By Gita Enders, LMSW, MA, NYCPS

One of the critical issues in maintaining a thriving peer support workforce is the lack of career path models. In general, the path for career advancement is to leave the profession, either by doing some form of non-peer related work or by acquiring education and licensure in a clinical discipline (Jones et al., 2020). This is not only an issue of salary, but of pride in the profession and general conceptions of the value of lived experience versus that of post-secondary education. Lack of career advancement opportunities may interfere with job satisfaction (Clossey et al., 2018). Moreover, Medicaid reimbursement regulations require that peer specialists be supervised by licensed clinicians, making it challenging for peer support providers  (adult peer specialists, youth peer advocates, and/or family peer advocates) to follow potential pathways to supervisor status.

A significant barrier to advancement remains the stigma associated with self-disclosure (Chapman et al., 2018, Jones et al, 2020). Promoting from within has advantages. People advancing along a promotion pathway are already familiar with the agency, are aware of policies and procedures, and serve as motivators for other staff (Gusdorf, 2008).

One way to establish a career path is to create a tiered system of peer specialist/advocate titles in which increasing responsibility is met with an increase in level, or grade, and a corresponding increase in salary. In such a model, first tier peer specialists/advocates can provide support services as outlined in the job description, second tier peer specialists/advocates can offer mentoring and precepting to less experienced peer specialists, and third tier peer specialists/advocates can provide supervision for other peer providers particularly in cases where services are non-reimbursable.

Other promotion tracks for peer specialists/advocates include training, with corresponding levels ranging from co-facilitator to director of training, and administration, starting with the supervision described above and moving to director of peer support services. Different opportunities for advancement of course include roles not in direct service, such as researcher or professor, although these may be less satisfying than continuing to provide peer support. Finally, agencies need to remain cognizant of the dignity of risk, as they are with non-peer professionals.

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Chapman, S. A., Blash, L. K., Mayer, K., & Spetz, J. (2018). Emerging roles for peer providers in mental health and substance use disorders. American Journal of Preventive Medicine, 54(6), S267-S274.

Clossey, L., Solomon, P., Hu, C., Gillen, J., & Zinn, M. (2018). Predicting job satisfaction of mental health peer support workers (PSWs). Social Work in Mental Health, 16(6), 682-695.

Gusdorf, M. L. (2008). Recruitment and selection: Hiring the right person. USA: Society for Human Resource Management, 1-14.

Jones, N., Kosyluk, K., Gius, B., Wolf, J., & Rosen, C. (2020). Investigating the mobility of the peer specialist workforce in the United States: Findings from a national survey. Psychiatric rehabilitation journal, 43(3), 179.