Hype Manual Section 4

SECTION FOUR: HYPE SERVICE PLANNING
HYPE Manual v1 July 2017 Section Four: HYPE Service Planning 4.i
HYPE Feasibility Pilot Training
SECTION 4: Notes
HYPE SERVICE PLANNING
This section consists of the following topics:

A. Goal Planning
B. Functional Assessment & Development
C. Resource Assessment & Development
D. Accommodation and Assistive Technology Education and Advocacy
E.
INTRODUCTION
Comprehensive goal development and subsequent service planning are at the heart of
HYPE services. To help develop intentional services that prevent or minimize the number
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and length of disruptions to their chosen role, HYPE services focus on early identification
of the factors associated with change. Change is difficult for everyone, regardless of the
presence or absence of a mental health condition, and understanding these factors is
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critical to providing strategic services and supports that quickly help a young adult develop
or pursue his or her goals. Therefore, in addition to understanding the facilitators of
change, this section will outline goal planning, including how practitioners can develop the
factors associated with change.
HYPE service planning is made up of a series of assessments that culminate in

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comprehensive goals that consist of targeted and specific interventions and steps. As
described in Section 3, understanding the stage of change (TTM) and phase of service
(C-G-K-L, which is described more in this section) helps practitioners to develop strategic
interventions and services. This section will describe the factors associated with change,
how they influence service planning, as well as describe the three prongs of HYPE services
that are critical to goal and service planning: (1) Functional Assessment, (2) Resource
Assessment, and (3) Accommodation and Assistive Technology Education and Advocacy.
Please see Figure 4.1: Service Planning
HYPE Manual v1 July 2017 Section Four: HYPE Service Planning 4.1
DO NOT COPY OR DISTRIBUTE
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These components of service planning allow practitioners to assess the critical skills needed for success, the resources
required to meet the demands of the new environment and role, and the accommodations and assistive technology
that may be helpful in mitigating the functional implications of the young persons mental health condition. A
thorough assessment process should include evaluating the factors associated with change and completing the
functional and resource assessments that will drive the development of a comprehensive goal plan and address the
skills, resources, accommodations, and assistive technology that a young adult may need. Completing a thorough
initial assessment, however, does not negate the need for future assessments nor is it intended to delay entrance into a
chosen environment. Assessments should be completed periodically, while a young adult is pursuing a goal, to reassess
areas of strengths, needs and to continue to inform the goal planning process. In the absence of assessments and the
information they provide the practitioner, the goal plan becomes arbitrary and most likely will not address the true
needs of the young adult.
GOAL PLANNING Notes

Young adults who are participating in service planning are those who have an expressed
interest in going to school or work. Some young adults are unsure of what exactly they want
to do, but are interested in pursuing something; these young adults are in the Choose phase
of services. Some know what they want to do, but need help accessing the opportunity;
these young adults are in the Get phase of services. Others will seek services because they
are in their environment of choice (e.g., enrolled in school or employed), but need support
because they are struggling with maintaining performance; these young adults are in the
Keep phase. Others may come (or return) to services because they are unhappy with their
current situation (e.g., job or academic program) and they need help changing; these young
adults are in the Leave phase, which typically triggers the initiation of another C-G-K-L
cycle by reassessing the goal.
Regardless of the phase, HYPE services will help a young adult develop a vision for his
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or her future and provide the supports needed to achieve the dream. The young persons
vision often becomes a long-term goal, but because long-term goals are just thatlong
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termthey can be hard to accomplish. It can be difficult to break large goals down into
individual steps and, once broken down, the goal then becomes a very long list of things
to do. This type of list can feel overwhelming to a young adult. In HYPE, and in many
other services, the long-term goals are instead broken down into a set of short-term goals
that become more manageable and easier to achieve. A series of small successes reinforces
forward movement toward the larger goal.
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How to Write a Goal Plan: A goal becomes a wish when there is no a plan.
Goals are difficult for everyone to achieve and thats why they are a goal: something for
which to strive and intentionally work toward to achieve. When training new practitioners,
they are asked to consider the approach used to set and meet personal goals. In these
trainings, it is often found that practitioners struggle with accomplishing their own goals
and are reluctant to share their goals openly with the group. This becomes a very valuable
lesson for practitioners, as they forget that goals are personal and articulating goals to
others can make a person feel vulnerable.
Practitioner Note: During the goal setting process, practitioners need to be

