C4 Innovations

Peer Support and Intersectionality

An episode of “Changing the Conversation” podcast

Jonathan Edwards and host Ashley Stewart discuss intersectionality in the context of the peer support workforce. This episode is sponsored by the New England Mental Health Technology Transfer Center Network (MHTTC).

April 10, 2023

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Ashley Stewart, Host (00:05): Hello and welcome to Changing the Conversation. I’m your host, Dr. Ashley Stewart, the Director of Health Equity at C4 Innovations. This episode is sponsored by the Mental Health Technology Transfer Center, or MHTTC. Our topic today is authenticity, driving opportunity, and we’ll be talking about intersectionality in the peer workforce.

(00:26): My guest today is Dr. Jonathan Edwards, calling in from New York City. Dr. Edwards identifies as a public health professional, researcher, educator, licensed clinical social worker, peer support workforce expert, and a person in long-term recovery. Dr. Edwards, thank you so much for joining us today.
Jonathan Edwards, Guest (00:45): Thank you so much, Dr. Stewart. It’s really a pleasure to be here this afternoon. I’m really looking forward to helping to change the conversation in any way that benefits the listener.

Ashley (00:57): Awesome, and we are so excited to have this conversation with you. You and I had the opportunity to talk a little bit before the podcast, and I am like overjoyed with this opportunity to have this conversation.

(01:12): In preparation for our talk, I spent a lot of time reviewing and looking at your work, your career portfolio, and it’s just simply astonishing. You are managing a lot of different affiliations, and the thing that I appreciate the most is how thoughtful you are with intersectionality as it relates to your work, showing up and making sure that that intersectionality is paramount. We know why intersectionality is critical, and I’m just wondering how do these critical intersections show up in your work?

Jonathan (01:43): I always question myself as to how consistent I’m being with the thoughtfulness that you have noted and mentioned this evening. Intersectionality is so very important because it’s one of those tools that really help me to get in touch with myself and therefore be able to reach, connect with, coach, provide education and support to other individuals.

(02:14): I’m thinking mainly of the students that I teach in graduate social work education, really addressing issues around race, power, oppression and privilege. In order to have those conversations, it’s important that we look at the various ways that we show up. Oftentimes the conversation takes place with many white students who are coming from a position of privilege. It’s rather rewarding to walk the journey with them to help them to understand how many identities they embrace, where previously they may have only seen themselves as a white person.

(02:54): Intersectionality, although I learned about it through the lens of a person of color, as a black man, as a black gay man, as a black gay man who has a lot of recovery experience among other experiences, it’s interesting to work with the dominant culture around this concept, and for them to understand the multiple identities they’re bringing to the table.

Ashley (03:16): Absolutely, absolutely. I think that’s one thing that I really appreciate we share in common, right? Teaching students and being in spaces to talk about power, racism, oppression and privilege, and introducing sometimes folks to the concept of intersectionality. I find that often people are unaware of what it means and how it shows up and what it looks like and the implications that it has in our lives.

Jonathan (03:43): Yeah, I agree. I totally agree with that. I think of last semester, I had a young man in my class who was really wrestling with his identity as a cis white, heterosexual male, also coming from a European culture that he felt was sometimes oppressive, but also still having the white skin privilege. Also, bringing to the table a lot of different attitudes.

(04:13): I remember we did a role play together, and of course, I was the parent who was being questioned around parenting, and he was the social worker. When I reacted passionately, he said, “Why are you so angry?” We were able to debrief that in class, and it was really rewarding for both of us because it really made us dig down and explore the different experiences we were bringing to the table as well as our biases.

(04:43): I think because of where we were at and our willingness to do the work, even as instructor and student, that we really came away getting a lot out of it. I think we even developed a sense of mutuality. It leveled the playing field as two individuals who are bringing feelings to their work, and despite the titles that we carry, we’re all carrying a heavy burden and we’re all working through a lot of things. I like to connect with the students that way. I mean, it’s clear that I have the privilege of instructor and the title of instructor, but if we’re not there doing the work together, then it’s not as meaningful.

Ashley (05:20): Absolutely, yeah. I also think about the space and place in which we’re having these conversations. Well, some folks might be thinking, oh, that sounds like a cool class exercise that you took folks through, a really profound moment in the classroom. What’s really underpinning or underlining that is that that’s also a transformative moment for the next generation of folks who are out here doing the work. Those conversations are critical to happen because, well, the folks who we’re working with, the people who are intending to serve through our work are not–you know, we don’t get to fake it till we make it. We don’t get to practice on people.

