Peer Specialists Are Not Clinicians
by patricia.deegan on Wednesday, June 21, 2017 - 9:54am
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Peer Specialists are an emerging workforce in behavioral health. Many Peer Specialists work side-by-side with clinicians on ACT teams, psychiatric rehabilitation programs, CommonGround Decision Support Centers, inpatient units, first episode psychosis teams, integrated health/behavioral health teams, etc. There is no doubt that Peer Specialists have many unique skills that enrich the entire team. However, within these traditional clinical settings, it's not unusual for Peer Specialists to begin to adopt the language and practices associated with the clinical worldview. In other words, over time the work of many Peer Specialists begins to resemble the work of other clinicians on the team.

In my opinion, it is imperative that Peer Specialists remain peer. We are not junior clinicians. I've been thinking about this issue a lot lately in my work with Sascha Altman DuBrul, Iruma Bello and others at OnTrackNY.  What are the differences and where is the overlap between the Peer Specialist perspective and the clinical perspective?  The chart below offers some thoughts. I'd love to hear your thoughts on this important issue.

Peer Specialist and Clinical Perspectives

 

Peer Specialist Perspective

Overlap

Clinical Perspective

Work is guided by the Principle of Mutuality defined as a focus on the connection between the Peer Specialist and the peer wherein there is reciprocity.

Unconditional positive regard for the individual being served.

Clinicians are in the role of helping and supporting participants with a focus on diagnosis, identification of strengths and treatment. There is not an expectation of reciprocity in clinician/participant relationships.

Focus on learning together rather than assessing or prescribing help.

A desire to support recovery and the person’s achievement of their human potential.

Focus on assessing and helping.

Emphasis on sharing and exploring life experiences where both individuals share personal experiences and perspectives.

The importance of connection, finding common ground, and respect.

Emphasis on exploring program participants’ experiences, with less expectation for the clinician to share their personal experiences.

There are many ways to understand the experience of what gets diagnosed as mental illness: bio-psycho-social; spiritual; cultural; distress as teacher; altered states; a natural variation of human experience, etc.

A commitment to support the person in making meaning of their experience.

The bio-psycho-social approach is the main framework for diagnosis and treatment while utilizing a cultural competency framework.

Do not participate in the delivery of involuntary interventions such as commitment to a hospital or outpatient commitment.

Both clinicians and Peer Specialists recognize the importance of choice and self-determination in the recovery process.

Involuntary interventions such as commitment to a hospital can be justified as clinicians struggle to balance the Duty to Care with the Dignity of Risk.

Trained to be advocates for and with participants. Advocacy may include speaking up about participant’s needs and goals, and/or coaching participants in speaking for themselves. Advocacy may also include advocating for participant’s legal rights, civil rights and human rights.

Both clinicians and Peer Specialists strive to listen carefully to the needs, preferences, goals and aspirations of participants.

Many are trained in recovery oriented practice which is strengths based, person-centered and aimed at supporting participants in achieving their unique goals.

Peer Specialists are members of a socially devalued group often referred to as “the mentally ill”. As such they are keenly attuned to stigma, dehumanizing practices, objectifying language, prejudice, discrimination and even offensive or traumatizing practices in mental health, health and social service systems. As advocates, Peer Specialists will speak up if clinicians slip into language or practices that  (often unintentionally) devalue participants or reinforce the status of being socially devalued.

Together, clinicians and Peer Specialists strive to create a culture of respect throughout behavioral health systems and in the general public.

Clinicians who have not self-disclosed a personal psychiatric history, are not part of the socially devalued group known as the mentally ill. 

Comments

In my experience, once you've been accepted as a team member you
Are expected to speak like the other team members. It becomes
Difficult to remain true to your own language and experience.
Even the individuals we serve will sometimes expect that we are
Clinicians. But no. Reminders of why you are there and your
Special role as a peer specialist is crucial. I am the only one with
My experience and the only one who can recognize things in others
The way I do and the only one who can share my experiences.
I also know the Common Ground resources far better than any
Clinician.

“Authentic service can be seen in the nurse who has nurtured herself, the healer who has been healed. It is the service we hear when the nurse can speak from her heart to the patient these simply and humble words, ‘I am here. Let's heal together.’ ” ~ Caryn Summers, RN
"How we walk with the broken speaks louder than how we sit with the great." - Bill Bennot

Those of us who are peer specialists are wounded healers, we straddle being in mental health recovery while also helping others in mental health recovery better help themselves. It is not only an honor and a privilege for me to be a wounded healer, but a life's calling. For the folks whom we serve to know that we've been through our own struggles and have gotten through them gives our peers hope as well as inspiration, and self-disclosure on the topic at hand with the right timing helps our peers feel more comfortable, more accepted but also can inspire and encourage them to do the right things to help themselves like consistently doing their own chosen Personal Medicine and advocating for their own wants, needs, concerns and goals with the rest of their treatment team. I will be in recovery from bipolar disorder type one with psychotic features until the day I die. This requires more dedication in many ways than the clinicians in mental health who do not have issues with mental illness or addiction. They get to leave the job at work; my recovery is 24-7-365. Not only do I talk the talk, but I walk the walk. I refuse to throw away my vulnerability as a peer wounded healer and act like or turn into someone whom I am not. Admitting my vulnerability is what often can inspire our peers to find their own inner strength. My heart is with those whom I have the privilege to help, and it is the essence of my life's purpose to help others, and they are helping me along the way too. Any good relationship is a two way street. Our peers' success is my inspiration, my encouragement, my fuel to continue to move forward.

"They that sow in tears shall reap in joy. He that goeth forth and weepeth, bearing precious seed, shall doubtless come again with rejoicing, bringing his sheaves with him." - Psalms 126:5-6, King James Bible

How do you become a peer specialist

Sometimes I think that everyone both clinicians and Consumers forget that just because a Peer Specialist is paid through an agency it doesn't mean they have the same training or skillset as clinicians. one thing I saw when I had both a Peer Specialist and a Case Manager, was that the paperwok for both my Peer Specialist and my Case Manager were the same the only difference was the department name and the name of the person I was in contact with, beyond that the same form was used by both departments for treatment plans. it was on my first encounter with my Peer Sppecialist that I noticed this and actually pointed it out to her that the form was identical and like me, she felt it needed to be different than what case management used, but we agreed that odds are someone higher up felt it would be more cost effective to re-use the same form rather than have something more specific to Peer Specialists' training. it was tough sometimes to look at any papers and know what was peer specialist and what was case management because the agency had specific requirements for how things needed to be worded by the peer specialists, which really to mee nearly killed the concept of peer specialists being complimentary to clinicians, but not the same as clinicians.... I view the concept of peer specialists as a sort of bridge across the gap between someone who is a Consumer and someone who is a clinician.... even for me serving on a Consumer Advisory Board, I found myself migrating towards a more clinical language for communicating during the meetings, so I get how easy it is to gravitate towards a more clinical language, but at the same time I do feel that Peer Specialists by definition really should be speaking in a manner that is comparable to the person their are speaking to... if they talk to a Consumer use common everyday language, but if they are talking to a clinician then save the clicical language style for them... A mix of common everyday language and clinical language would be ok, but when my Peer Specialist first started meeting with me, I honestly wasn't sure if she was a Peer or a Case Manager because she spoke fluent clinical language.... I'm not sure what the answer is, but I do feel part of the problem is that the clinicians seem to have the expectation that anyone in their meetings will either use clinical language or if they don't know it, will need to learn it in order to communicate with them as a result of this possibly unwritten yet very prominent expectation, I think Peer Specialists end up in a place where they forget to be Peers because they are speaking and writing clinical language every moment that they are working or training.

I am a peer in a crisis center and we do not diagnosis but we are there to help with the determination. We provide groups and we implement the directives of the clinical staff. In many cases the guest look to us a clinition as well. We let the know we have been in a similar place, however we are tasked with setting up in-patient as well as out patient solutions.

We are also being asked to respond more in a clinical way than ever before. The clinical staff touches the a few times and we touch them all th time. I am concerned in some cases the peers have little to no understanding and background in what is going on at a center. This may be ok as a case worker but not in a crises high stress short term scenario.

Just my 2 cents

Hello to Everyone!

This subject is a very hot topic for me. As a person with lived experience, my title at work is Vocational Wellness Educator. My workplace is at Crestwood BH. Inc. My roots started with The Berkeley Drop In Center and I worked my financial wellness to here.
My bottom line is this- I took a risk to let go of my public benefits (Section 8 Voucher, SSI/SSDI) to become part of sharing my gifts, skills, and talent as an contributor to my community. With awareness of stigma, bias ant coming from trauma and property.

