Supervision of Peer Support Specialists: An Interview with Tony Russo, CPS

Tony Russo, CPS, was one of the first Peer Support Specialists hired by the Veterans Administration, and one of the first to be promoted to Peer Supervisor. He has worked as a Peer Support Specialist for 16 years, helping develop the profession at the local and national level.   He is one of the most effective and innovative program developers I’ve had the privilege to work with.  Tony sat with me to talk on March 19, 2024 about supervision of Peer Support Specialists.

1.            Tony, so glad you were willing to join me for this.  Can you tell us about how you became a peer specialist.

Chuck, very glad to be here.  I was in treatment at the VA for addiction.  I was always looking for ways to move my recovery forward.  I heard about a weekly meeting for people interested in peer support and Peer Support Specialists.  It was open to anyone, so I started attending. At the time, I was working in the hospitality field – that type of work was not good for my recovery, and so I knew I needed a change.  When I heard that I could earn a living by using my recovery to help others, I found that was very attractive. 

 There was another Veteran who was also receiving services when I was – he had a very positive impact on me.  I learned a lot just by watching him, the way he was so disciplined – I saw him kneel and pray in the morning and night – that fit with my spirituality.  I could see how he was recovering, and I wanted to be like him….  and so I thought I’d love to do that for other people as well.  That helped me envision what this type of work could mean for other people. 

 I talked to people at that weekly peer advisory committee and said I wanted to become a Peer Support Specialist.  They were hiring five full time Peer Support Specialists and I was fortunate enough to be one of them.  This was back in 2008.  The VA helped me get certified through DBSA and I was fortunate to be hired.   

2.               Tell us about your experience as a supervisor for peer specialists.  What did you do?  What did you enjoy?  What did you not enjoy? 

 I have always aimed high. I laugh when folks in AA would use a phrase, “the world will be a better place when I run it!” but that fit my attitude perfectly. Before I had the CPS role, I was thinking about how to run the newly formed peer team. I was not bashful about exclaiming my fit for the role. I was a career manager I could envision myself in the role! I had to wait though there was someone already chosen and they were running the team.

 However, after I had worked as a Peer Support Specialist for about 6 years, I was asked to sit on a task force to develop a new community integration program to help Veterans get more engaged in their communities. Peer Support Specialists were going to work on the frontlines of that new program and they wanted me to help design their work and create the program. By serving on that committee, I was able to show the VA mental health managers some of the leadership traits that I had. Other committee members said they saw me as a leader and a creative thinker.  Volunteering for that work led to me getting offered a promotion to what was called a “lead peer”. After I became the Lead Peer Support Specialist, we tried some different ways of using the position, but it was difficult for a few reasons such as I was promoted above my peers to a position that was brand new to VA and nebulous in its description. There was not a great deal of clinical support for this position. I made the best of it by networking on behalf of the program and providing more training to the team.

 Eventually I was promoted to a “Peer Supervisor” position in which I supervised up to 20 peer support specialists, volunteers, and contractors.  It was challenging to say the least, but I gave it my all. In my opinion, it is not optimum to have more than 7-8 direct reports to be an effective manager, but I had no choice but to continue on. 

 As a supervisor, I would set up supervision meetings with individual peers based on their experience level.  If you were a newer peer, I'd meet you every week. If you were more experienced, maybe twice a month. I would ask that peers set an agenda for our weekly meetings.   We would talk about their work – what they were doing – what challenges they were having.  I would help encourage and guide each person while I was also keeping an eye on what they were doing to make sure they were providing quality peer support and working to make the whole program be great. 

 I also led education & training, team meetings, where I would invite interesting speakers to come and help the peers to develop their skills.  This would be skills like networking, being an ambassador, combatting stigma, crisis intervention, keeping good boundaries in peer relationships, etc.  We helped all the Peer Support Specialists see that they were ambassadors for their profession to the rest of the organization and beyond.  I wanted to encourage peers to build skills so that we could be looked upon as models of what peers could do. 

