A.     Introduction

In 1992, the Center for Substance Abuse Prevention (CSAP) in the U.S. Department of Health and Human Services inaugurated the CSAP Training System (CTS). The CTS took two decades of research and demonstrations in the fields of prevention and training and designed an entirely new system—one that has moved beyond traditional assumptions and redefines how to address complex social problems such as substance abuse. The intent of the CTS was to develop a permanent capacity for prevention training and technical assistance within key target groups and systems in order to increase the attitudinal and environmental changes needed to help protect people from alcohol, tobacco, and other drug problems. Today, a mere 4 years later, CTS training programs are reaching into virtually every area of our society. The great strength of CTS has been its ability to empower individuals and groups in all sectors of society. Those trained have carried their passion and commitment to other individuals and groups, creating a chain reaction. Thus, prevention has become the business of States, communities, and health professionals, public housing authorities, social service agencies, health care delivery systems.

In the CTS environment, the term “substance abuse prevention training” refers to a wide array of intentionally linked activities that have in common the goal of empowering communities and social institutions to cooperate in the multiple tasks of prevention—tasks that range from providing information about substance abuse to helping individuals acquire the skills needed to bring about community change.

Organizations and individuals who participate in the CTS training report that they are replicating the training for others in their communities. They are taking what they have learned and are passing it on. A key reason why this complex model is effective is that CTS has evolved the role of “trainer” to “facilitator” and of “trainees” to “learners” and/or “apprentice facilitators.” This is not merely a question of semantics. There are philosophical as well as practical differences. Thus, central to the CTS approach is the belief that the most thorough and applied knowledge, attitudes, and skills are those learned through a facilitated personal and/or group process of exploration rather than instruction. As discussed in more detail later, there are distinct differences between facilitators and trainers. For instance, when trainers become facilitators, their role becomes that of providing an array of means to help learners reach their learning goals. It is the learners who are responsible for acquiring the knowledge and skills they need. Single learners or small teams of colearners can also receive assistance from facilitators who help the learners stay on track, suggest applications for their learning, or question assumptions made by the learners. These altered roles require rethinking training and retooling the skills of trainers to make possible a more cooperative and learner-directed learning process.

This paper examines trainer and facilitator development approaches that were most useful to the CTS in ensuring that the trainers functioned as effective trainers and that facilitators were effective as facilitators.
 

The roles of trainers and facilitators
The principles that CTS draws on for trainer and facilitator development are based on adult learning theory. The original adult learning theory of Malcolm Knowles (1990) is still relevant: basically, adults will learn what they want to learn when they need it. Therefore, training should be problem-centered, should relate to the setting in which it will be applied, and should build on the knowledge that the learner already has. Trainers and facilitators share certain skills and attributes. For instance, both must be able to communicate effectively, to understand how adults learn, and to understand the role that culture plays in the learning process. Both need to be skilled in conflict resolution and consensus building. The trainer is usually a person with subject matter expertise who 1) presents the information clearly and accurately using effective platform skills; 2) gets the trainees involved in the learning experience; 3) uses questioning techniques and elicits feedback to make sure that the trainees understand the information provided and have acquired the skills taught, and 4) is sufficiently flexible to adjust both the training process and content, if necessary, to meet the needs of the trainees. The facilitator uses his or her skills to assist a group to establish and abide by common ground rules; to help the group solve problems, set goals, and make decisions; and to provide interventions that are congruent with the group’s level of ability to facilitate its own process. The goal of the facilitator is to transfer, over time, the responsibilities and skills for managing the group process to the group itself.

The key difference between a trainer and a facilitator is that the facilitator is there to help the learner to learn, rather than to instruct. The concept of facilitation acknowledges that each of us must do our own learning, in our own way, and that the learner must be in control of his or her own learning. When a facilitator works with a group, his or her focus is on the group process, on using the group process as an effective way to help the learners solve problems and make decisions.

The central role of a facilitator is to establish the necessary environment and conditions within which learning can take place. The concept of a learning community (such as the various audiences of the CTS) reinforces the idea that the facilitator is not necessarily a content area expert, but instead is skilled in creating conditions that promote learning. The facilitator enters into a partnership with learners, rather than maintaining a leader-follower relationship.