Recovery and strength base attitude is all part of my spiritual journey. Yes, I have people who have supported me and help me grow, including the resources like this one with Pat Deegan. Folks who seem to move upward in their grow getting education, becoming part of the American dream. We are all on a path. This is my issue-
Why are we expected to give our information, skills, gifts, and talents away to you for FREE?
Why do people have different levels of financial advantages, retirement planning skills , etc?

It has taken me many years to attain Wellness, self sufficiency and meaningful role! I feel great! I am grateful. I forgive myself for being a late bloomer on so many levels every day

But when we are both? I have run into this several times as a person with a Masters in Psychology and the lived experience of someone who lives with a diagnosis I am able to do both jobs. I personally feel that it enhances both sides of my work as a member of a crisis response team. on the chart above I am able to place everything in the overlap section. Other people attempt to place me in one box or the other but I do not fit.

This article is a breath of fresh air. The struggle is real. I have worked side by side with clinicians daily for the past 30 months. There has been days when we have clashed because of our approaches and I have questioned my own principles as a peer. Then I am reminded that the people I have been fortunate enough to work with has been so important to my own recovery/wellness and it is this realization that gives me the courage and the strength to keep pushing forward.

It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.
Theodore Roosevelt, 1910

I really appreciate this article. I'm in a strange role as I am a licensed professional counselor, but am currently working as a peer support specialist. I do not see peer support specialists as junior counselors, so I was thinking a cool title for this article could be "Peer Support Specialists Are Not Junior Counselors" So grateful for your good work!

Recovery is a personal experience, which is unique and full of insightful and diverse people. Even in a group of Certified Peer Specialists we may have common ground with being in Recovery from mental illness, but potentially hold much diversity in a room together. I am peer support first. I have worked in various roles and have various trainings in mental health not necessarily always incorporating the peer support role. I am not a clinician, but in a crisis have training in areas beyond peer support. My recovery motto that recovery is possible and there is always hope stays the same, but I can be flexible to adopt and adapt to different things outside the traditional peer support role. The key is that I never act outside the scope of anything I have received training, education, or lived experience in. I have received therapy and can talk about my lived experience, but I am not a therapist. I am a mentor and advocate. I do not think peers should be expected to petition involuntary commitments unless it's a last resort to keep someone safe and they have received adequate training in doing so. My opinion is hospitalizations are a last resort, but are necessary when there's extreme symptoms to keep people safe until there able to return to baseline. They should always be given a choice whenever possible. Mental health consumers like myself deserve to be in the least restrictive environment, in which we are safe to ourselves as well as others.

Clinicians are not peer specialists. 50 years ago, as a very young professional student working in a NYS Psychiatric Center, I observed that many of the individuals (Patients in the Hospital) helped each other through varied trials and tribulations and they did it well. As an attendant, with little training and a large group of individuals to look after I appreciated the interactions I saw; that I now know reflected a mutuality of understanding and acceptance toward each other. I was the guy with the keys and tried to relate but fell woefully short of real understanding. As I think about it now, I witnessed the essence of the peer support concept. They could emphasize, share similar stories, frustrations, fears and offer real understanding and acceptance. The therapists, Physicians, psychologists, nurses, social workers and other attendants, like me, could not. That is something in my career I have never forgotten.

The journey from there to here has been a long and difficult one and the differences and similarities between peers and clinicians have always existed and add to the power of healing and successful recovery for many.

Beautiful. Thank you for sharing George. No doubt about it: peer support has always existed and is freely given.

Hi Pat,

I hadn't noticed that there was space to put comments here until recently. I appreciate the effort to differentiate between peer supporters, and clinicians, but I have worries about this sort of thing being developed by people who aren't directly working in these roles or haven't worked directly in these roles in a long time. This is a trend in this movement and it has been a real problem on a number of levels.

I also have a lot of concerns about the end result of the chart that's included here. It misses a lot of marks for me.

