Promoting psychologically safe workplaces for peer workers supporting people who experience domestic and family violence: peer perspectives and the potential role of psychologists

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Victim-survivors often engage mental health workers to assist with their recovery, including lived experience peer workers who are an important group increasingly being employed across many types of services, providing support underpinned by mutuality, equality and reciprocity, drawing on their own lived experiences. No studies have investigated peer worker perspectives and experiences regarding their support needs when working with people who have experienced or are experiencing DFV and the support psychologists might provide. Methods This Australian study employed four qualitative focus groups with lived experience mental health and suicide prevention peer workers. Participants shared perspectives about their support needs when working with people who have experienced DFV, the potential role of psychologists and other professionals in supporting peer workers’ wellbeing at work, and what they need to promote psychologically safe workplaces that value their lived experience expertise. Lived experience researchers, psychological scientists and psychologists worked collaboratively to analyse data using descriptive thematic analysis methods. Results Participants included 20 peer workers (18 women / 2 men), working across diverse mental health and suicide prevention service roles in psychosocial and clinical settings. One overarching theme of ‘safety’ and three subthemes were identified. Safety was seen both as an issue for people that peer workers support as well as psychological safety for themselves in the workplace. Participants spoke about challenges in navigating differences in the expertise, knowledge and practice of peer workers as compared to psychologists and other professionals as part of supporting peer workers’ wellbeing at work. Participants identified needs as individuals and within organisational culture, practice, and service systems, including greater acknowledgement of their role and expertise, more attention to privacy and confidentiality, education and training for psychologists and other professionals about lived experience peer work, and more explicit focus on DFV within peer workers education and training, peer group reflection and supervision. Conclusions Findings underscore the need for more education and training for all workers supporting people with DFV experiences, including peer workers and psychologists. Addressing these concerns is essential to create psychologically safe workplaces for this important workforce. Trial registration Not applicable Domestic and Family Violence Peer Workers Lived Experience Psychologists Psychological Safety Mental Health Services Mental Health Support Safety Workplaces Organisational Culture Introduction A significant proportion of people who have experienced domestic and family violence (DFV) experience mental health challenges. Supporting people with these experiences, therefore, is an important focus for mental health workforces. In Australia, similar to many countries, DFV is a significant health and welfare issue (AIHW, 2025a). In 2021–2022, approximately 2.3 million Australian women (1 in 4) were impacted by intimate partner violence (2025b) and there were 90 reported deaths by homicide in 2023–2024 alone (AIHW, 2025c). A report from the Coroner’s Court of Victoria indicates that 1 in 4 Victorians who died by suicide between 2009–2016 had experienced DFV (Fitzgibbon, 2024; CCV, 2024). The economic impact of DFV goes beyond its victims. A report of data for 2015–2016 indicated that violence against women and children cost approximately $ 22 billion AUD due to pain, suffering and premature mortality, healthcare system and productivity costs, and other direct and indirect costs (AIHW, 2025a, 2025b; KPMG, 2016; DSS, 2016). These estimates do not include the additional costs and burden of undisclosed abuse (Fitzgibbon, 2024). DFV has considerable, often long-term, debilitating impacts on mental and physical health, education, and financial wellbeing (AIHW, 2025a; AIHW, 2025d; GVRN, 2020; DSS, 2022), which can be intergenerational (AIHW, 2025a; KPMG, 2016). Mental health conditions are considered to have the largest repercussion on the burden caused by DFV (AIHW, 2025a; KPMG, 2016; ANROWS, 2016). Victim-survivors often engage psychologists to assist with their recovery (Cortis et al, 2018; APS, 2024a). Psychologists are trusted professionals who provide evidence-based, trauma-informed care (ICP, 2020; APS, 2025). According to Australian research with consumers and family carers, 90% of survey respondents would recommend psychologists to family or friends (LEA, 2021). Similarly, in Australian research, 83% of Australians believed that those who are impacted by DFV should have access to more psychological services, and 70% considered psychologists to be very or extremely important in supporting women who experience DFV; 91% of psychology professionals believed that people impacted by DFV needed greater access to psychological services (APS, 2025). At various points of their DFV experience and recovery, victim-survivors may seek psychological care. This has led to the Australian Psychological Society (APS) advocating for victim-survivors of DFV to have direct access to psychologists without the need for a mental health diagnosis or General Practitioner (GP) referral (e.g., APS, 2023, 2025). Another important consideration is the potential impacts on individuals who work in the health, mental health, and suicide prevention sectors with people who have been affected by DFV (Pfitzner et al, 2022; AIFS, 2023; Kim et al, 2021; Baffsky et al, 2022). Supporting victim-survivors to access safe spaces to rebuild their lives can lead to compassion fatigue and take a significant toll on mental health and wellbeing for workers (Kim et al, 2021). Peer workers are people in paid or voluntary roles who have lived experience of recovery from mental health challenges, are living well, and are working in dedicated consumer or family/carer peer worker roles. They are an important group that is increasingly being employed across many types of mental health, suicide prevention, and psychosocial support services and programs. Peer workers provide support underpinned by mutuality, equality and reciprocity principles (Byrne et al, 2021) informed by their lived experience. In their recovery-oriented and strengths-based practice, peer workers role model provision of autonomy and informed choice, activating empowerment and hope (Davidson et al, 2016). Evidence of their effectiveness in supporting recovery, improving quality of life and system navigation, and reducing crisis has been established (Hancock et al, 2022; King & Simmons, 2018; Lawn et al, 2008; Lawn et al, 2024). A recent systematic review of international evidence for peer work models (Lawn et al, 2024), undertaken for the Australian Government’s Department of Health to inform its National Unleashing Workforce Strategy (DoHDS, 2025), confirms there are significant gaps in training, supervision and support to the peer workforce. Supporting peer workers’ wellbeing is important to ensuring this workforce thrives. Peer workers may have their own lived experiences of DFV that form an important part of their recovery journey and, therefore, their work with individuals who are in contact with services. However, it is unclear how peer workers are supported to use that lived experience in their work. Further, recent studies identify organisational culture, role identity and a lack of understanding of the role by non-lived experience mental health workforces as key barriers to integration of peer support in services (Ibrahim et al, 2021; Mutschler et al, 2022; Reeves et al, 2024). For example, Reeves et al. (2024, p.1260) argue that “Crucial to peer work is the sharing of lived experience which can be challenging in environments where workers feel unsafe or unvalued for the expertise they bring.” Given peer workers may have their own lived experience of DFV, it is imperative that their mental health and wellbeing is supported, to build a healthy and sustainable workforce (Baffsky et al, 2022). Many existing supports are general, not addressing specific impacts such as vicarious trauma (Kim et al, 2021). Based on Australian research, the Australian Institute of Family Studies (2023) recommend team check-ins to promote DFV service personnel wellbeing, particularly for those working remotely (AIFS, 2023). Psychologists are well suited to provide check-ins, as they have training and expertise in recognising the impacts of trauma, promoting wellbeing and recognising workers who are at risk of vicarious trauma or burnout (APS, 2025; Burke, 2017). To date, there have been no studies investigating the perspectives and experiences of peer workers with lived experiences of DFV, explicitly seeking their views on what support they may need when working with people who have or are experiencing DFV. Against this background, the current study sought to explore experiences and views of an Australian sample of peer workers regarding what they need to maintain their own wellbeing when working with people with experiences of DFV, and what role psychologists, other health professionals, and others within services that employ peer workers might play in supporting their wellbeing to fulfil their peer work roles. Methods Design This qualitative research was underpinned by phenomenology with its focus on exploring how human beings make sense of and transform experiences both individually and as shared meaning (Mohapatra & Satpathy, 2022). It acknowledges that lived experience is an interpretive process, and the importance of social and cultural contexts in which people live and work (Dowling, 2007; Heidegger, 1962). An interpretive phenomenological approach was used to explore the subjective meanings, experiences, and perspectives of peer workers (Hesse-Biber & Leavy, 2011; Van Manen, 1990). It involved four focus groups with peer workers, exploring their views on: The role of psychological services for people with current or past experiences of DFV; What is working well; What could be improved; How they as peer workers can be supported in their role when supporting people with current or past experiences of DFV; and What role psychologists might play in supporting peer workers (see Supplementary File 1: Focus Group Guide). The project was a partnership between lived experience researchers and psychologists and psychological scientists at [blinded]. Principles that promoted the partnership were: lived experience leadership and inclusion from the beginning, power sharing within the partnership, equity in time and resource sharing, inclusive research processes to ensure it was ‘with’ people and not ‘on’ or ‘about’ them as objects of research, and mutual respect and valuing the perspectives of the worlds in which each researcher was positioned (Walters et al, 2025). Sample and Recruitment The invitation to participate in focus groups was distributed by Lived Experience Australia (LEA) to its national representative panel of 120 + consumers and/or family-carers-supporters involved in advocacy consultations and research opportunities. Approximately half (n = 70) of this panel have experience as peer workers and bring diverse intersectional lived experience perspectives including psychosocial disability, physical disability, DFV, alcohol and other drug use, gender and cultural diversity, First Nations people, rural and remote, youth, adult, and older persons experiences. They submitted expressions of interest to LEA in which they confirmed that they had current or past peer work experience, lived experience of DFV, and nominated preferred availability to attend a focus group from four options. Data Collection Focus groups were held online via MS Teams, using the recording and transcription function to capture group discussions, with permission from each group. They were facilitated with sensitivity to how the discussions proceeded, and reassuring participants upfront that they could opt to contribute as little or as much as they wished, to any aspects of the discussion, and/or exit the focus group at any time. Participants were provided with LEA’s ‘Safe Advocacy Spaces’ (LEA, 2025) following consent and prior to commencement of the focus groups to help establish expectations and support participation. Follow-up also occurred with each participant as soon as practicable after each focus group to thank them, respond to any questions related to their involvement, and to offer general debrief, if needed. Participants were assured that any comments that may identify participants would be removed prior to sharing the deidentified transcripts with other members of the research team for data analysis. A small honorarium was provided to each participant to acknowledge their time and expertise. Data Analysis Focus group data were analysed using descriptive thematic analysis methods, informed by the steps outlined by Braun and Clarke (2019, 2021) that include a structured approach to coding, with each researcher working independently to manually code the transcribed qualitative data. Researchers then met to exchange reflective notes and discuss and debate the coding process over several meetings to improve overall coding rigor, and to interpret and make meaning together in the discussion of the data. Through this process, we determined tentative themes, privileging lived experience perspectives in the finalisation of the analysis. Reflexivity Statement This research was undertaken collaboratively by a team comprising lived experience researchers (SL and VS-R), psychologists (KC and JA), and a psychological scientist (AM). This positional diversity, founded on respect and shared commitment to advancing understanding and responses to DFV, enabled us to resolve any potential tensions (e.g. between lived experience and medicalised perspectives), and to have open and robust discussions that helped address concerns about equity of voice, power sharing and decision-making with regard to the research process. Focus groups were facilitated by a lived experience researcher (SL) with lived experience of mental health, DFV and peer work, fostering a safe and trusted environment for group discussions by modelled values of mutuality, equality and reciprocity. Several members of the research team identified with a lived experience of DFV. All identified as female. Whilst the research team had varying levels of qualitative research experience, they came together with equity and respect for each other’s expertise and contributions. Results Twenty peer workers participated across four focus groups (4–5 in each group), delivered in early 2025. This included 18 who identified as women, and two men, with participants ranging in age from 20s to 60s. Detailed demographic information was not collected because we were concerned that this might make individuals identifiable, given the relatively small number of the peer workforce employed in these roles in Australia. Participants were working in clinical community or inpatient mental health services, non-clinical community managed organisations delivering mental health and psychosocial supports, or State Health Departments in Lived Experience leadership roles. Most participants were in paid peer work roles or had been in these roles within the past two years; a small number of participants were not currently employed in any paid roles. Peer workers were employed in consumer peer roles or family peer roles. One overarching theme regarding ‘Safety’ and three subthemes were identified: 1. Peer Workers and DFV lived experience: unrecognised and unspoken expertise; 2. Peer workers and psychologists: two worlds; and 3. Potential ways forward. Overarching theme : Safety – Importance placed on safety for peer workers and people who have experienced DFV The overarching theme of safety was evident throughout the four focus groups. Safety was raised both as an issue for the people that peer workers support as well as for themselves. This involved psychological safety in the workplace for peer workers, their own lived experiences of DFV and the importance of safety as part of their recovery, and more broadly safety for people who have experienced DFV to whom they now provided peer support. Issues around safety for people who have experienced DFV: DFV relates to attachment (Grobbelaar, Strauss & Guggisberg, 2020; Knox, Karantzas & Ferguson, 2024) and, as such, there are issues associated with trust and safety in therapeutic spaces – not the intervention itself but the relationship with health professionals (including psychologists). Feedback about the safety of people who have experienced DFV included the following: • There being a level of safety that people who have experienced DFV never have again “There’s a level of safety that we never have again. You’re like, there’s living with this feeling of being unsafe or the other word – safety and shame for me” (FG1) • To trust a health professional, a person needs to feel safe and listened to “I think one of the first things that we need to ask is, do you feel safe? I think if you come to a psychologist and that's somehow disclosed is not how you feel because you might feel like I've got to look after somebody. I love them. They're my partner. I think one of the first questions we need to ask is do you feel safe, and do you want to explore that, do you need support with that, or do you want me to refer you to someone with that?” (FG2) The number one priority is a person’s safety, not therapy and do they want/need support with that Drawing on their own lived experience, some focus group participants emphasised the importance of prioritising safety first over therapy. By this they meant holding space for listening, believing, nurturing autonomy, and choice about what happens with disclosure of DFV, and asking about safety as the first step, rather than jumping to ‘fixing people’ with clinical responses. Whilst psychologists and other health professionals are trained in prioritising safety and, in some cases, they might be the first contact who has picked up on safety concerns, peer worker participants expressed strong views of centring the person’s need to feel safe when in contact with services. “…the number one, you know if you’re you find out you know someone’s going through this number one priority is their safety. And you know what and how you can support and link that person to be safe, you know that really helps. And how not to make it worse…I don’t think the first step would be, you know, going and seeing a psychologist.” (FG3) Issues