Earlier this fall, the Nordic-Baltic network about educating and training peer support workers met up in Trondheim. After the meeting, we asked the others some questions (below) about how it is in the different countries now, and what impact the network have had. In addition to the group attending the meeting in Trondheim, the network also contains members from Estonia and Latvia.
Questions:
1. What kind of training exist for Peer Support Workers in your country? 2. What are your plans for further development regarding training of Peer Support Workers (PSW)? 3. Has the Nordplus-network made an impact on this development? 4. In what way has this network inspired you further development?
Sonny and the others from NSPH in Sweeden, tells us that they have a training program for peer support workers, that they plan to expand.
What kind of training exists for Peer Support Workers in your country?
Currently, there are no training courses available in Lithuania as we are still in the early stages of establishing them. However, some individuals have attended Intentional Peer Support training courses in Iceland and are enthusiastic about applying their acquired knowledge.
What are your plans for further development regarding the training of PSW?
In the near future, we plan to pilot peer support in mental health facilities. Therefore, we are eager to start peer support education. However, we are still looking for the best way to do it in accordance with the Lithuanian context and the available resources.
Has the Nordplus-network made an impact on this development?
The Nordplus network has had a significant impact in the development of peer support in Lithuania. This network has provided us with a great opportunity to learn about best practices from Baltic and Nordic countries as well as different approaches to peer support training. This experience has inspired us to consider how we can implement these practices in Lithuania.
In what way has this network inspired your further development?
We were given many opportunities to take tangible steps towards developing peer support within our network. This led some of us to participate in an Intentional Peer Support training course in Iceland. However, the most significant outcome of our efforts was the meaningful connections we made with one another. Peer support is the beginning of a social change, and this process can be challenging. Having the support and being able to ask for advice when needed is crucial during this rewarding but difficult path to implementing that change.
Ebba from Iceland think the network speeds up the process in some countries.
What kind of training exist for Peer Support Workers in your country?
Intentional Peer support. Core training that takes 40 hours.
What are your plans for further development regarding training of PSW?
Our plan is to proceed in IPS training and give people opportunity outside of the the capital Reykjavik. One has already been held in the north – Akureyri. For those who are feeling inspired to share the material with others can take a course Train the trainer 40 hours. The first one in Iceland will be held in December.
Our aim is to follow up the Swedish model which takes 5 weeks. We have a recovery school in Iceland that could offer this and then the participants from Sweden could help in developing further education. Hopefully the Norwegian model could be offered at a university level and that would require teachers from the group to help get started.
Has the Nordplus-network made an impact on this development? In what way has this network inspired you further development?
Yes it has speeded the process and for the first time one could see that there are more than one way. The Nordplus network has shown us that here are different possibilities and ways to back up Peer support workers. That you can take different roads in education.
People in the group are also willing to help out to help those countries that have come shorter in this process. Through the Nordplus network IPS in Iceland connected to the delegates from Lithuanian.
Three from them came to Iceland in August and took the core training. If not for Nordplus this would never have happened.
We also see that this group could help the countries to develop faster peer support workers and develop the education that is needed. We have also been explored to research from Sweden and Norway which is very helpful along with having the contact you need to ask questions that are relevant.
Without these meetings this would not have happened either. We look forward in working on this project in the future with great hope to develop peer support workers in our country.
Karl Johan and Preben at KBT Vocational college are eager to meet others that train peer support workers in different countries.
Co-teaching in higher education is quite new. In Europe, some universities have started with co-teaching in programs like social studies and mental health studies. Some countries and teaching institutions have more experience with co-teaching than others.
In the Erasmus+ project SEKEHE, some of the project participants have seen good results through several years. Others are still exploring the possibilities.
Sharing experiences across Europe
SEKEHE stands for “structural embedding of knowledge by experience in higher education through process of co-creation”. In September, the participants in the SEKEHE project had a meeting at KBT Vocational College in Trondheim.
One of the meeting activities was to share experiences of co-teaching. Even if the project participants had a shared perception of experiential knowledge earlier, the presentations led to an understanding that they still have a lot to learn from each other.
With project partners from 4 different countries, there is both cultural and linguistic differences to explore in the context of the project.
At the meeting in Trondheim, the project partners hold presentations of their experience with co-teaching.
