Course Content
This session will introduce students to the course and through the use of exercises promote general discussion encouraging the students to begin to get to know each other. The session will cover confidentiality, participation, commitment and a general overview of the course. 
What is Recovery?
The aim of this session is to explore the development of the recovery approach in mental health and to examine key concepts in recovery and a range of factors that support recovery.
Personal Recovery
The aim of this session is to explore personal experience of mental health problems and recovery and consider how the key concepts and factors supporting recovery (covered in session 2) have impacted on your own story of recovery.
What is Peer Support?
Now that we have been introduced to recovery characteristics and developed an understanding of the things that can help and hinder that process, we are going to consider the role the role of peer support in more detail. Firstly, we will examine what we mean by a peer and we will then go on to consider the relationship between peer support and recovery.
The Peer Relationship
In this session we will examine in more detail the processes and practices of establishing peer relationships. We will build on our earlier learning about the role of mutuality and empowerment in peer relationships. There will be a focus on issues of power, choice and control in peer relationships.
Review and Evaluation
The aim of this session is to give candidates the opportunity to reflect on learning to date; provide support and feedback on the assessment task and to review the content to date. The first assessment task is a written assignment in essay format where students consider their personal recovery story in relation to the recovery approach and the role of peer support.
Use of Language and Communications
As peer supporters, the language we use and how we communicate are key to building good connections with the people we are supporting. This session will focus on how we use the language of recovery and our wider communication skills in the peer relationship. The language of recovery is designed to bring out the strengths and abilities of those in recovery. The aim of this session is to introduce candidates to elements of effective communication, including verbal and non-verbal communication, active listening and the use of recovery language, and to enable them to use these to foster an effective peer support relationship.
Using Your Experiences Effectively
One of the most effective ways to explain recovery to others is by people sharing their experiences. It brings to life the reality of recovery. This session builds on previous learning to enable peer supporters to develop their skills and experience in sharing their experiences in ways that are helpful. This sharing is often described as intentional.
Surviving and Thriving
The aim of this session is to look at approaches to working with people which focus on their strengths and capabilities and on building resilience. This will include examining the ways in which strengths based approach might validate and reframe experience and how it uses role modelling and hope to help individuals build resilience. Strengths based approaches are at the heart of peer support practice.
Positive Risk Taking and Boundaries
The aim of this session is to examine the implications of formalised peer support, encouraging students to examine the related concepts of boundaries, role tension and working with risk. The session will introduce the concept of positive risk taking and the approaches that can be used to help in this process. This will include examining the balance between risk and responsibility in the peer relationship. As part of this, students will deal with the difficult topics of trauma, suicidality and risk.
Review and Evaluation
The aim of this session is to give candidates time to review and evaluate the course and their experience of it, and to finish off any outstanding work. it is an opportunity to reflect on learning, discuss experiences and discuss the final assignment.
Useful Resources
Peer Support Training
About Lesson

To understand the unique role that peer support can play in promoting and supporting mental health recovery, we first need to understand the wider context that encouraged its growth. The development of what is sometimes described as a ‘recovery approach’ and the new learning it brought to the experience of personal recovery was instrumental in the creation of new peer worker roles around the world.


Before we look at historical influences we should consider two core elements of the recovery approach. 


The first is that it is based on a fundamental belief that everyone has the potential for recovery — no matter how long-term or serious their mental health problem.


Secondly the approach is based on learning directly from people who are in recovery, or who have recovered from mental health problems. This learning is then applied in the way that mental health supports are developed. This also means that people should be able to play an active part in managing their mental health and recovery in directing the support they receive.


This may sound like an obvious thing to do, but in reality it can lead to significant changes in our approach to providing support and treatment. This can be a challenge mental health services, service users and their informal supporters alike. The recovery approach and the drive to adopt recovery-focused systems of support have become a driving force in mental health policy and practice internationally.


Firstly it is important to keep in mind that people have always recovered from mental health problems. What has changed is the emphasis on  recovery as a way of improving services and experiences. A number of factors have contributed to the development of the recovery approach.  These originated in the United States and then spread more widely. They include:


• Long term outcome research
• Activism and the rights based approach
• Sharing experiences and recovery narratives
• Social perspectives in mental health


Long-term outcome studies involve tracking people over time to review their mental health. This involves repeating the same outcomes measures,  sometimes over many years. The majority of these studies have focused on people with a diagnosis of schizophrenia. They have been important to the development of the recovery approach because their findings, while variable,
have consistently identified significant numbers of people recovering.


This provides a more encouraging picture of the course of schizophrenia than the traditional view first described by eminent psychiatrist, Emil Kraepelin (1856–1926). He described a continued deterioration with little hope of recovery.


In the second half of the last century, there was a move to close large psychiatric institutions and to focus more on supporting people with mental health problems in the community. This led policy makers and academics to more closely consider the extent to which people, who may have traditionally spent the majority of their lives in hospital, could in fact enjoy a degree of recovery in community settings.


A series of long-term outcome studies were developed around the world to assess people’s progress over time. While measures and outcomes varied  between studies, the research identified that many people were going on to enjoy full and complete recoveries in community settings — something almost unimaginable before the closure of large psychiatric institutions.


Perhaps the most widely cited study is the Vermont Longitudinal Study of Persons with Severe Mental Illness conducted between the mid-1950s and early-1980s (Harding et al 1987). The findings of this study revealed that two-thirds of the 262 previously long-stay patients had either improved considerably, or had recovered 25 years after their first assessment, having
undergone a rehabilitation and community aftercare programme. 


These findings challenged the assumption that people who suffer repeated episodes of illness can only ever regain marginal levels of functioning. Sixty-eight per cent of the study’s sample was rated as functioning above a level of ‘mild impairment’ and fifty-five per cent received a rating of ‘slight or no impairment’.


A Scottish Recovery Network discussion paper is available for further reading on this subject. Evidence of Recovery: The ‘Ups’ and ‘Downs’ of Longitudinal Outcome Studies highlights a number of key points including:


  • The phenomenon of ‘late recovery’ in schizophrenia
  • World Health Organisation research suggesting better outcomes in  some developing countries when compared to developed countries
  • A review study suggesting no apparent improvement in recovery rates over the 20th century despite the introduction of new treatments and approaches
  • the limitations of outcome studies and the extent to which measures used fit the unique and personal nature of recovery
Exercise Files
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