Ethics and Peer Support

A Kentucky Peer Support Specialist is not a clinical professional. The specialist goes through certification to perform the job, but that certification alone does not replace the years of studying and experience of therapists and psychologists. Although we are not clinical professionals by our certification alone, we still must follow ethical guidelines.

 

 

There are ethical violations that could cause conflict between the Peer Support Specialist, the patient, and the clinician.  One of these is medication suggestions.  The Peer Support Specialist, having a mental illness, has probably been on a lot of different kinds of medication.  In my case, the medication is working properly, but I must never disclose the type of medication I am on to the patient.  It can cause conflict between the patient and his or her psychiatrist.  Medication works differently for individuals.  Just because mine works, that does not mean it will stabilize someone else.

 

 

Another possible ethical violation is criticizing other clinical professionals around the patient.  This undermines the patient’s treatment.  It affects the patient’s ability to trust their doctor, which is important.   The Peer Specialist wants to avoid any negative talk about staff in general, unless it pertains to violations of a patient’s rights or safety. It is the Peer Specialist’s role to listen actively, so negative talk from the Specialist should not become a problem.

 

 

Accepting gifts, making promises one doesn’t keep, doing everything for them, and encouraging anger toward a family member or another person are other ways to cause possible harm in a Peer Support relationship.  Peer Support is a relationship between the Specialist and the patient based on mutual respect, and that respect includes the respect of other patients or those not present to defend themselves.  Although we aren’t “clinicians” so to speak, it is important to understand boundaries and conduct ourselves as professionals at all times.

 

 

I hope by this time, people have begun to get to know me a little as they’ve seen me with the patients.  It is a joy working with your patients, knowing that together we are truly making a difference in many lives.

 

 

Rebecca Coursey, KPS
Peer Support Specialist

 

Summary of Pachankis, J.E., & Goldfried, M.R. (2004) Clinical Issues in Working with Lesbian, Gay, and Bisexual Clients

 

 

 

Heterocentrism, or the bias against the Lesbian, Gay, Bisexual, Transgendered, or Questioning (LGBTQ) population, can be seen at every level of our society, from laws restricting the rights and opportunities of LGBTQ individuals to homophobia manifested in face-to-face prejudice. Homophobia can even be turned inward, toward the self.

 

 

“Internalized homophobia” is seen when an LGBTQ individual assumes the negative bias of society against his/herself, often leading to anger and/or shame.  In a therapeutic setting, these beliefs present as anxiety, depression, relationship difficulties, suicide ideation, and the devaluation of LGBTQ activities.  Prejudices can be acted upon by even the most well-intentioned clinicians in various ways: assuming the client is heterosexual or excessive focus on orientation of the client, even if it is not an issue at hand.

 

 

Important issues that may require a clinician’s assistance have been identified by Clark (1987) as “encouraging LGB[TQ] clients to establish a support system of other LGB[TQ] individuals, helping clients become aware of how oppression has affected them, desensitizing the shame and guilt surrounding homosexual thoughts, behaviors, and feelings, and allowing clients’ expression of anger in response to being oppressed.” Identity development, couple relationships and parenting, families of origin and families of choice, as well as other relevant issues are of particular importance and can be especially difficult for LGBTQ individuals (Pachankis& Goldfried, 2004). It is the ethical responsibility of clinicians to be familiar with these issues and ensure their competency in addressing these with LGBTQ clients.

 

 

For more information about topics salient to the LGBTQ community as well as current research, please visit the American Psychological Association’s Division 44: Society for the Psychological Study of Lesbian, Gay, Bisexual, and Transexual Issues website

 

 

References

Pachankis, J.E., & Goldfried, M.R. (2004). Clinical issues in working with lesbian, gay, and bisexual clients. Psychotherapy: Theory, Research, Practice, Training,  41(3), 227-246.

 

 

Cassandra A. Sturycz, B.A.
Psychology Student Intern