SEKEHE Project partners
University of Ostrava (the Czech Republic)
University of Applied Sciences and Arts, HOGENT (Belgium)
Universiteit Ghent (Belgium)
Universita’ Degli Studi Di Milano-Bicocca (Italy)
NTNU (Norway)
KBT Vocational College (Norway)
Learning of and about experts by experience
At the meeting in Trondheim, we took the opportunity to do a short interview with the project leaders, Jessica (Belgium) and Jakub (Czech Republic).
About the origin of the project, Jessica explained that she met a colleague of Jakub, Martin, at a conference about mental health, and the idea started in an informal way. At the conference, Jessica and Martin discovered that they were thinking a lot alike.
They started talking, and a friendship developed. More people got involved, and they started talking about how they were working with experts by experience. They then decided to write a project together on the topic, and invited other colleagues they were in touch with. The colleagues from Italy were also om a workshop at the conference where Jessica and Martin met. The group slowly grew, and then Ottar Ness from NTNU came in, and now here we are.
Discovered different contexts along the way
The SEKEHE project are now at the end of the first year. In the first work package, they have been sharing experience of co-teaching. How can they embed knowledge by experience in the courses that they give to their students? There have been different experiences in the different countries in the last year.
Jakub explain that they in this phase of the project, are realising there is difference in the context for the project partners. Now they are discussing what experiential knowledge really means. It can mean different things in different countries. They are still trying to find some kind of framework for describing this activity.
The project is a good arena for exploring the topic and inspire each other. Each country and institution are in different phases of developing this kind of work. In Italy they are just starting and in Ghent they already have a lot of experience.
In the output of the project, you can see experience from those who are just starting and those who have been developing it for many years.
SEKEHE project meeting in Trondheim, fall 2023.
Systems for support
Next year they are going to set up systems of support for students and finding out how they can embed knowledge by experience in those systems of support. They have started with a focus on the teaching, now they are shifting more to the support part. Jessica adds that there’s also a third layer of the project: Focusing on structurally embedding the knowledge by experience in the education. What should change in the universities and university colleges?
The final goal is to have inclusive education where knowledge by experience is a pillar besides the scientific and the professional knowledge.
Structural challenges in the universities
When asked about challenges of co-teaching at universities, Jessica points out that she have met some structural challenges. Not all experts by experience have a formal degree, and therefor they have requested some flexibility from people at the HR department. Also, they need to honour them properly for the work they are doing.
On the level of cooperating with other lecturers, Jessica tells us it’s taking time to create a common ground where people are aware of the benefits of co-teaching. They have to make opportunities to speak about doubts. Is this a good idea? Should we do this? “It’s important to create this openness!”, she says. “This is something we are going to do, and this is the way to go. Without this openness, you lose half of the people before you even started.”
Self-stigma
On the question “Have you met any stigma in this project?”, Jessica says:
“The last two days, some of the experts by experience have been talking about self-stigma. It’s partly in how the organization structure in education is organized. They sometimes feel less as an expert by experience in the current system, because you really have to fight to get your position there as an expert by experience. It’s often only seen as an added value, but not a necessity. They were talking about self-stigma, but it is also somehow created by how the education system is organized. “
Jakub continues: “That’s a big part of some of their stories. It can depend on the stage of their life. Some told that they have met stigmatizing reflections from their students. The students want to bring something into it, and may not be reflecting about the labels, that some of their experience is stigmatizing.
This is an important moment where they can open a discussion. The teachers and the co-teachers try to not judge the students when bringing up something stigmatizing, but to open up a discussion about it. It’s also a difficult situation that brings in insecurities. It’s something we have to look more into, how to work with stigmatization in this teaching process.”
Vebjørn Ørsjødal presenting experiences of co-teaching at KBT Vocational College.
Reducing stigma by openness
Jessica says she think it also takes stigma away in some way. “Because when we started with the co-teaching, we see that the students are suddenly much more open to talk about their own vulnerabilities. It’s some kind of a catalysator: “Ah! It’s okay to talk about these things”. Without this, this openness wouldn’t happen. It’s another way of interacting and creating a dialogue. So, by doing that it’s also breaking stigma. Because all of the sudden subjects are much easier to talk about. It goes in both directions.