supportive, genuine, and non-judgmental. Young adults need to be assured that
their conversations are maintained within the bounds of confidentiality and are
intended to help them achieve their goals. Promoting hope, as well as reflecting
sincere appreciation when a young adult shares his or her goals, is a critical piece
in creating a therapeutic alliance with the practitioner.
HYPE uses SMART (Specific, Measurable, Achievable, Relevant, Timed) as a method for
writing goals. This approach is considered the gold standard for goal planning, but can
be challenging for practitioners to learn. HYPE has developed a worksheet that can assist Notes
practitioners in creating SMART goals (See SMART GOALS worksheet in Appendix). This
can be used to refine a young persons goal plan to adhere to each of the SMART standards
listed below:
Specific: Is the goal described in precise terms? Would a stranger be able to read it and
understand what you meant?
Measurable: How will you know if it has been accomplished? Is the goal supported by
measurable objectives that state how progress will be assessed?
Achievable (Action-oriented): Does the plan contain the necessary objectives supports/
skills/interventions/knowledge to make the goal happen? Does the goal advance
progress of one area of need?
Relevant: Is the goal consistent with immediate and long-term plans?
Timed: What is the time frame? Does the goal and each objective have a clear start and end
point?
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A goal plan is the map of services and should be able to be used by any practitioner at
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any time. In the absence of a well-articulated plan with concrete steps and corresponding
timelines, goals are often not accomplished. During changes in staffing, an inadequate goal
plan means that a young adult must start the process all over again with a new practitioner.
Therefore, it is crucial to help a young adult develop a solid and understandable plan with
achievable steps the first time around.
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Goal Planning and Choose-Get-Keep-Leave Approach
Young adults goals are influenced by many factors. As previously noted, goals can be
formed based on interests and values however goals are also influenced by the current
phase. The C-G-K-L approach to HYPE is normative, meaning all individuals, regardless
of the presence of a health condition, go through them. In order to develop a tailored goal
plan, understanding the current phase a young person is in is critical to facilitating success.
The below are descriptions of each phase and how they relate to goal planning. Also, please
see Table 4.2: HYPE Educational Activities by Phase.
Choose Phase (how it happens and what helps)
The Choose phase is designed to assist people in making an informed choice about where,
when, why, and how they want to work or attend school. It is also the phase of service
where goals are initially developed, refined, and documented. The Choose phase requires
exploration of the young persons values, interests, and preferences to assist the individual
in making informed choices of what academic program they want to enter or what job
they would like to obtain. Furthermore, assessing the factors associated with change helps
to figure out the young adults immediate willingness to go to school or work and helps
guide the practitioner in how best to connect with, assist, and support the young adult.
These change factors should influence the development of the goal plan by matching
interventions and supports to the identified needs. If the young adult has many barriers Notes
associated with entrance into work or school, developing a Choose goal may be help
focus services as well as satisfy documentation and reimbursement/billing requirements.
Choose goals may look like, I will choose a vocational program that is in-line with my
preferred job by January 20XX or I will research careers in advertising by March 20XX.
Some literature indicates that the time needed for developing an educational or
employment goal in the Choose phase ranges from three weeks to six months depending
on the young adults interest and other factors (MacDonald-Wilson, Mancuso, Danley, &
Anthony, 1989; Sullivan-Soydan, & Legere, 2004). On the other hand, some young adults
come into services with a fully articulated and well thought out goal.
Get Phase (how it happens and what helps)
In the career development process, the Get phase is the planning portion where the young
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adult articulates the goal he or she wants to achieve. When the young adult has identified
a goal, either through the Choose phase or if one was developed upon referral to HYPE,
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the practitioner will help to refine the goal with the young adult by specifying his or her
preferred area of work or academic interest, a desired job site or school/training setting,
the desired level of participation (e.g., part-time or full-time school and/or work), and a
target date for acquiring the job or enrollment in the educational program. For example,
a young adult with an educational goal might state, I will enroll full-time in a local
community college for the Fall Semester. Or a young adult with a work goal might state,
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I will have a full-time job in the comic book store by June 15. The goal statement focuses
the work of the practitioner and young adult. Based on the results of the Factor Associated
with Change Assessment (FACA) and strengths assessment, critical skills and resources
are identified. Planning for successful goal achievement requires the practitioner and
young adult to work together to identify the important tasks, determine whos responsible,
and set task deadlines in order to accomplish the goal. The practitioners support will be
needed for young adults who do not yet have competencies in executive functioning and
self-management skills (e.g., setting a schedule, meeting deadlines, monitoring progress).
Additionally, if the young adult does not have previous experience with entering into the
desired environment, it may be difficult for him or her to be largely self-directed. Therefore,
additional instruction about how to accomplish each task may be required (e.g., completing
a FAFSA, creating a resume).
During the Get phase, it is also important to develop critical resources that provide specific
types of support. Core resource needs can be assessed, defined, and then added to the goal
plan through administration of the Resource Assessment (See Appendix). Some examples of
commonly identified resources are a financial aid specialist or an advisor from the potential
school, an organization that donates interview clothes, a computer, or a peer practitioner to
help support a transition.
Another critical task in the Get phase is the identification of any potential needs for Notes
academic adjustments or reasonable accommodations in both school and work. Academic
adjustments or reasonable accommodations are needed when the mental health condition
prevents the young adult from performing some of the tasks associated with the role. For
students, adjustments can be made in the classroom (e.g., allowing a student to audio record
the class), during exams (e.g., a specific amount of extended time to complete the test),
or in administrative requirements (e.g., permission for early registration). For workers,
accommodations may include adjusted schedules, quiet space, the use of headphones to
mask background noise, or written instructions to supplement oral directions given by a
supervisor. An in-depth discussion about the role of disclosure of a mental health condition
(i.e., do I tell, who to tell, what to tell, and how to tell it), as well as the role of the Office of
Disability Services for students and Human Resources for employees to help align such
adjustments and accommodations, is important at this juncture. Young adults should work
with their HYPE practitioner and clinicians to collect necessary documentation to provide
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to these offices. HYPE has included the Functional Implications Assessment worksheet
in the Appendix to assist the practitioner in evaluating the functional implications of
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the young adults mental health condition. This assessment will help identify the ways in
which the mental health condition may impact the role of student or employee and what
accommodations, resources, and skills could offset the impact.
Keep Phase (how it happens and what helps)
The Keep phase is the longest and most time and energy intensive of all of the phases.
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Successful keeping involves ongoing commitment and recommitment from both the
young adult and the practitioner. A wide range of skills needs to be assessed, taught,
practiced, and evaluated. HYPE services focus on developing and refining skills so that
young adults can master critical skills and use them when needed across different roles and
environments. Other Keep activities are designed to help the young adult sustain the role
and ensure that the experience is both satisfying and successful. Skills that cut across both
educational and employment environments include clarifying assignments, managing time,
completing assignments on time, preparing for exams or meetings, responding to feedback,
managing internal distractions, and negotiating with employers or professors. The HYPE
Critical Skills Assessment assists the practitioner in identifying the skills that a young
adult is proficient in and the corresponding Skill Lessons guide the practitioner in how to
teach the skill(s) in order to facilitate goal achievement. (See Critical Skills Assessment in
Appendix A and Section 5.)
Practitioner Note: There is a difference between satisfaction and success.

