faith and religion, and personal/life-changing experiences
(Charities Aid Foundation, 2010). The takeaway is that people in my target group –
philanthropists with the means to donate generously – typically do so in response to an appeal to
their values.
How it Differs
In 2014, the New York City Rescue Mission launched a campaign to answer the question
of whether the homeless had become so invisible to us that we wouldn’t notice our own family
members living on the street (Landau, 2014). The problem was that homeless charities rarely
made New Yorker’s list of organizations they wished to support. “Other than occasionally
dropping a dollar in an outstretched coffee cup, most New Yorkers were not engaged with
solving the problem of homelessness in their midst” (Effie Worlwide, 2015, p. 2). The Rescue
PEER2PEER COUNSELING SUPPORTS 101
Mission faced a rising need for additional funds and donations—demand for the homeless shelter
exceeded capacity and strained the organizations limited resources during a particularly intense
winter in New York.
New York City Rescue Mission launched a Make Them Visible Campaign to raise
awareness about the homeless population in New York City that accomplished three things. It
was very successful in (1) changing New Yorker’s perceptions of the homeless in their city; (2)
increasing volunteerism at the New York City Mission; and (3) appealing to people’s values.
The #InterruptHomelessness campaign differs from the Make Them Visible (MTV)
campaign in some respects, and it is similar others. #InterruptHomelessness also seeks to impact
the public’s perceptions of the homeless, but it focuses on perceptions toward a subgroup of the
homeless – young adults, ages 18-25. Secondly, #InterruptHomelessness will go beyond simply
changing the way we view people experiencing homelessness by spurring wealthy donors into
action with their pocketbook. The ultimate aim is to increase donations toward the cause.
Finally, #InterruptHomelessness will appeal to values, like the MTV campaign, but in a slightly
different way. MTV appealed to the value of family ties and the influence of those older than us,
and #InterruptHomelessness appeals to values of caring for the younger generation who were
neglected by the systems that were intended to support them.
Campaign Details
Using Cialdini’s (2006) concept of Social Proof, the campaign will: (1) capitalize on
celebrity endorsements; and (2) personalize the appeal to donors to garner support for P2P and
the #InterruptHomelessness campaign. Regarding celebrity endorsements, the artists of the song
used in the background music of the short-form video (“Holding On” by The Piano Guys), via
their music publisher, have granted permission to use their song free of charge for up to one year,
PEER2PEER COUNSELING SUPPORTS 102
which can be renegotiated at the end of the term. The publisher stated, “We’d like to show our
support of what your organization is doing by granting you a 1-year license free of charge.” I
will highlight their support and tag the artists on social media (Twitter and Facebook) and on my
nonprofit organization’s website (https://www.p2psupports.org) where the video will be housed.
The message will incorporate the concept of Social Proof (Cialdini, 2006). Social Proof
says that if a lot of people are doing something, then others perceive it’s the right thing to do. As
greater numbers of people deem a behavior to be the correct one, there’s the fear of missing out.
“Nobody wants to be the one who’s lacking what all the others have” (Crankovic, 2016).
Crankovic suggests that appeal of this nature talk about your neighbors who are seeing their gifts
double in impact, doing good and saving lives…look at how they’re helping…they’re taking
positive action and making a real and lasting difference in the world…. “The message is that
‘they’ are good, humanitarian people doing all these admirable things, and before long, your
prospective donor starts thinking, ‘Hey, I want to do those things too’” (Crankovic, 2016, para.
18). The message of #InterruptHomelessless will include a social proof appeal that says, “here’s
your opportunity to do good, just as the others in the group are doing.”
The overall goal of the #InterruptHomelessness campaign is to see more unhoused youth
accessing the supports they need to interrupt the cycle of chronic homelessness. In order to fund
these supports, in terms of providing certified peer counselors who have lived experiences of
homelessness, the message will communicate the need for financial backing from philanthropists
who value caring for the younger generation who were neglected by systems of child welfare.
References for this Appendix are included on the following page.
PEER2PEER COUNSELING SUPPORTS 103
Appendix K Campaign Paper References
Brown, A., Rice, S. M., Rickwood, D. J., & Parker, A. G. (2016). Systematic review of barriers
and facilitators to accessing and engaging with mental health care among at-risk young
people. Asia-Pacific Psychiatry, 8, 3-22.
Charities Aid Foundation. (2020). Why do we give to charity? Retrieved from
https://www.cafonline.org/my-personal-giving/long-term-giving/resource-centre/why-do-
people-give
Cialdini, R. B. (2006). Influence: The psychology of persuasion. Harper Business.
Crankovic, G. (2016, May 2). 4 ways to use social proof more effectively—and 1 to seriously
avoid. NonProfitPRO. Retrieved from https://www.nonprofitpro.com/post/4-ways-use-
social-proof-effectively-1-seriously-avoid/Johnstone, M., Parsell, C., Jetten, J., Dingle,
G., & Walter, Z. (2015). Breaking the cycle of homelessness: Housing stability and
social support as predictors of long-term well-being. Housing Studies, 31(4), 410-426.
DOI: http://dx.doi.org/10.1080/02673037.2015.1092504
Effie Worldwide, Inc. (2015). New York City Rescue Mission, Make Them Visible.
https://www.effie.org/case_database/case/NA_2015_9993
Landau, J. (2014, May 29). See it: New York City Rescue Mission aims to make homeless
visible through surprising experiment. New York Daily News.
https://www.nydailynews.com/new-york/video-brings-attention-issue-homelessness-
article-1.1809937
Morton, M. H., Kull, M. A., Chávez, R., Chrisler, A. J., Carreon, E., & Bishop, J. (2019). A
Youth Homelessness System Assessment for New York City. Chicago, IL: Chapin Hall at
the University of Chicago.
PEER2PEER COUNSELING SUPPORTS 104
Steiner, M. (2018, Feb. 5). Why philanthropists give. Medium. Retrieved from
https://medium.com/@Philanthropist/why-philanthropists-give-part-i-d7984b299c35

Abstract (if available)

Abstract Ensuring healthy development for all youth is one of the Grand Challenges of Social Work that focuses on prevention efforts to facilitate child development and mental health (Jenson & Hawkins, 2018). The aim of this grand challenge is to ensure that all youth grow up to become healthy and productive adults (Jenson & Hawkins, 2018). There is a group of young people, however, for whom opportunities to become independent, successful, and contributing members of the community are seemingly unreachable goals—they are transition-age youth (TAY) who are experiencing homelessness. ❧ A significant number of homeless young people experience mental health problems—as many as 80%, according to some researchers (Hodgson, Shelton & Van den Bree, 2014

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Asset Metadata

Creator LaBarbera, Robin Lyn (author)

Core Title Increasing access to mental health counseling for homeless youth: Peer2Peer Counseling Supports

School Suzanne Dworak-Peck School of Social Work

Degree Doctor of Social Work

Degree Program Social Work

Publication Date 11/30/2020

Defense Date 11/13/2020

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag homeless youth,Mental Health,OAI-PMH Harvest,peer counseling,well-being

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Brooks, Devon (committee chair), James, Jane (committee member), Wu, Shinyi (committee member)

Creator Email doktarobin@icloud.com,rllabarb@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c89-400088

Unique identifier UC11667192

Identifier etd-LaBarberaR-9169.pdf (filename),usctheses-c89-400088 (legacy record id)

Legacy Identifier etd-LaBarberaR-9169.pdf

Dmrecord 400088

Document Type Capstone project

Rights LaBarbera, Robin Lyn

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA