Top 5 Mistakes Clinical Providers/Administrators Make: #3 Failing to Train All Clinicians about the Role and Strategic Value of Peer Support Specialists
Peer Support Specialists represent a truly unique addition to the teams who work in healthcare settings. They are dramatically different than any other group in their role, their expertise, and their training. Their potential impact depends greatly on the degree to which the team understands the Peer role and how to use it strategically.
Most clinical settings incorporated Peer Support Specialists without training staff about their role and expertise. Many clinicians had no understanding about what Peers bring to the setting. Is it surprising then that those clinicians started asking Peers to do work that had no relationship to their training or their unique role? Some Peers were asked to serve food and provide transportation. Others were asked to do the work of clinicians. Many Peers felt unrecognized and disrespected, failing to understand that the staff had never been educated about what Peers can do.
As the complaints and problems grew in frequency, national organizations like the National Association of Peer Supporters (NAPS) created guidance for clinicians and supervisors about how to understand the Peer role and how to supervise and guide the work of Peers effectively (Foglesong, Knowles, Cronise, Wolf, & Edwards, 2022). Unfortunately, many clinicians n of that guidance, never heard about that guidance, and continued to work with little understanding of their own team members.
This failure to provide even basic training to clinicians about the role and strategic value of Peer Support Specialists is almost universal. In a recent review of one of the earliest pioneers of Peer Support Specialists (Pollice et al., 2025), the community mental health services of the Friuli Venezia Giulia region in Italy which has been integrating Peers into mental health clinical teams for more than 2 decades, researchers found that many of the limitations in the work of Peers were related to poor training of clinicians. Uninformed clinicians failed to use Peers strategically, instead asking them to do work unrelated to their role and keeping them disconnected from clinical teams. One of the top recommendations made by this review was to improve the education of clinicians regarding the role of Peer Support Specialists.
What specifically should be included in this training? Consider the following basic information:
A. PEER SUPPORT SPECIALISTS ARE EXPERTS IN THE EXPERIENCE OF ILLNESS, TREATMENT, AND RECOVERY
Clinical knowledge about an illness and treatment is different from the knowledge people gain by having the illness, by participating in treatment, and by recovering from the illness. Peers bring unique expertise in the experience of illness, treatment, and recovery, and help clinicians and clinical teams use that information to improve the success rates of the treatment they provide. Many of the largest barriers to successful clinical care involve some aspect of the experience of illness, treatment, and recovery. These include poor therapeutic alliance and low trust in providers (Isaacs, 2022), poor healthcare fluency, difficulty navigating healthcare systems (Griese, Berens, Nowak, Kelikan & Schaeffe, 2020), poor individualization of care (Riis et al., 2020), stigma and healthcare disparities (Cook et al., 2019; Corrigan et al., 2015), social isolation and loneliness (Office of US Surgeon General, 2023), the high cost of healthcare (Dieleman et al., 2020), and the impact of social determinants of care (Taylor et al., 2016). Peers have a natural role in addressing all of these barriers.
B. PEER SUPPORT SPECIALISTS HAVE ADVANTAGES WHEN THEY SERVE AS THE FACE OF THE CLINICAL TEAM TO CLIENTS
Many clients feel a natural distance from and distrust of clinicians. They can also misunderstand a clinician’s statements and motives. All these factors lead to reduced effectiveness of care and undermine the recovery process. Peer Support Specialists should be active in representing the clinical team to the client. They are often the team member that clients feel most understood by. This creates an opening for Peer Support Specialists to improve the client’s engagement in treatment in a number of ways, including
1. Educating clients about the clinicians and the clinical team, and their role and motives.
2. Improving the alliance between the client and the clinical team, including mediating conflicts and misunderstandings.
3. Reminding clients that clinicians are very much like them.
4. Reminding the client that the clinicians work for them. The client is the decider in most healthcare decisions, and the clinicians are supposed to use their expertise to help the client achieve their goals. Clients can forget this, and so being reminded of this arrangement can be key to empowering clients to own their treatment and recovery.
5. Adding information to the clients’ decisions about their care and recovery. In particular, Peer Support Specialists often provide a great deal of important information about the process of recovery.
6. Introducing clients to clinicians that they don’t know but may benefit from working with.
C. PEER SUPPORT SPECIALISTS HAVE ADVANTAGES WHEN THEY SERVE AS THE FACE OF THE CLIENT TO THE HEALTHCARE TEAM
Clinical teams have traditionally consisted only of licensed clinicians. It is typical that clinical teams think and talk about themselves in a way that is different from how they think and talk about their clients. Many clinicians have deep empathy for their clients, but they still tend to see them as different and separate.
When a Peer Support Specialists joins a clinical team, their presence breaks that symbolic division between the clinical team and the clients. Now a “client” is on the clinical team—part of the meetings and discussions, and part of the decisions. By being the face of the client inside the clinical team, Peer Support Specialists add important information about the client’s perspective to discussions and decisions by:
1. Changing the nature of the alliance between the team and the client, making it more collaborative.
2. Reminding clinicians that clients are very much like them.
3. Reminding the clinical team that the recovery of the client is the overarching agenda of their work.
4. Serving as a natural advocate inside the team.
5. Emphasizing the process and likelihood of recovery. (Clinicians often forget about this, as they are typically less involved in the later parts of recovery.)
