This study explored experiences of validation and invalidation among clients with severe mental illness in treatment with either peer providers or traditional providers. Associations between six- and 12-month outcomes and validating and invalidating provider communications were also examined.
A total of 137 adults with severe mental illness were randomly assigned to either peer-based or traditional intensive case management. At six and 12 months participants completed self-report questionnaires on their quality of life, obstacles to recovery, and perceived invalidating and validating qualities (positive regard, empathy, and unconditional acceptance) of relationships with their providers.
Mixed analysis of variance showed that communications from and interactions with providers were perceived to be more validating than invalidating by clients in treatment with peer providers than by those in treatment with traditional providers. Regression analyses showed an association at six months, but not at 12 months, between favorable outcomes and the experience of invalidation from peer providers; invalidation from peer providers was linked to improved quality of life and fewer obstacles to recovery, an association that was not found for clients who experienced invalidation from traditional providers.
Peer providers, who reveal their experiences of mental illness to their clients, were perceived to be more validating, and their invalidating communications were linked with favorable short-term outcomes. Both peer and traditional providers sometimes express disapproval of clients' attitudes, values, or behaviors-a form of invalidation. This study found that early in the course of treatment peer providers may be effective in fostering progress by challenging clients' attitudes, values, or behaviors.
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"Six of the studies directly mentioned principles of peer support (Table 1), indicating ways that the experiences of or history of mental illness can offer assistance and hope to the people involved in peer support [13-18]. "
[Show abstract][Hide abstract] ABSTRACT: We conducted a comprehensive narrative review and used a systematic search strategy to identify studies related to peer support among adults with mental health difficulties. The purposes of this review were to describe the principles, effects and benefits of peer support documented in the published literature, to discuss challenging aspects of peer support and to investigate lessons from peer support. Fifty-one studies, including 8 review articles and 19 qualitative studies, met the inclusion criteria for this review. Most of the challenges for peer support were related to "role" and "relationship" issues; that is, how peer support providers relate to people who receive peer support and how peer support providers are treated in the system. The knowledge gained from peer support relationships, such as mutual responsibility and interdependence, might be a clue toward redefining the helper-helper relationship as well as the concepts of help and support.
Clinical Practice and Epidemiology in Mental Health 04/2012; 8(1):22-9. DOI:10.2174/1745017901208010022
[Show abstract][Hide abstract] ABSTRACT: The recovery model refers to subjective experiences of optimism, empowerment and interpersonal support, and to a focus on collaborative treatment approaches, finding productive roles for user/consumers, peer support and reducing stigma. The model is influencing service development around the world. This review will assess whether optimism about outcome from serious mental illness and other tenets of the recovery model are borne out by recent research.
Remission of symptoms has been precisely defined, but the definition of 'recovery' is a more diffuse concept that includes such factors as being productive and functioning independently. Recent research and a large, earlier body of data suggest that optimism about outcome from schizophrenia is justified. A substantial proportion of people with the illness will recover completely and many more will regain good social functioning. Outcome is better for people in the developing world. Mortality for people with schizophrenia is increasing but is lower in the developing world. Working appears to help people recover from schizophrenia, and recent advances in vocational rehabilitation have been shown to be effective in countries with differing economies and labor markets. A growing body of research supports the concept that empowerment is an important component of the recovery process.
Key tenets of the recovery model - optimism about recovery from schizophrenia, the importance of access to employment and the value of empowerment of user/consumers in the recovery process - are supported by the scientific research. Attempts to reduce the internalized stigma of mental illness should enhance the recovery process.
Current opinion in psychiatry 06/2009; 22(4):374-80. DOI:10.1097/YCO.0b013e32832c920b · 3.94 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Peer support is unique in the mental health field because peer specialists provide a role model of recovery to both staff and people in recovery. Peer support as an evidence-based practice is reviewed. A personal recovery story and the experience of working as a certified peer specialist are shared to show the power peer supporters have in transforming the mental health system. Research supporting a more selective role for medication is reviewed along with the role of peer supporters in helping individuals to maximize their own unique medication needs with self-advocacy and negotiation skills. The importance of making choices is explained as a key motivating factor to keep both staff and people in recovery from giving up. Two main science-to-service gaps in real-world schizophrenia treatment are discussed: the lack of available peer support and the need for medication self-determination.