Satisfaction is how happy someone is with his or her own performance or position,
whereas success is how happy someone else is with a persons performance or
position. For example, a student can be completely satisfied in a class that has a
fun professor and only two exams. However, the professor may view the student as
unsuccessful due to poor grades.
Once a young adult has entered into his or her preferred environment (a school or job), Notes
aligning critical resources is a major feature of the Keep phase. Educational environments
are typically rich with support resources, such as tutors, advisors, counselors, the student
union, a college counseling center, or physical and recreational activities. Off-campus
links to crisis intervention, psychiatric services, housing, and financial resources are
also useful at this stage. Arranging for academic adjustments, accommodations, and
assistive technology may be ongoing throughout this phase. Skill development, service
coordination, and consultation with campus faculty and staff may be simultaneously
needed when problem situations emerge in the school setting, such as during potentially
stressful parts of the semester (e.g., beginning of school year, during examination time).
Employment resources will vary with the type and size of the employer organization. Large
businesses may provide access to counseling and support through an employee assistance
program (EAP), an on-site exercise facility, payment for uniforms, discount transportation
passes, or financial support for continuing education. Small businesses most likely will not
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have these resources available, but may be more flexible with adjusting the job expectations.
Leave Phase
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The Leave phase can occur rapidly, without prior notification or planning (e.g., a student
needs to withdraw mid-semester due to emergency surgery, an employee gets laid off
due to a reduction of their companys workforce). It is critical for the practitioner to help
the young adult navigate this process by helping him or her complete all of the necessary
documentation and other associated procedures to ensure that the return to their stated
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goal or environment is not negatively impacted (e.g., the student did not submit withdraw
paperwork and now has an outstanding semester bill, the employee did not return to work
after learning of impending layoff and no longer has a viable reference). The Leave phase
can also be expected and intentional, like when a student graduates or an employee obtains
a new position. While there are unique steps to complete this phase, it also usually triggers
the start of the C-G-K-L all over again.
Another important component influencing the C-G-K-L process are the factors associated
with change. Assessing factors associated with change is critical to intentionally supporting
young adults in their career development and can help the practitioner better understand
where the young adult is at upon entering services. Moreover, evaluating the factors
associated with change helps the HYPE practitioner identify the phase of service and stage
of change, clarify goals, and develop interventions in order to help a young person achieve
his or her goals.
Table 4.2: HYPE Educational Activities by Phase
Choose Get Keep Leave
HYPE Manual v1 July 2017

Goal Development Goal Planning Goal Refinement Goal Re-evaluation

Resource Assessment
FACA Resource Assessment Resource Development
Aligning Critical
Strength Assessment Functional Assessment Skill Development Resources
FACA Admission deadlines Develop community/campus Complete required

support leave paperwork
Interest exploration Application process
Linkage to critical resources Explore leave
Job analysis related to major Standardized procedure
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Academically focused services
Informational interviewing o entrance exams
Wellness Planning
Researching Schools School Financial planning
Section Four: HYPE Service Planning

tours Register with ODS
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o FAFSA
Exploring personal criteria
Transportation
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Determine Accommodation &
Assistive Technology
Exploring benefits of education
Identifying Academic Develop effective interpersonal
Exploration of educational Pathway skills
pathways
School/program interviews Develop critical academic skills
Supportive counseling
4.8
Identifying Factors Associated with Change Notes

