Safeguarding the Integrity of Peer Professional Roles: Understanding, Addressing, and Preventing Peer Drift

By: Christa Cornelius, MHP, CRSS

Peer professionals are individuals equipped with training to utilize their personal, lived experience of recovery in order to support and enhance the resilience of others facing mental health and/or substance use challenges. This role is distinct and separate from the framework of a clinical or medical model.

Peer professionals go beyond clinical treatment by offering non-clinical, strengths-oriented support. They help individuals connect with or remain engaged in the recovery process through shared understanding, mutual empowerment, and respect, drawing on shared experiences. It's important to note that peer professional services do not replicate the responsibilities of behavioral health specialists. Peer professionals help lay the foundation for recovery based on mutuality through a non-hierarchical relationship. They help make connections with other services and supports, assist individuals in understanding their care, and empower people to make informed decisions.

More and more often we are seeing increasing rates of peer drift. Peer drift, otherwise known as co-opting, manifests when the responsibilities of a peer professional begin to stray from the distinctive practices that set them apart from clinical or other recovery providers. It may also arise when peer professionals feel uneasy in their role, leading them to transition towards a more medical treatment-oriented position. This shift could involve a focus on symptoms and/or diagnoses, or a tendency to encourage individuals to adhere to advice rather than supporting them in making their own decisions.

SAMHSA recognizes two categories of peer drift which include organizational and individual peer drift. They explain that organizational peer drift happens when peer professionals are marginalized and assigned tasks that misalign their intended duties. Individual peer drift is discussed as the peer professional acting in a role that differs from their dedicated responsibilities, which can look like acting in a more hierarchical position (coach, sponsor, counselor, etc), or like stepping into a more clinical approach. It can also evolve into allowing boundaries to be lax, creating a less structured relationship with the individual.

Peer drift can happen when there is a lack of understanding regarding the role of peer professionals, pressure to comply/conform, or when the distinctly different perspective from which peer professionals work is not honored. Co-opting happens when the peer professional role is different from what it is intended to be or by doing the work of

others.

Peer professionals are not therapists/counselors, case managers, nurses, friends, transportation services, bill collectors, sponsors, or coaches. They do not provide or use religious advice or promote religious affiliation, assess or provide diagnosis, take over

someone else's recovery, oversee medications or any type of testing, or insist

on recovery if someone isn't willing.

How can we avoid peer drift and co-opting?

·      By becoming very familiar with the National Practice Guidelines for Peer Support Specialists and Supervisors (read here)

·      Staying anchored to the model of providing non-clinical, non-hierarchical, strengths-based support through shared experiences.

·      Avoiding the use of clinical concepts and elevating the voice of lived experience.

·      Join or create an Advisory Council to receive ongoing input from peer professionals working in the field and seeking input at every intercept.

·      Train non-peer professionals at organizations that hire Peer Support Specialists about what Peer Support is rooted in and taking action to prevent assimilation into other roles.

·      Advocate for policies and procedures to be developed or improved to take into account the actual role of peer support.

What to do if you feel your role has drifted or your work is being co-opted?

·      Talk to your supervisor. Review your job description and the National Practice Guidelines for Peer Support Specialists and Supervisors. (read here) Suggest formalized training for the whole organization to get a better understanding .

·      Contact your Advisory Council to discuss the issues you are having.

·      Contact NAMI Illinois Alliance of Peer Professionals to get more information (Contact NIAPP)

Resources:
Understanding and Avoiding "Peer Drift" presented by 814-CRSS Success Learning Collaborative Division of Mental Health

Peer Support Services in Crisis Care by SAMHSA

National Practice Guidelines for Peer Specialists and Supervisors presented by National Association of Peer Supporters