Taking ‘Hope’ Seriously in the Work of Peer Support Specialists

Recovery Emerges from Hope. The belief that ‘recovery is possible’ provides the essential and motivating message of a better future.  People need to know that people like them can and do overcome the internal and external barriers that confront them. Hope is directly tied to how much work people will do to recover.  It can be fostered by peers, families, providers, allies, and others. Hope is the key catalyst of the recovery process, which is why it is listed as the first element in the SAMHSA Definition of Recovery (https://store.samhsa.gov/sites/default/files/pep12-recdef.pdfr). 

 We don’t give hope enough careful attention and so we miss opportunities to help people make more progress in their recovery.   Consider the following:

 1.     Researchers in the field of Behavioral Economics suggest that hope is tied directly to the client’s estimate of how likely it is that they will get a positive outcome from their efforts to recover.  That level of hope determines how much work they do to achieve recovery.  That suggests that we would be wise to invest in finding ways to persuade clients that they can be successful.  We assume that clients will come with whatever level of hope they have and that we work with that level.  We need to become experts at building hope in order to increase our client’s willingness to work for recovery.

 2.     Many mental illnesses include symptoms that undermine hope.  Hopelessness is key symptom of depression – the most common form of mental illness.  Anxiety disorders include symptoms related to fear of negative outcomes.  Many mental illnesses follow a relapsing/remitting pattern, waxing and waning.  This pattern can also undermine hope, as clients have to face the reality that relapse may be in their future.  Overall, most mental health disorders actively undermine hope, and thus reduce motivation to recover.  To treat these illnesses, we clearly need to target hope if we have any chance to helping our clients to fully pursue recovery.

 3.     As a Peer Support Specialist, you are concrete evidence that success is possible.  The more Peer Support Specialists that clients see, and particularly Peer Support Specialists who are very similar to the client in terms of problems they’ve overcome, background, demographics etc., the more likely they will believe that recovery for them is possible, and even likely.  Your involvement will build hope which will increase motivation.

 4.     Programs rarely share success rates with clients.  This is simply not seen as something clients will be interested in.  This is unfortunate, because clients have a great need to know whether they are likely to benefit from a specific treatment.  Most mental health treatments have success rates over 50% and many are around 80%.  That should tell prospective clients that if they complete the intervention, they are more likely than not, to benefit.

 5.     Programs rarely assess clients’ hopefulness about their recovery.  Again, this is unfortunate, as it is directly tied to how much work clients will engage in.  Hopefulness is often very individual, and only a frank conversation with clients will help clarify why they are hopeful or not.  Such conversations will give you opportunities to correct any flawed reasoning that is undermining their hopefulness.

 6.     Researchers in the field of Behavior Economics also suggest that timeliness is directly tied to hopefulness.  If an intervention will result in benefits to the client fairly quickly, then hopefulness will be high and motivation will be high.  If the benefits will take months or even years, the hopefulness is reduced.  If there is a waitlist before they even start participating, hope and motivation are reduced.  We often don’t focus on producing benefits in a timely way, but our clients are focused on it.  Many of our best interventions take weeks to months to produce real benefits and some have lengthy waitlists. Can we find ways to add quicker benefits or to spotlight shorter term benefits? If we do, we can expect greater hopefulness and motivation from our clients.

 7.     Given the importance of hopefulness in determining the motivation and persistence of our clients in pursuing recovery, we need to become experts in building and maintaining high levels of hopefulness.  Peer Support Specialists can play a key part in assessing and tracking hopefulness, and in developing strategies for building hopefulness.  In one sense, the primary role of Peer Support Specialists is to build hope.  The experience of recovery is part of the expertise of Peer Support Specialists, and so you naturally can help lead the charge on building effective programming to ensure our clients are truly hopeful.

KEY WORDS: Peer Support Specialist, Recovery, Hope, Modeling Success, Peer Support, Peer Support Training, Peer Support Certification, Peer Support Jobs