Facilitating change is a basic concept in Motivational Interviewing (MI) and the
Transtheoretical Model (TTM; also known as stages of change) and understanding the
factors associated with change is considered a foundational skill in HYPE. The three most
important areas that are focused on in this manual are motivation, commitment, and
awareness. Motivation and commitment are complex factors that are critical to initiating
and sustaining change. Given their complexity, cultivating these factors require thorough
assessment and thoughtfulness. Awareness is divided into two sub-categories: knowledge
of self and knowledge of the desired role. It is important to success and satisfaction and
is more straightforward than motivation and commitment in terms of cultivation. In
addition to motivation, commitment, and awareness, there are other important factors
associated with changes such as support and self-efficacy. The Factors Associated with
Change Assessment (FACA) is a tool that is used within programs to help a HYPE
practitioner initiate conversations with a young adult about motivation, commitment, and
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knowledge of self and desired role as it relates to their goal (See Appendix A). FACA is a
semi-structured tool that is intended to guide conversations that allow the practitioner to
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systematically identify the barriers and facilitators to change. The result of the discussion(s)
is to help service planning, goal setting, and goal acquisition activities become strategic
and intentional. Practitioners target factors that are underdeveloped and are required to
facilitate and sustain the change process.
Practitioner Note: Other practitioners using the FACA state that not only does
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the discussion help them develop intentional supports for young adults, but that
the young adults benefit from the discussion as well. It helps them recognize their
accomplishments, their supports, and their values and helps to solidify the goal in
their minds.
The FACA is a guide that helps practitioners ask targeted questions to better understand
the young adult. This assessment has been modified from work completed at the Center
for Psychiatric Rehabilitation (CPR; Farkas, Sullivan-Soydan, & Gagne, 2000) at Boston
University and at the Department of Psychiatric Rehabilitation at Rutgers University
(Roberts & Pratt, 2006) and from other related work completed in the field (i.e., Smith et
al., 1998).
The three areas that are the focus of the FACA are summarized below.
Motivation
Motivation is comprised of the reasons why a person wants to accomplish something and
the amount of pressure the person is experiencing to make a change. Those with high levels
of motivation feel a push to change or a push away from the current situation or behavior.
Areas that are commonly associated with motivation are external pressure, consequences,
urgency to change, and increased dissatisfaction with the current state of affairs. Overall,
a high need to change is characterized by serious consequences of not changing and an Notes
urgency to avoid those consequences.
Commitment
Commitment feels like a pull to change and can be broken down into the following
components: the degree to which a person believes that change will be positive, the persons
belief that change is possible and that he or she can make the change happen (self-efficacy),
and the belief that other people will support the change. It can be helpful to include
the persons belief about whether he or she is likely to be able make the change happen.
Commitment to change is increased when the expected outcome is highly desired by the
person, the person believes that his or her actions can and will cause the desired outcome,
and the person believes that he or she is capable of performing the necessary actions.
Commitment and motivation tip the scale (or the decisional balance fulcrum; Janis &
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Mann, 1977) from contemplating to preparing for action. This is the persons internal
desire to change and combines a sense that the current state of affairs cannot go on and that
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changing would be better than staying as is.
Awareness
Awareness is the last major factor and is divided into (1) knowledge about oneself and (2)
knowledge about the desired role. Self-awareness and role awareness are both needed for
informed decision-making and to create the foundation for setting a goal that drives the
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process (Cohen et al., 1993). These two factors are easier to influence and develop, as they
are based in knowledge and interactions with self and others.
Factors Associated with Change Assessment (FACA)

Assessing the factors associated with change is most beneficial when a practitioner first
begins to work with a young adult. The FACA was developed to explore motivation,
commitment, and awareness in order to aid service planning as well as goal development
and pursuit. The FACA provides structure to discuss the young adults current situation
and previous experiences and takes about 45 minutes to an hour and a half to complete,
depending on the young adult. When practitioners are initially learning how to use the
tool, they may speed through the assessment because they are not comfortable or do not
understand the purpose of the discussion (i.e., to explore and pursue information that
impacts change).
Because the purpose of the FACA is to generate discussion, practitioners should use
their counseling skills, such as reflecting and summarizing, to facilitate the discussion
and pursue content that is relevant to motivation, commitment, awareness, and support.
Further, they may want to discuss previous experiences that have influenced the young
adults confidence and feelings of self-efficacy in his or her desired role and or environment.
The FACA can be broken up into two discussions; however, motivation and commitment Notes
should occur in one discussion, as they often influence each other.
The FACA is made up of 28 questions. Given the nature of the tool, not all questions will
need to be asked as the discussion from one question may naturally lead to answering an
additional question. The FACA is not intended to be a self-report measure (i.e., giving it to
the student to fill out will yield poor results) nor is it intended to be a series of rapid-fire
questions. The questions identified on the FACA are a starting point, so after reflecting
on and summarizing a response, practitioners should ask follow-up questions to better
understand the factors associated with change. The analogy of peeling back the layers of
the onion is often used to describe the process. A young adults initial answers are akin
to the dry outer layer of the onion (the easiest layer to get to) and the FACA allows the
practitioner to get to the part of the onion that is often not readily exposed, but is the part
that the practitioner wants. The FACA is highly reliant on counseling skills (please see
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Addendum for more information about MI and other counseling techniques).
Practitioner Note: When using the FACA, practitioners should avoid fixing or
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providing advice. The purpose of the FACA is to seek to understand the young
adult. By simply exploring these factors, practitioners better understand the
strengths, needs, attitudes, and beliefs of the young adults they serve and begin to
build a strong therapeutic alliance.
Young adults seen by HYPE services will vary widely in their needs. Some will come
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to services with high levels of commitment, motivation, and awareness, but may need
help with executing their goals. Others will come in with varying levels of these three
factors and the HYPE practitioner will need to identify how best to develop the factors
associated with change. The FACA can provide additional information about the factors
associated with change as well as some clarity regarding the stage of change. The results
from the FACA provide a strong foundation for developing a service plan to help cultivate
the needed factors to either articulate, pursue, or achieve a goal. Section 6: Support
Strategies describes the common ways to support students in returning to school (Also see
Educational Intervention Matrix in Appendix).
Developing Factors Associated with Change
After completing the FACA, the HYPE practitioners task is to develop a set of
interventions, resources, and supports to best assist the young adult in achieving his or
her goal. The development of factors associated with change, such as motivation and
commitment to work and/or attend school, is critical to sustaining forward-moving
traction on expressed interests. Developing these areas through the use of activities,
experiences, and interactions with others will help young adults learn more about
themselves and their options, build confidence, and recognize the positive possibilities that
work or school might offer.
The following sections describe ways to build factors associated with change by reviewing Notes
specific activities, experiences, and interactions the HYPE practitioner can offer. These
activities, experiences, and interactions should be incorporated into the young adults goal
plan.
Values Clarification
Values clarification exercises, originally developed for use with youth, are popular as
readiness development activities, are used for increasing self-awareness (see e.g., Simon,
Howe, & Kirschenbaum, 1995), and take several different forms. SE practitioners often
conduct values clarification exercises with those they work with. It is just as important to
conduct values clarification activities with young adults, as their values are developing and
taking shape. Below are a few recommendations that have been successful in engaging
young adults in meaningful conversations. (Please see Values Clarification Section in the
Appendix for more resources).
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One or more open-ended questions can help prompt a discussion about values (e.g.,
Describe your ideal day, What would you do if you won $1 million?).

