Beyond generic support: incidence and impact of invalidation in peer services for clients with severe mental illness.
ABSTRACT 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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ABSTRACT: OBJECTIVE Peer-delivered services have burgeoned, and evidence of the effectiveness of peer support is increasing. However, the potential benefits to peer support specialists (PSSs) themselves are not as well understood. The authors conducted a survey of PSSs to examine potential benefits. METHODS A survey instrument was developed and refined and sent anonymously via the Internet to PSSs who had been employed for a minimum of two months by an agency that employs a large number of PSSs. RESULTS A total of 253 respondents completed the survey (70% response rate). Respondents reported a variety of benefits in the intrapersonal, social, mental health, recovery, spiritual, and professional domains. Forty percent of respondents reported discontinuing at least one type of disability or social benefit. CONCLUSIONS Results suggest that employment as a PSS is a potent vehicle for improving recovery and quality of life. Results accrue to society in reduction of public benefits.Psychiatric services (Washington, D.C.) 02/2014; · 2.81 Impact Factor
- Psychiatrist 01/2010; 34(1):3-5.
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ABSTRACT: The use of peer support for persons with mental illness has been gaining force. While research has demonstrated the benefits of peer support, few studies have investigated the qualitative characteristics of how peer support aids persons recovering from mental illness. Therefore, this study sought to clarify the characteristics that constitute peer support and its contribution to recovery. We conducted ethnographic fieldwork and semi-structured interviews with nine peer advocates at a consumer-run organization in New York City, and identified three themes that describe how peer support influences recovery: transforming experience into expertise, understanding the mechanics of peer support, and launching peers towards their own recovery. Peer support plays a critical role in helping clients move beyond their patient role to an empowered sense of personhood. Additionally, the value of peer support highlights current deficiencies within the mental health system and how a bolder shift towards recovery might repair them.Community Mental Health Journal 01/2014; · 1.03 Impact Factor