Peer Support: Defining the Peer Relationship

Peer support is a unique and often misunderstood role in the mental health and addiction recovery field. The traditional counselor-client relationship is rooted in a medical model for recovery that focuses on the diagnosis and treatment of illness. Doctors, psychiatrists, and other professionals maintain hierarchical relationships with their clients. The professional is an authoritative figure who serves to direct the person’s recovery and the client is an object of treatment. While many counselors try to cultivate non-hierarchical relationships with their clients, the counselor is not permitted to self-disclose so there remains some distance between counselor and client. Counselors typically undergo extensive training, usually at a master’s degree or higher, to develop their skills, and are not required to have lived experience with mental health or addiction issues.

The peer relationship is based on shared personal experiences and empathy, focuses on strengths rather than weaknesses, and works toward a person’s well-being rather than away from the person’s problems. Peer supporters derive their knowledge and skills from lived experiences as well as specialized training. Peer support training encompasses a wide-ranging skill set that is grounded in the principles of co-learning and mutual respect. Collaborative learning and sharing lived experiences are the main factors that set peer supporters apart from traditional counselors. Peer supporters offer hope, empowerment, and companionship on the journey toward recovery.

The collaborative relationship that is nurtured through the peer support process often leads to conflict among professionals and peer workers. Case workers and other professionals serve to ensure that the client complies with a medically directed service plan. Many professionals who work with peer supporters do not comprehend that peer supporters are positioned to advocate for the person’s interests, rather than the interests of medical professionals. Such conflict has led to a widespread attempt to more clearly define the peer support role.

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