Peer counseling: an overview

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Introduction

The counseling room is crowded. It is obviously not designed for two people in wheelchairs. One of the individuals in the wheelchair is a counselor, the other individual is the client. The client is in the process of telling how embarrassed he was the first time he went to the beach. The conversation went something like this:

Client: "I suddenly hated all the manhandling - being lowered into the water by someone else with everyone on the beach looking on. All of my plumbing (catheter and leg bag) were exposed. I became acutely aware that I did not have the body beautiful that you see on T.V."

Counsellor: "Yeah, there are big bodies, little bodies, straight bodies, and not so straight bodies. With us the old locker room concerns about penis size and breast size become very insignificant."

We both laughed and proceeded to compare notes on experiences we have had as persons with disabilities. Many sessions followed where we talked about and experimented with various coping mechanisms we used, to deal with everyday problems.

Robert was my first client and from that very initial experience I realized how important it was for a person with a disability to have the experience of meeting and talking with another person with a disability. I also realized the uniqueness of my own experiences and how valuable it was to me to share those experiences. This is what peer counseling is all about. The peer counselor is that individual who has attained disability related experiences, knowledge, and coping skills, to assist others with their disability related experiences. The goal of peer counseling is directed toward enabling the individual to meet personal needs in order to more fully function and take control of his life, in his home, community and employment.

Independent Living model

In order to understand peer counseling fully, one should look at it in the context of the Independent Living model. This model is a concept or an expression of people's desires to be in control of their own lives. This model can be understood more fully when compared to the rehabilitation model. The rehabilitation model, to put things very simply, states that if changes or adjustments are to be made they happen within the client. The client is expected to internalize, to see his/her weakness, his/her shortcomings, make changes within him/herself, and most of all learn to be accepting of his/her disabilities. The counselor working within the Independent Living model would look at the problems from outside the client - that is looking at the environment and helping the client determine what in the environment needs to be changed in order for the client to function more fully.

Advantages

Peer counseling has many advantages to the client, the counselor and the community. The client is given the opportunity to model after someone whom s/he has reached out to. S/he is given the opportunity to develop coping skills that presumably work because they work with the peer counselor s/he is relating to. S/he can learn to advocate on his/her own behalf. His/her feelings of self-worth can be enhanced because s/he has a counselor who truly understands.

The peer counselor gains in feelings of self-worth for s/he has the opportunity to share a valuable and worthwhile experience. This in turn can motivate the counselor to reach out to others and to perfect his/her skills. For many peer counsellors this position can be a vehicle for career development.

The community, of course, is helped to form a positive image of the disabled. More important, the service to persons with disabilities is improved allowing these persons to take up a more meaningful role in the community. The development of peer counsellors would appear to be the grassroots answer to a growing technology, allowing people to grow closer together rather than apart.

Personal characteristics

It should be pointed out that not all individuals can be peer counsellors. The good counselor is a person who can show empathy toward other people's problems, be able to listen, communicate, be direct, sincere, be able to share personal experiences, be trusting, and have knowledge and skill that would be helpful. The counselor should have a broad range of good personal characteristics.

In addition to the above a peer counselor must have a 'rights bearing' attitude. This involves an understanding and acceptance of the fact that people with disabilities have the same rights and responsibilities as all other individuals. That is, they have the right to make contracts, hold a drivers license, make a will, marry, adopt or bear children, hold and convey property, equal educational rights, equal employment opportunity, and an opportunity to vote and participate in political affairs. This suggests that the peer counselor must have a fair knowledge about many issues relative to disabilities.

Ethics

It is important for the peer counselor to know the philosophy and policies of the place s/he is working. It is highly important that the counselor know his/her abilities and limitations. It is important to know when and when not to act. This issue of confidentiality is important. The counselor must know the difference between being a support person and being a 'protector' or 'rescuer'. It has to be recognized that persons with disabilities have a right to make their own decisions and to live with the consequences of that decision.

Models of peer counseling

There are various models of peer counseling being used. The kind or kinds of models used depends on the needs of the community and the expertise of the peer counselor. There are four approaches which are most common.

The generalist approach

Almost every program has one person amongst them who can work as the 'generalist' in the program. Often this person is placed at the 'intake' level or is the first person to come in contact with the person seeking help. It is the responsibility of this type of counselor to feel out the nature of the problem, to determine who could best work with this individual and determine how long the involvement would be. Usually, the generalist works for a very short time with the individual and then refers to someone who is more specialized in what the person needs.

Instructional counselor

This approach basically involves the teaching of skills. This type of counselor is often called peer educator or peer tutor. The main objective of this type of counseling is to help individuals make that transition from being totally dependent to being as independent as possible by giving training in the areas that the individual seems to be lacking, e.g. social skills, attendant management, financial management, functional needs, academic skills, etc.

Outreach

This type of work involves going out to people to make known to them what the Independent Living philosophy is. This type of counselor is meeting with people who often do not have the ability to reach out. In some ways they have become too accepting of their situation and do not realize there are other ways.

Advocacy

The main function of this type of counselor is to help people work their way through systems so that they can get what is rightfully theirs. This can be looked upon as more a teaching role - what is the nature of the system, how does one work through the hierarchies to get what one wants. There may be a need to teach letter writing, communication skills, telephone skills, etc.

History

Peer counseling is a term being heard with greater frequency, particularly throughout the various Independent Living centers in North America. Although to some it seems like a new concept, the concept has been in existence for many years and proven to be very worthwhile. Such organizations as the Alcoholics Anonymous, the Canadian Paraplegic Association, the Canadian Association of Children with Learning Disabilities, parent groups that form to help improve and get involved with school systems, the Cerebral Palsy Association, etc., the list could be very long. All the organizations have demonstrated that consumer based organizations can deliver important kinds of service. They all use peer support and peer counseling as a feature of their service. They all operate on the premise that:

  • the peer counselor provides a role model,
  • the peer counselor can serve as a link between the person seeking help and the service provider,
  • the peer counselor can draw on a wide range of unique experiences which cannot be observed by anyone else.

Program planning

The peer counseling movement is a response to a number of different factors in our society. Recognizing this and recognizing the potential that peer counseling has for improving service steps should be taken to finance, administer and develop such programs. Initial issues which have to be addressed in setting up a program such as this are:

  • do the counsellors need professional training or not,
  • how formal should a peer counseling program be,
  • should peer counsellors be paid or should they be willing to offer their area of expertise on a volunteer basis.

There are legal concerns, as well, that have to be addressed:

  • what is the liability of the organization using peer counsellors,
  • what supervisory mechanisms need to be in place in order to use peer counsellors,
  • how can the client's rights to confidentiality be guaranteed when the peer counsellors do not belong to a licensed body whose responsibility it is to monitor this.

Conclusion

Peer counseling is a developing concept that should not be looked upon as a panacea for alleviating personal problems in others. However, evidence of the benefits of peer counseling can be seen in many programs and it should be evaluated as an area of great potential.


Source:
Patricia Sisco,
COPOH,
926-294 Portage Ave, Winnipeg Man R3C 0B9, Canada

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