It also brings challenges, because all of a sudden, students bring up a lot of issues they’re confronted with. And you see a lot of colleagues thinking: “Ouf! What now? What do we have to do with it?” It’s still an insecurity there with professionals and lecturers. “What’s our role in this? If we break the stigma, somethings come up, and what then? “ ”
Why is a project like SEKEHE important?
There are many layers of why this project is important. Jakub says: “One of them is to give a value of this kind of practise in an institution, because it’s kind of connected to the project. It brings more visibility in the institutions. Even the colleagues that are not involved, or were not interested before, now see that its more power in it. It’s covered by something international.
It’s also a lot of inspiration across context, that we have seen during the workshops. The enthusiasm of people coming here, hearing and seeing that they are not alone in this. That they can connect and that they have friends around in Europe.
Also, the level of creating some robust justification and the ground for how to describe this kind of thing. So, it’s not just an addition to the ways of how we are teaching and learning, but as a core thing in the context.”
Jessica continues: “I think it’s good if it can be a way in how to support inclusive education. In the end, all partners want that the education systems are open to everyone. And it’s in how you look at knowledge, by really embedding this knowledge by experience. But also, how can people in vulnerable situations be included in our education system as well.
It’s content wise, but also about transforming your education system. So that we don’t exclude people from our education system, and that we don’t start already with this excluding process in our own institutions. It’s a big aim, but maybe we can start with planting a seed with SEKEHE.”
In the SEKEHE project, photo voice is used as a method. Here is the result of a photo voice session
Photo voice as method
During the SEKEHE project, all of the teams have been working with photo voice, where art meets research. They use photography to discuss certain topics that are relevant to the project.
Jessica says: “I think that’s an innovative way of working, which is also very useful if you want to have social impact and change. Because you will reach another audience than when you just write an article, or a paper or whatever.
It’s social change on that level, but it’s also another way of working with people. You work with them in the identity of a photographer, not someone with a background of mental health issues. You are working in this project in the role as a photographer, and what’s important for you. It’s a whole different way in how you look on how you work with people. You’re in an equal position. Because the lecturer is also working as a photographer to bring his or her story. I think this is something special in the SEKEHE project, that also unites us.
Maybe there can be an exhibition of the photos on the SEKEHE website. It can intrigue people in a different way by creating these kinds of material as well.”
About Jessica and Jakub
Jeccica is from Belgium. She works at the University of Applied Sciences and Arts, HOGENT in Ghent. There she is a coordinator of the EQUALITY//Research Collective. That’s a research centre where they do practice based research, mostly in the social domain. Two important frames of references: Human rights and quality of life. Embedding knowledge by experience is one of the central pillars of the research centre.
Jakub is from the Czech Republic. He works at Ostrava University, Faculty of social science, educating social work. They focus on social work and bringing the experienced knowledge into the studying of social work. Also, they emphasis is on critical aspects of social work.
Jakub is involved in a project which invited people with specific experience to be a part of the educational process. They have experimented with this the last few years, even before the SEKEHE project started.
Last: What do you think about Trondheim?
Jakub: “I like it. Compared to where I live, it’s less cars. More green cars. With small kids, it’s good to experience a city where you can move more freely, with bikes and green areas. I like to have nature around and clear air. I would like to hike around. “
Jessica: “I was surprised that this is the third largest city in Norway. Went to the fortress and sent a picture to her boyfriend with the text: This is how a city could also look like.”
This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.
KBT Vocational School are continuously developing. This summer we finally got Peer support workers in our team. With our roots from KBT Competence Center for Lived Experience and Service Development, we have had Peer support workers connected to us since the start. Also in the board, we have Peer support workers.
It’s still something different to have peer support workers dedicated to the work of the vocational school. From administration to representation and student contact.
Former students at education for peer support workers
All of the new Peer support workers are graduates from the first study program at KBT Vocational College: Eduaction for peer support workers. Therefor they know all about how it is to be a student here. And they will be a great resource to help us improve the student experience.
Many of our students haven’t been to school for many years. They needs other kinds of support than a 19-year-old coming straight from high school. Some of them have dyslexia and similar challenges. Peer support worker Yvonne knows that that can be hard – but that you can still make it. Actually, she is using her own experiences from coping with such challenges to help today’s students. That has become a popular offer.