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An extreme situation activity can encourage the young adult to think about and make
complex decisions (e.g., What six things would you take if you knew you were going
to spend two months alone on a remote desert island?)
Values exercises that require ranking values work best for most people with a set of
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cards listing different values, so the person can move the values around. A sample set
can be downloaded from http://www.motivationalinterview.com
Exploring Interests and Preferences

Exploring interests and preferences is critical with young adults, as this is the time where they
are rapidly developing them. Every opportunity, whether positive or negative, creates learning
experiences and influences a young persons trajectory. Some opportunities change young adults
very little, while others have a great impact on their interests and preferences. Practitioners
never know what is going to make a small or large impact for the young adult, so it is important
to offer many different opportunities without having preconceived expectations.
Exploring the interests and preferences of young adults who want to return to school is
similar to the work practitioners already do in SE. In SE, for young adults who are in the
contemplation phase and do not believe there are many job options, exploring interests can
provide a wider lens and involve exploring hobbies and cultivating the idea of work that is
in-line with something they love. For example, when working with a young adult who likes
to skateboard, a HYPE practitioner may arrange to meet him or her at a caf near a skate
shop and suggest going into the skate shop after their meeting. The practitioner could ask
the young adult questions about certain boards, wheels, and other equipment associated
with skateboarding. The skill of job development becomes handy as the practitioner Notes
develops the job seeker by using MI techniques to plant the seed of working at a skate
shop. For young adults, choosing a school exploring class size, campus size, location, can all
be factors associated with finding the right fit regarding deciding what school to attend.
Gaining Experiences
As true for all people, young adults gain experiences by working, going to school,
participating in their communities, and being social. Exposure to new experiences allows
for the continued development of the young adults interests, values, preferences, and
identities. Young adults might believe that they like something, but in the absence of trying
it, it is unclear. Or, they might try a new activity and gain confidence from finding that they
are good at it and enjoy doing it. Similar to IPS, HYPE recommends competitive, integrated
paid employment positions for young adults who are interested in working (i.e., the same
positions that are available to other young adults without mental health conditions). All
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competitive employment should be considered a valued experience, as each position
develops vocational maturity. Vocational maturity is the process of developing values,
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interests, preferences, and skill sets. Although positions are often short-term because of
the labor market that most young people work in prior to gaining higher-level training
or education, the connection to the labor market (not the length of their tenure) is what
is important for the young adult. It is developmentally normative to get and leave many
positions as a young adult and developing the skill of how to leave each position (even if
the young person hates the job) is critical to developing social capital and retaining positive
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references.
Given their age and developmental phase, young adults can also benefit from internships
and short-term volunteer positions. These positions can help young adults evaluate their
interests, abilities, and preferences, as well as give them the chance to work in roles and
in environments that they would otherwise not be qualified to access. For instance, a
young adult who has a Bachelor of Fine Arts degree is interested in pursuing a graduate
degree in an unrelated field. Her bachelors degree does not make her competitive as
an applicant to an experimental psychology program, so she investigates opportunities
as a research assistant in an experimental psychology lab at a local state university. She
finds she is not qualified for paid employment in the lab, but is offered a volunteering
position to help the lead researcher with tasks that are akin to the research assistants
in the lab. This opportunity serves multiple purposes, as it (1) helps the young adult
to explore if experimental psychology is actually of interest, (2) develops a valuable
vocational experience that can be added to a resume, and (3) develops social capital
that can be used as a reference for graduate school or future employment opportunities.
While paid employment is ideal, internships and volunteer positions are developmentally
normative for young adults. Young adults without mental health conditions often use these
experiences to develop valuable human and social capital that cannot be gained through
available competitive employment opportunities.
Practitioner Note: Practitioners and young adults may want to explore Notes
volunteering as a way to develop commitment and motivation toward work
during the contemplation phase, but volunteerism can be a dubious trap for some.
Those who are scared to go to work may see volunteering as a safe option and
therefore may prolong the period of time needed for exploration. If a volunteer
position is used to help move the young adult from contemplation to preparation,
it needs to be a short-term opportunity (less than three months) with a clear
purpose and learning objectives. If you can work for free, you can work for pay.
Discovering Strengths and Talents