around safety for peer workers: Participants spoke about safety for peer workers in the workplace, particularly using their lived experience in their role, given the challenges of supporting people who experience trauma associated with DFV. Their concerns included: • The importance of psychological safety within the workplace A key finding was about peer workers not having sufficient supervision, training, and everyday reflective practice support around them, built into their roles. They emphasised that psychological support, such as being sent off to Employee Assistance Programs (EAPs), once they may have been already struggling, and that may or may not have any sense of the peer role or ability to support peer workers, was insufficient and did not meet their needs. They spoke about human resource (HR) departments within their workplaces that do not have the structures for understanding the peer workforce role as unique in its use of lived experience as foundational to their work – so if things start to unravel with their lived experience ‘tools of trade’ there is limited support. In addition, they spoke about most HR departments being very traditional in separating the boundary between service providers (us) and service users (them) and not having the legal and HR structures to navigate peer support which is uniquely founded on mutuality and reciprocity. Given these recognised gaps in current understanding, in which participants felt that their psychological safety in the workplace could not always be guaranteed, they noted that peer workers may or may not want to share their lived experience of DFV, because it was unclear how the service would then respond, particularly from a trauma-informed perspective. [When working with other staff in the multi-discipline team] “I’ll often, I won’t share what happened to me, but I’ll often use very validating type phrases…I don’t go into what that experience was…for fear of retribution…but also from a trauma-informed perspective of looking after…I’m sort of thinking about what are the boundaries that I want to put in.” (FG1) One participant described this concern in the context of their experience as a peer worker in an inpatient mental health unit. They were concerned that debriefing or supervision support should not be provided by a “graduate psychology person that doesn’t have any life experience,” which could potentially make them feel unsafe. With the absence of sufficient training and support within the team, they described resorting to external supervision and support from a lived experience senior peer work consultant. (FG3) • Support for peer workers needs to be confidential Participants also highlighted safety for themselves and the people they provided peer support to; the context being the importance of how confidentiality is managed in the environment in which they work as central to trust, and therefore safety, in seeking support. “Where is the safety? Where is the confidentiality right? It's in individual choices? So, any workplace can have a confidentiality agreement, but you know the practice of it is actually on individual choices. So, what we've got is a culture of people not connecting…not being vulnerable, not being open, not seeking help. Because they don't trust, because it's other individuals they're not trusting. And the way we support people in making good choices around confidentiality and availability and vulnerability, right is to constantly practice it. That we've seen people show evidence of being able to do it and that we have some level of confidence or evidence in their ability to apply those principles in a meaningful way. Then we're increasing the level of trust in the environment.” (FG3) Subthemes: Three subthemes were apparent that related to the need for safety for peer workers and the people they support. These are described below, with further layers and exemplar participant quotes within each subtheme displayed within tables. Peer workers and DFV lived experience: Unrecognised and unspoken expertise a. The value of being a peer worker Focus group discussions emphasised the unique role of peer workers, with the value of this role not always understood, recognised and respected by others within DFV services working alongside peer workers. This relates back to feelings of psychological safety in the workplace, as not feeling valued could lead peer workers to feel unsafe to disclose their DFV lived experience within team interactions. Participants described the value of their DFV lived experience in a range of ways; for example, how peer workers “get it”, because they come from an informed place and have a deeper understanding of DFV from their own lived experience. Participants described how valuable the peer role is in listening, creating and holding space for and walking alongside the person. They emphasised the value of the underpinning relational principles of mutuality and reciprocity that inform how they work with people; as processes fundamental to how boundaries are actively and routinely negotiated with the person, particularly as lived experience of DFV is a ‘tool of the trade’ for peer workers. These themes are demonstrated in Table 1 below. Table 1 The value of being a peer worker Areas of Value Participant Comments • Value of being a peer worker not in telling one’s story but in people just knowing you have experience. “We may not disclose the story when we’re working with peers, we actually come in from an informed place…there’s an embodied presence of being able to be present.” (FG1) “Also just knowing that someone else may have similar lived experience can make someone more comfortable about opening up about their experiences too.” (FG2) “…particularly around things like coercive control. You know all of those things that you might, but the person may be able to sense, yes, this person understands this as a peer…can talk about the feelings that you might have felt at the time…but not actually talking about the experience (FG1) • Good at listening to the person, holding space, and not telling them what to do. “Oh, you’re the first person that’s just listened to me without telling me what I should be doing” …It took that power to have someone who was willing to walk through it with me” (FG1) “There are not enough services or psychologists. This is where peer workers could come in. Walk beside someone and show and hold hope for the future…” (FG4) • Links made between relational nature of peer work and mental health work. “All mental health work is presumably relational work, but peer work is particularly relational work. You know, it’s very much about values, principles, reciprocity, mutuality.” (FG2) • Reciprocity in sharing or not and understanding the boundaries of sharing (e.g., own self-care) and trauma-informed care. “Mutuality and reciprocity to the person so that they understand that if they raise anything that is going to be traumatising to me, I can ask them to stop in the same way that they can ask me to stop if that happens to them.” (FG1) • Own evolution can mean being more present in the role. “Because I’m comfortable in that place that used to be a distress place, because I’m really at ease…it allows the other person to drop into whatever they need.” (FG1) “I think what as a lived experience person, I think part of the gift of what we bring is that we sit more in a vulnerable space. We’re much more at home with being vulnerable.” (FG1) • Able to have a more flexible approach (e.g., less bound by length and frequency of sessions) than other professionals. “…one of the beauties of peer work is that we're not thinking, ‘I’ve got to wind up in 45 minutes and always close a can of worms.’ That's not necessarily done. So, we do have some creativity there with the length of time. And the frequency that we can engage…” • Can advocate for the person’s needs and assist with a connection being made with a clinician; can teach other professionals about the needs of people experiencing DFV (e.g., trauma-informed care). “And you know, there's a whole lot of issues around stereotypes, but the peer role has fundamentally an advocacy component in it.” (FG2) [Table 1 : The value of being a peer worker] b. Needs of peer workers Focus group participants identified a number of needs related to their role in relation to DFV (see Table 2 ). They spoke of the importance of self-care for peer workers, including setting boundaries around sharing one’s own story and the work they can take on, having support to manage the impact of the work they do (e.g., a lot of trauma around them) and preventing burnout. They noted that DFV was not a topic covered in any depth in their training qualification (Certificate 4 in Peer Work), if at all. An example was given when a participant emailed their organisation regarding access to DFV training but was told it was clinical training and not appropriate for peer workers; it fell to the participant to find other training for themselves. A common theme was around peer workers’ concerns related to receiving support from a psychologist or other EAP or HR professional in the workplace; this included their reservations about seeking support. Peer workers emphasised the importance of support from fellow peers, either informally or within Communities of Practice, and senior peer supervisors. Participants also highlighted the tensions between their employee role and their inherent advocacy position, and perceived power imbalance between them and other disciplines, particularly when they are not being listened to for their lived experience expertise. This may prompt them to become more forthright in their advocacy for client perspectives, including being more critical of the dominant systems within which they work, causing them to feel alienated within their workplace. Hence, understanding their needs in order to create cultural safety within their workplace requires a thorough understanding and acknowledgement of the peer work role. Table 2 Needs of peer workers Needs Participant Comments • Self-care “…when we employed experienced workers, they do receive, they do get a lot of trauma if they haven’t had their healing and their self-care plans…peer workers are not always getting proper care in dealing with that.” (FG3) • Gaps in support, skill development, capability development, and training for peer workforce (DFV-specific and more broadly). “…any training… an area where it’s particularly important to be trained in…responses, but also trauma-informed care. I wouldn’t like to see volunteers in the FDV space perhaps sharing parts of their own story…”. (FG1) “IPS [Intentional Peer Support] training. I think everything should do IPS as the framework and you can adapt it to wherever you’re working… helps protect peer workers to have a framework” (FG1) o Need for a solid framework for peer workers about DFV, to ensure support within their scope of practice “Approach has to be very, very gentle and soft…I find the issues that lived experience person may be helping a lot, but…I haven’t seen a very solid scope of practice written down…And I think it's important that we have a solid framework for our peer workers, so they're not left to either fill the paperwork or listen to something traumatic and don't know how to interpret that because they themselves then get a little bit shocked. And they need some time for themselves because it is emotionally taxing, so I just find that sometimes the clinical staff tend to kind of go – ‘It's your fault’.” (FG3) o Training and supervision needs to be done by an experienced person “But you know, supervision training, external supervision, mentoring, who does the training, you know, by God, that better not be a new graduate psychology person that doesn't have any life experience.” (FG3) o Gaps exist regarding experienced mentors /supervisors who come from a lived experience background “Not all peer workers have you know mentors, supervisors who come from a lived experience background…. There are things that peers have an understanding of because that’s their expertise.” (FG2) “They need to be safe enough to be real in the supervision setting to really explore whatever happened in them in a safe way that’s away from the work itself” (FG1) “In a lot of places, they have an operational supervisor for everyday things and then they’ll have a supervisor for reflective practice, and they may or may not be a lived experience senior peer.” (FG2) o Need support from other peers too and more opportunities for reflection (e.g., an external community of practice). “They have to have the adequate support around them. And that comes back both from a clinical and obviously their own other peer support workers around them. That they’re able to support each other, because otherwise you know we’re going to end up with these people that will be leave. And that’s really, really important that we need to provide it to them.” (FG2) o Support needs to be accessible “Support for peer workers needs to be accessible and free and at the time that we need it and not limited to the usual 6 sessions.” (FG3) • Concerns about psychological safety in the workplace “I think you would have to feel that you're in an incredibly safe environment. Because 90% of the time you're not being seen as part of the team anyway, because it's all so clinical…that's becoming better as peer workers are more included and inclusive …Part of that is the assumption that, you know, for example, if that was occurring and the peer worker did go to psychology. The context is whether [the psychologist] is external to the organisation, whether they're in some sort of management role, whether they're the HR person who is talking to you about return to work. And other concerns about confidentiality; privacy for you as the peer. This concept of psychological Safety at Work.” (FG4) “With a lot of these roles, difference in power. There needs to be an understanding of where the person is in the power. If you’re dependent, you need that job and that needs to be recognised” (FG1) “The other thing is that the managers in this particular role, they change within three years. They had seven managers. And every manager was told instead of doing debriefing, it would be, you know, “have a smoke or just have a break. You need a break between people because it's just too much pressure on yourself.” Or just tell them to go to EAP. It’s not actually fixing what's happening; the gaps, everything and the politics. It’s more about “Oh, you've got a problem. You have to go to EAP. If you don't do this job, we'll hire somebody else.” (FG3) They need advocacy support and an understanding of their role as an advocate “And the fundamental value of advocacy, I'm sure you know, there will be peers in some particular settings that may really find their work difficult when many around them are not seeing things the way that they're seeing things, for example, and that can lead to burnout at work. They up the ante in advocacy when they're feeling that they're not listened to by other disciplines, for example, and the more you’re backed into a corner, the more you traumatise yourself around the story and the advocacy that you're trying to get other people to understand your perspective.” (FG2) “…but it's the nature of the culture of the setting that the more someone ignores me, the more I'm going to jump up and down. I feel like a lot of our power and has been taken away from us and it's like our way of reestablishing that sense of power and like, connection back into the community when a lot of that has been taken away. The power differential is actually the mechanism at work here, and lack of respect for the role.” (FG2) • They emphasised the importance of trauma-informed care and trauma-informed workplaces /organisations “There needs to be trauma-informed organisations and teams, not just trauma-informed practice. So trauma-informed teams and systems and cultures is vital. And I think there's a tokenistic recognition that peer workers, you know, we have to be careful and dance around them and be aware of their histories. But there's not a really full understanding or respect that we have a lot of knowledge, a lot of experience. There's a lot of myths …this term trauma-informed care gets thrown in a lot doesn't it? And I'd like you all to think about it. What does that actually mean for peer workers? …psychologists and others would say, ‘Well, we work in a trauma-informed way. We train people to be trauma informed.’ People with lived experience know about trauma-informed care in relation to your work as a peer worker in relation to family violence that you work with…you bring your lived experience connection to the work, even if it's not explicit. It's part of who you bring to the work; to the person in your reciprocity and mutuality, all those things as a peer worker.” (FG3) • ‘Lack of tribe’ and being a solo worker “And there's issues within the tribes…I think with the doctors, allied health, nurses, their debriefs and you know, coffee catchups and they can bounce off each other's ideas and learn and look at things differently. But when you employ one lived experience person or two, maybe it's you don't have your tribe. I mean, depending on the organisation, sometimes they have excellent friendships regardless of your occupation. But in some in other organisations, like, are they being respected? Have they been given the same authority and power? …Sometimes it's the pay, like ‘I get paid more than you, so I'm important.’ I find if you're not welcomed in that role and this went for a lot of our Indigenous roles where they said if I was the only indigenous person helping, it's just a lot of pressure.” (FG3) [Table 2 : Needs of peer workers] 2. Peer workers and Psychologists: Two worlds a. Peer workers’ experiences of psychological services for themselves Some of the feedback suggested that it is not a natural ‘fit’ for psychologists to support the peer workforce. Some participants described peer workers and psychologists working from quite different paradigms, with psychologists perceived as problematising peer workers’ challenges in their role within a deficits-based medical model. There were concerns that this approach to therapeutic support to help peer workers cope with distress, trauma or retriggering within their work with clients experiencing DFV could, inadvertently, do more harm to peer workers. Feedback highlighted the need for professionals (including psychologists) to work collaboratively with peer workers, including drawing on the insight and value that peer workers bring to working relationally with clients. Drawing upon their previous experiences of seeing a psychologist for their own mental health (where applicable), peer workers noted mixed experiences with receiving support from psychologists, which then shaped their views about their peer work role and the potential support psychologists might provide. Some questioned the need for psychologists and other support professionals for peer workers and thought it would be better to hire peer workers; there were also some positive experiences with psychologists and other professionals too. Peer workers may need help to be connected to psychologists who have an empathetic and informed framework for assisting people who have experienced DFV (e.g., via word of mouth). However, feedback about experiences with psychologists was often referring to support for peer workers’ own experience of DFV rather than support to them in their peer worker role. Psychologists and other professionals were perceived by some participants as predominantly working from a medical model; that is, an approach that focuses on diagnosis and treatment (medicines and therapy) determined by clinical professional ‘expertise’. This approach to how other professionals then viewed peer workers and what peer workers might need to cope with the rigors of their lived experience roles was seen as problematic from the outset. This is because, by contrast, participants described working from values and principles of mutuality and reciprocity that underpinned their work, and a holistic view of the client, within a relational, environmental context. Psychologists were perceived by some as working from a narrower perspective focused on the internal world of the individual. As also highlighted within some of the other themes, peer workers experienced differences in power between themselves and other professionals. This had potential to impact their experience of psychological support. For example, if they were receiving support within the workplace, they were concerned how this perception of ‘not coping’ could reflect negatively on their continued tenure, prospects for career advancement and standing with the service and team. Feedback also included that there were different hierarchies across professionals, with peer workers not recognised as a profession. These experiences of feeling powerlessness also had the potential to be retraumatising and retriggering for peer workers given their lived experience of mental health systems and of DFV. Feedback also suggested that there is a need for continued work to reduce the stigma of seeing a psychologist. These themes are demonstrated in Table 3 below. Table 3 Psychological services: peer workers’ experiences Experiences of Psychological services Participant Comments • Experiences with support from professionals, including psychologists, were mixed “No, I don’t think we’d miss them [psychologists] if they all left. Really…I actually don’t think we really need them at the end of the day. I think people are the experts on themselves, and psychologists to be quite ineffectual at listening to people, to be honest”. (FG1) “…I've obviously had my own experiences with, like psychologists in general, and some of them can be like really great and some of them can be like really harmful or like not supportive.” (FG2) “We actually need the clinical stuff if say we're going for like a work cover claim, you know, injury and all of that sort of stuff. But it was through word of mouth, this really good clinical psychologist and…she was a mum of three boys like me…she shared some of her life and that way I knew she got what I was talking about…I don't think all psychologists are bad, but finding those psychologists that are prepared to, you know, stretch the boundaries a little bit in terms of their professional code of conduct and relate, you know, be able to relate to the person.” (FG3) • Medical model and “fix-it” mentality “There's automatically a power imbalance when peer workers are speaking up and wanting support and getting so-called supervision. And that just perpetuates our feelings of not being heard and valued and it doesn't strengthen us. It doesn't empower us per se, so it's still being done to us and for us, not with us…it's through the illness lens. It's a medical model…a problem saturated lens of what's wrong with this peer worker and how do we fix them? It's not to do with resilience, growth, strength at all. It's very pathological, and that's the system as well.” (FG3) “I found probably the hardest thing was not to become medicalised myself” (FG4) “And what I worry… is if we go back into that, say if we go the reflective cycle, if we go into psychology and say, ‘Well, tell me all about it. What happened?’ Let's go back and regress it. Is that triggering? This model that is essentially looking after the wound and not the person right 'cause they're medically trained, right?” (FG3) • Differences in power for peer workers compared to other professionals “It's really so with a lot of those roles. There's a difference in power. So, I think there's needs to be an understanding of where the person is in the power and if you're dependent or you need that job then it needs to be recognised that there's a dependency and a difference in power, and often that's not explicit and that does change things. And also, the defensiveness of the person themselves.” (FG1) • Stigma associated with seeing a psychologist “And there needs to be a breaking down of the stigma of actually seeing a psychologist or allied health person, or whoever it is that has the necessary skills to provide that support. I think it's really difficult for some people to actually say ‘Well I'm struggling’ or ‘I need a bit of support’. I'm going to see someone external that I don't know. It's not a friend. I think that can be a really difficult decision to make.” (FG3) [Table 3 : Psychological services: peer workers’ experiences] b. Views on psychological services for people who have experienced DFV There was also feedback that psychologists might not always be communicating with or providing therapy to clients in the most effective way. The perception was that professionals working with people with experiences of DFV tend to have a ‘fix-it’ mentality, with a focus on trying to fix people rather than understanding the long-term consequences of trauma and acknowledging the powerlessness in a lot of situations. Whereas, it is okay for professionals to say that they do not know. In some cases, a medical model/pathological approach to psychological care was noted, rather than looking at holistic care, including resilience, growth and strength. This can also come across as being dismissive of the depth of the problems and the person’s needs. According to participants, the ‘fix-it’ mentality also restricted taking into account the wider context for the person, such as their family circumstances. Related to this, participants perceived that there were gaps in some professionals’ understanding of the client’s situation, such as what they are going home too. Some perceived that other professionals lacked the understanding, context and lived experience of DFV. This was felt by some as offensive and interfered with the therapeutic relationship. On the other hand, it was considered important that psychologists understand how to safely share their own personal experience. Participants noted that there are limitations with the Medicare (Better Access) funding model, including a restriction on the number of sessions, wait lists, cost and a need for more immediate, accessible and free care. They noted that people who have been through DFV may not have access to their finances if they are also controlled financially or have been in the past. They may also not feel comfortable sharing their narrative with a GP, given the reluctance to have a medical framework applied to their circumstances. Feedback on barriers also included that clinicians need skills and training in language. For example, education is needed to be able to explain to children the issues around DFV, trauma, safety, and connected issues such as mental illness. Participants felt that it can cause more harm by saying the ‘wrong’ things. Participants highlighted the importance of professionals’ knowledge of DFV, and being experienced in general to be able to work with people who have experienced DFV. There is a need for sound knowledge of DFV to understand associated complexities (e.g., coercive control and DFV perpetuated by carers, each perpetrator being unique, intergenerational DFV, vicarious trauma, intersectionality, challenges with high profile cases, potential media exposure and other legal complexities, understanding emotional impacts), and not confine knowledge to stereotypes (e.g., men are impacted by DFV too). Professionals working with people who have experienced DFV need to have worked through their own personal issues, to understand boundaries of sharing lived experience and to undertake self-reflection. According to participants, where this knowledge or personal work was lacking, there were barriers to getting effective psychological care. Psychology was perceived by some participants as quite individually focused with more emphasis on family therapy needed. Clinicians need to understand the complexities of DFV within families. These themes are demonstrated in Table 4 below. Table 4 Views on psychological services for people who have experienced DFV Views on psychological services Participant Comments • Mixed experiences and perceptions about psychological services “I've used psychologists...a couple of times…when I felt guilt. And that's quite common when someone you love suddenly behaves badly and hurts you and you feel guilty. The psychologist said that it’s not OK that I'm on the receiving end of somebody's mental health issue. I'm a catalyst to get them support, but I'm not receiving it, and I thought that was really validating…I found it very beneficial, and I think it's really just the validation and the establishment of boundaries and establishment of personal rights.” (FG2) “I can't make assumptions for all the psychologists out there but yeah, I just know in the back of my mind like most of them are probably trying their best. Maybe sometimes the way that they go about it isn't the most effective way…understanding like different people's needs and personalities…I just wanted someone to listen to me. And obviously, like there were times where like I didn't want advice and there were times where like I wanted it…it would have been nice to have someone ask me actually what I wanted out of the sessions as well.” (FG2) • Barriers to receiving adequate psychological care “The long-term consequence of trauma isn’t fully recognised. Try to fix you or move you on but the trauma it just stays and shows itself in so many ways, basically for entire lives…I don’t think that’s really been taken on board… I’ve been told that, you know, treatment wise, I need to just let it go now. That’s not helpful.” (FG1) “…what I’ve really experienced first-hand by several professionals. They are not comfortable with the utter powerlessness that’s in a lot of this stuff…they are into fixing or making you better or solving.” (FG1) “I also think a lot of psychologists, from my experience, make a lot of assumptions about family violence and they don't always take in or consider the whole picture. I'm not saying all psychologists do that, but the ones I found in my experience, they just focus, especially my clients with disability, the effect on the disability. Really, they didn't look at what's happening in the environment around the person. You know, they just want to fix the person… need to support, listen, but not necessarily “fix it”. (FG4) “The ones that have worked well are the ones that have taken into account the families, systemic relationships in family therapy. Psychology is very individual focused.” (FG4) o Fix-it mentality o Recovery is not ‘textbook’ and cannot be ‘learned’; it comes from lived ‘expertise’ “When psychologists are working with lived experience, I think being very open-minded to that…recovery isn’t textbook. I think a lot of the times, with a lot of clinicians, they have all this education but a lot of what’s important is not in a textbook. It’s like a midwife that hasn’t given birth can’t tell you how it’s supposed to feel. So, I’d ask psychologists just to be very open…I don’t think you can train for that. Unfortunately, our lived experiences are obtained through some things that probably a lot of us would have preferred not to live through, but there is no training that they can acquire to do that.” (FG2) o Perception of professionals working from a different paradigm to peer workers “I’ve had several experiences of being with a professional person on the other side of the desk and they may know stuff but they don’t get the stuff…and there’s the difference.” (FG1) “…that particular school counsellor, she has also experienced family violence as well. And she told me about her experiences in my like sessions, which I thought was totally wrong, because I felt like that was supposed to be my space.” (FG2) “They [client] will share things with the peer worker that they don’t share with the clinicians and that can cause conflict with clinicians because clinicians may feel they’ve missed something. They haven’t assessed properly or take it personally, that it hasn’t been shared with them…just not having that sense of understanding of the depth. It is being dismissive of the peer, but also dismissive of the person. And dismissive of the need.” (FG4) “We’re more likely to ask questions, deeper questions because we know that underlying this façade or what people are going through, this could have been happening to them. And I know I was never asked in the mental health system what I was going home to. Or you know what I was coming in from…we’re more likely to ask the question.” (FG1) o Funding issues “I wonder how much of that is around the way things are funded as well. Because sometimes it can this program funded for 12 weeks…it’s like how much of how they do the delivery is down to because that’s best practice. Always because of the money. Wages put up. Everything inflated because of NDIS.” (FG1) o Gaps in clinician education about specific language and health literacy “The other thing I'd like to say is that education is important. But education about language and specific language…nobody had the skillsets to explain to children the complexities of mental illness and their rights to safety from violence…and I'm not just talking about culture. You can cause much more harm by, you know, saying especially the wrong thing to children, the wrong thing to older people…skills in training in language is huge.” (FG2) o Knowledge of DFV “I remember my very first experience with a psychologist was actually in the FDV realm around my children…their very first question to me was ‘How does that make you feel?’ and I just thought, ‘Oh my God, that’s so textbook. Like, did this person only just come out of school?’…that bothered me quite a lot. And actually, from that moment on, I thought ‘Oh, I can’t really share anything with this person.’ ” (FG2) “Just got to hold that space and just do the reflective part later. So, the damage happens if the worker, the so-called expert, is not self-aware enough to catch the process happening. Because then the client, or whoever the person is coming, they will feel shamed again, or wronged again, and that their trauma will be retriggered…or silenced. They will lose their voice. They will go mute. (FG1) “Each perpetrator is unique because they’ve all got different mindsets and different ways they can work out how they’re going to get you with this or whereabouts hit you or whatever…That has to be understood.” (FG1) “There's actually so many layers to this and it's not a straightforward, you know, this person has belted this person because they needed control…there's a lot of complexities, especially when you're looking at young people in these situations where there's mental illness and drug use…there's just so many complexities and they don't always want to leave. And we need to really consider that.” (FG4) “Not making assumptions, or it's the male's fault. But sometimes it can be the female…it just depends on the circumstances of what's happening. There's some misalignments perhaps in how psychologists may then work with or respond to peer workers, because there may be differences in some of those structures of understanding and assumptions.” (FG4) o Stigma around people in DFV relationships (and a feeling that people block the topic). “It’s about the trouble people have connecting to the topic. So, it's really important to not put guardrails up around the discussion. You know good critical thinking skills and good acceptance and just to have this conversation.” (FG3) “I don't think this is because of a culture. I think there's a stigma attached to all…. You just have to bear it all, and they say, ‘We can't help and it's just too complex’….And I think that's wrong given that we are a multicultural society, and we know that DV is really bad in some of the groups and what happens is in a court of law, the man goes ‘I was just running discipline’….Violence is not our religious or cultural condition. Like it is a condition that they use to control you, but it is inhuman. And I think that is so wrong” (FG3) [Table 4 : Views on psychological services for people who have experienced DFV] 3. Potential ways forward: What is needed Participants discussed how peer workers and professionals can work together. Their comments suggest the need for a middle ground in which peer workers and psychologists come together as equals with mutual respect for each other’s expertise with defined scopes of practice, for psychologists and other professionals to have more understanding of what peer workers do, why they do it, how they work in terms of sharing their story, or not, and how they can become allies and show trust and respect towards them. Generally, participants wanted psychologists to change their perceptions of how they can support peer workers. For example, not all psychologists work within a medical model. In addition, psychologists are skilled at coming from personal growth, support and resilience perspectives as well as working collaboratively on goals important to clients. These ways of working are likely to align more closely with peer worker perspectives. Nevertheless, the data suggests a need for broader training of the psychology workforce in working with people who have experienced DFV and in supporting peer workers. Participants also emphasised how psychologists and other professionals can learn from peer workers, such as developing skills to assist in building connection with clients who have experienced DFV. The peer worker can help to address the power dynamic between the professional and the client. For example, some participants spoke of how health professionals, some