By Tyrus Curtis, Family Peer Training Coordinator, Families Together in New York State

Introduction

Peer Specialists/Advocates (PS/As) bring the invaluable perspective of lived experience to their roles, offering a depth of empathy and connection that enhances their ability to support the people they work with. However, this unique approach also introduces ethical challenges that require careful navigation. Supervisors play a crucial role in guiding Family Peer Advocates (FPAs), Youth Peer Advocates (YPAs), and Certified Peer Specialists (CPSs) through these complexities while maintaining professional integrity.

This article highlights common ethical dilemmas faced by PS/As and provides actionable strategies for supervisors to support their teams in addressing these challenges.

Common Ethical Challenges for PS/As

1. Balancing Advocacy and Professionalism

PS/As must strike a delicate balance between using their lived experiences to connect with people they work with and maintaining a “professional” boundary. While empathy-driven support can foster trust, it may also lead to over-identifying with people they work with or unintentionally stepping outside the support role, such as providing therapy. Supervisors can help by reinforcing the importance of maintaining boundaries while honoring the PS/A’s authentic connection with people they work with. (Salzer, Schwenk, & Brusilovskiy, 2010).

2. Dual Relationships and Boundaries

PS/A’s often serve in communities where they may have pre-existing personal relationships with people they work with.. For instance, an FPA might know a family socially, or a YPA might share a school or social circle, or an CPS may now work alongside someone they once received services from. Such dual relationships can blur the lines between work and personal roles. Supervisors should provide clear guidelines and ethical training to help navigate these scenarios effectively (SAMHSA, 2012).

3. Confidentiality Concerns

PS/As are frequently entrusted with sensitive information. Misunderstandings about confidentiality—such as what can be shared with team members or external systems—pose a risk to trust and integrity. Supervisors must ensure that all PS/A’s understand confidentiality requirements and the importance of clear documentation (National Association of Peer Supporters (N.A.P.S., 2019).

4. Conflicts of Interest

PS/As may face situations where their personal beliefs, relationships, or past experiences influence their professional judgment. Supervisors can mitigate these conflicts by encouraging PS/As to prioritize person-centered approaches and providing a framework for addressing such dilemmas (Mead, Hilton, & Curtis, 2001).

5. Emotional Impact and Bias

The deeply personal nature of peer support and advocacy can sometimes activate unresolved trauma or personal biases in PS/As. Supervisors should foster an environment where PS/As feel safe to discuss these challenges and seek support, thereby turning potential pitfalls into opportunities for growth (Salzer et al., 2010).

Strategies for Supervisors

1. Fostering Open Communication

Supervisors should create a supportive environment where PS/As feel comfortable discussing ethical challenges without fear of judgment. Reflective supervision can be a powerful tool for helping PS/As process emotions and dilemmas (SAMHSA, 2012).

2. Providing Clear Boundaries and Guidelines

Supervisors must ensure that PS/As have access to clear, written policies outlining professional expectations. Providing examples of appropriate and inappropriate behaviors across various scenarios can help PS/As feel more confident in their roles (N.A.P.S., 2019).

3. Offering Ethics Training

Ongoing training sessions incorporating real-world case studies and role-playing exercises can prepare PS/As and those they work with for ethical challenges. Tailoring these scenarios to the unique roles of Family Peer Advocates (FPAs), Youth Peer Advocates (YPAs), and Certified Peer Specialists (CPSs) ensures that training remains relevant and practical. The PeerTAC resources, such as Peer Support: Supervision, Fidelity, and Peer Drift and Exploring Ethical Dilemmas as a Supervisor, provide supervisors with structured guidance for developing training materials that address ethical challenges while emphasizing the importance of maintaining fidelity to peer values. These resources also include strategies for addressing “peer drift,” by ensuring the work of PS/As remains aligned with their roles while navigating ethical complexities.

4. Implementing a Decision-Making Framework

Teaching PS/As a structured approach to ethical decision-making can empower them to navigate challenges independently. Supervisors can encourage not only PS/As but all staff to:

• Identify the ethical issue.
• Review relevant policies or guidelines.
• Consult with a supervisor or colleague.
• Document the decision-making process and outcomes (SAMHSA, 2012).