Peer support workers with great engagement
There’s no doubt that our new peer support workers have a lot of passion for both people and developing our education programs. Anne Louise points out that if we want to be serious about user involvement, it’s about time we hired peer support workers.
She hopes help speeding up the process of integrating peer support workers both in Trondheim and the rest of the country.
This fall KBT Vocational College, in cooperation with Prios, started up a new course for immigrants. Trøndelag Fylkeskommune (Trøndelag County Municipality) has allocated funds for the training of immigrants who want to establish their own business.
With this course, KBT Vocational College and Prios will contribute to strengthening and developing the regular offer of establishment training in Trøndelag. By offering training to immigrants, we want to contribute to increased employment and growth in the region, and that immigrants can become part of this.
Resourceful people who had to flee their country
Most of the people starting on this new course this fall, are from Ukraina. They have various backgrounds, and many of them are highly educated. As we have learned in projects such as SMAB – Smart business for all, every country has its own systems and rules. With this course, hopefully it will make the way into starting new business in the region will be easier for immigrants with a lot to offer.
The goal of the project is to help immigrants creating their own workplaces in Trøndelag. We hope that as much of 70 percent of the people taking this course, will start their own business, alone or in cooperation with others.
The fall of 2023, KBT Vocational College welcomed students in our second study program: Social entrepreneurship. Social entrepreneurship focuses on solving societal problems and working with social improvements, by developing and implementing innovative and sustainable business models. Social entrepreneurs work in a way similar to regular businesses, but aim to create social value, and not just financial profit.
Some of the students have earlier finished the education program for peer support workers. With their unique experience from the mental health and/or substance abuse field, they also may have a different approach for which type of services should be available. Other students have different backgrounds.
The new education program connects the dots when it comes to some of the projects KBT Vocational School are involved in at the moment. For exampe SMAB – Smart business for all.
A potential bachelor program in the future?
KBT Vocational College are still in its early years and developing. We are now working with applications and formalities to get a subject area accreditation. If we succeed in this, we can develop new study programs and courses without asking for permission for each program.
Vocational Colleges are getting more attention in Norway lately. Some have even started talking about bachelor programs at Vocational Colleges – in addition to shorter, vocationally oriented courses. In the future, a bachelor program can become relevant at KBT Vocational School – time will show.
KBT Vocational College is part of a Nordic-Baltic network for the education and training of Peer support workers. The network is initially supported for one year through Nordplus, till spring 2024.
By sharing knowledge and experiences, we can in a Nordic-Baltic network strengthen and support each other in our various needs in the years ahead. The advantages of this network for KBT Vocational College are many. Some realistic examples for KBT Vocational College are more access to research, more alternatives to the possible syllabus, but also guest lecturers who can strengthen the education for Peer Support Workers at KBT Vocational College.
In the network, subjetcs such as strategies, research, co-teaching, cooperation and Recovery can be discussed.
Different models for training Peer support workers
Today, there are different ways of training Peer Support Workers in different countries. Here in Norway, we have everything from one year programs at KBT Vocational College, to shorter courses from for examle Erfaringsskolen i Oslo (The experience school of Oslo). Norway also have a interest organization for Peer support workers, Erfaringssentrum.
In Sweden, NSPH are providing training of Peer support workers. They have shown interest for the education KBT Vocational College offers. This network is a good place to exchange experiences and ideas around training and education.
The field of peer support workers are still quite new. There are still discussions of which type of training should be available, and which kind of actors should provide them. Also, in which areas the peer support workers can and should work are still up for debate. We think peer support workers have a great potential in several different fields, and that we maybe will discover new areas in the years to come.
A network such as this, can be positive for bringing the field further.
Over the past 10 years, various training concepts have been developed for Peer Supporters (and similar) in several countries in Europe. Although there are different concepts and cultures, the core competence is built on experience. EX-IN in Germany has a training program for what they call experts through experience.
In March 2022, we met the boardmembers of EX-IN and we talked about their work, how the training they provide works and what kind of role and position peer support has in both Norway and Germany. In November KBT Vocational school went on a study tour to experience EX-IN’s teaching in practice.
Peer Supporters in Norway and Germany
The profession of Peer Support workers is fairly new in Europe, and still under development. There are different terms, as for example Peer support worker, peer supporter or expert through experience.