D. PEER SUPPORT SPECIALISTS ARE THE FACE OF THE COMMUNITY OF RECOVERING PEOPLE
Clients need to know that a community of people in recovery exists, and that this community includes people who may be able to provide support for them. But clients often do not know about the existence of this community, or how to contact them and take advantage of the support they offer. Peer Support Specialists represent that community and can help clients feel connected to the large group of people living successfully through recovery.
E. PEER SUPPORT SPECIALISTS MODEL A HEALTHY STANCE TOWARD SUFFERING
A deeper problem underlies illness and recovery, whether that illness is mental or medical. Suffering is part of life, and this is something that we are understandably ambivalent about. Illness may involve various forms of suffering, including physical/emotional pain, other physical/psychological symptoms, anxiety about future illness, lost functioning (e.g., lost days at work), failures caused by the illness, remorse and regret about ways we may have contributed to the illness, and subsequent unmet needs and desires.
The term common humanity refers to a healthy stance toward suffering, reflected in two key beliefs: (1) the belief that suffering is a universal human experience, and (2) that all humans are the same in their basic needs and desire to avoid suffering (Strauss et al., 2016). People who have these beliefs use them to interpret their own experiences. For example, for a client who holds these beliefs, the experience of dealing with a physical or mental illness will be interpreted as something other people also experience—not something that isolates them (Ling, Olver & Petrakis, 2020).
Researchers have found that people who have common humanity beliefs have greater social connection and more mutually supportive relationships (Gilbert & Leahy, 2007). They are less likely to feel isolated due to illnesses, relapses, and failures, recognizing that everyone faces challenges of some sort. They see these challenges as something that they share with others, and so are opportunities for connection to other people. Talking openly about challenges often leads to positive connection to others who share similar challenges.
Encouraging “common humanity” beliefs is at the core of how Peer Support Specialists help clients. Peers talk openly about their own experience of illness and recovery. By doing this, they help clients accept their own suffering and better connect with others.
F. OTHER TOPICS FOR INCLUSION IN TRAINING INCLUDE:
1. The Current Research Evidence Regarding the Benefits of Peer Support Specialists
2. Strategies for Effective Collaboration Between Clinicians and Peer Support Specialists in Medical Care, in Mental Health Care, and in Substance Use Treatment.
3. Appropriate vs Inappropriate Duties for Peer Support Specialists
The US healthcare system currently employs over 30,000 Peer Support Specialists, with many more in Europe, Canada and around the world. This represents an investment of many millions of dollars in this professional group. This is a wasted investment and a lost opportunity for improvement if the clinical providers and administrators are not adequately trained to know how to collaborate and use these key players strategically in healthcare. The failure to fully train clinicians in how to understand and collaborate with Peers has been a quiet disaster for clinical programs and for those Peers who are trying to build this new field. Reorganizing efforts to educate all staff about the Peer role has to be part of the solution.
REFERENCES
Cook, B. L., Hou, S. S. Y., Lee-Tauler, S. Y., Progovac, A. M., Samson, F. & Sanchez, M. J. (2019). A review of mental health and mental health care disparities research: 2011-2014. Medical Care Research and Review, 76(6), 683-710.
Corrigan, P. W., Larson, J. E., Michaels, P. J., Buchholz, B. A., Del Rossi, R., Fontecchio, M. J., ... & Rüsch, N. (2015). Diminishing the self-stigma of mental illness by coming out proud. Psychiatry Research, 229(1-2), 148-154.
Dieleman, J. L., Cao, J., Chapin, A., Chen, C., Li, Z., Liu, A., ... & Murray, C. J. (2020). US health care spending by payer and health condition, 1996-2016. Jama, 323(9), 863-884.
Foglesong, D., Knowles, K., Cronise, R., Wolf, J., & Edwards, J. P. (2022). National practice guidelines for peer support specialists and supervisors. Psychiatric Services, 73(2), 215-218.
Griese L, Berens EM, Nowak P, Pelikan JM, Schaeffer D. (2020). Challenges in Navigating the Health Care System: Development of an Instrument Measuring Navigation Health Literacy. Int J Environ Res Public Health,17(16):5731.
Isaacs, R.S. (2022). Five steps to restore trust in U.S. healthcare. Harvard Business Review. https://hbr.org/2022/09/5-steps-to-restore-trust-in-U-S-health-care.
Office of the Surgeon General: Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Report on the Healing Effects of Social Isolation and Comunity. Washington, D.C.; 2023.
Pollice, G., Bodini, C. F., Menchetti, M., Da Mosto, D., Negrogno, L., Betti, L., ... & Quaranta, I. (2025). Exploring the Integration of Peer Support Workers and Their Experiential Knowledge in Mental Health Services: An Ethnographic Study from the Dual Perspectives of Peer Support Workers and Professionals in Trieste and its Region.
Riis, C. L., Jensen, P. T., Bechmann, T., Möller, S., Coulter, A. & Steffensen, K. D. (2020). Satisfaction with care and adherence to treatment when using patient reported outcomes to individualize follow-up care for women with early breast cancer–a pilot randomized controlled trial. Acta Oncologica, 59(4), 444-452.
Taylor, L. A., Tan, A. X., Coyle, C. E., Ndumele, C., Rogan, E., Canavan, M., ... & Bradley, E. H. (2016). Leveraging the social determinants of health: what works?. PloS one, 11(8), e0160217.