(06:02): But by going through exercises that evoke that real authenticity and responses, the critical processing in those responses, helps prepare us to go and do this work in a completely different way, an innovative way, an anti-oppressive way. That’s really a big part of the difference that’s being made, and I know for me personally, one of the most gratifying parts of teaching and also training in my work.

Jonathan (06:29): It really brings us through an exercise of cultural humility, examining our own implicit bias, looking at our own vulnerability, using the vulnerability to inform us as opposed to pushing us down. So, getting feedback from students that you help them to navigate a really difficult and uncomfortable process, I think is the greatest compliment that you can receive.

(07:02): I was very, very pleased to see the student evaluations that I received, not because they were scored so high, but because of the verbal comments that people offered, or rather the written comments that people offered, really explaining what it meant to go through a process that was sometimes alarming and painful, but they felt embraced and supported in doing the difficult work.

(07:29): One might ask, “Oh, how did you develop those skills, Dr. Edwards?” I think skills development in that area just comes from my own commitment to continuing to do the work, looking at my own implicit bias, looking at my vulnerability, looking at my fears, looking at the balance between feeling fear, but showing up anyway. It really is a parallel process, so doing my own work helps me to help others do theirs.

Ashley (08:02): I appreciate that so much. Speaking of that critical self-awareness, speaking of implicit bias and fears. I think that these kinds of conversations evoke a lot of great opportunity to talk about the advancement of this type of thoughtfulness and inclusivity in the peer workforce. I know that this is a space where you really lean in and your work has been extremely influential. What do you see as opportunities for advancement in the peer workforce?

Jonathan (08:35): I’d like to start out just by giving a quick off-the-cuff definition of peer support, and it’s really about connection between individuals who have experienced similar situations, issues or problems. It’s based on principles of mutuality, of hope, of identification, and not basically saying Ashley or Dr. Stewart, I think you should do something this way, but Ashley, this is what worked for me and I’m sharing the resources that I used. You probably have others that you may want to talk about. I’m here if you want to talk about them.

(09:16): Peer support shares a lot of the same principles as social work espouses or purports to embrace: self-determination, unconditional positive regard, hope. But I think the unique thing about peer support is that a person is practicing openly through her or his lens of lived experience, and so there’s that added piece of disclosure. The disclosure is not around telling you my entire story, hoping that it helps you, but really sprinkling the interaction with pieces of my story where I feel it might be useful to you, or laying out the ingredients and allowing you to select from them what might season your palate in the best possible way. I use a lot of food metaphors, but I also need to exercise more. May I just add that.

Ashley (10:13): I love that. I love the accountability. I’m going to commit to working out and exercising more with you, and I also love food. So analogy well received here.

(10:25): Speaking of sprinkling things on top, I think your point is so well taken. There’s something so special about peer support that we must recognize and pour into, find more resources for, and create more space to talk about.

(10:44): What I love most about peer support and the peer workforce is that lived experience component that brings about authenticity in our conversations. We’ve been talking a lot, both in talking about our experiences in teaching and training folks on these topics, talking about the critical imperativeness of peer support. What’s underpinning that is authenticity and vulnerability, and I’m wondering where does that show up most in your work, your own authenticity, your own vulnerability?

Jonathan (11:15): Well, despite any concerns about who might hear this and setting myself up for potential exploitation, I’ll say that I think I connect with authenticity the best around this work because oftentimes I forget that I’m being paid for certain things that are related to peer support, whether it’s working with organizations to help them to envision and to develop and implement peer support services, whether it’s working with supervisors who could use some guidance and direction around connecting with a workforce that’s still considered new, and oftentimes not even a workforce. Whether it’s training or making comments somewhere.

(11:57): The only place where I never really expect to get compensated monetarily is submitting articles to journals. But there’s probably a secret to getting paid for those as well. But the bottom line is I oftentimes forget, or it’s the last thing that I think of, oh, and I’m getting paid for this also. That goes back to that adage, I believe we call that, “Do what you love and you’ll never work a day in your life.” I don’t always love it.

(12:25): But thinking about peer support and its origins, it started out as something that was non-monetary. It was voluntary exchanges of support between individuals experiencing similar situations, problems, issues, challenges. One of the inherent tensions in the workforce is balancing the authenticity with traditional service delivery models where a worker’s expected to not disclose, to go along with anything that the dominant culture, in this case being the organization or the institution or the regulations mandate.

(13:08): Whether it’s to make someone feel like they have no choices around what medication they’re going to take, whether we think a person is not motivated enough, and the judgements we could make about them. The stigmatizing beliefs we can have around someone’s diagnosis, and peer support disrupts all of that traditional thinking and way of practicing and behaving and using language to describe people who were experiencing, in this case, mental health and substance use issues.

(13:44): Peer support, I don’t know if the system is really yet ready for it because in many instances, if not all, peer support workers are under-compensated. There really is no formal career ladder in place. Supervision across human services in general is usually lacking or inadequate. Imagine trying to support a workforce that is coming in with particular nuanced challenges, coming back to work after being away from the workforce for a long time. Dealing with internal stigma and also stigma from coworkers, dealing with getting back on your feet, and then not having good solid guidance and supervision.

(14:35): That’s another, I would say, deficit or liability in looking at how peer support is set up in systems. There are a lot of tensions because I think organizations, no matter how noble they may want to appear, there’s a lot of concern about the bottom line. Peer support workers could save us money, peer support workers could decrease the bottom line.

(15:00): If that’s secondary gain, that’s fine. But the other thing is peer support workers have a particular scope of work, and that’s another issue is that there’s a lot of role ambiguity and there’s not clearly defined boundaries. There aren’t clearly defined expectations of what peer support workers do, so oftentimes they end up being exploited.

(15:22): If you’re coming back to work and trying to get back on your feet, you don’t really feel like you’ve can leverage that too well to say, this is not my job, this is my job. Or I’m not comfortable watching someone to make sure that they don’t self-injure. I would rather meet with people and talk to them about healing options, but I don’t want to sit at someone’s room door on an in-patient unit and surveil them. I don’t even know if that’s a word, but to perform surveillance.

(15:56): I just feel like I’m going off on a tangent, but a relevant tangent around the challenges to authenticity in peer support in the workforce is that oftentimes the systems in which peer support is being delivered are antithetical to what peer support is really about. Peer support is not about mandating that someone do something. In fact, the first core principle of peer support is that it’s voluntary. Unlike other services or engagements, a person should not be required to talk to a peer supporter or to do peer support. It should be self-selected, voluntary. It’s respectful, it’s not coercive. It relies on self-determination.

(16:48): Peer support of its core facilitates change. I think what we see today in terms of peer support is a rather romanticized and diluted version because peer support at its core is really about disrupting the system and it’s about advocacy and it’s about bringing to light abuses that have occurred in healthcare settings historically over time. Some of them still exist, they may look a little different. It’s not to say that the system is all bad.

(17:25): I think about, I don’t want to get political, but I’m just thinking about the whole current argument around law enforcement and our temptation to polarize them as like, we need them, we don’t need them, versus what’s broken and how can we fix it. I don’t think that the system’s all bad and peers are the panacea for every problem, but I think that there’s a lot of misunderstanding about what peer support is and really how to engage the workforce, to hold them accountable, but to also compensate them equitably.

(18:04): To think about career ladder, and a career ladder for a peer support worker should not be, well, I’m going to become a social worker so I can make a livable wage. That’s not authenticity unless the person says, I think I want to become a social worker and bring my unique experience as a peer support worker into that work. But to work in another title so that I can make more money is not authentic. It’s easy for me to talk about what’s not authentic versus what’s authentic because there’s a lot that’s unauthentic or inauthentic about what’s going on in the peer support world.

Ashley (18:42): Yeah, there is, and there’s so much great content. I mean, we clearly need to do a part two to unpack and to process more about what you just shared in so many ways. You really talked about what that secret sauce is. It is the authenticity under it. It is the dedication and commitment to connection, and the fact that we aren’t seeing or leaning into that being of itself and not only a skillset, but a necessary ingredient for change to occur.

(19:22): Not recognizing and seeing the merit that comes with offering that type of support to someone. How do we begin to change and shift the systems to recognize connection as just as valuable, if not more valuable, than some of the other skill sets that we might bring into different workforces. There is something that is unequivocally special about the heart, spirit, mind, commitment, personal connection that goes into this work that’s transforming lives.

(20:00): That is something that people can enhance and grow in how they see themselves as a professional. But to your point, not something that folks should have to go on and get some other kind of credential to make a livable wage, and that’s something we need to address and have more conversations about, and urgently.

