What Is The Peer Workforce? What Is a Peer Support Specialist?

...
Note: I am available for consultation work, curriculum development, trainings, etc.. I enjoy partnering with organizations on development of more accurate understandings of the realities of human social systems.

I can be reached by email at taylor.geomatics@gmail.com

Please consider donating to support this work. I am disabled, financially struggling, and am forced by existing social structures into producing content like this for free. I hope decision-makers will eventually shift priorities toward increased support for lived experience content generation and expertise sharing.

 Donations are never required and always appreciated. Donate Link: https://ko-fi.com/socialrealitylab
...

The following is a note I sent to managers of an Oregon state-managed grant funding opportunity looking to support what's sometimes called the peer workforce. These are lived experience individuals who don't have direct degrees or licenses* for the services they're providing. Their credential is their own life experience and it is that which establishes them as a worthy expert. Often on this blog we refer to such individuals as being Experts by Experience (EBE). 

*Increasingly, U.S. states are attempting to create certification programs for peer workers, and opinions on whether this helps or hampers the peer workforce is mixed with many valid points in opposition to the practice. Names for these roles have included Peer Support Specialist (PSS) and Peer Wellness Specialist (PWS). In Oregon, obtaining such a license requires completion of either a 40-hour or 80-hour training course. 

In the note below, I express concern over whether the grants funds will be awarded to the full peer workforce, or just to the subset labeled "peer support specialists". These roles are often low-level, low-paying, and at the bottom of hierarchal power structures. For background reading on the history of the Peer Support Specialist role, I recommend this article by Darby Penney and Peter Stastny...

Article Link: Peer Specialists in the Mental Health Workforce: A Critical Reassessment

Note to State Funding Managers - Ensuring Inclusivity on What a "Peer Worker" Means

The sector of the peer workforce whom I train, collaborate with, work alongside, and myself am a member of includes staffers and unpaid individuals with work roles/duties including...

Broad View of Peer Workforce

- Leading workshops / trainings

- Developing the content of workshops / trainings

- Peer developed support material resources (example - this peer-developed crisis / suicide hotline caller guide)

- All manner of advocacy efforts (including lobbying for the funds that supports opportunities like this grant itself)

- Journalism

- The Arts (theater, authors, musicians)

- All manner of activism efforts, like the 15+ year effort to ban electroshock devices in autism/IDD care

- Peer consulting on research projects like this project from the UK

- Program administration and program management

I am concerned that, when considering grant applications, the review team might be biased towards thinking of "peer worker" in the more commonly employed roles doing...

Narrow View of Peer Workforce

- Help with direct health resource navigation

- Help with secondary "pass to other service" resource finding 

- Various forms of one-on-one and group peer support sessions

- Clerical and office administration "front-desk" type roles

I would anecdotally guess (I don't have a direct report but have met and talked with dozens of workers in such roles) that 95% or more of peer-certified specialists in this state perform that second set of roles. I'm very concerned that the grant reviewer team might think that none of the work roles from the Broad List discussed above counts as a "peer support" or "peer worker" role. That worry carries additional weight considering that, if you do a web search for "Oregon peer support job", virtually every listed position you'll find will exclusively be performing work in that second list. It creates a situation where the Narrow List, and only that Narrow List, is what becomes synonymous with the term "peer worker". 

Would welcome a conversation with stakeholders on how to equitably address this concern as part of the grant review instruction process, and can report that I am in active conversation with the Oregon state team managing the grant about these concerns.

...

The America "Dream" of Children Needing Saving and Parents Deserving Blame

On of my trauma discussion forums a member posted this question recently...

Why is there so much emphasis on healing from the effects of unsupportive and harmful parenting and so little emphasis on the prevention of unsupportive and harmful parenting?

My response is below, and was a great direct application of themes discussed often on this blog.

...

One theory and observation I can offer is that, systemically (at least in the US), the dominant paradigm is that we offer child protection services. In America, a dominant world view these services are built upon thinks that...