Too often, mental health service practitioners focus on weaknesses, limitations, and
symptoms. Services that are strengths-focused, build resilience, grit, and identity.
Strengths are not just things a person does well, but also include skills, competencies, and
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characteristics that create a sense of personal accomplishment; contribute to satisfying
relationships with family members, peers, and adults; enhance ones ability to deal with
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adversity and stress; and promote ones personal, social, and academic development
(Epstein & Sharma, 1998, p. 3).
A strengths-based approach affirms the principle of resilience (Rapp & Goscha, 2006),
specifically the idea that young adults with mental health conditions can get better and
build lives that are happy and economically self-sufficient. Using a strengths assessment
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and strengths-based interventions recognizes that the young adult directs the process and
helps to define his or her relationship with the practitioner. This therapeutic alliance is
regarded as the primary and essential medium for change.
There is a growing body of evidence that supports the importance of the therapeutic
alliance in improving rehabilitation and behavioral health outcomes (Cloitre, Stovall-
McClough, Miranda, & Chemtob, 2004; Egan, 2013; Lustig, Strauser, Rice, & Rucker,
2002; Price, Hilsenroth, Callahan, Petretic-Jackson, & Bonge, 2004). The therapeutic
alliance is commonly conceptualized as consisting of three main variables: an affective
bond as well as an agreement on goals and tasks between the provider of and receiver of
services. Genuineness, flexibility, and the ability to truly listen have also been recognized as
important (Martin, Garske, & Davis, 2000; Laski, Smith, Wislocki, Minami, & Wampold,
2013). Because it serves as the basis for all future program activities, fostering this alliance
is a primary activity during engagement and continues as a major focus throughout HYPE
services.
Strengths can be relevant to one or more life domains (i.e., living, learning, working, social,
recreational, spiritual, financial, and health; Rapp & Goscha, 2006) and fall into a variety
of categories. Research on child and adolescent development (see Fraser, 2004) suggests
that an individuals positive characteristics, supportive family and friends, and a positive Notes
community environment all contribute to healthy development.
Strengths assessment process

When developing or conducting a strength assessment, there are a set of core beliefs and
principles (Epstein & Rudolph, n.d.; Rapp & Goscha, 2006) that should be followed during the
process. The following beliefs and principles should be woven through all of the HYPE services:
Everyone has strengths.

Strengths are discovered over time through conversation and shared experiences.
Motivation is enhanced by pointing out strengths.
The focus is on individuals strengths rather than deficits.
Failure to acquire a skill does not mean a deficit, but suggests a lack of exposure to the
experiences and instruction needed to master the skill.
Family, community, and culture are sources of strength.
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Strengths provide a foundation on which to build a service plan.
A young persons interests may be considered strengths, or at least sources of strength.

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Plans for the future represents a strength as well.
In addition to personal strengths, the young adults assets are also considered sources of
strength. For instance, a connected and supportive family is an asset, especially when
certain characteristics are evident, such as being close (cohesive), being stable (has
consistent routines), having harmonious relationships, using (or used) effective discipline,
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having good role models, and being available in a crisis. Young adults have a broader
definition of family and some may consider friends and other members of their community
as part of their family, while others may not consider biological parents and siblings as
part of their lives. Therefore, the more inclusive term of the chosen family may be used.
A young adults local community may have characteristics that make it an asset as well,
such as being a stable, safe neighborhood; having public transportation options; having
accessible and affordable healthcare, dental care, and childcare (if needed); and providing
varied opportunities for education, employment, and social/recreational activities. Other
assets or sources of strength include financial resources, religious or spiritual practices,
positive ethnic/racial identity, strong cultural traditions, language (e.g., being multi-
lingual), access to computers and the internet, and readily accessible health care services
and information (including contraception).
Practitioners often get stymied when trying to think of what to include in a strengths
assessment. For a sample of questions and categories, please see the Strength Assessment in
the Appendix.
Enhancing Motivation
Motivation is an internal state and is the feeling of drive to do (or avoid) something.
However, the only evidence of that drive is someone taking action. A lack of action does Notes
not necessarily mean that a young adult has no interest in accomplishing something. Many
factors contribute to motivation and to taking action. Rather than dismissing a young adult
as unmotivated, the practitioner needs to consider and explore the many factors that may
decrease motivation to act, increase motivation to avoid acting, or block action in spite of
desire and interest.
Interests and preferences, as described earlier, are important factors. For young adults,
these may need to be discovered through experience. However, some mental health
conditions, such as depression, may decrease interest and the experience of pleasure
and result in decreased participation in new experiences. The negative symptoms of
schizophrenia may also include a loss of motivation and drive, possibly due to disruptions
in the brains reward systems and difficulties in anticipating pleasure (Velligan et al., 2014).
Physical factors matter, too. Psychiatric medications can cause drowsiness and may cause a
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young adult to feel too fatigued to act on interests or desires. Other medications can cause
obesity, which may limit energy and willingness to actapparent laziness is likely the
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result as well as a contributor to becoming overweight (Lustig, 2013 Fat Chance). Poor
diet, secondary to poverty, the local community, or living on the streets, also may rob a
young adult of the energy needed to put plans into action.
Additionally, expectations, beliefs, and attitudes play a role in what a person does (see,
e.g., Ajzen, 1996 [in Gollwitzer book]). This makes logical sense, in that if you believe an
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action will have a positive outcome, it is likely that you will do it. However, if you have the
expectation of a positive outcome, but doubt your ability to do the required action (low
self-efficacy), then the likelihood that you will do it decreases (Bandura, 1991). Some of
these expectations and beliefs develop from past experiences of success or failure and from
past rewards for and feedback about efforts (Dweck, 1996).
Having a choice about what actions to take, or whether or not to take action, contributes
to motivation as well (Deci & Ryan, 2000). This means the young adult has made the
independent and autonomous decision to take action, not necessarily thinking up that
action on your own:
Many behaviors that are not intrinsically motivated (i.e., that are not rewarding
or enjoyable in their own right) are volitionally initiated and valued, and are thus
autonomous. For example, one may quite willingly and wholeheartedly take on
an onerous administrative tasknot because one sees it as interesting or fun, but
because one believes it is valuable and personally important for some reason in this
instance, the task may be phenomenologically experienced as autonomous or self-
caused, even though it is extrinsically motivated. (Ryan et al., 1996 [in Gollwitzer
book], p. 10)
Valued relationships also contribute to motivation through the desire to please someone Notes
a person sees as important (Deci & Ryan, 2000). Therefore, motivation and the resulting
action are more likely to occur if a young adult thinks that the important person wants him
or her to change, the outcome of an action will improve the relationship, or that the effort
will be seen as positive by the important person. For young people who are so focused on
social relationships, this may be a very strong factor in motivation. However, to adolescents
and some young adults, peer relationships are often more significant than relationships to
adults (Steinberg, 2015). This means that peer pressure, especially in group situations, can
override judgment and derail the best of intentions (Steinberg, 2004).
When considering how to engage young adults in the areas of enhancing motivation,
exploring interests /experiences, and developing goals/plans, HYPE practitioners can
examine the multiple factors listed in this section to figure out a number of possible next
steps. First and foremost, it is important to avoid labeling a young adult as unmotivated.
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The practitioners job is instead to discover what might motivate a person and to design
interventions that will tap into any area of interest and motivation that exist. Motivation is
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discovered, not created; helpers cant make a person motivated.
Second, practitioners need to become proficient at setting SMART goals that are relevant
and behavioral. Often young adults will present a broad aim that they want to achieve and
state it as, I want to be The practitioner can explore some of the actions they would
need to do in order to meet that broad be goal, which can ultimately link them to what
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they want to be.
Third, it is important to ensure that the goals and actions that are being stated belong to the
young adult and that they have been freely chosen and not arrived at by default or dictated
by somebody else. Exploring and enhancing positive expectations and self-efficacy is
essential and can be achieved by continually looking for and pointing out the young adults
specific strengths and areas of success from past and current experiences. Someone who
takes too long to make a decision? Turn it into a strength: that person is likely someone
who thoroughly thinks through problems.
Finally, practitioners need to build a solid relationship with trust and genuine caring as the
foundation. Find ways to help the young adult create his or her own circle of support by
connecting him or her with same-age peers who can provide support and model resilience
and maturity.
Intervention Development
HYPE intentionally and purposefully develops a young adults levels of commitment,

