Twelve Key Differences Between Peer Counseling and Psychotherapy
Peer Counseling is a vague term that is poorly understood. There are many kinds of “counseling” – career counseling, pastoral counseling, genetic counseling, and even camp counseling. But what exactly is peer counseling? There are dangers in not being clear about what you are doing when you are providing “peer counseling”. Healthcare in general involves organized treatment systems that include a large number of guidelines and carefully defined roles. As a peer counselor and/or a Peer Support Specialist, you will want to be able to explain your role, including what you do and what you don’t do.
Peer Counseling is one type of peer support, and is defined as “counseling by an individual who has a status equal to that of the client, such as a college student trained to counsel other students or an employee trained to counsel coworkers.” (APA Dictionary of Psychology, 1/23/2024). Note that this definition states that the peer counselor has (1) equal status with their client and (2) special training to provide the counseling. The counselor and the client are specific and different roles – so this definition does not apply to two members of a peer support group who meet to mutually support each other. Peer counseling is more formal than that.
In a healthcare setting, it is most important to be able to explain how Peer Counseling is different from Mental Health Counseling/Psychotherapy. Consider these key differences:
Peer counseling is provided by a Peer Support Specialist or a person in another peer support role. Psychotherapy is provided by a licensed psychotherapist, trained specifically in psychotherapy. These could be psychiatrists, psychologists, social workers, licensed mental health counselors, licensed marriage and family therapists, or nurse practitioners.
The credibility of the Peer Support Specialist is based on their personal experience with illness, treatment and recovery. The credibility of the psychotherapist is based on their graduate training in providing psychotherapy, as well as their experience in providing psychotherapy in the past.
Peer counseling emphasizes the fact that the provider and the client are peers – that they share the same or similar experiences. The psychotherapist and the client may have personal experience with the same problem, but this is not emphasized and is often not talked about or even acknowledged.
Because the credibility of the peer counselor is based on their personal experience, peer counseling always includes the peer counselor sharing their personal experience and information about themselves. Psychotherapy does include self-disclosure by the therapist, but this is relatively rare.
Peer counseling is provided in a range of settings in which peer support is appropriate. Psychotherapy is provided in a clinical setting such as an outpatient clinic, private practice office or an inpatient program.
The goals of peer counseling include providing mutual support to someone in a way that encourages their recovery. The goals of psychotherapy include helping the person address a specific clinical problem(s) by helping them gain insight into themselves or their situation, and thus change their behavior or environment.
Peer counseling can include a variety of interactions, ranging from brief conversations in the hallway to ongoing individual meetings over extended periods of time. Psychotherapy usually takes place in a private office and usually occurs in specific sessions, most of which are 1 hour long.
Peer counseling includes a variety of interactions, some very short and others lengthy. It is not typically reimbursed as a specific intervention by most insurance companies. Psychotherapy is a specific intervention, typically provided in thirty- or fifty-minute increments. It is recognized and paid for by most insurance companies and other sources of funding.
Peer counseling can help people address a wide range of problems of living. These may or may not be secondary to a diagnosed disorder. Peer counseling does not focus primarily on a disorder. Psychotherapy usually focuses on issues tied to a specific diagnosed disorder.
Peer counseling usually focuses on problems that the client wants to talk about. The peer counselor may bring up issues for discussion but the client brings up most topics. Psychotherapy often goes more deeply into the client’s problem, drawing the client into a discussion of underlying and less conscious experience and feelings that they may not be aware of.
Peer counseling often involves the peer counselor connecting the client to other people. This may be a new connection to another peer support provider, or a new connection to people in the community or even a new provider. Psychotherapists may refer clients to other providers, but they rarely, introduce clients to other people in the community.
Peer counseling may involve going with the client into the community to meet other people or to accompany them while they participate in a community-based group or activity. Psychotherapy rarely involves any activity in the community, and when it does, it is tied directly to the psychotherapy protocol.
KEY WORDS: Peer Support Specialist, Peer Counseling, Psychotherapy, Peer Support, Peer Support Training, Peer Support Certification, Peer Support Jobs