of whom may be used to being able to help people feel better, can feel uncomfortable “with the utter powerlessness” (FG1) but participants discussed that “it’s OK to say you don’t know…It’s a not knowing space.” Participants highlighted the importance to peer workers of support that is confidential, and the need to break down the stigma associated with receiving help. Psychologists and other professionals need to prioritise the value of connection and trust, especially in the DFV context. It is important that peer workers can reach out to someone in the workplace who is trusted; someone who can validate for peer workers that it is okay to feel something. Hence, it is important that the whole team is working in a trauma-informed way, not just with clients but with each other given the increasing presence of peer workers in multidisciplinary teams. Participants emphasised that they want psychologists and other professionals to understand the importance of using relationship building skills, including listening and not necessarily telling the peer worker what to do, being present and authentic, listening and validating, showing interest and curiosity. Related to this, they emphasised that mental health professionals working with peer workers should aim to create a safe space and help a person build a connection with them, or if that is not possible, with someone else, to build trust. These themes are demonstrated in Table 5 below. Table 5 Potential ways forward Ways forward Participant Comments • Professionals and Peer Worders working together o Need to integrate lived experience and psychological knowledge “Well, I don’t know what to say. And I don’t really know what to do, but let’s work it out together.” (FG1) o Could employ a peer worker, or psychologist and peer worker together, or a psychology role in workplace injury as an ally “I think they should all employ peer worker for at least, you know, two days a week or something, who will teach them this stuff and show them the way.” (FG1) “I’m wondering if the psychologist couldn’t be almost the ally in trying to understand perhaps psychological injury in the workplace for a peer worker because they’re the ones who who’ve got that opportunity to really deeply understand and be able to report that back.” (FG1) o See peer worker as a conduit between the person and clinician /psychologist to create a connection (a key point on peer worker value vis a vis a psychologist) “Value of peer worker is like the conduit between the person that requires a service, to the actual clinician to ensure that connection happens. To make sure that it's working. It's not just going to be this tokenistic, ‘I'm just going to go in there and vent and then I think I've resolved things’, but nothing's actually really happening…that's where the value of the peer support worker will be. It's harder because we're restricted by if the person gives consent…The resolution is, you know, hopefully that we can actually get people to be able to see these good psychologists.” (FG2) “I just think that like having a peer worker can also reduce that power dynamic as well between the psychologist and then you know the person involved in it. Also just knowing that someone else may have similar lived experience can make someone more comfortable about opening up about their experiences too. Peer workers, alongside with psychologists? Yeah, and then learning from each other.” (FG2) • Support needs of peer workers “I think it’s absolutely vital that there’s support available. But it doesn’t necessarily need to be psychologist. It needs to be professionals who are trained in specifically this area and trauma informed care and also it needs to be accessible and free and at the time that we need it and not limited to the usual six sessions.” (FG3) o Peer workers see the need for support but not necessarily from psychologists o Need to find the right psychologist (importance of word of mouth/relatability) “I don’t think all psychologists are bad; but finding those psychologists that are prepared to…stretch the boundaries a little bit in terms of their professional code of conduct…be able to relate to the person.” (FG3) o Confidentiality “…it needs to be confidential as well. And there needs to be a breaking down of the stigma of actually seeing a psychologists or allied health person…it’s really difficult for some people to actually say ‘Well, I’m struggling’ or ‘I need a bit of support.’ ” (FG3) o There needs to be an opportunity for a connection to be made and trust to be developed “The psychologist needs to be truthful for themselves that if they can’t connect with the person that they need to try and get them to connect with someone else, not just lead them on…. because specially if you’ve come from that domestic violence…you’ve lost all that trust, so you want to be able to trust somebody again. So that’s really, really important.” (FG2) “It’s brought up a lot for me and maybe it’s something that can’t wait until my supervision session. So, I’ve sought out somebody that I trust in a clinician, whether that’s an OT, psychologist, a mental health nurse, or whoever it is. And I’ll talk to them about, you know, what was brought up, how it affected me and have that debrief session.” (FG4) o It is important that there is trust and professional respect for the peer worker role [In the example below a psychologist attended a session with a peer worker and the psychologist found out more about how to ask questions, which led to respect between colleagues and a better understanding of the peer role] “It's very much trust and respect for me. I remember one of the services I was in, I was asked by a rather bombastic psychologist if they could sit in on one of my family meetings and I sort of hesitantly said yes, OK. And he sat there, almost agog and at the end of it, when it all finished…he said, ‘Oh my God, I've never thought of things like that. You know, the questions that you've asked, can I use those as well?’…after that he became…very much a confidante, much better. He trusted me and respected my role, and I think that's what's so very hard for peer workers to get in a clinical situation. And it's not something that psychologists seem to. It's that we have to prove ourselves before they'll give us the same respect that they feel that they have and just, I just don't think they kind of see us as on the same level.” (FG4) o The Issue of trauma is important for psychologists to understand when working alongside peer workers “The issue of trauma is a really important thing for psychologists to understand. Obviously, the people they’re working with, but also around how peer workers might work with people and respond. So pretty fundamental for the peer worker, who may have experienced trauma as well.” (FG4) • What peer workers would like psychologists to understand “…what I really want psychologists to know and then understand is that peer workers are working in a system that pathologises and stigmatises the tools of their trade…Peer workers may present requiring an understanding of the physical limitations they live with, and this requires a significant self-care gaze and an understanding of the physical implications of stress and fear. It can be helpful for some peer workers to explore the structural context of their family violence. Peer workers thrive on transparency. Ask the peer worker what they want and need and that would be helpful to explore. There are big emotions. This does not make the peer worker unprofessional. If this occurs it may be that you have created a safe place for the peer worker. The peer worker may be experiencing psychological pain…this same pain also drives the delivery of best practice peer work…peer worker will pick up on assumptions made about their role…modern day pioneers of a transparent, compassionate, respectful, dignified, optimistic practice…is powerful. The systems peer workers work in may diminish that power and create the need to seek psychological support, but the premise and delivery of best practice peer work is powerful beyond measure. It is the system that has brought the peer worker to you” (FG4) o The context that peer workers work in o Use relationship building skills “Psychology can help support people by listening and validating.” (FG4) o Concern that psychologists not be threatened by peer workers “Tell the psychologist not to be frightened of peer workers because a number of people that I’ve worked with who have gone to see psychologists have actually stopped because they wanted peer support. That was what was valuable to them. That was what was healing for them.” (FG4) [Table 5 : Potential ways forward] Discussion The importance of psychological safety for peer workers in the workplace Participants in this study spoke of the importance of the organisational culture in which they worked for creating psychological safety in their role. Organisational culture means the values, norms and shared behaviours of the organisations in which a person works that impact their experience in the workplace, and a psychologically safe workplace is “one in which employees feel safe to voice ideas, willingly seek feedback, provide honest feedback, collaborate, take risks and experiment” (Newman et al, 2017, p.521). Participants’ comments also reflect the importance of organisational climate (that is, their perception of the psychological impact a workplace has on their functioning and well-being (Reeves et al, 2024; MHLEPQ & QLEWN, 2024). Both of these concepts are known to be profoundly important to support inclusion of peer workers in mental health organisations, to achieve systems reform, and promote recovery-aligned care models (Jones et al, 2020). A psychologically safe workspace is also important more broadly for promoting greater work participation, increased job satisfaction, and social inclusion (Hunt et al, 2021). Applied specifically to peer workers, “Provision of psychologically safe environments for peer workers underlies their self-perception of being valued. Creating a space where a peer worker feels comfortable to share aspects of their story and utilise this experience to support others is crucial to effectively executing the peer role and promoting worker sustainability” (Reeves et al, 2024, p.1258). However, significant challenges exist in valuing of lived experience knowledge and expertise, particularly within multi-disciplinary mental health settings and traditional clinical mental health service systems (Lawn et al, 2024). An Australian study by Reeves et al. (2024) involving interviews with 18 peer workers currently working in mental health services is one of the few to examine psychological safety for this workforce. They found that factors relating to organisational culture and climate were a central theme. They highlighted the perceived harm of negative organisational climate for peer workers, and the importance of leadership, language, education within the workplace about the peer work role, and supervision aligned with peer values and needs. In particular, they emphasised that, “A leader’s ability to provide support through professional supervision, lived experience specific training and education on the peer role was considered to facilitate overall understanding and acceptance among non-peer colleagues highlighting the need for consistency from leadership at all levels of the organisation to support and value expertise brought by peer workers” (Reeves et al, 2024, p.1259). Another Australian study examining psychological safety of peer workers, involving three focus groups (n = 21 participants) and a statewide survey (n = 43 participants) found that, “Peer workers identified how exposure to psychosocial hazards led to feelings of further marginalisation, victimisation, disempowerment, othering, and exclusion and that these emotions could and do trigger past trauma.” (MHLEPQ & QLEWN, 2024, p.28) Education about the peer worker role and how psychologists can support them Psychologists play an important role in supporting people who are impacted by DFV, including victim survivors, family members and peer workers. The current research has highlighted the need to educate the public and other professionals about how psychologists can help people affected by DFV, for example by providing trauma-informed care, advocating for systemic change and educating the public on the psychological impacts of DFV. Not all psychologists work within a medical model, with many using a holistic approach that considers psychological, biological, cultural and social factors (APS, 2025). In an Australian survey of psychologists most (78%) reported extensively integrating these different factors into their practice (APS, 2025). Nonetheless, there are gaps in the training of psychologists, with 20% of psychologists and 20% of psychology students reporting no formal education on working with DFV survivors (APS, 2025). Recent research suggests that more can be done to help train psychologists and other health professionals to provide best-practice care to those who have experienced DFV (Marsden, Humphreys & Hegarty, 2021, 2024). In an Australian survey, 75% registered psychologists reported completing some form of training to work with clients experiencing DFV; of these, one-quarter undertook training lasting five to ten hours, 24% completed training of less than five hours, while 17% completed comprehensive training programs of 40 or more hours. Among psychology students, 39% had been taught about DFV to some extent, while 41% had been taught very little (APS, 2025). Greater resources and training are needed to ensure that psychologists and other professionals can provide best-practice trauma-informed care to people impacted by DFV (APS, 2025). The APS has advocated to expand trauma-informed training for psychologists and health professionals to improve support for DFV survivors (APS, 2024a, 2025). There is a need also to highlight the ways that psychologists can work with peer workers and to continue efforts to educate psychologists (e.g., APS, 2024b) and other professionals about the important role of peer workers in mental health. Peer workers and psychologists working together The findings of this study suggest there is value in mutuality of education and awareness raising about the role and scope of practice for both peer workers and psychologists to promote greater understanding, opportunities to work together more effectively and an invitation for psychologists to advocate for and champion the work of peer workers in DFV services. For example, a UK study involving interviews with four psychologists and five peer workers about their co-delivery of a trauma support program for healthcare workers experiencing potentially traumatic events (Teo et al. 2025) found that such an approach fostered a more compassionate workplace culture. It did this by reducing stigma and encouraging help-seeking behaviours, enhanced peer workers’ professional growth and enhanced confidence. It also enabled more efficient use of workforce resources by enabling both peer workers and psychologists to take on the more cases that aligned better with their scope and skillsets. Strengths and limitations Strengths of this research were the collaborative partnership established from the outset. Together, we identified the knowledge gap, determined the focus group process and questions, undertook data analyses and reporting processes that valued expertise of all involved, with equity, and continually reflected upon potential biases that we each brought to the research. Lived experience facilitation of focus groups, and the mutuality and safety this created for participants (being able to speak freely without APS researchers present) was also a strength. Several limitations should be noted. The research involved a relatively small Australian convenience sample. First Nations and culturally diverse perspectives were not explored and would be an important area for further research. Most participants identified as female (two were men); hence, the views of other groups may not be reflected in the results. Two of the four focus groups were mixed gender groups (one male in each) which meant some participants may not have spoken up as much as they might have in gender-specific groups. More detailed information about participants’ peer work experiences, training and supervision experiences, and differing roles and expertise levels were not explored. This research did not include the views of psychologists about their contact with peer workers, including the distinction between a therapeutic intervention and a wellbeing check. Further research is suggested, including regarding a distinction between the contribution of psychologists in providing therapeutic interventions versus having a more supportive, wellbeing-based role in supporting peer workers. Conclusion This Australian study on DFV and the support needs and experiences of peer workers indicates that, while peer work and psychology may differ in their scope of practice and approaches to support delivery, there are several practical next steps for enhancing their interactions and increased opportunities to working together. Fundamental is the need for more education and training for all workers supporting people with experiences of DFV, including peer workers and psychologists, so that ill-informed responses to peer workers’ support needs do not cause harm, stifle help-seeking, and inadvertently stigmatise them. Addressing these concerns is essential to creating psychologically safe trauma-informed workplaces for this important and emerging peer workforce. List of abbreviations AUD Australian Dollars AIFS Australian Institute of Family Studies AIHW Australian Institute of Health and Welfare ANROWS Australia's National Research Organisation for Women's Safety APS Australian Psychological Society CCV Coroner’s Court of Victoria DSS Department of Social Services DFV Domestic and Family Violence GVRN Gendered Violence Research Network ICP International Council of Psychologists LEA Lived Experience Australia Declarations Ethics approval and consent to participate A Participant Information Sheet was provided, and consent was confirmed with each participant prior to commencement of focus groups. This research was approved by the Flinders University Human Research Ethics Committee (No.8004) in accordance with the Declaration of Helsinki. Consent for publication Plans for publication were described in the Participant Information Sheet and consent was contained within the consent to participate process. No identifiable data was collected. All direct quotes were de-identified to ensure removal of any potentially identifiable references to specific people, services or locations. Availability of data and materials The datasets