1) We should infantilize children. They are seen as helpless and immature beings who are incapable of knowing what's right or best for them. We, the adult authority, do, and so it is our duty to save them.

2) We should place enormous and unjust personal responsibility on adults. Adults are viewed as self-empowered. They are seen as, themselves, to blame for any actions they've taken. They are not allowed to call themselves victims or be in need of care.

Given those two world views, it justifies building support and protection for children but little to none for adult parents. The script is to save the child from the parent until the parent, themselves, puts in the work to "deserve" the child again. Don't ask the child what they want. And don't ask the parent how they got where they are.

Also note that much of the "support" built to help adults in fact is still ultimately a self-responsibility ask. Job skills asks you to develop skills. They often don't just give you a job. Therapy asks you to develop skills. They don't just support you. They demand self-growth.

This is not to say that the answer is zero percent personal responsibility. But it is, to my mind, through gross injustice and objectively impossible demands placed almost 100% of the blame and responsibility for adult life outcomes on the individual alone.

I believe both views have a kernel of truth while being brutally and devastatingly wrong. We need to work with kids and treat them as co-collaborators and as intelligent, capable, and insightful autonomous human individuals. And we need to understand the principle of interdependence. No human is 100% self-responsible for their outcomes in life. Social factors matter, and are often root causes of failure or struggle.

As the commenter suggests, if parents are struggling to parent, we can ask not just what their personal issues are, but what their social issues are. We could ask they themselves their opinions about it versus assuming that we perfectly know exactly what's best. And we work to co-create adjustments to social factors if we want to decrease child abuse and neglect. Versus always asking the individual alone to somehow heal. 

...

Can contact me at socialrealitylab@gmail.com

Please consider donating to support this work. Never required. Always appreciated. 

Donate Link: https://ko-fi.com/socialrealitylab

Mental Health Advocacy Resources

List of resources I frequently use and send to others as part of mental health advocacy work. Work in progress. Open to suggestions for things to add.

Oregon Peer Workforce & Peer Advocacy Network

https://www.facebook.com/groups/829706504923619

Statewide networking and professional support for individuals working to promote peer and lived experience co-creation of knowledge and service offerings. Primarily focused on mental health and other social supports.

Community Centric Fundraising

https://communitycentricfundraising.org/

Coalition movement working to dismantle status quo fundraising philosophy and practice. Fantastic networking and peer professional support opportunities through the Slack social media channel.

CCF Slack Channel: https://ccfundraising.slack.com/ssb/redirect

Campaign for Trauma-Informed Policy and Practice

https://www.ctipp.org/

National group that offers advocacy training and support for grassroots mental health organizations.

 

Staff Open Help Sessions: https://www.ctipp.org/chat-with-ctipp-staff

CTIPP Newsletter Sign-up: https://ctipp.salsalabs.org/subscribe/index.html

Mad in America

https://www.madinamerica.com/

News organization offering mental health and psychiatric news, research, and user stories from a critical psychology and social justice lens. 

Mad Justice and Disability Justice Heroes

Darby Penny bio 

Judy Heumann bio

If Money Expresses Value Why Does So Much Preventable Suffering Exist?

Afters years of talking with people about the role of money in society, I have two observations that seem at odds with each other...

1) In general, most humans have compassion and don't want others to suffer*

2) One cause of suffering for large portions of the population is low pay and not having enough money

*A huge caveat is that there seems to be profound world view disagreement on what causes suffering and who or what to hold responsible 

If we look at one of the common definitions of money, it lists that money represents three things. It is a medium of exchange, a way to store value, and a measure of value. If this is the whole picture though, then how are statements 1 and 2 above co-exisiting?

Clearly, at a systemic level, the fact that so many don't make enough money to do much more than merely survive  means the value we give to the life and work of these people is not enough to prevent their suffering. So our current economies, broadly speaking, does not value humans not suffering.

But we also know that, broadly speaking, most humans have a level of basic compassion. I realize that statement can be contentious in the face of hatred, prejudice, violence, etc. It's a tough topic I welcome conversation and examination of. I will, for this essay, stick with the hypothesis that outside of psychopaths most humans have some level of compassion. And another way to say "has compassion" is - does value humans not suffering. 