Although many have an idea of what the profession entails, there is still a long way to go before we have a common understanding throughout society. Everyone knows what a teacher or an engineer is, even though within the title they can have many different tasks, fields and ways of working. And the understanding of this is relatively similar almost wherever you are in the world.
Peer Support work becoming recognized as professional
In Germany it seems that Peer Support work is regarded as assistance, but not yet qualified as professional. With their training programme, EX-IN want to facilitate people to do their jobs as well as possible.
In Germany, there are strict rules for who can work in psychiatry, and it has only been a couple of years since Peer Support workers were recognized as a professional group that can work in the field.
In Norway, we know that Peer Support workers and Peer Supporters have a variation of different tasks, and that some almost have to create their own job description. Nevertheless, in Norway we have a lot of good things going on in the work to get the profession more established.
Pioneering work in both countries
Both EX-IN and the Norwegian training for Peer Supportare quite new and it needs a forward thinking and continous developing. An exchange of experience helps a lot in this work.
We discovered that EX-IN and KBT have many similarities in our training programme. For example that the students/course participants use their experiences actively during the training, through dialogue and group tasks. And that we believe that experience and profession must be in equal dialogue to get better services. Though we have different types of training programs.
May learn from each other even if we have different approaches
EX-IN’s courses consist of a lot of self-development, coping with life and learning how to use your experiences to help and support others with similiar experience. EX-IN don’t call it a Peer Support worker, but an “expert through experience”. In that sense, they equate them with professionals. They are experts through their experience, while the skilled worker is an expert through his professional competence.
When first consultant Anne and headmaster Karl Johan were on a study tour this autumn, they were able to take part in one of 12 training modules. In this way, they gained first-hand knowledge of how EX-IN’s teaching program works.
What did we learn from the experience exchange? What insights did we get?
Compared to the teaching at KBT Vocational School there seems to be a bit mote focus on diagnosis at EX-IN. That approach is different from the study program in the vocational school. Basic knowledge of diagnoses is one thing, but there’s a balance how to use it. Also timing for this is relevant. We want the resources found in each individual to be the focus, and not the labels. A trained Peer Support worker from KBT will not be a therapist in the clinical and traditional sense.
But there are of course lessons for us to learn from how course participants at EX-IN experience the training. The participants became much involved in the course and somehow forced them to get in touch with their story and to learn how to share it.
Also the personal presentation of their story and the background of diagnosis made it more believable and real. What we may learn from this is to gain inspiration for how to activate and involve our students personal experience in the lectures.
Similarities to our education was the use of activating the participants in groupwork and tasks. High focus on reflection based training and dialogue.
Why is international collaboration important to KBT Vocational School?
KBT Vocational school still has a distinctive education compared to what we know of other education and training programs. The higher vocational education for Peer Support Workers is not a life management course, though students do report on growth and selv-development. It seems to be meaningful.
There is a need to develop more pedagogy in the area of educating and training Peer Support workers. It is therefore essential to exchange experiences and knowledge across the field.
After 2 and a half years of teaching, KBT is og course still developing. By collaborating with others who offer various forms of training for experience consultants, we can exchange experiences to mutual benefit – not least for future students, and for Peer Support as a profession.
In October, 9 representatives of the Erasmus+ PIA project went to Romania and the Alzheimer Europe Conference. There they got to present the project on a poster and were met with a lot of curiosity and interest. Especially persons with dementia and their relatives wanted to know more about our approach to dementia care. The fact that you can be a resource based solely on your personal experience with dementia seemed to be appealing to this group.
Peer Support Workers as an Innovative force in Advocacy in dementia care (PIA) is an Erasmus+ project with partners from Greece, Italy, Romania and Norway.
This project aims to make sustainable and competence enhancing services for persons with dementia. We want to find new ways to involve users and relatives in the development of services.
Project goals
Developing learning material and methods training peer supporters in dementia care
To develop strategies for policy. In PIA, they will find out how they can start national strategies for dementia, and open up the opportunity to use peer supporters
To develop a digital collaboration platform
Dissemination of knowledge of the results
Building networks and bridges
Attending a European Conference of this scale, gives good opportunities to building networks at an international level. In the long run we can hopefully get fruitful cooperations around developing a new and supplementary role in European dementia care. This year, for example, we got in touch with the Swedish and the Danish dementia associations. And we got to tell them about our project about Peer Support Workers in the dementia care.