generated and/or analysed during the current study are not publicly available due to it being owned by Lived Experience Australia and used with permission for the current study. The dataset is available from Lived Experience Australia on reasonable request ( [email protected] ). Competing interests SL, VS-R, KC, AM and JA have no competing interests to declare. SL holds a research position at Flinders University and also a management role at Lived Experience Australia. Funding This research was funded in-kind by Lived Experience Australia and the APS, with each contributing funds towards participant honoraria and VS-R’s involvement as a lived experience researcher. Authors' contributions SL: Conceptualization, Data Curation, Methodology, Investigation, Project Administration, Resources, Funding Acquisition, Writing – Original Draft, Writing – Review and Editing. VS-R: Data curation, Writing – Review and Editing. KC: Data Curation, Methodology, Writing – Original Draft, Writing – Review and Editing AM: Data Curation, Methodology, Writing – Original Draft, Writing – Review and Editing JA: Data Curation, Methodology, , Writing – Original Draft, Writing – Review and Editing. All authors read and approved the final manuscript. Acknowledgements We wish to thank the peer workers who contributed their lived experience expertise to this research. We express our appreciation to Dr Zena Burgess, CEO of the APS, for her commitment to this topic. We also acknowledge the early contributions made by former members of the APS research team, Dr Zara Lasater and Dr Vinita Godhino. References Australian Institute of Family Studies (AIFS). Safeguarding worker wellbeing for remote delivery of domestic and family violence support. Melbourne, Australia: AIFS, 2023. https://aifs.gov.au/resources/short-articles/safeguarding-worker-wellbeing-remote-delivery-domestic-and-family-violence. Accessed 26 January 2026. Australian Institute of Health and Welfare (AIHW). Family, domestic and sexual violence. Canberra, Australia: AIHW, 2025a. https://www.aihw.gov.au/family-domestic-and-sexual-violence. Accessed 26 January 2026. Australian Institute of Health and Welfare. Economic and financial impacts. Canberra, Australia: AIHW, 2025b. https://www.aihw.gov.au/family-domestic-and-sexual-violence/responses-and-outcomes/economic-financial-impacts Accessed 26 January 2026. Australian Institute of Health and Welfare. Domestic homicide. Canberra, Australia: AIHW, 2025c. https://www.aihw.gov.au/family-domestic-and-sexual-violence/responses-and-outcomes/domestic-homicide Accessed 26 January 2026. Australian Institute of Health and Welfare. FDSV summary. Canberra, Australia: AIHW, 2025c. https://www.aihw.gov.au/family-domestic-and-sexual-violence/resources/fdsv-summary Accessed 26 January 2026. Australian Psychological Society (APS). Build, Support, Prepare: Investing in Australia’s Future—APS Pre-Budget Submission 2023-24. Melbourne, Australia: APS, 2023. Australian Psychological Society. Trauma. Melbourne, Australia: APS, 2024a. https://psychology.org.au/for-the-public/psychology-topics/trauma Accessed 26 January 2026. Australian Psychological Society. Understanding the mental health peer work role. Melbourne, Australia: APS, 2024b. https://psychology.org.au/event/24238 Accessed 26 January 2026. Australian Psychological Society. Thinking Futures: Psychology’s role in transforming women and girls’ health. 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Thousand Oaks, CA, USA: SAGE Publications, 2011. Hunt DF, Bailey J, Lennox BR, Crofts M, Vincent C. Enhancing psychological safety in mental health services. International Journal of Mental Health Systems 2021; 15(1):33–50. doi:10.1186/s13033-021-00439-1 . Ibrahim N, Thompson D, Nixdorf R, Kalha J, Mpango R, Moran G, Mueller-Stierlin A, Ryan G, Mahlke C, Shamba D, Puschner B, Repper J, Slade MA. A systematic review of influences on implementation of peer support work for adults with mental health problems. Social Psychiatry and Psychiatric Epidemiology 2021;55(3):285–293. doi:10.1007/s00127-019-01739-1. International Council of Psychologists (ICP). What do psychology and psychologists offer humanity? Seattle, WA, USA: ICP Inc., 2020. https://icpweb.org/psychologists-worldwide-unite-statement-on-the-value-of-psychology-to-humanity/ Accessed 26 January 2026. Jones N, Teague GB, Wolf J, Rosen C. 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The Cost of Violence against Women and their Children in Australia. 2016. https://www.dss.gov.au/women/publications-articles/reducing-violence/the-cost-of-violence-against-women-and-theirchildren-in-australia-may-2016 Accessed 26 January 2026. Lawn S, Smith A, Hunter K. Mental health peer support for hospital avoidance and early discharge: an Australian example of consumer driven and operated service. Journal of Mental Health 2008;17(5):498–508. https://doi.org/10.1080/09638230701530242 Lived Experience Australia. Consumer and Carer Experiences of Psychology Services in Australia. Adelaide: Lived Experience Australia, 2021. https://www.livedexperienceaustralia.com.au/_files/ugd/07109d_2814e70b9ef94966949a7a283f29ed3f.pdf?index=true Accessed 26 January 2026. Lived Experience Australia. Shared Advocacy Spaces. Adelaide: Lived Experience Australia, 2025. https://6f044093-f272-427f-b749-e2aef1d4ae8d.filesusr.com/ugd/07109d_f262308248634f269aec1abb568dbf00.pdf?index=true Accessed 30 January 2026. Marsden S, Humphreys C, Hegarty K. Women survivors’ accounts of seeing psychologists: Harm or benefit? Journal of Gender-Based Violence 2021;5(1):111–127. https://doi.org/10.1332/239868020X16040863370635 Marsden S, Humphreys C, Hegarty K. Whose Expertise Counts? Women Survivors’ Experiences with Psychologists. Violence and Victims 2024;39(1):71–87. https://doi.org/10.1891/VV-2021-0146 Mental Health Lived Experience Peak Queensland (MHLEPQ) & Queensland Lived Experience Workforce Network (QLEWN). Psychosocial Hazards in the Lived Experience (Peer) Workforce, Project Report. 1 March 2024. Brisbane, Australia : MHLEPQ & QLEWN, 2024. https://mhlepq.org.au/wp-content/uploads/2024/03/Psychosocial-Hazards-Project-Report-Final.pdf Accessed 26 January 2026. Mohapatra M, Satpathy S.P. Interpretative Phenomenological Analysis: A Constructive Approach in Qualitative Research. IOSR Journal of Humanities and Social Science (IOSR-JHSS). 2022;27(3):39–45. doi: 10.9790/0837-2703083945. Mutschler C, Bellamy C, Davidson L, Lichtenstein S, Kidd S. Implementation of peer support in mental health services: a systematic review of the literature. Psychological Services. 2022;19(2):360–374. doi: 10.1037/ser0000531. Newman A, Donohue R, Eva N. Psychological safety: a systematic review of the literature. Human Resource Management Review 2017;27(3):521–535. https://doi.org/10.1016/j.hrmr.2017.01.001. Pfitzner N, Fitz-Gibbon K, True J. When staying home isn’t safe: Australian practitioner experiences of responding to intimate partner violence during COVID-19 restrictions. Journal of Gender Based Violence 2022;6(2):297–314. https://doi.org/10.1332/239868021X16420024310873 Reeves V, Loughhead M, Halpin MA, Proctor N. “Do I feel safe here?” Organisational climate and mental health peer worker experience. BMC Health Service Research 2024; 24:1255–1262. https://doi.org/10.1186/s12913-024-11765-8 Teoh KR, Lishman E, Page A, Donnelly O. The perspectives of peer practitioners and psychologists on the effectiveness of a trauma support programme for healthcare workers. Journal of Work-Applied Management 2025; Ahead-of-print. https://doi.org/10.1108/JWAM-01-2025-0014 van Manen, M. Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. Ontario, CA, USA: State University of New York Press, 1990. Walters C, Lawn S, Maghidman M, Solich H, McDonald, E, Stevenson T, Sheers C, Simic N, Harms J, Petrakis M. Goodyear M. Mental Health Family Carer Co-Researchers: Co-Production Principles to Elevate Lived-Expertise in Research. Research on Social Work Practice 2025;0(0). https://doi.org/10.1177/10497315251316833 Additional Declarations No competing interests reported. Supplementary Files Supplementaryfile1FocusGroupGuide.pdf Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 27 Mar, 2026 Reviews received at journal 07 Mar, 2026 Reviewers agreed at journal 05 Mar, 2026 Reviewers agreed at journal 03 Mar, 2026 Reviewers agreed at journal 02 Mar, 2026 Reviewers invited by journal 24 Feb, 2026 Editor assigned by journal 23 Feb, 2026 Editor invited by journal 30 Jan, 2026 Submission checks completed at journal 29 Jan, 2026 First submitted to journal 29 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Supporting people with these experiences, therefore, is an important focus for mental health workforces. In Australia, similar to many countries, DFV is a significant health and welfare issue (AIHW, 2025a). In 2021\u0026ndash;2022, approximately 2.3\u0026nbsp;million Australian women (1 in 4) were impacted by intimate partner violence (2025b) and there were 90 reported deaths by homicide in 2023\u0026ndash;2024 alone (AIHW, 2025c). A report from the Coroner\u0026rsquo;s Court of Victoria indicates that 1 in 4 Victorians who died by suicide between 2009\u0026ndash;2016 had experienced DFV (Fitzgibbon, 2024; CCV, 2024). The economic impact of DFV goes beyond its victims. A report of data for 2015\u0026ndash;2016 indicated that violence against women and children cost approximately \u003cspan\u003e$\u003c/span\u003e22\u0026nbsp;billion AUD due to pain, suffering and premature mortality, healthcare system and productivity costs, and other direct and indirect costs (AIHW, 2025a, 2025b; KPMG, 2016; DSS, 2016). These estimates do not include the additional costs and burden of undisclosed abuse (Fitzgibbon, 2024). DFV has considerable, often long-term, debilitating impacts on mental and physical health, education, and financial wellbeing (AIHW, 2025a; AIHW, 2025d; GVRN, 2020; DSS, 2022), which can be intergenerational (AIHW, 2025a; KPMG, 2016). Mental health conditions are considered to have the largest repercussion on the burden caused by DFV (AIHW, 2025a; KPMG, 2016; ANROWS, 2016).\u003c/p\u003e \u003cp\u003eVictim-survivors often engage psychologists to assist with their recovery (Cortis et al, 2018; APS, 2024a). Psychologists are trusted professionals who provide evidence-based, trauma-informed care (ICP, 2020; APS, 2025). According to Australian research with consumers and family carers, 90% of survey respondents would recommend psychologists to family or friends (LEA, 2021). Similarly, in Australian research, 83% of Australians believed that those who are impacted by DFV should have access to more psychological services, and 70% considered psychologists to be very or extremely important in supporting women who experience DFV; 91% of psychology professionals believed that people impacted by DFV needed greater access to psychological services (APS, 2025). At various points of their DFV experience and recovery, victim-survivors may seek psychological care. This has led to the Australian Psychological Society (APS) advocating for victim-survivors of DFV to have direct access to psychologists without the need for a mental health diagnosis or General Practitioner (GP) referral (e.g., APS, 2023, 2025).\u003c/p\u003e \u003cp\u003eAnother important consideration is the potential impacts on individuals who work in the health, mental health, and suicide prevention sectors with people who have been affected by DFV (Pfitzner et al, 2022; AIFS, 2023; Kim et al, 2021; Baffsky et al, 2022). Supporting victim-survivors to access safe spaces to rebuild their lives can lead to compassion fatigue and take a significant toll on mental health and wellbeing for workers (Kim et al, 2021).\u003c/p\u003e \u003cp\u003ePeer workers are people in paid or voluntary roles who have lived experience of recovery from mental health challenges, are living well, and are working in dedicated consumer or family/carer peer worker roles. They are an important group that is increasingly being employed across many types of mental health, suicide prevention, and psychosocial support services and programs. Peer workers provide support underpinned by mutuality, equality and reciprocity principles (Byrne et al, 2021) informed by their lived experience. In their recovery-oriented and strengths-based practice, peer workers role model provision of autonomy and informed choice, activating empowerment and hope (Davidson et al, 2016). Evidence of their effectiveness in supporting recovery, improving quality of life and system navigation, and reducing crisis has been established (Hancock et al, 2022; King \u0026amp; Simmons, 2018; Lawn et al, 2008; Lawn et al, 2024).\u003c/p\u003e \u003cp\u003eA recent systematic review of international evidence for peer work models (Lawn et al, 2024), undertaken for the Australian Government\u0026rsquo;s Department of Health to inform its National Unleashing Workforce Strategy (DoHDS, 2025), confirms there are significant gaps in training, supervision and support to the peer workforce. Supporting peer workers\u0026rsquo; wellbeing is important to ensuring this workforce thrives. Peer workers may have their own lived experiences of DFV that form an important part of their recovery journey and, therefore, their work with individuals who are in contact with services. However, it is unclear how peer workers are supported to use that lived experience in their work. Further, recent studies identify organisational culture, role identity and a lack of understanding of the role by non-lived experience mental health workforces as key barriers to integration of peer support in services (Ibrahim et al, 2021; Mutschler et al, 2022; Reeves et al, 2024). For example, Reeves et al. (2024, p.1260) argue that \u0026ldquo;Crucial to peer work is the sharing of lived experience which can be challenging in environments where workers feel unsafe or unvalued for the expertise they bring.\u0026rdquo;\u003c/p\u003e \u003cp\u003eGiven peer workers may have their own lived experience of DFV, it is imperative that their mental health and wellbeing is supported, to build a healthy and sustainable workforce (Baffsky et al, 2022). Many existing supports are general, not addressing specific impacts such as vicarious trauma (Kim et al, 2021). Based on Australian research, the Australian Institute of Family Studies (2023) recommend team check-ins to promote DFV service personnel wellbeing, particularly for those working remotely (AIFS, 2023). Psychologists are well suited to provide check-ins, as they have training and expertise in recognising the impacts of trauma, promoting wellbeing and recognising workers who are at risk of vicarious trauma or burnout (APS, 2025; Burke, 2017).\u003c/p\u003e \u003cp\u003eTo date, there have been no studies investigating the perspectives and experiences of peer workers with lived experiences of DFV, explicitly seeking their views on what support they may need when working with people who have or are experiencing DFV. Against this background, the current study sought to explore experiences and views of an Australian sample of peer workers regarding what they need to maintain their own wellbeing when working with people with experiences of DFV, and what role psychologists, other health professionals, and others within services that employ peer workers might play in supporting their wellbeing to fulfil their peer work roles.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eDesign\u003c/h2\u003e \u003cp\u003eThis qualitative research was underpinned by phenomenology with its focus on exploring how human beings make sense of and transform experiences both individually and as shared meaning (Mohapatra \u0026amp; Satpathy, 2022). It acknowledges that lived experience is an interpretive process, and the importance of social and cultural contexts in which people live and work (Dowling, 2007; Heidegger, 1962). An interpretive phenomenological approach was used to explore the subjective meanings, experiences, and perspectives of peer workers (Hesse-Biber \u0026amp; Leavy, 2011; Van Manen, 1990). It involved four focus groups with peer workers, exploring their views on:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eThe role of psychological services for people with current or past experiences of DFV;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eWhat is working well;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eWhat could be improved;\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eHow they as peer workers can be supported in their role when supporting people with current or past experiences of DFV; and\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eWhat role psychologists might play in supporting peer workers (see Supplementary File 1: Focus Group Guide).\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThe project was a partnership between lived experience researchers and psychologists and psychological scientists at [blinded]. Principles that promoted the partnership were: lived experience leadership and inclusion from the beginning, power sharing within the partnership, equity in time and resource sharing, inclusive research processes to ensure it was \u0026lsquo;with\u0026rsquo; people and not \u0026lsquo;on\u0026rsquo; or \u0026lsquo;about\u0026rsquo; them as objects of research, and mutual respect and valuing the perspectives of the worlds in which each researcher was positioned (Walters et al, 2025).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSample and Recruitment\u003c/h3\u003e\n\u003cp\u003eThe invitation to participate in focus groups was distributed by Lived Experience Australia (LEA) to its national representative panel of 120\u0026thinsp;+\u0026thinsp;consumers and/or family-carers-supporters involved in advocacy consultations and research opportunities. Approximately half (n\u0026thinsp;=\u0026thinsp;70) of this panel have experience as peer workers and bring diverse intersectional lived experience perspectives including psychosocial disability, physical disability, DFV, alcohol and other drug use, gender and cultural diversity, First Nations people, rural and remote, youth, adult, and older persons experiences. They submitted expressions of interest to LEA in which they confirmed that they had current or past peer work experience, lived experience of DFV, and nominated preferred availability to attend a focus group from four options.