I would therefore argue that money is failing to express our human values accurately. Money is not an accurate "measure of value" as the population definition claims. Which begs the question - what then is it?

My current answer is - I don't know. I've been trying to research definitions and understandings that would answer seeming conundrums like the one I've identified above. And thus far I've been left extremely wanting. What I can say is that I'm very motivated to find and build community willing to ask these questions and to ask/demand that better definitions and explanations be built that more accurately describe the world around us and how it operates.

Am hoping that others believe this sort of work needs funding and support. 

And happy to discuss if the above observations seem correct or not. They make sense to me, but one goal is to create less non-alignment on basic world view observations such as answering "what is money", which includes everyone (me and you) sometimes changing our views and opinions. 

Can contact me at socialrealitylab@gmail.com

Donate to support this work. Never required. Always appreciated. 

Donate Link: https://ko-fi.com/socialrealitylab

...

Photo by Jason Leung on Unsplash

When Personal Boundaries Fail - Part 1 and Part 2

Ongoing work in progress exploring and critiquing the concept of "healthy boundaries" as a wellness advice and conflict management tool.

Part 1

Came across this blog post on social media tonight...

HOW TO HAVE A BLISSFUL CHRISTMAS TIME: HOLIDAYS SURVIVAL KIT OF DAUGHTERS WITH NARCISSISTIC MOTHERS

And most of the advice came down to "your rules, your way, your needs". Others can either respect it or you just walk away from them. And I have mixed and complex feelings about that.

It's pretty telling that modern society's answer to dysfunction is "abandon and jettison the hurt ones who hurt others".

It's horrible to bring this up when the target audience here is often people dealing with codependent relationships. In the short term it can be a very needed answer. But half the time attempts to set boundaries just end up with worse fighting than ever. Sometimes they don't! For sure. But often they do.

And so we then say "well, if they don't accept you you're better off without them". Which only feels half true. Feels like a lose-lose moreso than the win-lose as its often framed as.

It's also just so odd to me. There's zero accountability for actual resolution and we start to almost normalize it as a society functioning well. The message of "abandon those who don't serve you on your terms" is a weird standard of advice that modern wisdom seems to be addicted to. And by saying that, I'm also not saying "stay in one-sided harmful relationships" either.

So much mental health advice boils down to...

"if they don't accept you you're better off without them"

Which only works if you have others that will accept you. If you don't, this advice essentially says "go be an isolated hermit with no friends, assistance, or interaction of any kind". Which is basically a death sentence. So that's a horrible thing to tell someone. 

The core of stand up for yourself has something to it, don't want to lose sight of that. But it's completely lost in the reality of the other half of this - walking away only works if you have somewhere to walk to - which many people don't.

And it still doesn't address the lingering injustice of the conflict happening in the first place and potential need for justice (another thing we're mostly told to not need and get shamed for not "moving past"). 

The self-help narrative has retraumatized and gaslit me for years. It's taken years to start to recover from these prevalent narratives and I'm still not out of the woods with it. This is my effort to break free of what everyone else says is good for my health, and it's been an awful, unsupported, and fight-filled journey against a lot of the help-that-doesn't-actually-help community.

But, am slowly getting there.

Part 2

While doing research on the topic of personal boundaries, one of the top web search results I found was this one-pager FAQ sheet. It was developed in 2006 by TherapistAid.com and is hosted on a UC Berkeley website.

The second sentence about personal boundaries says this...

"A person with healthy boundaries can say “no” to others when they want to"

Note the heavily lifting done by the word can. If you can, you're healthy. If you can't, you're unhealthy. As I've pointed out numerous times over the years*, the barriers preventing a person from being able to say "no" effectively might originate from any or all of factors including..

