Choice and control in peer support
What does choice and control mean in peer support?
People must be able to choose whether and how they participate in peer support. This includes control over:
- when they attend or take part
- how often they attend
- what they choose to share
- what support they want to try
- what role they take in a group or an interaction
- how long they stay in peer support
- turning off their video in an online forum.
Peers need to be able to withdraw from peer support for a period of time and return to it later, as well as be able to miss meetings or leave a session early. It’s vital that they can do this without being penalised or fearing disapproval.
"It’s just as important that [participants] choose not to attend a group, as it is to attend a group… If people don’t want to turn up, they don’t have to… In the past, I’ve had people who have turned up, and halfway through a meeting, [they’ve] decided to leave… because, actually, they have got what they wanted from the meeting."
Why is choice and control important in peer support?
Many people who choose to access peer support have had previous experiences where they were not in control of what happened to them. Some have experienced other forms of mental health services in which they felt under pressure to talk about difficult or painful experiences, or attend a service regularly. Sometimes their own preferences about the type of care they received were not listened to or taken seriously.
For many people, this may make them reluctant to take part in any form of support where they feel they won’t have control over what happens to them, or what they’re expected to share about themselves. If peers don’t feel in control over what’s happening to them, they may feel unsafe and withdraw from peer support. Having choice and control over support can make people feel empowered.
Peers want to have control in how they engage with peer support. It should be up to the individual to decide whether they are comfortable with:
- actively seeking support
- actively sharing their experiences
- actively offering support to others
- being present to listen to others
- choosing what coping strategies to use and what to ignore
People should be helped to feel a sense of ownership over their peer support by
ensuring that all members can be involved in important decisions. For example:
- being jointly responsible for ground rules to guide behaviour
- deciding if the time or venue should change.
"I just kept it as a trial and error kind of thing, so I tried it and if I didn’t like it then I wouldn’t continue with it. But I do like it, so I’ve carried on with it."
What can choice and control look like in practice?
- Being able to talk online with someone late at night on an online form of peer support, when other support would not be available.
- A peer who is new to a group not feeling they have to say anything at all, while they get a sense of how everything works.
- Somebody deciding to go home early from their peer support as they don’t feel well, rather than struggling through to the end.
- A group discussing what activities they would like to continue or develop before putting in a new grant application.
- Someone deciding to leave the group, to find one that suits them better.
"We are working in a more women-centred way… this is a new approach for us to work specifically with women and we have had to learn rapidly some new ways of working that may be obvious to others in this field. For example, no male staff to enter the group when in session, no male participants to visit during the session… this is working well and the group have set ground rules on their terms, giving them more choice and control."
Reflective questions
- How comfortable do people feel to dip in and out of peer support?
- Is it generally okay not to say anything?
- Are peers able to decide how the peer support is run?
- Are there ways to provide feedback either anonymously, or in a way that doesn’t need you to talk with the whole group? For example, a suggestion box or talking one-to-one with the facilitator.
- Do we need training or discussion to consider our boundaries (what we feel comfortable sharing, and what we don’t, at the present moment in time)?
