Speaking Out: The Peer Role

The Basis of Peer Support is Mutuality. Peer support is my passion. Peer support changed my life. For years, I was plagued by feelings of hopelessness, helplessness, and worthlessness. Thirteen years after being diagnosed I met someone involved in peer support. For the first time, I was a in a group facilitated by someone who had “been there” instead of a group led by a professional telling me things I should do to feel better. This experience certainly motivated me to look at my life differently and I found the energy to redefine my life and that brings me to where I am today.

The basis of peer support is mutuality. We are not in a power-structured relationship. The fact that one person is getting paid and others are not make this a very hard concept to uphold in practice, so I believe everything we do must be directed toward that mutual relationship. There is a difference between being someone with lived experience who chooses to disclose and being in a peer role. Sharing your story is definitely a big part of that role, but it isn’t the only thing that makes it a peer role. Anything I do that puts me in the position of being the expert in the room or in a position to have power over another pulls me out of the peer role. I think most of us agree that things like medication management or serving as a rep payee put us in this power-over-others position and are not truly “peer.” But I hear a lot of disagreement beyond this.

When asked to do an assessment, plan an intervention, or write a treatment plan, and the person I am supporting isn’t assessing, planning an intervention, or writing about me, I am no longer respecting the mutuality of the relationship. My role is not to convince the people I support to do as they’re told, but to get the treatment team to hear and respect the people they support.

A case manager with lived experience is still a “peer,” but is not in a peer role. In my case, I directed a training program for peer specialists. I had power over the schedule, the material taught, the testing, and participant evaluation. I shared my lived experience as part of my job almost every day, but I was not working in a peer role. I still held firm to the values of peer support in the way I conducted myself, but I was in a power position.

An example from my previous career illustrates this. I am a veterinarian. People brought their ill pets for my expert opinion. I am also a pet owner. So, in this respect, I was my clients’ peer. But, in the exam room, I was the expert. I shared my experience as a pet owner, even one who had faced very difficult end-of-life decisions. I cried with my clients, but I was still the expert in the room. When a client faced a very difficult decision and asked me what to do, I answered as the expert, not as a peer.

The lack of appreciation for and understanding of the peer role will hamper the development of a career ladder in peer support. A certified peer specialist should not be required to get an advanced degree for advancement or be expected to grow up to become a case manager or a social worker. I believe we need to respect people who are great at peer support and who love peer support through a career path that allows them to stay in peer support. Experienced peer specialists can become mentors for newer peer specialists. They can be more involved in supervision and policy decisions. However, their primary role with people coming to the organization for support remains a mutual relationship. We don’t ask therapists or psychiatrists to give up their professional role in order to have a satisfying and successful career. Why do peer specialists need to move beyond peer support to advance?

We should be developing peer specialists into great supervisors and leaders. Such roles should be present at all levels of the organization, and should have peer specialist experience as a prerequisite and not be based on a college degree. The importance of the peer specialist experience and the valuing of the peer role evident in this new career track will provide the recognition that peer workers are unique—and need to be recognized and supported to be true to their role.

Pullout: “…we need to respect people who are great at peer support and who love peer support through a career path that allows them to stay in peer support. Experienced peer specialists can become mentors for newer peer specialists. They can be more involved in supervision and policy decisions….”