- Issues with self

- Issues with community 

- Issues with broader society  

 People in positions of low power are disempowered from saying no effectively. They don't have the luxury of privilege. They are at high risk. Saying "no" sometimes isn't just ineffective - it can be downright dangerous. More dangerous than the already existing harm from the "no" being ignored. It could risk physical or emotional abuse. It could result in getting fired from a job. It could risk smaller but still impactful microaggressions. And these are often people who do not have the privilege to just go somewhere else when these things happen (which is a topic deserving it's own article).

Do we call these people "unhealthy"? Are the poor "unhealthy"? Are marginalized people of any or all kinds "unhealthy"?

I hope it feels uneasy thinking about that. We may identity these people as "in distress". But I don't think "unhealthy" is the correct term. Maybe, on some technical level, health does not imply cause. Mental health professionals I've interacted with rely on this technicality a lot. Technically, they say, they know and account for social factors. In practice though...

The term health, in contexts like this, is often solely linked to and heavily implying that the issue is an issue with self. That you are unhealthy and that the tools of psychotherapy and relationship advice are all that is needed to fix you and solve the problem - in this case the problem of boundary violation.

Instead of calling boundary violation "unhealthy", call it what it is - boundary violation. 

Begin with a much more explicit separation of experience from cause, which is often not currently done. Put another way, I argue that, in practice, when professionals say "you are unhealthy" what they are also saying is "you are the problem". 

Much like medical disease, we center the problems within the self. And we focus solutions at the level of self. Not the environment. Not the community. That, in my estimation, is one of the key aspects (not the sole one, but a major one) of what it means to discuss the medical model of mental health and why it's problematic.

All the tools of emotional and relationship aid are aimed at what the individual is not currently doing and what they could/should be doing differently. Which, put another way, is telling them that they are doing it wrong and that we need to correct and fix them until they do it right. Being corrected and fixed is sold as the key to freedom from distress.

I am not opposed to the notion that individual-focused self-change strategies sometimes help. But when it becomes the only thing we talk about, it's a massive problem. Because no, individuals are not the sole and only source of their own problems and distress. Period.

*A tool I developed for helping map out causes between self, community, and society is The Accountability Triangle, available here. 

Report: The Lived Experience Input Gap

Latest Update: 11/29/22

Issue Brief Developed by Max Taylor

Social Reality Lab

http://www.socialrealitylab.com/


Framing Question

Where are the inroads for lived experience survivor input on resource development and service offerings? a.k.a "The Gap"


Analysis

• Existing opportunity are seemingly sparse, to the point of being wholly non-existent

• Numerous documented examples of outright hostility / "getting slammed" when a survivor critiques or questions existing offerings

• Populations of concern

        • "The Harmed" (existing services hurt or outright traumatized the user)

        • " The Unhelped" (the service user needs help, often wants helps, and is not being effectively        helped)

• Needs

        • Culture shift to validate and respect "The Gap" existing

        • Capacity (improve conditions of empowerment for Harmed / Unhelped, including inancial, social, etc.)


• Potential First Step Ideas

        • Micro-capacity offerings



Background Reading (work in progress)

Article: The Hard Truth Of When We, Sometimes, Can Do Almost Nothing To Help



Selected Quotes from the Harmed and Unhelped populations

“[There is] a culture of victim shaming and dismissiveness that pervades when I seek help for myself and others.”


“It didn't seem to matter what approach I took or who I spoke to, my efforts to help are repeatedly misinterpreted as trying to destroy the school. Destroy. Not trying to protect and cherish and make better. Even when the school (or others involved) asked for my feedback about the school, that feedback was then rejected and pushed aside. So much emotional labor, for zero result. Often I've been rejected because I am too well-informed, more than most at the school today, and too direct, which leaves people feeling threatened. Rather than listen, they shut down every avenue for discussion. Playing nice didn't work, and I'm not willing to play mean.”


“As members of the population we are serving, we are often under-or-unemployed, multiply disabled, and struggle to maintain attention on advocacy and activism when so much time, energy, attention, and labor needs to be spent on keeping a roof over our heads and food on the table. Many of us also have families, children we are responsible for. The burnout factor is always high, which is why a great many of us dip in and out of active status on the front lines.