NAPS Annual Conference 2024: Internal and External Visions of Recovery

One of the reasons to attend the annual meeting of the National Association of Peer Supporters (NAPS) is to hear how people are thinking about the work of Peer Support and Peer Support Specialists.  People from around the country talk about the field and their work from their own perspective.  I like to listen to those talks, with a special ear for where this innovative field is growing.  This can help us all in many ways, including:

1.     You can hear what the newest issues are that are facing the field.  Presenters are often leaders in the field or innovators who are pushing the boundaries of our work.  When they talk, they typically refer to the newest successes and the latest headaches.  I want to hear about the new successes and I want to know what the headaches are, so that I can avoid them.

2.     You can see differences, and even tensions between the perspectives of different presenters.  We all want to know where those tensions are, because they may become barriers to our future efforts.  They may also become challenges for the entire profession.

3.     You will hear viewpoints that you disagree with, and recommendations that you can’t support.  I like to listen to people whose views are not like mine --- I find I learn and grow more by listening to them.  Sometimes they make me even more convinced of my own views, but often I come to embrace some of what they are proposing.

At the 2024 NAPS Convention in Chicago, I saw eight different presentations and heard national leaders talk about their perspective on the current challenges for Peer Support Specialists. 

 Within their presentations, I noticed something I had not fully recognized before.  Some presenters almost exclusively focused on the external social and environmental struggle for recovery and others emphasized the internal psychological and emotional struggle for recovery.  Both elements have been talked about in the development of peer support, but I had not recognized such distinct and non-integrated versions before. I walked away feeling concerned about such different visions.

 Several presenters talked almost exclusively about the societal and cultural factors that contribute to mental illness.  From their perspective, all interventions should be focused on changing the environment.   From their view, ‘recovery’ primarily refers to recovery from the negative impact of the environment. These presenters emphasized the role of Peer Support Specialists as advocates and change agents, pointing out the destructive influence of forces like culture, government, stigma, and moneyed healthcare interests. They talked primarily about healthcare and healthcare providers as part of the problem.

 Several presenters focused on biopsychosocial factors that cause or support mental illness, with a keen focus on internal struggles that people go through to achieve recovery.  The internal journey of recovery was the focus here, and they saw healthcare and healthcare providers as key allies.

 The history of Peer Support Specialists evolved out of historical events in which cultural and environmental factors caused great harm to people using healthcare services.  Peer support providers rightfully recognizes the need for “consumers” to take the lead in directing their own recovery, and asserting their rights and preferences to the healthcare system. 

 After listening to the different visions of the presenters, I was left concerned by how different and unintegrated their perspectives were.  A complete focus on the external barriers to recovery vs. a complete focus on the internal barriers of recovery results in two very different action plans.  It can also give rise to tensions within the field, as these views have a “black and white” quality to them – “It is all the environment” or “it is all internal”.  That is concerning.  One of the things I have learned over many years is that recovery is not a black and white issue – the causes, the means of recovery, and the outcomes are always varied – which is why SAMHSA included variation as the first element of their definition of recovery.

 It also helps me think clearly about my own conclusions about recovery. 

1.     Recovery is rarely simple, while people’s recommendations for recovery are unfortunately, often simple.

2.     Black and white explanations are more exciting to hear about but rarely represent real life. Actions based on black and white thinking often lead to bad outcomes that then need more work to fix.

3.     The environment has a key part in causing and sustaining mental illness and suffering, and involves factors that undermine recovery.  Internal factors including biological factors and psychological factors, play a key part in causing and sustaining mental illness and suffering, and also function to undermine recovery.

4.     Peer Support Specialists have a critical voice in pointing out how real recovery works – recovery in the lives of real people.  If Peer Support Specialists oversimplify the story of recovery, their is diminished.

5.     People in recovery have a unique perspective from which they can call for change in the environment, but they also should call for courage and change from the individuals on the path to recovery.  Both messages are important and require courage. People who only see the environment as the problem are missing the key internal struggle we have to have with ourselves — a struggle that is central to real recovery. People who only see the internal factors as the problem are not paying attention to how society and economic/political forces create real barriers to recovery and are missing an opportunity to help change these factors.

 I was left feeling concerned about how these distinct voices will move forward in this field, and what the impact of these black and white views will have on our future work.  I was not the only one, as I heard others talking about the same issue.  By attending the conference, I got to see this tension within the field and participate in those discussions.  We will hopefully be able to be part of moving those discussions forward in a way that benefits our clients. 

 If you’ve not attended a professional conference related to being a Peer Support Specialist, I encourage you to consider it.  Your work will take on new meaning and energy when you spend time with others doing the same work.  There is a cost in terms of time and money, but your understanding of the current and future role(s) of Peer Support Specialists and peer support will grow, and your work will be enhanced.  Keep an eye out on the NAPS website (https://www.peersupportworks.org/) for announcements about the next conference.  Announcements usually come out in late spring or early summer.

DISCLOSURE: I have no financial tie to the National Association of Peer Supporters and no conflict of interest.  I have been a member since 2023.

KEY WORDS: Peer Support Specialist, NAPS Conference, Peer Support, Recovery