Independent Living Institute


Peer support

Peer counseling programs:
observations from the field

The ILRU Newsletter featured a series of articles on operating peer counseling programs. The following excerpt is taken from their third article.

"These articles are synthesized from discussions among mid-level managers in Independent Living centers. They occurred during our two management training programs focusing on supervising peer counseling programs. These training program were attended by 24 program managers. These individuals came from small centers and large ones, from urban and rural settings, and from all parts of the country. Their approaches to peer counseling service delivery were very different, ranging from all volunteer counselors to all professional counselors to qualified non-professional counselors, from use of the group session format to the one-on-one format to a mix of both.

Despite their differences in approaches and settings, the 24 participants had many things in common--the difficult things: insufficient community resources, perceived lack of consumer progress, peer counselor discouragement and burnout, a sense of disconnection within the center, consumer apathy or passivity, and overwhelming paperwork demand among others. Ways that centers are addressing these problems to operating peer counseling program were presented in the two previous instalments of this series. In this third instalment, the proper balance between service delivery and advocacy will be addressed. It should be noted that all of the comments belong to the training participants, as captured in our notes.

Regarding the importance of systems (also known as community) advocacy in Independent Living centers, Lex Frieden told training participants that advocacy is what people in Independent Living centers are doing that traditional service providers cannot do. He added that it is advocacy that tells us what services are needed. At these two training sessions, a frequently expressed concern was that because of the high demands of delivering services--including having more requests for services than can be met to completing endless paperwork--systems advocacy, which focuses on changing the community, does not receive the attention it should.

One long-time center administrator wondered if centers nationwide were becoming complacent--and putting too much emphasis on service delivery and much too little on advocacy. This led to a discussion of the proper time split between services and advocacy. When asked to estimate the percentage of time spent at their centers on services and on advocacy, most of these mid-level managers said 80 percent services, 20 percent advocacy. Some put advocacy a little bit higher. When asked what the ideal spit should be, the managers' consensus was 60 percent to 40 percent in advocacy's favor. Some would like to see it 80 percent advocacy to 20 percent service delivery.

Being middle managers and therefore essentially task-oriented and practical, they wondered how such a swing in center emphasis could be implemented, for it would mean limiting services. How, they asked--and no one had a ready answer--could that position be sold to the board, center consumers, and the community?

Some centers have found ways to help their service delivery staff keep a focus on advocacy's significance. In a western center, the staff meets every three months to review activities being done by center personnel to change the system. This was instituted in response to management's need to remind staff of the center's 'roots' and to stress the importance of advocacy. In a midwestern center, staff are assigned both service delivery and advocacy responsibilities. It is believed that this dual responsibility provides essential perspective: through service delivery activities, staff learn about problems and can then develop (or try to) ways to address the problems.

One program manager raised the issue of centers' responsibility to help consumers become self-advocates. He expressed the concern that consumers' needs have been met just enough to keep them quiet and uninvolved--and with no anger to motivate action for change. He believes that staff should help them realize that they have a right to be angry (e.g., "Why should I have to vote from my car window? Why can't I enter the voting precinct and cast my ballot like everyone else?") and then help them channel that anger into positive action. In this discussion, another experienced counselor said that in such cases, the center needs to provide consumers with assertiveness training because of the difficulty associated with confronting and working with anger.

We will close this piece on the proper role of advocacy in centers with a comment by Lex Frieden when asked about the threat to funding if a center does 'too much advocacy'. His response was, "Who decides how and why we get the money? This is why we need to get people on since rehabilitation agency boards and why we need to influence legislation. It is our responsibility to make changes."

ILRU Insights, The National Newsletter for Independent Living,
Vol.7 No.5&6, Sept.-Dec. 1989.

ILRU at Texas Institute for Rehabilitation,
2323 S. Shepherd, Suite 1000, Houston, TX 77019, United States.

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