motivation to change, and desire to achieve set goals by integrating Boston Universitys
approach to identifying, developing, and acquiring goals (Farkas et al., 2000) with TTM
and MI interventions. The intention is to help a young adult become more committed Notes
to making a change. It means that a young adult may need to increase awareness about
barriers or obstacles they might be facing. Using MI techniques to help a young adult
recognize the need to change is an important element of HYPEs work. Finding activities
that will increase the young adults confidence and hope also helps to develop and maintain
motivation. Developing targeted interventions that focus on the factors associated with
change is by definition an individualized and creative process that requires thought,
patience, and belief that motivation can increase with positive experiences.
To develop interventions that help to intentionally and consistently move a young

adult toward setting and acquiring goals, a stage-wise approach that matches service
practitioner activity to the persons stage of change (Prochaska et al., 1994) is critical.
Obviously, if someone is at the action stage, then the approach could be suggesting and
supporting action (this is commonly the area where most service practitioners already
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have expertise). Choosing the right approach for a young adult in pre-contemplation,
contemplation, or preparation is less obvious. In pre-contemplation, the young adult
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will see no need or reason to change, using the interventions of building trust, providing
feedback, building hope, and negotiation harm reduction strategies are useful in supporting
a person in this stage. Once in contemplation, a person is already considering pros and
cons of making a change (e.g. obtaining a job or entering school), so supporting these
processes by creating experiences is beneficial. In addition, consciousness-raising can help
through exploring current knowledge about options steps, providing information, sharing
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experiences (especially through peer support), highlighting strengths, and building self-
efficacy.
In order to assist practitioners in developing ideas and implementing effective strategies