5. Promoting Self-Awareness and Resilience

Supervisors should encourage PS/As to regularly reflect on their personal experiences and how these influence their work. The PeerTAC Supervision Self-Reflection Tools (all PS/A types) provide structured prompts and exercises to help PS/As explore their emotions, biases, and professional growth areas during supervision. These tools are invaluable for fostering an intentional and mindful approach to self-awareness, ensuring that PS/As can effectively manage their emotional responses while maintaining professional boundaries.

The National Practice Guidelines for Peer Specialists and Supervisors reinforce the importance of integrating trauma-informed care and resilience-building practices into supervision. Supervisors can use these guidelines to design support systems that enhance PS/As’ capacity for self-care and long-term sustainability in their roles (N.A.P.S., 2019). By combining reflective tools with evidence-based practices, supervisors can empower PS/As to turn challenges into opportunities for growth and resilience. (Mead et al., 2001). 

6. Role-Specific Ethical Considerations

Family Peer Advocates (FPAs): FPAs support parents navigating family dynamics. Supervisors can help FPAs address situations where family members’ actions may conflict with the FPA’s values or the family’s needs (SAMHSA, 2012).

Youth Peer Advocates (YPAs) often engage with peers who are similar in age, making it essential for supervisors to support them in establishing clear professional boundaries while building trust and maintaining positive relationships.. x

Certified Peer Specialists and Family Peer Advocates (CPS/FPA): CPS and FPA must balance supporting people with lived experience while avoiding dependency. Supervisors play a key role in ensuring the CPS focus on choice, independence, and self-advocacy (Mead et al., 2001).

Conclusion

Ethical challenges are an inherent part of the work of PS/As but they also provide valuable opportunities for growth and development. Supervisors are instrumental in guiding PS/As through these complexities by fostering open communication, providing clear guidelines, and promoting resilience. By addressing ethical dilemmas proactively, supervisors not only support the PS/As, but also strengthen the integrity of their teams and enhance the quality of the support they provide to all.

References

Mead, S., Hilton, D., & Curtis, L. (2001). Peer support: A theoretical perspective. Psychiatric Rehabilitation Journal, 25(2), 134–141.

National Association of Peer Supporters (N.A.P.S.). (2019). National practice guidelines for peer support. Retrieved from [N.A.P.S. Website].

Salzer, M. S., Schwenk, E., & Brusilovskiy, E. (2010). Certified peer specialist roles and activities: Results from a national survey. Psychiatric Services, 61(5), 520–523.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2012). Core competencies for peer workers in behavioral health services. Retrieved from [SAMHSA Website].

PeerTAC Resources (e.g., “The Value of a Structured Approach to Supervision for Peer Specialists and Advocates [PS/A]”).

Existing PeerTAC Supervision Curated Articles September 23, 2024

1. Peer Support: Supervision, Fidelity, and Peer Drift – July 30, 2024
2. The Value of a Structured Approach to Supervision for Peer Specialists and Advocates (PS/A) – June 3, 2024
3. Effective Supervisor Qualities – February 12, 2024
4. Peer Supervision Begins with an Attitude Assessment

About the writer: 

TJ Curtis is a dedicated Family Training Coordinator at Families Together, where they leverage years of experience in youth and family mental health advocacy and peer-to-peer support. TJ’s journey in this field began as a youth advocate for CCSI, leading him to serve on the board of directors for Youth M.O.V.E. National Inc. TJ has also contributed their expertise to the boards of the Federation of Families and SAMHSA.

In their current role, TJ focuses on developing workshops and training programs aimed at enhancing youth and family development services. His passion lies in supporting youth, families, men, and fathers to ensure healthy outcomes for all. Alongside his professional commitments, TJ is pursuing a graduate degree in Marriage and Family Therapy at North Central University, furthering his expertise to better serve those in need. TJ’s tireless dedication to the well-being of families and their commitment to advocacy make them a valuable asset  to the community.

Email Address: Tcurtis@ftnys.org     Phone:  646.276.0534