\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003e Focus groups were held online via MS Teams, using the recording and transcription function to capture group discussions, with permission from each group. They were facilitated with sensitivity to how the discussions proceeded, and reassuring participants upfront that they could opt to contribute as little or as much as they wished, to any aspects of the discussion, and/or exit the focus group at any time. Participants were provided with LEA\u0026rsquo;s \u0026lsquo;Safe Advocacy Spaces\u0026rsquo; (LEA, 2025) following consent and prior to commencement of the focus groups to help establish expectations and support participation. Follow-up also occurred with each participant as soon as practicable after each focus group to thank them, respond to any questions related to their involvement, and to offer general debrief, if needed. Participants were assured that any comments that may identify participants would be removed prior to sharing the deidentified transcripts with other members of the research team for data analysis. A small honorarium was provided to each participant to acknowledge their time and expertise.\u003c/p\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eFocus group data were analysed using descriptive thematic analysis methods, informed by the steps outlined by Braun and Clarke (2019, 2021) that include a structured approach to coding, with each researcher working independently to manually code the transcribed qualitative data. Researchers then met to exchange reflective notes and discuss and debate the coding process over several meetings to improve overall coding rigor, and to interpret and make meaning together in the discussion of the data. Through this process, we determined tentative themes, privileging lived experience perspectives in the finalisation of the analysis.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eReflexivity Statement\u003c/h3\u003e\n\u003cp\u003eThis research was undertaken collaboratively by a team comprising lived experience researchers (SL and VS-R), psychologists (KC and JA), and a psychological scientist (AM). This positional diversity, founded on respect and shared commitment to advancing understanding and responses to DFV, enabled us to resolve any potential tensions (e.g. between lived experience and medicalised perspectives), and to have open and robust discussions that helped address concerns about equity of voice, power sharing and decision-making with regard to the research process. Focus groups were facilitated by a lived experience researcher (SL) with lived experience of mental health, DFV and peer work, fostering a safe and trusted environment for group discussions by modelled values of mutuality, equality and reciprocity. Several members of the research team identified with a lived experience of DFV. All identified as female. Whilst the research team had varying levels of qualitative research experience, they came together with equity and respect for each other\u0026rsquo;s expertise and contributions.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTwenty peer workers participated across four focus groups (4\u0026ndash;5 in each group), delivered in early 2025. This included 18 who identified as women, and two men, with participants ranging in age from 20s to 60s. Detailed demographic information was not collected because we were concerned that this might make individuals identifiable, given the relatively small number of the peer workforce employed in these roles in Australia. Participants were working in clinical community or inpatient mental health services, non-clinical community managed organisations delivering mental health and psychosocial supports, or State Health Departments in Lived Experience leadership roles. Most participants were in paid peer work roles or had been in these roles within the past two years; a small number of participants were not currently employed in any paid roles. Peer workers were employed in consumer peer roles or family peer roles.\u003c/p\u003e \u003cp\u003eOne overarching theme regarding \u0026lsquo;Safety\u0026rsquo; and three subthemes were identified: 1. Peer Workers and DFV lived experience: unrecognised and unspoken expertise; 2. Peer workers and psychologists: two worlds; and 3. Potential ways forward.\u003c/p\u003e \u003cp\u003e \u003cspan type=\"BoldUnderline\" class=\"BoldUnderline\" name=\"Emphasis\"\u003eOverarching theme\u003c/span\u003e: \u003cb\u003eSafety\u003c/b\u003e \u0026ndash; \u003cb\u003eImportance placed on safety for peer workers and people who have experienced DFV\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThe overarching theme of safety was evident throughout the four focus groups. Safety was raised both as an issue for the people that peer workers support as well as for themselves. This involved psychological safety in the workplace for peer workers, their own lived experiences of DFV and the importance of safety as part of their recovery, and more broadly safety for people who have experienced DFV to whom they now provided peer support.\u003c/p\u003e\n\u003ch3\u003eIssues around safety for people who have experienced DFV:\u003c/h3\u003e\n\u003cp\u003eDFV relates to attachment (Grobbelaar, Strauss \u0026amp; Guggisberg, 2020; Knox, Karantzas \u0026amp; Ferguson, 2024) and, as such, there are issues associated with trust and safety in therapeutic spaces \u0026ndash; not the intervention itself but the relationship with health professionals (including psychologists). Feedback about the safety of people who have experienced DFV included the following:\u003c/p\u003e\n\u003cp\u003e• There being a level of safety that people who have experienced DFV never have again\u003c/p\u003e\n\u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e\u0026ldquo;There\u0026rsquo;s a level of safety that we never have again. You\u0026rsquo;re like, there\u0026rsquo;s living with this feeling of being unsafe or the other word \u0026ndash; safety and shame for me\u0026rdquo; (FG1)\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003cp\u003e\u0026bull; To trust a health professional, a person needs to feel safe and listened to\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e\u0026ldquo;I think one of the first things that we need to ask is, do you feel safe? I think if you come to a psychologist and that's somehow disclosed is not how you feel because you might feel like I've got to look after somebody. I love them. They're my partner. I think one of the first questions we need to ask is do you feel safe, and do you want to explore that, do you need support with that, or do you want me to refer you to someone with that?\u0026rdquo; (FG2)\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eThe number one priority is a person\u0026rsquo;s safety, not therapy and do they want/need support with that\u003c/b\u003e \u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eDrawing on their own lived experience, some focus group participants emphasised the importance of prioritising safety first over therapy. By this they meant holding space for listening, believing, nurturing autonomy, and choice about what happens with disclosure of DFV, and asking about safety as the first step, rather than jumping to \u0026lsquo;fixing people\u0026rsquo; with clinical responses. Whilst psychologists and other health professionals are trained in prioritising safety and, in some cases, they might be the first contact who has picked up on safety concerns, peer worker participants expressed strong views of centring the person\u0026rsquo;s need to feel safe when in contact with services.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;\u0026hellip;the number one, you know if you\u0026rsquo;re you find out you know someone\u0026rsquo;s going through this number one priority is their safety. And you know what and how you can support and link that person to be safe, you know that really helps. And how not to make it worse\u0026hellip;I don\u0026rsquo;t think the first step would be, you know, going and seeing a psychologist.\u0026rdquo; (FG3)\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eIssues around safety for peer workers:\u003c/h2\u003e \u003cp\u003eParticipants spoke about safety for peer workers in the workplace, particularly using their lived experience in their role, given the challenges of supporting people who experience trauma associated with DFV. Their concerns included:\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003e\u0026bull; The importance of psychological safety within the workplace\u003c/h2\u003e \u003cp\u003eA key finding was about peer workers not having sufficient supervision, training, and everyday reflective practice support around them, built into their roles. They emphasised that psychological support, such as being sent off to Employee Assistance Programs (EAPs), once they may have been already struggling, and that may or may not have any sense of the peer role or ability to support peer workers, was insufficient and did not meet their needs. They spoke about human resource (HR) departments within their workplaces that do not have the structures for understanding the peer workforce role as unique in its use of lived experience as foundational to their work \u0026ndash; so if things start to unravel with their lived experience \u0026lsquo;tools of trade\u0026rsquo; there is limited support. In addition, they spoke about most HR departments being very traditional in separating the boundary between service providers (us) and service users (them) and not having the legal and HR structures to navigate peer support which is uniquely founded on mutuality and reciprocity.\u003c/p\u003e \u003cp\u003eGiven these recognised gaps in current understanding, in which participants felt that their psychological safety in the workplace could not always be guaranteed, they noted that peer workers may or may not want to share their lived experience of DFV, because it was unclear how the service would then respond, particularly from a trauma-informed perspective.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e[When working with other staff in the multi-discipline team] \u0026ldquo;I\u0026rsquo;ll often, I won\u0026rsquo;t share what happened to me, but I\u0026rsquo;ll often use very validating type phrases\u0026hellip;I don\u0026rsquo;t go into what that experience was\u0026hellip;for fear of retribution\u0026hellip;but also from a trauma-informed perspective of looking after\u0026hellip;I\u0026rsquo;m sort of thinking about what are the boundaries that I want to put in.\u0026rdquo; (FG1)\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eOne participant described this concern in the context of their experience as a peer worker in an inpatient mental health unit. They were concerned that debriefing or supervision support should not be provided by a \u0026ldquo;graduate psychology person that doesn\u0026rsquo;t have any life experience,\u0026rdquo; which could potentially make them feel unsafe. With the absence of sufficient training and support within the team, they described resorting to external supervision and support from a lived experience senior peer work consultant. (FG3)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e\u0026bull; Support for peer workers needs to be confidential\u003c/h2\u003e \u003cp\u003eParticipants also highlighted safety for themselves and the people they provided peer support to; the context being the importance of how confidentiality is managed in the environment in which they work as central to trust, and therefore safety, in seeking support.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;Where is the safety? Where is the confidentiality right? It's in individual choices? So, any workplace can have a confidentiality agreement, but you know the practice of it is actually on individual choices. So, what we've got is a culture of people not connecting\u0026hellip;not being vulnerable, not being open, not seeking help. Because they don't trust, because it's other individuals they're not trusting. And the way we support people in making good choices around confidentiality and availability and vulnerability, right is to constantly practice it. That we've seen people show evidence of being able to do it and that we have some level of confidence or evidence in their ability to apply those principles in a meaningful way. Then we're increasing the level of trust in the environment.\u0026rdquo; (FG3)\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eSubthemes:\u003c/h2\u003e \u003cp\u003eThree subthemes were apparent that related to the need for safety for peer workers and the people they support. These are described below, with further layers and exemplar participant quotes within each subtheme displayed within tables.\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003ePeer workers and DFV lived experience: Unrecognised and unspoken expertise\u003c/b\u003e \u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003ea. The value of being a peer worker\u003c/h2\u003e \u003cp\u003eFocus group discussions emphasised the unique role of peer workers, with the value of this role not always understood, recognised and respected by others within DFV services working alongside peer workers. This relates back to feelings of psychological safety in the workplace, as not feeling valued could lead peer workers to feel unsafe to disclose their DFV lived experience within team interactions. Participants described the value of their DFV lived experience in a range of ways; for example, how peer workers \u0026ldquo;get it\u0026rdquo;, because they come from an informed place and have a deeper understanding of DFV from their own lived experience. Participants described how valuable the peer role is in listening, creating and holding space for and walking alongside the person. They emphasised the value of the underpinning relational principles of mutuality and reciprocity that inform how they work with people; as processes fundamental to how boundaries are actively and routinely negotiated with the person, particularly as lived experience of DFV is a \u0026lsquo;tool of the trade\u0026rsquo; for peer workers. These themes are demonstrated in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e below.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe value of being a peer worker\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAreas of Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParticipant Comments\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eValue of being a peer worker not in telling one\u0026rsquo;s story but in people just knowing you have experience.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;We may not disclose the story when we\u0026rsquo;re working with peers, we actually come in from an informed place\u0026hellip;there\u0026rsquo;s an embodied presence of being able to be present.\u0026rdquo; (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;Also just knowing that someone else may have similar lived experience can make someone more comfortable about opening up about their experiences too.\u0026rdquo; (FG2)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u0026hellip;particularly around things like coercive control. You know all of those things that you might, but the person may be able to sense, yes, this person understands this as a peer\u0026hellip;can talk about the feelings that you might have felt at the time\u0026hellip;but not actually talking about the experience (FG1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eGood at listening to the person, holding space, and not telling them what to do.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;Oh, you\u0026rsquo;re the first person that\u0026rsquo;s just listened to me without telling me what I should be doing\u0026rdquo; \u0026hellip;It took that power to have someone who was willing to walk through it with me\u0026rdquo; (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;There are not enough services or psychologists. This is where peer workers could come in. Walk beside someone and show and hold hope for the future\u0026hellip;\u0026rdquo; (FG4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eLinks made between relational nature of peer work and mental health work.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;All mental health work is presumably relational work, but peer work is particularly relational work. You know, it\u0026rsquo;s very much about values, principles, reciprocity, mutuality.\u0026rdquo; (FG2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eReciprocity in sharing or not and understanding the boundaries of sharing (e.g., own self-care) and trauma-informed care.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;Mutuality and reciprocity to the person so that they understand that if they raise anything that is going to be traumatising to me, I can ask them to stop in the same way that they can ask me to stop if that happens to them.\u0026rdquo; (FG1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eOwn evolution can mean being more present in the role.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;Because I\u0026rsquo;m comfortable in that place that used to be a distress place, because I\u0026rsquo;m really at ease\u0026hellip;it allows the other person to drop into whatever they need.\u0026rdquo; (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;I think what as a lived experience person, I think part of the gift of what we bring is that we sit more in a vulnerable space. We\u0026rsquo;re much more at home with being vulnerable.\u0026rdquo; (FG1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eAble to have a more flexible approach (e.g., less bound by length and frequency of sessions) than other professionals.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;\u0026hellip;one of the beauties of peer work is that we're not thinking, \u0026lsquo;I\u0026rsquo;ve got to wind up in 45 minutes and always close a can of worms.\u0026rsquo; That's not necessarily done. So, we do have some creativity there with the length of time. And the frequency that we can engage\u0026hellip;\u0026rdquo;\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eCan advocate for the person\u0026rsquo;s needs and assist with a connection being made with a clinician; can teach other professionals about the needs of people experiencing DFV (e.g., trauma-informed care).\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;And you know, there's a whole lot of issues around stereotypes, but the peer role has fundamentally an advocacy component in it.