that enhance motivation and commitment, the Educational Intervention Matrix was
developed to help practitioners match a factor associated with change (e.g. motivation,
commitment) and TTMs stage of change (please see Appendix A). The interventions
noted are common MI techniques and support strategies coupled with interventions
for supporting academic goals. Given the familiarity of employment interventions, the
interventions noted are only for educational environments. The matrix is not exhaustive of
all possible activities, but those selected have been used by practitioners and were found to
help propel young adults toward goal setting and acquisition.
FUNCTIONAL ASSESSMENT
The functional assessment provides a means for the practitioner and the young adult to
develop an understanding of the skills the young adult currently can and cannot perform
related to achieving the goal. A list of skills is gleaned from both the environmental and
role requirements as well as any skills or behaviors that are personally important to the
young adult. To address skill assessment, practitioners should utilize the Critical Skills
Assessment worksheet to evaluate the core skills needed for goal attainment (See Appendix). Notes
When using the worksheet, a unique functional assessment should be developed for each
young adult by having him or her identify 8-10 critical skills from the list of skills (critical
means that without them success would be very difficult to achieve). The young adult works
with the practitioner to evaluate his or her present use of this skill and to see how his or her
current skill performance matches up against what is needed. Of course, unless the young
adult is actually in the desired environment, any such assessment is only a suggestion of
capability, since skill use and proficiency will vary across settings. Skill areas might include
concrete or practical competencies, like completing applications, organizing work, taking
notes, or asking questions or might include more complicated competencies, such as asking
for help, coping with stress, overcoming test anxiety, responding to supervisor feedback,
working on a team, or improving concentration (See Critical Skills Assessment worksheet in
Appendix A).
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Skill Development
Practitioners are not often taught how to teach skills. Given the complex skills that
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are required to be successful in school and the lack of formalized training of most
practitioners, this manual contains 12 skills that are viewed as critical to young adults
in both work and school. The 12 skills are discrete and have been unpacked from larger
macro skills. For instance, time management is actually a category of skills. It has many
smaller skills that make up what most people describe as time management. Time
management, however, is often the product of a series of behaviors and skills that result
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in a person being able to handle many tasks in a timely fashion. This manual allows a
practitioner to help a young adult to understand which part of time management they may
be struggling with, for instance, setting priorities or identifying responsibilities. The skills
in this manual then become stackable in an effort to develop an individualized approach
to developing critical skills for school and work. The lesson plans also provide practitioners
with a template to create additional skill development lessons (please see Section 5).
RESOURCE ASSESSMENT
A resource assessment measures the presence or absence of supports needed to meet the
goal. Supports are broadly defined and encompass a wide range of resources, such as family,
therapists, friends, academic advisor, a supportive supervisor, a cell phone, a disabled
parking sticker, e-mail, a student or employee lounge or cafeteria, a church group, smoking
space, AA meetings, or an exercise class. Similar to the functional assessment, resources
that are critical to success and satisfaction should be identified early in order to link
students to a broad range of supports when entering school or work.
Resource Development
Young adults should be provided and linked to the resources and supports that will help
them to achieve their goal. In an effort to maintain community integration, participation,
and identity, HYPE does not duplicate a service that is provided in the community, Notes
but rather supports the young adult in using the service or support. Young adults are
connected to community-based and naturally occurring supports that any other young
adult or student would access. For instance, HYPE does not provide tutoring services, but
a practitioner may help the student access the schools tutoring services by accompanying
him or her the first time or by checking in after the sessions to see if the services are
helpful. Linking young adults to resources are a critical feature of HYPE, but teaching
young adults how to identify and access resources (e.g., finding help) are critical life skills.
These skills are often used by young adults, especially when entering into a new role or
relocating to a new city or school.
ACCOMMODATION & ASSISTIVE TECHNOLOGY (AAT) EDUCATION &

ADVOCACY
Similar to the work in Supported Employment, HYPE practitioners need to assist
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young adults entering educational programs in learning about and advocating for
accommodations and assistive technology (AAT). However, instead of disclosing to Human
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Resources as young adults in the role of employee would be required to do, those in the role
of student would disclose to the schools Office of Disability Services (ODS). Unfortunately,
most students with mental health conditions do not utilize ODS for multiple reasons. First,
there is the lack of awareness that this office serves students with mental health conditions.
For students who are aware of ODS, the lack of registration with this office is tied closely
to the shame and fear of disclosure, as they believe that by registering with disability
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services, professors and administrators will be notified of their psychiatric disability
(Collins & Mowbray 2005; Quinn et al., 2009). Moreover, and perhaps due to a lack of
education regarding the legitimacy of their condition as a disability, students with mental
health conditions believe that they do not deserve AAT and have expressed that they do
not want to cheat by receiving them, regardless of the impairments they experience in
the academic setting due to their psychiatric condition. In addition, it is suspected that, in
some cases, ODS does not specifically advertise to students with mental health conditions
because of the lack of perceived legitimacy by ODS administrators and staff regarding
the functional implications associated with mental health conditions within the learning
environment. These attitudes further compound issues related to the lack of experience and
specialized knowledge among ODS staff regarding students with mental health conditions
(Becker, Martin, Wajeeh, Ward, & Shern, 2002). ODS staff are typically very skilled in
working with students who are diagnosed with physical, attention, and sensory conditions
(e.g. blindness), but have not been adequately trained on the functional implications of
mental health conditions and how to identify meaningful AAT for this group of students.
Therefore, it is critically important for the HYPE practitioner to be knowledgeable about
AAT and to develop effective relationships with ODS Directors and staff. Please see Section
6 for more information regarding determining effective AAT.

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SECTION FOUR: HYPE SERVICE PLANNING

This section consists of the following topics:

HYPE service planning is made up of a series of assessments that culminate in

GOAL PLANNING Notes

Practitioner Note: During the goal setting process, practitioners need to be

Choose Phase (how it happens and what helps)

Get Phase (how it happens and what helps)

Keep Phase (how it happens and what helps)

Practitioner Note: There is a difference between satisfaction and success.

Choose Get Keep Leave

HYPE Manual v1 July 2017

DO NOT COPY OR DISTRIBUTE

FACA Admission deadlines Develop community/campus Complete required

Section Four: HYPE Service Planning

Identifying Factors Associated with Change Notes

Factors Associated with Change Assessment (FACA)

Developing Factors Associated with Change

Exploring Interests and Preferences

Discovering Strengths and Talents

Strengths assessment process

Everyone has strengths.

HYPE intentionally and purposefully develops a young adults levels of commitment,

To develop interventions that help to intentionally and consistently move a young

In order to assist practitioners in developing ideas and implementing effective strategies

ACCOMMODATION & ASSISTIVE TECHNOLOGY (AAT) EDUCATION &

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