Although done quickly and not in any way in final form, you'll find both some of my concerns about the chart and a different chart that addresses some of the missed marks... https://www.dropbox.com/sh/x92wn2v3eyirxon/AADy84-32eb15CQWBo_qt24Ea?dl=0

Thanks,

Sera

In my opinion as a professional and peer worker...I have seen more peers relate to patients and clients than clinicians. Clinicians have an extreme sense of their abilities and often, an extreme sense of their own importance.

This is another way to belittle people with skills that perhaps someone who spent 15 years in school simply, does not have compared to the peer worker.

I thrive in the social sector, and have bypassed coworkers and others who have higher education than me, based on my ability to relate, make sense of, be a peer before a degree holder and so on.

I don`t need a chart, or someone who is a clinician to tell me or anyone else in the respected field that there is a difference between any of us. You are either born to service or you are not. I have spent many experiences solving a problem that my fellow colleague who holds a Phd in this and that can`t figure out, and I have seen this over and over.

I think there is a sense of panic in the world of clinicians, that "peer people" can walk into a position and provide better care and service than the clinician; real life experience, what a concept!

Do you assume someone who has lived experience in gang culture, would prefer working with a clinician who spent years in school while the peer spent years on the streets living the actual life? perspective helps when the nose lifts from the book.

" In my opinion, it is imperative that Peer Specialists remain peer. We are not junior clinicians. " - In other words, bow down to those who have temper tantrums when their degree is threatened by a real person. Nor would I want to be a junior clinician, there in is an insult to my ability to thrive in my role without having been structured by textbooks.

Recently on a page for PSS employees, a clinician came to the site and posted a lecture about how the state we live in is just "using" individuals who are PSS's for "cheap labor" and lamented on how she couldn't find a position in her field because of it. It was rather insulting. But it is also insulting not to give credit where it is due, to those who work hard to earn their degrees and have to pay back student loans.

Having said that, I resent commentary where people are putting down one side or the other. I am working on a degree and I am a PSS. A PSS does not have the skills of a clinician and the clinician does not have the skills of a PSS.

Why does one side have to jab the other?

I agree that we are not clinicians and there are some things that are best suited for a qualified clinician to handle. I prefer it that way and do not want a clinical role for those aspects, among others. I also feel that my role allows me to connect on a deeper level with those I work with. I love what I do. However, I have a few points I'd like to share. The expectations that are put on us often go beyond the scope of what our job duties are, just like clinicians face in an overloaded, overwhelmed system. We feel it too. We have either elected to "get certified" or are forced into it, because that is the demand and requisite and still get paid the same or little more. Quite often I've given a lot of my time and talents away for free, and I am sure I am not the only one. We get milked for little pay and a lesser label that was reinforced by those who speak about giving back power. Consider for a moment if that 8/10 times the duties and tasks given were beyond scope, and actually an admin or other department duty. What expectations are in an agency: Performing and integrating at top level, catching the overflow, doing our own jobs, and still expected to somehow find time to fit 40 plus hours of training for a specialist certification for things that have been done at stellar for years. In my own opinion, the word peer has become overused and a way to reduce the value and role of a person with lived experience, who also may or may not have certifications, and may or may not have a degree. Whatever the variables, it makes clinicians uncomfortable and there is a struggle for power and an invisible wall up. Knowledge does go beyond textbooks. That said, in our own roles, it's important that we stick to our core values, boundaries, and ethical compass in serving others, because we are not X.

There are coaches out there who are self-made and getting paid. There is a whole other world out there, and yet we are forced to play small. You can have your Doctorate and be a really crappy clinician. Similarly, not all PSS's are great at their roles, either. I have met some amazing clinicians who are great at their jobs, and I have met some amazing peers who are also just as awesome. I have met both, who simply don't have it for whatever reason. Just because someone has bigger degree or title it should not be assumed they have more to give I or anyone else. That is what is wrong with our system. I don't consider you or I more important than the other. What does this say about how you view who you work with? This article rips up so much great work and throws "unconditional positive regard" out the window.

"Peer Specialists are members of a socially devalued group often referred to as “the mentally ill”.

"Do not participate in the delivery of involuntary interventions such as commitment to a hospital or outpatient commitment."