The facilitator fills many roles:

• As coach the facilitator helps the learners develop learning agreements and a plan for carrying them out, observes them as they carry out the plan, offers suggestions, conducts demonstrations, helps learners identify learning opportunities they may overlook, monitors their progress, suggests new approaches as necessary, and otherwise assists learners.
• As guide, the facilitator points the learners in an appropriate direction in their learning and helps them negotiate a path to their goal.
• As learning environment designer or architect, the facilitator assists the learners to construct a learning environment tailored to their needs.
• Ideally, the facilitator also serves as role model or mentor. However, not all learning facilitators are able to fulfill this role, nor are they expected to.
• As evaluator, the facilitator provides the learners an objective—or at least, another—view of their learning progress.

The learning facilitator can assist learners with the learning process itself, by helping them

• Establish a vision and keep it updated, a clear image (vision) of the change they would like to become—what it will look and feel like when they are there. This is essential in order for the change/learning to take place.
• Become increasingly aware as they proceed with their learning of the specific knowledge, attitudes, and skills they will need to realize their vision.
• Seize opportunities for learning, particularly taking advantage of new, unanticipated learning opportunities as they present themselves.
• Gauge their learning progress frequently and make appropriate adjustments in their learning strategy—monitoring progress on their learning plan.

B.     What the CTS learned about trainer/facilitator development

How did these ideas about the roles and characteristics of facilitators translate into effective practice? This section looks at what CTS learned about 1) trainer and facilitator selection, 2) initial trainer/facilitator training, 3) ongoing trainer/facilitator development, 4) evaluating and monitoring trainer/facilitator performance, and 5) the ethics of training/facilitation in prevention.
 

1.     Trainer/facilitator selection

Because of the way the CTS evolved, most CTS projects started out by selecting experienced trainers rather than facilitators. Most CTS projects selected persons who were representative of the target audience (e.g., persons from the same community and racial or ethnic group), or who were professional peers (e.g., dentists to facilitate prevention training for dentists; social workers for social workers, etc.).

Early on, CTS managers learned that effective trainers do not necessarily make good facilitators. Some of the trainers who were used to delivering traditional, standup training had a hard time making the transition to the facilitation model. They were more used to sharing and providing information than trying to elicit the information from a group. Moreover, in traditional training there is an agenda, a set way of doing things, and a script to be followed. Many of the traditional trainers found it difficult to make the transition to a model that called for a more flexible approach, where there is no script and no preestablished direction for what’s going to happen next. In general, the CTS managers selected as facilitators persons who were recognized in the field as effective facilitators, or trainers to whom they provided training in facilitation. Some projects used the same cadre of trainers and facilitators throughout the project, whereas others continuously developed new trainers and facilitators. There were advantages and disadvantages to each of these approaches. Because of the intensive investment needed to prepare trainers, one might assume that it is better to engage well-prepared and experienced trainers than to continuously train new trainers. However, projects found that a set group of trainers can resist adapting to a new paradigm. Moreover, projects with a set group of trainers found it more difficult to make the change to a model that emphasized facilitation. They also found it more difficult to select facilitators who represented new learning groups. What did not work was building a pool of supposedly interchangeable trainers and facilitators. It is important to know which parts of the curriculum call for a trainer who can provide a more didactic presentation, and which parts of the curriculum are process events that call for a facilitator. To assume that a given individual can do everything is to invite failure.
 

2.     Initial training of trainers and facilitators

For both facilitators and trainers, the initial training covered two key areas: a) prevention, and b) the process of training or facilitating. For some otherwise experienced trainers and facilitators, the content area was new. However, when the trainers and facilitators were recruited from other professions (notably the health professions), they also had to learn the facilitation and team training processes (which for most was quite different from the solo didactic presentations they were used to). Many also had no prior experience in the CTS prevention model. Thus, medical specialists and rehabilitations specialists first had to “unlearn” their preexisting notions of what primary prevention meant. This often took a considerable amount of time. Each group of professionals started with a working definition of prevention taken from the frame of reference of their own profession.

