Peer rehabilitation leadership for empowerment

By Jennifer Feng

 

For the past century, disability advocacy and disability advancement have led to an immense burgeoning of civil rights dialogue, civil rights activism, and even legislative reform based on the revolutionary movements and values which have been brought about as a result. Much of the results that have stemmed from these activist-based efforts are focused on an empowerment component that seeks independence, autonomy and other associated human rights for individuals with disabilities.  This empowerment approach has helped individuals to not only build power in solidarity. but it has also enabled them to form an active approach in cultivating a segue for not only representation but a mechanism for both professional skills and personal life goals fulfillment.

An active and powerful programmatic venue in which individuals with disabilities have engaged society with their skills, identities, values, experiences and other assets is the world of peer support. Peer support is an innovative strategic method of intervention that allows consumers and persons with disabilities to consult with someone who is not necessarily a mental health professional but someone who has been through similar lived experiences with mental health and other associated experiences.  By putting their skills to good use by either assisting their peers, counseling their peers, or encouraging and advocating for their peers, individuals with disabilities are not only demonstrating the usefulness and applicable nature of their lived experiences but also forming a more active rehabilitation plan.

In many ways, the role of a peer support specialist and peer advocate in empowering others has many beneficial points for the peer who has a lived experience with disabilities. For one, it solidifies the identity of one who has a disability, recognizing the implications it has for someone with a disability. On another note, it helps them to engage with the world in a more concrete manner, thereby providing liberation. This occurs mostly because individuals now can identify more freely who they are, how they choose to be known, and how they wish to engage with the world. It also gives them the power to choose how they wish to live their lifestyles, what they would like to do, among many other life decisions (Fisher, 1994). Most of all, they now have more autonomy and are given more liberties both by assisting others and by cultivating more solid identities.

Peer support has been known to provide many benefits, both mutually and to the individual(s) involved. For one, peer support has been known to help those providing the support a sense of self-esteem enhancement, self-efficacy, and confidence. By assisting someone else with challenging matters, the peer is able to realize and pinpoint their strengths and weaknesses in addition to alternative perspectives that they may or may not have recognized previously. For peer support, the process provides many parallels that are very different from the typical licensed mental health provider and client relationship. For one, it levels the playing field on which the supportive relationship is formed and built. Many individuals with mental health disabilities, for example, may not feel comfortable consulting a licensed mental health and/or rehabilitation professional because of the professional nature of the relationship. Clients and consumers may not feel that they are as relatable, or they may not feel at ease with disclosing certain matters for fear that they may not understand as well as someone who has experienced a similar situation. In addition, peer support provides a strong venue for individuals with disabilities to form a solid identity connection with their peer.  Often, individuals with disabilities are motivated, encouraged by, and ultimately empowered by the shared experiences of working with someone with a disability. It provides a solid mutually beneficial ground for both to work toward a destination that is familiar to both.

Peer support has also been demonstrated to provide immensely beneficial supports, resourceful advantages and outcomes in the vocational realm.  Peer support in the vocational realm can take many varied forms, including but not limited to natural supports, peer supports which function as co-worker supports, job coaches, career coaches, among others. Many of these roles work by blending into the work culture and atmosphere in which the worker with disabilities functions. They may serve to assist the worker in completing their duties, or they may serve more as an advocate which helps to bolster the worker’s sense of self, purpose and perception from coworkers and supervisors. A natural support would, for example, be someone already in the work environment working alongside the individual by providing moral support, supportive encouragement, and individualized accommodation supports to help complete job duties.  Job coaches would work similarly, although they would not be those already in the work space on a regular basis. Job coaches take a more evaluative approach, although they would function in a similar fashion as natural supports. To illustrate how a peer support specialist can work in the vocational and employment arena with someone with disabilities, I will describe two somewhat different examples of how peer support specialists help someone complete their job assignments. In these examples, many fundamental concepts of what constitutes the peer profession can be observed and assessed. Both share similar identity values and have experiences that relate well to each other.

In case scenario one, Mr. D is an activity helper who works at a day habilitation center for people with developmental disabilities. Mr. D is of African descent whom is shy, exhibits slight intellectual disabilities which at times hinder communication skills, and cultural competencies. Mr. D is assigned to work in a work unit that is comprised of a habilitation specialist, assistant habilitation specialist, and a habilitation aide. Within this team exists Mr. A, the habilitation specialist who administers habilitation plans, accommodation needs, and schedule changes for the clients in the day habilitation room. Mr. A is also of African descent, shares similar cultural values, and is someone who Mr. D often consults for advice on how to succeed in the workplace. Mr. A relates very well to Mr. D and both share common ground that they miss very deeply.  For example, their shared cultural origins and the feeling that the English language is not easy to learn and comprehend. Both also perceive the American norm and social interactions as somewhat complex. Both share difficulties understanding what is always culturally appropriate and because both have experienced some type of mental and developmental distress with this arena; both share a deep connection in this area. Mr. D consistently calls upon Mr. A on how to navigate the workspace that is comprised mostly of people of Caucasian descent. Mr. D has also come to recognize many new features of his cultural environment and feels more at ease socializing with his co-workers.  By connecting with Mr. D, Mr. A has also experienced a newfound appreciation for which he perceives his everyday situations. Both had connected on grounds of cultural identity and mental distress.

