RTP: Culture & Spirituality Webinar Materials, How Peer Specialists, Supervisors Can Work Together

Reciprocal Supervision: How Peer Specialists and Their Supervisors Can Work Together for Lasting Recovery

by M. C. Violet Taylor   Recovery to Practice Highlights  April 6, 2012

Reciprocal Supervision is a term I coined to describe the egalitarian relationship I have with my supervisor. She is the Assistant Chief Nursing Executive in a locked mental health institute and I am a Regional Peer Bridger-the consumer on staff. We work in an acute care setting, where the spectrum of mental health issues, cultures, languages, abilities, and lifestyles is as varied among consumers as it is among coworkers. Our State has not been as progressive as it has been diverse. Peer Support Specialists are still a rarity, and we are the signal of changes to come.

There is a true understanding of the concept “unconditional high regard” in the working relationships I’ve developed with my supervisors at the hospital. We have incorporated key elements of the Wellness Recovery Action Plan (WRAP) in our relationships, emphasizing Hope, Personal Responsibility, Education, Self-Advocacy, and Support to benefit everyone-especially the consumers we serve.

Peer Support Specialists take a different approach to mental health and recovery. Relationships are based on trust, and we emphasize the strengths a consumer has already developed or has the capacity to develop. Among peers, reciprocity and discretion are implicit. You might say we work “from the heart out,” with an appreciation for the preciousness of each other’s humanity. It goes without saying that we all strive to support and understand one another.

For these reasons, Peer Support Specialists can be seen as disruptive in workplaces where change is necessary.^[1] My focus is to help people return to work and their communities and, most importantly, begin the recovery process. Cleaning a consumer’s home to ease his return from the hospital, waiting in the car during a peer’s job interview, shopping with someone for work clothes and supplies… these are just a few of the tasks we perform, all the while gently encouraging peers to determine what assistance is needed for their recovery. Recovery is always a work in progress. We’re constantly changing together.

Each of my four supervisors has been a Recovery Champion. Along with peer leader Lisa Goodwin, the clinical staff have guided me with creativity and patience. Change has taken place at our organization and I believe healthy, strong relationships are part of the reason our consumers are so successful.

My first supervisor was Chief Nursing Executive Amy Rushton, RN. Looking back, I realize she was the driving force behind my work and recovery-oriented care at the hospital. Melissa Preston, Director of Social Work, was my supervisor the following year. She emphasized efficiency and customer service skills. Today I am supervised by Lauren Davis, ACNE, who has allowed me to write about and promote our success. These are women of vision, creativity, and strength.

Over the years, I have learned lessons from my supervisors that I still use today:

Ask the Consumer

When you’re not sure about what a person has in mind, ask. Start a dialogue-it will show consumers you support their health, life, and dreams. If they don’t know where to begin, help them create a list of viable options.

Give Your Supervisors What They Need to Help You!

At times, staff will question your work. My supervisor attends meetings where she’s grilled about my decisions. Because we keep the lines of communication open, she can help me handle difficult staff and administrative hurdles. When my decisions are based on health, safety, and common sense, they can be easily explained to anyone.

Make Opportunities for People to Shine

As a one-peer department, I needed help facilitating groups. When consumers at the hospital heard about peer-led groups, they were anxious. “They can’t be in a room alone together!” was the assumption. I responded that people need to be part of a support group where they can speak honestly, without fear of documentation or another diagnosis. My supervisor suggested each peer group leader work with an assistant, so someone would always remain in the room. We started with five peer-led groups and when consumers requested more, we obliged. I now co-lead about 14 groups each week, with help from consumers. Our groups are so effective, we host two at local drop-in centers.

Take Time to Speak Out

Consumers and I are usually responsible for presenting at local conferences. It was difficult to speak publicly at first, but my peers and supervisors brought me along. Allow your Peer Support Specialists to attend local and national conferences. If possible, let them bring consumers.

Guidelines I Use to “Manage My Supervisor”

• Honesty. If I have a problem, I go straight to my supervisor. She has worked in hospitals for a long time and helps me resolve issues quickly.
• Maintain role model transparency with supervisors, consumers, and staff-say what you do and do what you say.
• Respect your supervisor’s time. (Have you ever seen a mental health services provider who actually had enough staff?)
• Take time off if you’re not feeling well. Use your WRAP to catch early signs of illness.
• Clinicians sometimes teeter on the edge of burnout. Handle as much as you comfortably can on your own and always be kind to consumers. Remember: we are not here to “do” for our peers, only to provide support.
• Tell supervisors about new resources in the community (events, classes, etc.). Bring them information on trends and changes in technology, scholarship offerings, and conferences.
• Let your supervisor know when she’s doing well, and how her work has helped people. Note the changes you’ve made together.
• When you’re stuck, ask for help! Some clinicians, especially Recovery Champions, have been waiting for the chance to try something new.
• Peer Support Specialists have two jobs: to serve consumers in ways that promote recovery, and inform their supervisors about what does and doesn’t work inside the system. Don’t expect solutions to magically appear. It takes time before great changes can be made.

As Peer Support Specialists working in an organization, we cannot create an atmosphere of “us” and “them.” A string pulled in two directions is destined to break. Instead, show your organization you are all bound together by the sturdy, mutual, and heartfelt desire to help others overcome mental illness. There is no greater goal.

1. Patricia Deegan. 2011. Peer Staff as Disruptive Innovators-PDA Blog. Patricia Deegan and CommonGround-PDA. Retrieved from http://www.patdeegan.com/blog/posts/peer-staff-disruptive-innovators.

Violet Taylor is a Regional Peer Bridger in Falls Church, Virginia. Contact her at Violet.Taylor@dbhds.virginia.gov.