Health services in Europe – differences and equalities
In many countries outside of Scandinavia, the health services are built up on different ways than we are used to in Norway. While we have statutory services in Norway, other countries health services are more based on private initiatives and voluntary work. Not all countries have the same degree of public services to take care of the needs of its residents.
At the Conference, we met organizations from countries like England and Scotland, that we might collaborate with in the future. They have many of the same basic mindset as we have, but are more based on voluntary work. Peer Support, but not necessarily Peer Support Workers.
People from all over Europe getting an update on the dementia field at the Alzheimer Europe Conference 2022
To work as a Peer Supporter = being a resource
It’s important to most people being viewed as a resource. It does something with you, knowing someone needs us for something. Perhaps, especially if we have felt like a burden to someone earlier in life. To utilize the resources of people with dementia and their relatives, is also important in the PIA project.
Maybe that was the reason persons diagnosed with dementia and next of kin to persons with dementia showed the most interest and curiosity about the PIA project. Roger Santokhie from KBT remembered one in particular that came to talk to him at the Conference.
“We met a guy called Nathan at the Conference. He and his father are taking care of his grandmother, who have dementia. British Nathan thought it was convenient for the government, calling it “informal care giver”. So that they don’t have to pay them. But it IS a full-time job. So he thought it was nice to have a formal title on it: Peer Support Worker.”
Sense a change in how people look at persons with dementia
Karl Johan Johansen from KBT, states that he could sense a change of attitudes among the participants at the Alzheimer Europe Conference. People now increasingly see the need of user involvement from persons with dementia and their relatives. Also, there have been a development around how we relate to the diagnose. There’s new medications on the market, and studies imply that lifestyle can have an impact on the development of dementia.
Persons with dementia as active attendants at the Alzheimer Europe Conference
The conference in itself also gave the impression of taking user involvement seriously. Several of the attendants of the conference actually are diagnosed with dementia, and some of them was even listed as speakers in the programme. This contributed a lot to raise the user perspective. We can also see the tendence of strengthening user organizations. An example at the conference, is Deepnes dementia.
Santokhie also sensed a higher focus on user involvement in the dementia field. At the conference they were speaking about challenges far ahead in time. Even if there is nothing new about that, the focus of how people with dementia can be a more active part of solving the challenges were higher. In what way can persons with dementia and their relatives be a part of the solution?
Lifestyle and the society’s impact on persons with dementia
A central topic at the conference, were research on the possibilities of reducing the risk of getting dementia through changing lifestyle. Another topic was: What happens to persons with dementia in the Ukrainian war?
Next year: Hope to get more attention around the PIA project
The Alzheimer Europe Conference are arranged different places every year. Next year, it will be in Helsinki. There the project partners in PIA hope to have a parallel session about Peer Support Workers in dementia care. It’s a field with a lot of potential, and hopefully there will be a lot of development in the years to come.
Building bridges was the main headline of the 2022 conference
During the spring of 2022, the Erasmus+ project Smart Business for All have conducted case studies in Norway, Germany, Poland and Greece. They have interviewed both immigrants and people who seeks to support migrant entrepreneurs in the countries. Some of the findings in the report, is that there is potential for migrant entrepreneurs in the contries.
“The main challenges are discrimination, lack of language skills, bureaucracy, knowledge about the local market, basic knowledge about starting a business, and support in form of funding and mentorship. SMAB will be able to tackle some of these issues in the next part of our project.”, the conclusion says.
This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.
It’s been 2 years of educating Peer Support Workers here at KBT Vocational School. Two years with a higher vocational education for peer supporters in Norway. We are so proud of the achievements of our students. And to be able to welcome new students in a couple of months!
Another milestone for KBT Vocational School
The second graduation ceremony at KBT Vocational School, is another milestone for us. A lot has happened the last year. We have moved. Not far, but to a floor with more space. We have started working with 2 Erasmus + projects. And we’ve been lucky enough to get to travel to both Germany and Denmark to meet others who have different kinds of education programmes for peer supporters.