• Training of trainers. Many of the facilitators used during by the CTS were initially oriented through training-of-trainer events. CTS managers found that timing and continuity were important success variables: providing preparation onsite (especially for week-long training events), preparing trainers within days prior to the delivery of the training, including lessons learned from previous training, providing presite briefing and midtraining feedback and debriefing, and involving the trainers in curriculum development and asking for their feedback.

 

 

What did not work for the initial preparation and support of trainers was to hold a single         training-of-trainers event to develop a pool of trainers to work throughout the project. In a training-of-trainers event, too much time is spent looking at the curriculum, and not enough time is spent assessing and developing the trainers’ skills.

• Training of facilitators. Two key approaches were used for the initial training of facilitators. First, new facilitators were teamed with experienced facilitators. Generally, CTS projects found that new facilitators learn the facilitation process best by attending an actual course delivery and then sharing responsibility with a seasoned facilitator.

 

 

Second, the CTS provided a Facilitators Skills Development Process curriculum (the FSDP).  The CTS contractors sent trainers to the FSDP training (3 days of training followed by field practice during a CTS training event and concluding with an additional 2 days of training). Prior to the event, the facilitators-to-be completed a comprehensive self-assessment to decide which of nine skill areas to focus on. The nine topic areas were 1) assessment, diagnosis, and planning; 2) evaluation; 3) observation; 4) basic information about substance abuse; 5) communication; 6) managing group dynamics; 7) understanding the group process; 8) organizational development; and 9)understanding cultural diversity. Usually participants selected two to five topics, which they then pursued individually or in small groups. For all skill areas, the curriculum focused on self-directed learning and hands-on experience in facilitation (e.g., through facilitation of small groups, and role play). At the completion of the training, the facilitators were asked to review their initial self-assessment plan, identified further learning goals, and developed a personal learning plan.

3.     Ongoing trainer/facilitator development

Two key approaches were used. In Year 3 of the CTS, a “staff college” was designed to assist each person involved with the CTS on a continuing basis to identify his or her learning needs related to the CTS and to address them in a manner that furthered the goals of the CTS, utilizing current research in cognitive science and ATOD prevention. Although the staff college was designed for all staff, consultants, and facilitators, it was in fact used primarily by staff.

Throughout the CTS, there was ongoing evaluating and monitoring of facilitator performance. Three sources were used for monitoring the facilitator: a) the facilitators were asked to monitor their own performance and to note areas where they needed to improve, and to then seek out the needed assistance and/or learning; b) fellow facilitators and supervisors observed the performance and provided feedback during regularly scheduled debriefing sessions, and c) the learners who completed evaluation forms provided feedback on trainer/facilitator effectiveness.
 

4.     The ethics of prevention training and facilitation

For each individual entering the prevention field, there is a challenging personal and professional question: Am I able to live the principles of health and community well-being that I teach to others? An integral part of the development of prevention trainers and facilitators is to ask them to seriously consider how well they “walk the talk.” This is a question that the prevention specialist must ask of him/herself but can also ask of others. For instance, in one project the facilitators asked the participants to observe them over the course of the week and to let them know whether they were modeling the approaches they advocated. (See Appendix B, the National Prevention Professionals Association’s Code of Ethics.)
 

C.     Recommendations:  What should be done differently in the future

CTS project staff make the following recommendations about how trainer and staff development should be handled differently in the future.

1.     Upfront training and support

• Trainers and facilitators need more up-front training and support. For instance, team training was new to some trainers, especially to health professionals, who were used to doing solo didactic and traditional presentations.
• The CTS should develop a self-assessment tool to allow new facilitators to assess their skill in cofacilitation as well as basic prevention knowledge.
• High-tech toolboxes are needed to encourage and enable more self-directed learning and to get state-of-the-art information to trainers and facilitators (and their target audiences).
• The CTS curricula should indicate in the trainer notes whether the skills of a trainer or facilitator are required. Overall, the CTS should more clearly define, for all settings, what is expected of trainers and facilitators.
• New trainers and facilitators need support systems and networks.
• New facilitators need the opportunity to work with a senior facilitator.
• Each CTS project should have biyearly meetings of facilitators and trainers to share what works and what has been difficult.