\u0026rdquo; (FG2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e[Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e: The value of being a peer worker]\u003c/h2\u003e \u003cdiv id=\"Sec18\" class=\"Section3\"\u003e \u003ch2\u003eb. Needs of peer workers\u003c/h2\u003e \u003cp\u003eFocus group participants identified a number of needs related to their role in relation to DFV (see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). They spoke of the importance of self-care for peer workers, including setting boundaries around sharing one\u0026rsquo;s own story and the work they can take on, having support to manage the impact of the work they do (e.g., a lot of trauma around them) and preventing burnout. They noted that DFV was not a topic covered in any depth in their training qualification (Certificate 4 in Peer Work), if at all. An example was given when a participant emailed their organisation regarding access to DFV training but was told it was clinical training and not appropriate for peer workers; it fell to the participant to find other training for themselves. A common theme was around peer workers\u0026rsquo; concerns related to receiving support from a psychologist or other EAP or HR professional in the workplace; this included their reservations about seeking support. Peer workers emphasised the importance of support from fellow peers, either informally or within Communities of Practice, and senior peer supervisors. Participants also highlighted the tensions between their employee role and their inherent advocacy position, and perceived power imbalance between them and other disciplines, particularly when they are not being listened to for their lived experience expertise. This may prompt them to become more forthright in their advocacy for client perspectives, including being more critical of the dominant systems within which they work, causing them to feel alienated within their workplace. Hence, understanding their needs in order to create cultural safety within their workplace requires a thorough understanding and acknowledgement of the peer work role.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eNeeds of peer workers\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeeds\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParticipant Comments\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eSelf-care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;\u0026hellip;when we employed experienced workers, they do receive, they do get a lot of trauma if they haven\u0026rsquo;t had their healing and their self-care plans\u0026hellip;peer workers are not always getting proper care in dealing with that.\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eGaps in support, skill development, capability development, and training for peer workforce\u003c/b\u003e (DFV-specific and more broadly).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;\u0026hellip;any training\u0026hellip; an area where it\u0026rsquo;s particularly important to be trained in\u0026hellip;responses, but also trauma-informed care. I wouldn\u0026rsquo;t like to see volunteers in the FDV space perhaps sharing parts of their own story\u0026hellip;\u0026rdquo;. (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;IPS [Intentional Peer Support] training. I think everything should do IPS as the framework and you can adapt it to wherever you\u0026rsquo;re working\u0026hellip; helps protect peer workers to have a framework\u0026rdquo; (FG1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eNeed for a solid framework for peer workers about DFV, to ensure support within their scope of practice\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;Approach has to be very, very gentle and soft\u0026hellip;I find the issues that lived experience person may be helping a lot, but\u0026hellip;I haven\u0026rsquo;t seen a very solid scope of practice written down\u0026hellip;And I think it's important that we have a solid framework for our peer workers, so they're not left to either fill the paperwork or listen to something traumatic and don't know how to interpret that because they themselves then get a little bit shocked. And they need some time for themselves because it is emotionally taxing, so I just find that sometimes the clinical staff tend to kind of go \u0026ndash; \u0026lsquo;It's your fault\u0026rsquo;.\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eTraining and supervision needs to be done by an experienced person\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;But you know, supervision training, external supervision, mentoring, who does the training, you know, by God, that better not be a new graduate psychology person that doesn't have any life experience.\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eGaps exist regarding experienced mentors /supervisors\u003c/b\u003e \u003cb\u003ewho come from a lived experience background\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;Not all peer workers have you know mentors, supervisors who come from a lived experience background\u0026hellip;. There are things that peers have an understanding of because that\u0026rsquo;s their expertise.\u0026rdquo; (FG2)\u003c/p\u003e \u003cp\u003e\u0026ldquo;They need to be safe enough to be real in the supervision setting to really explore whatever happened in them in a safe way that\u0026rsquo;s away from the work itself\u0026rdquo; (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;In a lot of places, they have an operational supervisor for everyday things and then they\u0026rsquo;ll have a supervisor for reflective practice, and they may or may not be a lived experience senior peer.\u0026rdquo; (FG2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eNeed support from other peers too and more opportunities for reflection\u003c/b\u003e (e.g., an external community of practice).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;They have to have the adequate support around them. And that comes back both from a clinical and obviously their own other peer support workers around them. That they\u0026rsquo;re able to support each other, because otherwise you know we\u0026rsquo;re going to end up with these people that will be leave. And that\u0026rsquo;s really, really important that we need to provide it to them.\u0026rdquo; (FG2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eSupport needs to be accessible\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;Support for peer workers needs to be accessible and free and at the time that we need it and not limited to the usual 6 sessions.\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eConcerns about psychological safety in the workplace\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;I think you would have to feel that you're in an incredibly safe environment. Because 90% of the time you're not being seen as part of the team anyway, because it's all so clinical\u0026hellip;that's becoming better as peer workers are more included and inclusive \u0026hellip;Part of that is the assumption that, you know, for example, if that was occurring and the peer worker did go to psychology. The context is whether [the psychologist] is external to the organisation, whether they're in some sort of management role, whether they're the HR person who is talking to you about return to work. And other concerns about confidentiality; privacy for you as the peer. This concept of psychological Safety at Work.\u0026rdquo; (FG4)\u003c/p\u003e \u003cp\u003e\u0026ldquo;With a lot of these roles, difference in power. There needs to be an understanding of where the person is in the power. If you\u0026rsquo;re dependent, you need that job and that needs to be recognised\u0026rdquo; (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;The other thing is that the managers in this particular role, they change within three years. They had seven managers. And every manager was told instead of doing debriefing, it would be, you know, \u0026ldquo;have a smoke or just have a break. You need a break between people because it's just too much pressure on yourself.\u0026rdquo; Or just tell them to go to EAP. It\u0026rsquo;s not actually fixing what's happening; the gaps, everything and the politics. It\u0026rsquo;s more about \u0026ldquo;Oh, you've got a problem. You have to go to EAP. If you don't do this job, we'll hire somebody else.\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThey need advocacy support and an understanding of their role as an advocate\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;And the fundamental value of advocacy, I'm sure you know, there will be peers in some particular settings that may really find their work difficult when many around them are not seeing things the way that they're seeing things, for example, and that can lead to burnout at work. They up the ante in advocacy when they're feeling that they're not listened to by other disciplines, for example, and the more you\u0026rsquo;re backed into a corner, the more you traumatise yourself around the story and the advocacy that you're trying to get other people to understand your perspective.\u0026rdquo; (FG2)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u0026hellip;but it's the nature of the culture of the setting that the more someone ignores me, the more I'm going to jump up and down. I feel like a lot of our power and has been taken away from us and it's like our way of reestablishing that sense of power and like, connection back into the community when a lot of that has been taken away. The power differential is actually the mechanism at work here, and lack of respect for the role.\u0026rdquo; (FG2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eThey emphasised the importance of trauma-informed care and trauma-informed workplaces /organisations\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;There needs to be trauma-informed organisations and teams, not just trauma-informed practice. So trauma-informed teams and systems and cultures is vital. And I think there's a tokenistic recognition that peer workers, you know, we have to be careful and dance around them and be aware of their histories. But there's not a really full understanding or respect that we have a lot of knowledge, a lot of experience. There's a lot of myths \u0026hellip;this term trauma-informed care gets thrown in a lot doesn't it? And I'd like you all to think about it. What does that actually mean for peer workers? \u0026hellip;psychologists and others would say, \u0026lsquo;Well, we work in a trauma-informed way. We train people to be trauma informed.\u0026rsquo; People with lived experience know about trauma-informed care in relation to your work as a peer worker in relation to family violence that you work with\u0026hellip;you bring your lived experience connection to the work, even if it's not explicit. It's part of who you bring to the work; to the person in your reciprocity and mutuality, all those things as a peer worker.\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003e\u0026lsquo;Lack of tribe\u0026rsquo; and being a solo worker\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;And there's issues within the tribes\u0026hellip;I think with the doctors, allied health, nurses, their debriefs and you know, coffee catchups and they can bounce off each other's ideas and learn and look at things differently. But when you employ one lived experience person or two, maybe it's you don't have your tribe. I mean, depending on the organisation, sometimes they have excellent friendships regardless of your occupation. But in some in other organisations, like, are they being respected? Have they been given the same authority and power? \u0026hellip;Sometimes it's the pay, like \u0026lsquo;I get paid more than you, so I'm important.\u0026rsquo; I find if you're not welcomed in that role and this went for a lot of our Indigenous roles where they said if I was the only indigenous person helping, it's just a lot of pressure.\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e[Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e: Needs of peer workers]\u003c/h2\u003e \u003cp\u003e2. \u003cb\u003ePeer workers and Psychologists: Two worlds\u003c/b\u003e \u003c/p\u003e\u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003ea. Peer workers\u0026rsquo; experiences of psychological services for themselves\u003c/h2\u003e \u003cp\u003eSome of the feedback suggested that it is not a natural \u0026lsquo;fit\u0026rsquo; for psychologists to support the peer workforce. Some participants described peer workers and psychologists working from quite different paradigms, with psychologists perceived as problematising peer workers\u0026rsquo; challenges in their role within a deficits-based medical model. There were concerns that this approach to therapeutic support to help peer workers cope with distress, trauma or retriggering within their work with clients experiencing DFV could, inadvertently, do more harm to peer workers. Feedback highlighted the need for professionals (including psychologists) to work collaboratively with peer workers, including drawing on the insight and value that peer workers bring to working relationally with clients.\u003c/p\u003e \u003cp\u003eDrawing upon their previous experiences of seeing a psychologist for their own mental health (where applicable), peer workers noted mixed experiences with receiving support from psychologists, which then shaped their views about their peer work role and the potential support psychologists might provide. Some questioned the need for psychologists and other support professionals for peer workers and thought it would be better to hire peer workers; there were also some positive experiences with psychologists and other professionals too. Peer workers may need help to be connected to psychologists who have an empathetic and informed framework for assisting people who have experienced DFV (e.g., via word of mouth). However, feedback about experiences with psychologists was often referring to support for peer workers\u0026rsquo; own experience of DFV rather than support to them in their peer worker role.\u003c/p\u003e \u003cp\u003ePsychologists and other professionals were perceived by some participants as predominantly working from a medical model; that is, an approach that focuses on diagnosis and treatment (medicines and therapy) determined by clinical professional \u0026lsquo;expertise\u0026rsquo;. This approach to how other professionals then viewed peer workers and what peer workers might need to cope with the rigors of their lived experience roles was seen as problematic from the outset. This is because, by contrast, participants described working from values and principles of mutuality and reciprocity that underpinned their work, and a holistic view of the client, within a relational, environmental context. Psychologists were perceived by some as working from a narrower perspective focused on the internal world of the individual.\u003c/p\u003e \u003cp\u003eAs also highlighted within some of the other themes, peer workers experienced differences in power between themselves and other professionals. This had potential to impact their experience of psychological support. For example, if they were receiving support within the workplace, they were concerned how this perception of \u0026lsquo;not coping\u0026rsquo; could reflect negatively on their continued tenure, prospects for career advancement and standing with the service and team. Feedback also included that there were different hierarchies across professionals, with peer workers not recognised as a profession. These experiences of feeling powerlessness also had the potential to be retraumatising and retriggering for peer workers given their lived experience of mental health systems and of DFV. Feedback also suggested that there is a need for continued work to reduce the stigma of seeing a psychologist. These themes are demonstrated in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e below.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePsychological services: peer workers\u0026rsquo; experiences\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperiences of Psychological services\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParticipant Comments\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eExperiences with support from professionals, including psychologists, were mixed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;No, I don\u0026rsquo;t think we\u0026rsquo;d miss them [psychologists] if they all left. Really\u0026hellip;I actually don\u0026rsquo;t think we really need them at the end of the day. I think people are the experts on themselves, and psychologists to be quite ineffectual at listening to people, to be honest\u0026rdquo;. (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u0026hellip;I've obviously had my own experiences with, like psychologists in general, and some of them can be like really great and some of them can be like really harmful or like not supportive.\u0026rdquo; (FG2)\u003c/p\u003e \u003cp\u003e\u0026ldquo;We actually need the clinical stuff if say we're going for like a work cover claim, you know, injury and all of that sort of stuff. But it was through word of mouth, this really good clinical psychologist and\u0026hellip;she was a mum of three boys like me\u0026hellip;she shared some of her life and that way I knew she got what I was talking about\u0026hellip;I don't think all psychologists are bad, but finding those psychologists that are prepared to, you know, stretch the boundaries a little bit in terms of their professional code of conduct and relate, you know, be able to relate to the person.\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eMedical model and \u0026ldquo;fix-it\u0026rdquo; mentality\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;There's automatically a power imbalance when peer workers are speaking up and wanting support and getting so-called supervision. And that just perpetuates our feelings of not being heard and valued and it doesn't strengthen us. It doesn't empower us per se, so it's still being done to us and for us, not with us\u0026hellip;it's through the illness lens. It's a medical model\u0026hellip;a problem saturated lens of what's wrong with this peer worker and how do we fix them? It's not to do with resilience, growth, strength at all. It's very pathological, and that's the system as well.\u0026rdquo; (FG3)\u003c/p\u003e \u003cp\u003e\u0026ldquo;I found probably the hardest thing was not to become medicalised myself\u0026rdquo; (FG4)\u003c/p\u003e \u003cp\u003e\u0026ldquo;And what I worry\u0026hellip; is if we go back into that, say if we go the reflective cycle, if we go into psychology and say, \u0026lsquo;Well, tell me all about it. What happened?\u0026rsquo; Let's go back and regress it. Is that triggering? This model that is essentially looking after the wound and not the person right 'cause they're medically trained, right?\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eDifferences in power for peer workers compared to other professionals\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;It's really so with a lot of those roles. There's a difference in power. So, I think there's needs to be an understanding of where the person is in the power and if you're dependent or you need that job then it needs to be recognised that there's a dependency and a difference in power, and often that's not explicit and that does change things. And also, the defensiveness of the person themselves.