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Peer Support:

Peer Specialists are Not Clinicians

Peer Specialists bring hope and healing.

By Rita Cronise

As MHOTRS clinics look toward the inclusion of Peer Support Services within their menu of services, it is important to consider the differences not only in perspectives but also in the purposes for each role on the team. For example, clinical providers have expertise based on formal training, practice in maintaining objectivity, and skill in assessing the best options for people to gain or regain greater control of their mental health. Those in peer roles have experiential knowledge (see previous blog by Thomasina Borkman) as someone who can either use what they’ve learned through their personal process of recovery and resilience (or as the parent of a child that that is receiving services in one or more of the systems of care) to offer program participants practical assistance with their challenges of life.

When including Peer Specialists on interprofessional teams, understanding the distinctions between these perspectives as well as how they complement each other will become more and more important to ensure that each member of the team is making the best use of their expertise or “playing from their strengths” through tasks and assignments that allow them to do the work they are best suited to do. Peer Specialists are not junior clinicians, assistants, or errand staff.

To begin this discussion, we want to turn to Pat Deegan who is a nationally recognized author with a PhD in clinical psychology who was diagnosed with schizophrenia as a teenager and writes about her lived experiences in surviving the mental health system. If you are not familiar with Pat’s work, it is grounded in real-world application while at the same time filled with inspiration based on her own lived expertise about finding (and sharing) hope and recovery. Her topics focus on recovery, personal medicine, shared decision making, and peer support. Of particular interest if you are in the process of including Peer Support Services in your MHOTRS clinic is a brief blog she wrote on the differences between Peer Specialists and Clinicians.

Here are some excerpts from the blog with a link to view it in its entirety.

“There is no doubt that Peer Specialists have many unique skills that enrich the entire team. However, within these traditional clinical settings, it’s not unusual for Peer Specialists to begin to adopt the language and practices associated with the clinical worldview. In other words, over time the work of many Peer Specialists begins to resemble the work of other clinicians on the team.”

– Pat Deegan

What are the differences and where is the overlap between the Peer Specialist perspective and the clinical perspective?  The chart below offers some thoughts.

Peer Specialist and Clinical Perspectives

Peer Specialist PerspectiveOverlapClinical Perspective
Work is guided by the Principle of Mutuality defined as a focus on the connection between the Peer Specialists and the participant (individual being served) wherein there is reciprocity.Unconditional positive regard for the participant (individual being served).Clinicians are in the role of helping and supporting participants with a focus on diagnosis, identification of strengths and treatment. There is not an expectation of reciprocity in clinician/ participant relationships.
Emphasis on sharing and exploring life experiences where both individuals share personal experiences and perspectives.The importance of connection, finding common ground, and respect.Emphasis on exploring program participants’ experiences with less expectation for the clinician to share their personal experiences.
A sampling of the differences in perspectives between peer support staff and clinical staff.

Learn More and Explore Pat Deegan’s Blog Site:

Understanding the distinctions between the peer specialist perspective and the clinical perspective, as well as the ways in which these roles complement each other, can be an important element for interprofessional teams to learn to work together more effectively. Pat Deegan’s chart illustrates the differing perspectives, and areas of overlap, in such a way that all members of the team can better understand their unique roles.

Next step? We recommend sharing this information with members of your team and discussing how all members of the team can work more effectively together as they come to better understand their roles.