Jonathan (20:19): I just want to share a resource because I think anyone listening who’s interested in knowing more about this or even looking at what peer support is and how it’s done. I recently had the opportunity to co-edit a book with three of my colleagues. The book is called What It Takes, Wisdom of Peer Support Specialists and Supervisors. We self-published it through Amazon. It was done in part to bring together summarized workshops and conference presentations over a five-year period that were presented at National Association of Peer Supporters, which is a national organization that supports the peer support workforce.

(21:11): It’s a bit of a fundraiser and to also increase the visibility of NAPS, but it was an opportunity for us to really create something by the peer support workforce, for the peer support workforce, and for anyone else who wanted to learn more about what the work looks like authentically and on the ground.

(21:32): I guess this is one of those propitious opportunities where I get to possibly promote a book because it’s relevant to the conversation, not just because we co-edited a book and it’s selling and it’s doing well and it’s gaining traction. We plan to do a lot more with this and to possibly look at doing other collections that can bring the voices of peer support workers. Many who typically don’t have a platform or an opportunity to use their voice or talk about their work to really give them an opportunity for visibility.

Ashley (22:06): Thank you so much for sharing that resource, and for co-authoring that resource. We are the work. We do the work. As we get close to our time for this particular episode of the podcast, I want to bring us together with something that you mentioned in a previous conversation.

(22:26): You talked about the mindset of showing up for yourself and not for others. Not coming into a space and deeming yourself as an authority figure, but recognizing that connection and not only the work that we do on the ground, but the work that we do that influences that connection between other people. When you talk about this mindset of showing up for yourself, what does that look like for you? And how might others, particularly folks listening to the podcast, develop a mindset of showing up for yourself?

Jonathan (23:05): Even though I think I was reared on education as a hierarchy and teaching going in one direction, it really is, once again, I’m going to bring up the term mutuality and reciprocity that particularly in social work, I think it’s important to set up the space as a mutual learning environment.

(23:31): As I said at the beginning of our time, is that if we’re really not looking at commonalities and we’re focusing on differences, whether that’s title or rank or skin color or height or salary, we’re not, we’re getting in the way of connection. I know it might sound very platitudinal and idealistic, and some days I’m just not there, but other days I am. I have to be really intentional about the showing up for myself. It’s not something that just happens. It’s something that I have to be really mindful of.

(24:08): What that could look like is a day where I’m not feeling so great, where I might be feeling a little worthless. Then I realize that doesn’t mean that I don’t have anything to offer, and I can’t always trust myself to let the actions mimic how I’m feeling. Sometimes I have to, as they say, act my way into right-thinking. I’m saying that to sort of balance the potential fantasy that people might have like, oh, this guy sounds really sane. No, I could spell it.

(24:41): But there’s a saying that I see that comes on, that flashes across the television. I listen to, I guess it’s not mood music, but serenity music, and these little sayings come up and one says, “The only zen that you’ll find on a mountaintop is the zen that you bring up there with you.”

(25:01): I try to get away from the expectation that I’m going to show up and it’s going to be there for me. It’s more like I have to show up and I may be carrying it, even if I’m feeling empty. It’s not necessarily an indication that I am empty. It could just be life challenging my vision. It could be life challenging my goals for the day, and we learn to move through it. I think it becomes tender and real when we realize that this is what other people may be going through in their lives, and it just makes us more relatable.

Ashley (25:35): It absolutely does. The only zen you’ll find on a mountaintop is the zen you bring with you, so good. Dr. Edwards, your work speaks for itself, the zen you bring, but also the passion, the vulnerability, the realness that shows up in how you teach and create spaces for students and how you advocate and how you support other people. It is just paramount, your authenticity in that.

(26:04): I’m just so grateful and thankful to have the opportunity to speak with you, but also to have your words of wisdom, your gems be imparted on our listeners. Dr. Edwards, thank you for joining us today.

Jonathan (26:17): Thank you so much, Dr. Stewart. It was really a pleasure to be here, and thank you for the opportunity.

Ashley (26:22): To our listeners, join us next time on Changing the Conversation.

Erika Simon, Producer (26:27): Visit C4innovates.com and follow us on Twitter, Facebook, LinkedIn, and YouTube for more resources to grow your impact. Thank you for joining us. This episode is sponsored by New England Mental Health Technology Transfer Center, and was produced by Erika Simon and Christina Murphy. Our theme song was written and performed by Peter Hanlon. Join us next time on Changing the Conversation.

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