In case scenario two, Ms. C is someone of Chinese descent who just immigrated to the United States. She is assigned to work at a restaurant washing dishes, waiting tables. and preparing meals for customers. Although the restaurant is comprised mostly of Chinese-speaking employees, Ms. C is one of the only ones with limited experience in the United States. Ms. C finds that her experiences adjusting to the United States is somewhat difficult and consults someone with similar experiences. Ms. C consults Ms. X who had immigrated to the United States somewhat earlier than Ms. C and has also found the journey toward American assimilation hard. Ms. C and Ms. X connect on this experience and both find that they share exceedingly similar experiences and how they can mutually benefit each other. Ms. X found that she had benefited tremendously from Ms. C’s strategies on combating depression, loneliness, and anxiety.  Both find that they do wonder how their identity as a cultural minority will work for them and how they will ever become proficient in the English language. In this scenario, we can observe how Ms. X’s experience combating depression, anxiety, and loneliness due to her immigration experience helps Ms. C, who had only recently immigrated to the United States. Ms. C now feels more comfortable seeking assistance in a new country comprised of essentially dissimilar values and systems than that of her homeland country.  Both had developed a solid identity and formed a shared and mutually beneficial connection based upon their experiences.

The peer support role is a newly formed, innovative programmatic objective designed to provide a counseling and mentoring approach that is geared toward empowering others. The peer role is meant to utilize the lived experiences of those who have already experienced a mental health disability and/or other disability-related matter to strengthen, encourage, bolster, and empower those who are seeking assistance. Peers play many different types of roles, but their main functions center around fundamental core values of mutually beneficial assistance, relating to their clients by utilizing what they had already experienced. It encompasses many elements of empowerment because it mostly helps to establish a core principle of enabling others to persevere. It mostly does this by offering a model of experience that is already established and thereby incorporates a unified identity approach. This unified identity, also known as solidarity, helps develop an identity that propels the recovery model based on peer support services possible.

The peer support model, which ultimately strengthens and encourages a shared identity and empowerment model, helps to cultivate and work toward an identity for the purposes of political advocacy, activism, and civil rights. Toward that end, the peer support model also benefits individuals by encouraging them to become more autonomous in their decision-making when it comes to independent living choices and accommodations, among many others. It encourages them to deliberately ponder and consider to what extent they would like to either assimilate or integrate into mainstream society. Most importantly, it encourages and gives them an opportunity to think about what type of identity they wish to adopt. It conveys values such as self-sufficiency, among many others.  This type of freedom to choose their identity can be very liberating, although there are still many debates that seek to argue otherwise (Schwartz, et. al., 1999).

In observing and witnessing the core fundamental values that govern the peer support role, it is very empowering to those who have been unable to promote change in their lives because it places the control back in the hands of those who have not had it. It also equips them with a coach who is on equal grounds to help propel them forward each step along the way. Each step along the way gives the individual a chance to choose and propel themselves forward by deciding and gearing toward the desired the goal. Much of the fit and alignment in how the peer role works is similar to how a typical licensed mental health professional set-up would work. It is dependent on many factors, including cultural factors that determine how comfortable someone would feel working with a peer. For example, as observed previously in this article, a newly-arrived Asian immigrant would feel more comfortable working with someone of a similar background whereas someone of African descent would feel more comfortable working with someone else of African descent. Most importantly, the role of a peer is to not only affirm but to come alongside and to work on a level playing field to help achieve what the individual with a disability is looking to achieve. Much of this requires an element of collaboration along with autonomy, independence and ultimately liberation. The peer identity can be very useful in opening dialogue centered on what it means to be disabled with ease. Not only does it encourage individuals to be more direct and honest, but it encourages acceptance and honesty inherent to personal introspection and reflection. The peer role is, in many ways, a big step toward a revolution for advancement of civil rights for people with disabilities. With this advent, people with disabilities experience more freedom to express themselves and all that they embody and represent with less stigma attached.

 References

Fisher, D. B. (1994). A new vision of healing as constructed by people with psychiatric disabilities working as mental health providers. Psychosocial Rehabilitation Journal, 17(3), 67-81.

Schwartz, Carolyn E. & Sendor, Rabbi Meir (1999). Helping Others Helps Oneself: Response shift effect in peer support. Social Science and Medicine. 48(11), 1563-1575.