What is Intentional Peer Support (IPS)?
Intentional Peer Support (IPS) is a particularly thoughtful approach to mental health support that is grounded in lived experience. It was developed by Shery Mead in the US, based on her extensive experience in the mental health system and peer-support communities, including peer-run crisis alternatives.
IPS is about connecting with someone in a way that contributes to both people learning and growing. It is not about providing treatment, nor is it about taking care of someone or being a paid friend. Intentional Peer Support:
- is about both giving and receiving;
- is not based on psychiatric models or diagnoses;
- is trauma-informed, recognising the value of exploring "what has happened to you?"
- encourages each of us to re-evaluate how we've come to know what we know;
- is about creating relationships that we can use to take a bigger-picture look at how we have learned to operate in the world and what we want.
IPS is spreading internationally and has been very popular in New Zealand in particular, but is just starting to establish itself in Australia.
How is Intentional Peer Support different to other forms of peer support?
"The "Intentional" part ... is to offer one another a different way of thinking about our experiences. ... to challenge each other, to open up possibilities that didn't exist before, ... it's part of building a conversation that's energising, that's educative, that's creating new ways of thinking. Lots of peer support isn't intentional - so it's sometimes good and sometimes not so good." -Shery Mead.
Firstly, Intentional Peer Support was created by people with lived experience of mental health problems, based on years of work in peer-support communities. So, it's a product of lived experience and practice-based evidence.
Secondly, it was created specifically as an alternative approach to other forms of peer support, based on observations and reflections about how things sometimes go astray. It is especially sensitive to the coercive and paternalistic tendencies within the mental health system, and of the capacity for people to get "stuck" in these dynamics.
IPS involves rethinking the idea of "help".
When we try to help another person, we often base our approach on what we assume will be helpful for them, how other people have helped us, or our own fears. Unfortunately - and this may be unintentional - many forms of "helping" are disempowering and counter-productive, especially in the mental health system. Most of us have had experiences where other people were "trying to be helpful" but where they didn't really listen to us, and their "help" was not actually all that helpful.
Intentional Peer Support is about giving us new tools, so that we can reflect on our experiences and learn from them, while also learning new ways to be in relationships, without falling back to familiar, but unintentional "helping" behaviours.
What does Intentional Peer Support involve?
There are four central tasks in Intentional Peer Support:
- Connection: Connection is the core of peer support. It is the powerful sense when we realize that someone else "gets it." It is the beginning of building trust. But the connection isn't permanent - we have to work at it; when we notice disconnection, we need to be willing to explore what's happening.
- Worldview: Through honest connection we can then explore with each other, seeking to understand how we have come to know what we "know." Together, we look at how we make sense of what's going on, and learn to sit with the differences in our worldviews. This process may challenge us to rethink our ideas and the "stories" we tell ourselves.
- Mutuality: In a relationship based on IPS principles, both people learn, grow and are challenged through the relationship. Mutuality is not to be confused with reciprocity - people taking it in turns to help each other. Mutuality means being in relation with another person, while staying present and aware of our own reactions, worldview, needs and assumptions.
- Moving Towards: Instead of thinking about moving away from our problems (and what we don't want), in IPS each person in the relationship reflects on what we want to move towards. Often, in mental health, focusing on our problems keeps us stuck. It's important to note that this task is not just about "positive thinking" or "problem solving," but builds on the work in the other steps - the mutuality and real connection of the relationship, and thoughtfully reconsidering our worldview and how we have come to know what we "know" about ourselves and the world. In some ways, this last task arises naturally out of the other three - the tasks are in order for good reason!
There are three principles that underpin the Intentional Peer Support approach, and that make it different to most other forms of mental health support:
- Learning versus helping: IPS is specifically about building a relationship where both people learn and grow, rather than one person helping the other (or taking it in turns to help each other). This changes the dynamics of the relationship - both are there to learn, not to "fix problems."
- Relationship versus the individual: Rather than focus on one person (usually the one who has "problems"), IPS specifically shifts the focus to the relationship. Each person is encouraged to be present to the other and to engage in a way that is real. This also encourages a shift away from "helping" to both people using the relationship to learn more about themselves and their relationships.
- Hope and possibility versus fear: IPS is about approaching discomfort and fear in new ways. Rather than operating from a place of fear, we operate from a place of hope. This hope is underpinned by the knowledge that there is learning to be gained by moving through discomfort.
What exactly does it mean to be "peer" anyway?
Intentional Peer Support is about valuing our lived experience of mental health issues as a basis for connection. Our capacity to connect with another person also may draw on our worldview and our personal ability to connect with specific individuals! In some work environments, it may help for peer workers to have had a specific experience (e.g. inpatient admission or experience using youth mental health services). This is not necessarily the case though, and the "sameness" (or "differentness") of our experiences can't necessarily be assumed. Our worldview, our experiences and the meaning we make of our experiences can be vastly different. IPS holds these differences with deep respect. It's about creating mutual, peer relationships and using these relationships intentionally to open up our thinking and our lives.
Unfortunately, sometimes in mental health, peer support workers can adopt a "better than" position - helping others from a position of being "more recovered" or "higher functioning." Intentional Peer Support rejects this dynamic and stresses the importance of staying peer. This can be especially challenging when one person is paid, and so there are necessarily power differences, but in an IPS approach, power is something we explore and try to be open about.
Is there evidence that Intentional Peer Support is effective?
Intentional Peer Support is supported largely by practice-based evidence. There are many places around the world that use an Intentional Peer Support approach - examples close to home are the Key We Way in Wellington, New Zealand and Brook RED in Queensland (which includes two peer centres, respite accommodation and a telephone support line). There are an increasing number of places around the world (including in Japan, Zambia and Scotland) using an IPS approach.
Many of the key elements in IPS are incredibly difficult to measure - things like real human connection, the expansion of people's personal worldviews, deeply respectful and honest conflict resolution, and people becoming "unstuck." But, we know that having a well-documented "evidence base" is persuasive in getting recognition and funding. So, there are people putting their energy into documenting and evaluating IPS, to measure these things as best as possible (e.g. see the Key We Way report, below).
Great, I like the sound of Intentional Peer Support! ... How can I find out more?
In Australia, there are Intentional Peer Support trainers based at Our Consumer Place in Melbourne, and at various locations in Queensland. See contact details below.
The basic Intentional Peer Support training is a 5-day course, and there are other supplementary courses (e.g. Advanced IPS, Train-the-trainer, Crisis Training, Co-Supervision). Shery Mead and Chris Hansen (based in the US) have travelled the world teaching Intentional Peer Support, and training other people to facilitate IPS training. To find out if there is a course in your area, it may be worth getting in touch with them (through the IPS website below) to find out if there is a course in your area.
- Intentional Peer Support, Shery Mead's website, based in the US: www.mentalhealthpeers.com
- Our Consumer Place (Melbourne): www.ourconsumerplace.com.au; (03) 9320 6839.
- Brook Red (QLD): www.brookred.org.au; (07) 3846 4209.
- Key We Way (Wellington, NZ): www.wellink.org.nz/pdfs/KeyWeWay_TheRealStory.pdf
- Shery Mead (explaining Intentional Peer Support): click here
The information in this pamphlet was written by Our Consumer Place, adapted from Shery Mead (2005) "Intentional Peer Support: An Alternative Approach".