There currently exists a code of ethical conduct for prevention specialists. (See Appendix B.) Although the focus is primarily on professionals involved in service delivery, the code is applicable to the work of prevention trainers and facilitators. Further dialogue should be held on the ethical dimensions of training and facilitating and on incorporating a code of ethics into all training and development activities.

As prevention specialists, trainers and facilitators need to

• Develop knowledge about ethical behavior, both personal and organizational
• Develop an understanding of the role of ethical decision making in the

prevention/community development and empowerment
• Identify and respond to key ethical dilemmas that arise from the work and society’s

response
• Develop skills for analysis and evaluation of ethical arguments.

3.     Systemwide trainer/facilitator development

The CTS would have benefited from more systemwide trainer/facilitator development with opportunities for cross-fertilization among projects. However, this might have required more time than was available. Moreover, the projects’ training needs varied widely. Some events were very short in duration (e.g., less than a day); others were week-long events with follow-up technical assistance. The latter projects called for trainers and facilitators who could nurture participants, build relationships, establish guiding principles, and so on.

4.     Building prevention leaders by preparing trainers and facilitators

• CTS needs to capitalize on the power and influence of facilitators who are professional peers of the target group. Facilitators are potential advocates for prevention. Motivating 40 “movers and shakers” in a field to serve as spokespersons is real capacity building. For instance, building connections with powerful health professionals who can serve as facilitators is the way to reach audiences in health maintenance and managed-care organizations.
• CTS needs to keep “at the top of the list” the necessity and importance of the peer nature of the facilitators and the project team. For instance, if health professionals had not served as trainers and facilitators for their peers, the CTS would not have been able to have access or credibility in the medical community.

Most of the trainers and evaluators were hired by the CTS projects as staff or consultants. Thus, the project managers had certain management and monitoring responsibilities. There is a need for more systematic monitoring procedures, based on the type of performance measures that are used for facilitators and trainers. These procedures might include examining how adequately the facilitator or trainer prepares for the training, whether he/she reviews evaluations and other feedback to improve performance, and the effectiveness of the training and facilitation delivery.
 

D.     Summary

The empowerment of individuals, groups, and communities is the core prevention strategy promoted by CSAP. Training and facilitating individuals, groups, and communities is the approach used by the CSAP Training System (CTS) to transfer the knowledge and skills needed to work in small or large groups to strengthen a community’s resilience to ATOD problems. The CTS trained groups from all sectors of society (residents of public housing, physicians, nurses, parents, volunteers, community members). In doing so, important lessons were learned about when to use trainers and when to use facilitators, about how to select, train, evaluate, and provide ongoing development activities for trainers and facilitators.

Bloom, M. 1993. Toward a code of ethics for primary prevention. The Journal of Primary
Prevention 13(3):173-182.

Brocket, R. G., and R. Hiemstra. 1991. Self-direction in adult learning. Perspectives on theory,
research and practice. London: University of Surrey. Routledge Series on Theory and
Practice of Adult Education in North America.

Buchholz, S., and T. Roth. 1987. Creating the high-performance team. New York: John Wiley
and Sons.

Jacobi, B. 1994. Exploring ethics in the prevention field. Louisville, KY: The National
Association of Prevention Professionals and Advocates.

Jedrziewski, D. R. 1995. Evaluating instructors: In search of the perfect method. An Encore
Presentation for the 1995 NSPI National Conference, Atlanta, Georgia. Idaho Falls, ID:

The Center for Performance Improvement, INEL Institute, Lockheed Idaho Technologies
Company, Inc.

Knowles, M. 1990. The adult learner: A neglected species. 2nd ed. Houston, TX: Gulf
Publishing Company.

Mowrer, S. H., and T. N. Strader. 1992. National association addresses tough prevention issues.
The Journal of Primary Prevention 13(1):73-77.

The National Association of Prevention Professionals and Advocates (NAPPA). 1995. Code of
ethics. Louisville, KY: NAPPA.

Powers, B. 1992. Instructor excellence. Mastering the delivery of training. San Francisco:
Jossey-Bass Publishers.

Tosti, D. 1986. Introduction to performance technology. Washington, DC: National Society for
Performance and Instruction.