  As a supervisor, I loved to see and publicize the situations in which our Peer Support Specialists stepped in to help people.  It was that front line work that made clinical staff and administrators realize who we are and what we can do.  I remember one example in which one of our peers recognized that a patient was having a heart attack and stepped up to get that person help.  In another situation, one of the peers pitched in to clean up a clinical area that really needed it.  The hospital director was there and saw that the peer was willing to step in and do anything to help the program, and that resulted in a lot of public praise for the willingness of Peer Support Specialists to do whatever is needed to help.  Another example which showed our true skills and value was at an outreach event.  A Veteran became agitated when the outreach person became agitated because they couldn’t access his VA information.  Before the Veteran could take the situation to another level, one of our peers stepped in and de-escalated the situation and was observed doing so by administrators.  That resulted in great publicity for our team. 
 

3. What do you think are the important things that supervisors do for the Peer Specialists they supervise? 

 I provided individual supervision and support to help them talk about their work and to build their skills. My style was based upon my career in management, but moreover it was based on a career of more than a dozen years as a CPS at the very site I was now charged with leading. I usually talked about Veterans and groups with my direct reports from a place of empathy since I had many of the experiences that they were facing. 

 Supervisors also must provide the structure and the discipline we all need to actually do good work. Discipline in VA is something that must be experienced to understand. Discipline used to never be fun for me until I took out the personal part of it.  My own growth edge was taking everything too personal -- once I truly realized that and just made it part of my work to support others, that part of the job became easier. As a supervisor it was my job to create the structure for the peers to work in, and I had to maintain that structure.  I tried hard not to micromanage – but really mentor them in their role, I would show up to a group if a peer was having difficulty and role model certain skills in real time and create the structure to support and guide them. 

 I also had to work with the bureaucracy of the hospital.  That would include working with Human Resources to get people hired, and working with the Fiscal Department to get people paid correctly.  Bureaucracy can be challenging.  At times I was literally not getting answers that I needed from these other departments.  But those conversations and conflicts were important.  I had to sit in meetings and represent Peer Support Specialists. Sometimes I had to advocate. Sometimes argue.  Often, I had to educate others about who we were and what we could do. 

 As a supervisor, I also found myself empowering the people I supervised.  At times I had to get them to do something outside their comfort zone. I know that sounds kind of cliche, but if I've got a Peer Support Specialist who worked in the community, but had never worked on an acute psychiatric unit, I might see if he or she would be willing to provide some coverage on that unit.   From time to time, I would have them go up and lead a peer support group on that unit and see what they thought about it. I didn’t want any supervisee to get siloed or only have an opportunity to develop a few skills.  I helped them expand their experience and find other things they were good at. That was an investment in their future and made them more valuable to the organization. I wanted to cross-train peers as long as it made sense to do so.  

 Finally, I also had to deal with other clinical staff who did not understand or treat my supervisees appropriately.  Sometimes they would act in a way that was condescending.  They didn’t understand what Peer Support Specialists could do or how valuable they were.  I had to advocate and push for our work.  

4.     What is the difference between having Peer Support Specialists supervised by another experienced Peer Support Specialist vs. some other type of clinician (such as a psychologist or social worker)? 

 Well, I know we've had conversations about this before.  In my opinion, having a supervisor who is also skilled in the work is essential.  They have to know the work first hand if they are going to really understand the experience and the challenges of the people they supervise.  Their supervisees will certainly trust them more if they’ve done the job. 

 Supervisees and more importantly other hospital staff will also see the supervisor role as a statement about the importance of Peer Support Specialists in the organization.  I had supervisees asking me why the organization didn’t treat me better – didn’t include me in key projects and discussions.  If the supervisor is not a Peer Support Specialist, that is a statement about the importance and trust placed in Peers. 

 I do believe that some clinicians can be effective supervisors for Peer Support Specialists, but others are not.  They have to really understand the role, be passionate about Psychosocial Rehabilitation, and have the support of the Peers. They also have to be good supervisors.  Many clinicians are not good supervisors, no matter how much training they’ve received. For example, I would be concerned about having a supervisor who is a 30-year-old psychologist or social worker.  They had been going to school for 20+yrs. And had little experience with peers or management.  We need better supervisors than that if Peer Support Specialists are going to continue to expand our work and our influence in healthcare and recovery.

Tony, thank you for taking the time to share your experience and thoughts as a Peer Support Specialist and Supervisor.  Hopefully, your insights can help others step into that same role and build this field more.  Again, thank you. 

Always good talking to you, Chuck. Happy to talk about this any time.  Take care yourself 

KEY WORDS: Interview, Peer Support Specialist, Supervision, Recovery, Peer Support, Peer Support Training, Peer Support Certification, Peer Support Jobs