I could go on. Insulting, and wrong. Perhaps you should get out there and be part of the "feet on the ground" out there keeping up, working hard, and are underpaid. Just like so many out there, and get a more accurate picture of what we actually do, the myriad of ways we contribute, and how we are also put into pickles because how we handle that not only speaks to our value and worth, and review your assumptions and language chosen to feature in this article. I realized what my experience and value were worth. I have stuck to my advocacy roots and passion for service which I was born with. I ventured onto my own path because I sensed the divide getting deeper, and my load piling with things not meant for me that ultimately affected how I could be of authentic service to those who came to me for help. I am so glad I did, and I hope others out there know how much they are worth, too.

Love what you do, and do what you love, there is a whole world out there waiting for your impact.

I am a man who has been in recovery from bipolar disorder since 2005, though my symptoms went into full force (i.e. became disruptive to my daily living) about 8 years prior to that. A past-president and still a volunteer with DBSA here in Colorado Springs, I became a certified psychiatric rehabilitation practitioner in 2012. Whether as a paid employee or consultant, my services are not valued by the 'system' (over-qualified or is it my advocacy reputation?), I decided two years ago to start a private practice in the field. Thus, I do the work of a peer specialist, but market my services as a life coach and employment specialist. In the latter phase of my work I follow the 'Choose, Get, Keep' model of vocational rehabilitation, which is not as widely accepted when compared to the Individual Placement and Support (IPS) model.

Who then appreciates what I do and is willing to pay for it? My clients and/or family members. It's a small, part-time business and i love what I do. Following the principles and practices of psych rehab and embracing the role of peer gives me an edge when it comes to helping my clients reach their chosen goals. It's all about the relationship, which means building and maintaining rapport and trust. They know my story and I know their story. We talk about the clinical stuff only in the context of options for health and wellness: medical services are helpful, talk therapy is helpful, medication can be helpful. It's ok to ask questions, get second opinions, do your own research, get input from family and other peers. YOU own your recovery. I'm not a disagnosis; I'm a parent, a husband, a follower of Jesus, and a 60 year old bald guy who wants to be your coach and mentor. What I provide is education, encouragement and accountability. Mental Wellness includes three very non-clinical components: meaningful work, a place to call home and friends.

It's quite easy to fall into 'clincial mode' in language and attitudes, especially when you are trying to secure referrals from licensed providers who are NOT peers. All I do know for sure is that for those who choose to hire me as a coach and we are successful with building the relationship right away, 'peer-ness' is a huge advantage. What I do works. And it's very much community based, often has the support and needed input from family members and reinforces the aspects of treatment that the client chooses to participate in. Thanks Pat for all that you do. This blog and the chart with it is very helpful in explaining the role of peer providers.

Thank you Pat, for the thoughtful characterization; It will be helpful for new people entering the field as either peer support specialists or clinicians, and also for clinicians who find themselves supervising peers without fully understanding their role. Why do we always find an "them" to have conflict with "us"? First it was patients vs providers, then peer specialists vs clinicians. It is also professional--i.e. paid--peer support vs. natural support, or family supporters vs peer supporters. I wonder if the taking on of a work role as a personal identity or the role of recovering person as our only identity makes it easier for anyone who doesn't understand or who belittles that role to personally offend us.

If we could take a deep breath, take a step back, and separate what we do--our roles at work--from who we are, we would not personalize so much, we would not be so easily offended, and we would be able to relate to others with less angst.

Having said all that, it's paramount to clarify our roles--understanding that just when we figure it all out, something new will emerge, and we'll have to change...

Thanks for your thoughtful reflection Jana. I think peer supporters can complement the work of clinical staff. As you say, this is not about a conflict between peers and clinicians. It's about trying to safeguard the unique worldview and skill sets of peer supporters in an effort to avoid the slippery slope of assimilation into the dominant clinical culture, which happens all too often I think.

When the peer-oriented approach has its historical roots in the peer helping movement in high schools where students were trained and supervised to be peer helpers (originally called "peer counselors"). This movement spread rapidly and is currently available in schools, colleges, and universities around the world.

The movement was not without its controversies. One of them was similar to what Patricia Deegan outlines in this article: how were professional school counselors different from peer counselors. The questions that were often asked: Are peer counselors an inexpensive replacement for school counselors? Instead of hiring expensive school counselors can we just train some students to do it for free?

The idea that student peer helpers were a substitute for professionals was often discussed and, unfortunately, actually happened in some school districts. Of course, this was completely inappropriate and unethical. While this issue is different than the clinical and peer specialist issue discussed in this article, it brings up the same question: What is the best, most optimal, relationship between those roles in helping others?

Our solution was to extend the training of peer helpers to include a training module that focused on role cooperation/co-optation, resisting professionalization of roles, and managing role clarity. We also create a training module for professional clinicians and counselors on how to maximize the assistance of peer helpers. These two additions helped both groups work more effectively with each other, rely on each other's strengths, and structure a bridge to manage conflicts.

Thanks Ray. This is really helpful. I was not aware of this historical development. Can you point me to further documentation of it? Pat

This has always been my opinion. Once formal training has been completed and you are receiving a pay check in a clinical setting you are no longer a peer; you have authority. The whole idea of being a peer is you are the same at the same level, and their is no position of authority. Once there is a position of authority, the idea of being a peer is eliminated, you are just a person with lived experience in a clinical role.

In mental healthcare there is a population who will dismiss anyone with any authority whether your title is "Peer" or not. That said, there is a great need for the "peer volunteer" who has minimal training, such as ASSIST or Mental Health First Aid. I believe there is a place for the more educated peer specialist, but the minimally trained peers are just as essential to reach those with issues of authority.

Care needs to be taken in matching peers mentors with clients regarding the peers education level, empathy, experience, triggers, etc... as well as the clients. Education does not necessarily make great peer specialists on every level.

Thank you for this table! I'm finding it helpful in establishing a shared set of values for a hybrid peer-clinical program (led by peers).

I came to my position as the first Peer Specialist employed by a state agency operating a homeless shelter.
Advocating for guests rights and having an influence on the culture of the work place has not always been supported because the supervisor and a coworker whom interviewed me and decided on my employment moved on. My goal has been to develop a culture of respect. There have been some success and some set backs. For example in a few situations I have been able to reduce the coercive nature of getting people into treatment. On the other hand management attempted to show me the door. But with the union's support I have stayed put. Then management put to work someone known by and selected by the site director. ( Politically supported employment. ) My faith in our ability to collaborate evaporated a year or so after working together.

(Now with this said let me get on topic.)

I think in my position I am not clear if I am in the role of a clinician or a Peer.

What if a guest needs and wants medication and isn't getting it? Advocating in this situation is more than sharing my experience.
What if a guest is planning to harm another guest?
Don't I have an obligation to act and help create a safe living situation ?
This position has helped my recovery and I have helped others take steps toward recovery.
But being informed on risk or advocating for evidenced proven treatment is something I have learned about and informs my interactions.
I believe that some folks living and working at this shelter need understanding a better "informed consent".
I feel like it is good to have worked as a Peer but I may take a test that would give me a credential that will lead me to assume a position as a clinician.

Peace
SCS

As Kevin S. remarked, "the struggle is real." I've been working a peer advocate in a mental health shelter in NYC for only a month and already I find it very easy to slip into using clinical language and adopting a clinical attitude. I work with great clinical folks, caring, well-meaning, etc., but I know it is imperative to remain alert and vigilant in my work as a peer and avoid the "peer drift" that sometimes occurs. Supporting my sisters in the shelter – those strong and resilient survivors living with trauma, mental illness diagnoses, substance use issues, domestic violence, and more – I am uniquely qualified and positioned to engage and support them in a way my clinical colleagues cannot (for many reasons). Our usefulness as peers will be diluted/contaminated if we collude with mental health system(s) in ways that may harm those for whom our presence is vital.

Well said. Powerful

The latest area where I like feed back.

A shelter guests asked me after months of avoiding discussing the problem for help with getting in an IOP then on another day getting in detoxification.Meds need to be packed & Docs called-orders rewriten- ect.

He gets service from a Peer at a shelter (me) and two MSW types one from the shelter on from CBFS. My advocacy creats problems since treatment plans label this guests as "precontemplative" and my view is he is more motivated (today). The back ground is guest is use to being 12ved (just made this up) He ends up in the hospital and after sharing all mt steps with our MSWs suddenly NO info comes my way.
?????????????

Now he is looking 4 work sober and I am kept uninformed.

So the language we share connects us and I am bilingual Peerist & clinical.

I have learned to use whatever works and with addicts I can get cauht w sht on my face.

But thats OK because this year we have an OK Program Director.

Things will change for the better some days and some other days I could be shown the door.

Peace- SCS

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