\u0026rdquo; (FG1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eStigma associated with seeing a psychologist\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;And there needs to be a breaking down of the stigma of actually seeing a psychologist or allied health person, or whoever it is that has the necessary skills to provide that support. I think it's really difficult for some people to actually say \u0026lsquo;Well I'm struggling\u0026rsquo; or \u0026lsquo;I need a bit of support\u0026rsquo;. I'm going to see someone external that I don't know. It's not a friend. I think that can be a really difficult decision to make.\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003e[Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e: Psychological services: peer workers\u0026rsquo; experiences]\u003c/h2\u003e \u003cdiv id=\"Sec22\" class=\"Section3\"\u003e \u003ch2\u003eb. Views on psychological services for people who have experienced DFV\u003c/h2\u003e \u003cp\u003eThere was also feedback that psychologists might not always be communicating with or providing therapy to clients in the most effective way. The perception was that professionals working with people with experiences of DFV tend to have a \u0026lsquo;fix-it\u0026rsquo; mentality, with a focus on trying to fix people rather than understanding the long-term consequences of trauma and acknowledging the powerlessness in a lot of situations. Whereas, it is okay for professionals to say that they do not know. In some cases, a medical model/pathological approach to psychological care was noted, rather than looking at holistic care, including resilience, growth and strength. This can also come across as being dismissive of the depth of the problems and the person\u0026rsquo;s needs. According to participants, the \u0026lsquo;fix-it\u0026rsquo; mentality also restricted taking into account the wider context for the person, such as their family circumstances.\u003c/p\u003e \u003cp\u003eRelated to this, participants perceived that there were gaps in some professionals\u0026rsquo; understanding of the client\u0026rsquo;s situation, such as what they are going home too. Some perceived that other professionals lacked the understanding, context and lived experience of DFV. This was felt by some as offensive and interfered with the therapeutic relationship. On the other hand, it was considered important that psychologists understand how to safely share their own personal experience.\u003c/p\u003e \u003cp\u003eParticipants noted that there are limitations with the Medicare (Better Access) funding model, including a restriction on the number of sessions, wait lists, cost and a need for more immediate, accessible and free care. They noted that people who have been through DFV may not have access to their finances if they are also controlled financially or have been in the past. They may also not feel comfortable sharing their narrative with a GP, given the reluctance to have a medical framework applied to their circumstances.\u003c/p\u003e \u003cp\u003eFeedback on barriers also included that clinicians need skills and training in language. For example, education is needed to be able to explain to children the issues around DFV, trauma, safety, and connected issues such as mental illness. Participants felt that it can cause more harm by saying the \u0026lsquo;wrong\u0026rsquo; things.\u003c/p\u003e \u003cp\u003eParticipants highlighted the importance of professionals\u0026rsquo; knowledge of DFV, and being experienced in general to be able to work with people who have experienced DFV. There is a need for sound knowledge of DFV to understand associated complexities (e.g., coercive control and DFV perpetuated by carers, each perpetrator being unique, intergenerational DFV, vicarious trauma, intersectionality, challenges with high profile cases, potential media exposure and other legal complexities, understanding emotional impacts), and not confine knowledge to stereotypes (e.g., men are impacted by DFV too). Professionals working with people who have experienced DFV need to have worked through their own personal issues, to understand boundaries of sharing lived experience and to undertake self-reflection. According to participants, where this knowledge or personal work was lacking, there were barriers to getting effective psychological care. Psychology was perceived by some participants as quite individually focused with more emphasis on family therapy needed. Clinicians need to understand the complexities of DFV within families. These themes are demonstrated in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e below.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eViews on psychological services for people who have experienced DFV\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eViews on psychological services\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParticipant Comments\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eMixed experiences and perceptions about psychological services\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;I've used psychologists...a couple of times\u0026hellip;when I felt guilt. And that's quite common when someone you love suddenly behaves badly and hurts you and you feel guilty. The psychologist said that it\u0026rsquo;s not OK that I'm on the receiving end of somebody's mental health issue. I'm a catalyst to get them support, but I'm not receiving it, and I thought that was really validating\u0026hellip;I found it very beneficial, and I think it's really just the validation and the establishment of boundaries and establishment of personal rights.\u0026rdquo; (FG2)\u003c/p\u003e \u003cp\u003e\u0026ldquo;I can't make assumptions for all the psychologists out there but yeah, I just know in the back of my mind like most of them are probably trying their best. Maybe sometimes the way that they go about it isn't the most effective way\u0026hellip;understanding like different people's needs and personalities\u0026hellip;I just wanted someone to listen to me. And obviously, like there were times where like I didn't want advice and there were times where like I wanted it\u0026hellip;it would have been nice to have someone ask me actually what I wanted out of the sessions as well.\u0026rdquo; (FG2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eBarriers to receiving adequate psychological care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026ldquo;The long-term consequence of trauma isn\u0026rsquo;t fully recognised. Try to fix you or move you on but the trauma it just stays and shows itself in so many ways, basically for entire lives\u0026hellip;I don\u0026rsquo;t think that\u0026rsquo;s really been taken on board\u0026hellip; I\u0026rsquo;ve been told that, you know, treatment wise, I need to just let it go now. That\u0026rsquo;s not helpful.\u0026rdquo; (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u0026hellip;what I\u0026rsquo;ve really experienced first-hand by several professionals. They are not comfortable with the utter powerlessness that\u0026rsquo;s in a lot of this stuff\u0026hellip;they are into fixing or making you better or solving.\u0026rdquo; (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;I also think a lot of psychologists, from my experience, make a lot of assumptions about family violence and they don't always take in or consider the whole picture. I'm not saying all psychologists do that, but the ones I found in my experience, they just focus, especially my clients with disability, the effect on the disability. Really, they didn't look at what's happening in the environment around the person. You know, they just want to fix the person\u0026hellip; need to support, listen, but not necessarily \u0026ldquo;fix it\u0026rdquo;. (FG4)\u003c/p\u003e \u003cp\u003e\u0026ldquo;The ones that have worked well are the ones that have taken into account the families, systemic relationships in family therapy. Psychology is very individual focused.\u0026rdquo; (FG4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eFix-it mentality\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eRecovery is not \u0026lsquo;textbook\u0026rsquo; and cannot be \u0026lsquo;learned\u0026rsquo;; it comes from lived \u0026lsquo;expertise\u0026rsquo;\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;When psychologists are working with lived experience, I think being very open-minded to that\u0026hellip;recovery isn\u0026rsquo;t textbook. I think a lot of the times, with a lot of clinicians, they have all this education but a lot of what\u0026rsquo;s important is not in a textbook. It\u0026rsquo;s like a midwife that hasn\u0026rsquo;t given birth can\u0026rsquo;t tell you how it\u0026rsquo;s supposed to feel. So, I\u0026rsquo;d ask psychologists just to be very open\u0026hellip;I don\u0026rsquo;t think you can train for that. Unfortunately, our lived experiences are obtained through some things that probably a lot of us would have preferred not to live through, but there is no training that they can acquire to do that.\u0026rdquo; (FG2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003ePerception of professionals working from a different paradigm to peer workers\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;I\u0026rsquo;ve had several experiences of being with a professional person on the other side of the desk and they may know stuff but they don\u0026rsquo;t get the stuff\u0026hellip;and there\u0026rsquo;s the difference.\u0026rdquo; (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u0026hellip;that particular school counsellor, she has also experienced family violence as well. And she told me about her experiences in my like sessions, which I thought was totally wrong, because I felt like that was supposed to be my space.\u0026rdquo; (FG2)\u003c/p\u003e \u003cp\u003e\u0026ldquo;They [client] will share things with the peer worker that they don\u0026rsquo;t share with the clinicians and that can cause conflict with clinicians because clinicians may feel they\u0026rsquo;ve missed something. They haven\u0026rsquo;t assessed properly or take it personally, that it hasn\u0026rsquo;t been shared with them\u0026hellip;just not having that sense of understanding of the depth. It is being dismissive of the peer, but also dismissive of the person. And dismissive of the need.\u0026rdquo; (FG4)\u003c/p\u003e \u003cp\u003e\u0026ldquo;We\u0026rsquo;re more likely to ask questions, deeper questions because we know that underlying this fa\u0026ccedil;ade or what people are going through, this could have been happening to them. And I know I was never asked in the mental health system what I was going home to. Or you know what I was coming in from\u0026hellip;we\u0026rsquo;re more likely to ask the question.\u0026rdquo; (FG1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eFunding issues\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;I wonder how much of that is around the way things are funded as well. Because sometimes it can this program funded for 12 weeks\u0026hellip;it\u0026rsquo;s like how much of how they do the delivery is down to because that\u0026rsquo;s best practice. Always because of the money. Wages put up. Everything inflated because of NDIS.\u0026rdquo; (FG1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eGaps in clinician education about specific language and health literacy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;The other thing I'd like to say is that education is important. But education about language and specific language\u0026hellip;nobody had the skillsets to explain to children the complexities of mental illness and their rights to safety from violence\u0026hellip;and I'm not just talking about culture. You can cause much more harm by, you know, saying especially the wrong thing to children, the wrong thing to older people\u0026hellip;skills in training in language is huge.\u0026rdquo; (FG2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eKnowledge of DFV\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;I remember my very first experience with a psychologist was actually in the FDV realm around my children\u0026hellip;their very first question to me was \u0026lsquo;How does that make you feel?\u0026rsquo; and I just thought, \u0026lsquo;Oh my God, that\u0026rsquo;s so textbook. Like, did this person only just come out of school?\u0026rsquo;\u0026hellip;that bothered me quite a lot. And actually, from that moment on, I thought \u0026lsquo;Oh, I can\u0026rsquo;t really share anything with this person.\u0026rsquo; \u0026rdquo; (FG2)\u003c/p\u003e \u003cp\u003e\u0026ldquo;Just got to hold that space and just do the reflective part later. So, the damage happens if the worker, the so-called expert, is not self-aware enough to catch the process happening. Because then the client, or whoever the person is coming, they will feel shamed again, or wronged again, and that their trauma will be retriggered\u0026hellip;or silenced. They will lose their voice. They will go mute. (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;Each perpetrator is unique because they\u0026rsquo;ve all got different mindsets and different ways they can work out how they\u0026rsquo;re going to get you with this or whereabouts hit you or whatever\u0026hellip;That has to be understood.\u0026rdquo; (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;There's actually so many layers to this and it's not a straightforward, you know, this person has belted this person because they needed control\u0026hellip;there's a lot of complexities, especially when you're looking at young people in these situations where there's mental illness and drug use\u0026hellip;there's just so many complexities and they don't always want to leave. And we need to really consider that.\u0026rdquo; (FG4)\u003c/p\u003e \u003cp\u003e\u0026ldquo;Not making assumptions, or it's the male's fault. But sometimes it can be the female\u0026hellip;it just depends on the circumstances of what's happening. There's some misalignments perhaps in how psychologists may then work with or respond to peer workers, because there may be differences in some of those structures of understanding and assumptions.\u0026rdquo; (FG4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eStigma around people in DFV\u003c/b\u003e \u003cb\u003erelationships\u003c/b\u003e (and a feeling that people block the topic).\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;It\u0026rsquo;s about the trouble people have connecting to the topic. So, it's really important to not put guardrails up around the discussion. You know good critical thinking skills and good acceptance and just to have this conversation.\u0026rdquo; (FG3)\u003c/p\u003e \u003cp\u003e\u0026ldquo;I don't think this is because of a culture. I think there's a stigma attached to all\u0026hellip;. You just have to bear it all, and they say, \u0026lsquo;We can't help and it's just too complex\u0026rsquo;\u0026hellip;.And I think that's wrong given that we are a multicultural society, and we know that DV is really bad in some of the groups and what happens is in a court of law, the man goes \u0026lsquo;I was just running discipline\u0026rsquo;\u0026hellip;.Violence is not our religious or cultural condition. Like it is a condition that they use to control you, but it is inhuman. And I think that is so wrong\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003e[Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e: Views on psychological services for people who have experienced DFV]\u003c/h2\u003e \u003cdiv id=\"Sec24\" class=\"Section4\"\u003e \u003ch2\u003e3. Potential ways forward: What is needed\u003c/h2\u003e \u003cp\u003eParticipants discussed how peer workers and professionals can work together. Their comments suggest the need for a middle ground in which peer workers and psychologists come together as equals with mutual respect for each other\u0026rsquo;s expertise with defined scopes of practice, for psychologists and other professionals to have more understanding of what peer workers do, why they do it, how they work in terms of sharing their story, or not, and how they can become allies and show trust and respect towards them.\u003c/p\u003e \u003cp\u003eGenerally, participants wanted psychologists to change their perceptions of how they can support peer workers. For example, not all psychologists work within a medical model. In addition, psychologists are skilled at coming from personal growth, support and resilience perspectives as well as working collaboratively on goals important to clients. These ways of working are likely to align more closely with peer worker perspectives. Nevertheless, the data suggests a need for broader training of the psychology workforce in working with people who have experienced DFV and in supporting peer workers.\u003c/p\u003e \u003cp\u003e Participants also emphasised how psychologists and other professionals can learn from peer workers, such as developing skills to assist in building connection with clients who have experienced DFV. The peer worker can help to address the power dynamic between the professional and the client. For example, some participants spoke of how health professionals, some of whom may be used to being able to help people feel better, can feel uncomfortable \u0026ldquo;with the utter powerlessness\u0026rdquo; (FG1) but participants discussed that \u0026ldquo;it\u0026rsquo;s OK to say you don\u0026rsquo;t know\u0026hellip;It\u0026rsquo;s a not knowing space.\u0026rdquo;\u003c/p\u003e \u003cp\u003e Participants highlighted the importance to peer workers of support that is confidential, and the need to break down the stigma associated with receiving help. Psychologists and other professionals need to prioritise the value of connection and trust, especially in the DFV context. It is important that peer workers can reach out to someone in the workplace who is trusted; someone who can validate for peer workers that it is okay to feel something. Hence, it is important that the whole team is working in a trauma-informed way, not just with clients but with each other given the increasing presence of peer workers in multidisciplinary teams.\u003c/p\u003e \u003cp\u003e Participants emphasised that they want psychologists and other professionals to understand the importance of using relationship building skills, including listening and not necessarily telling the peer worker what to do, being present and authentic, listening and validating, showing interest and curiosity. Related to this, they emphasised that mental health professionals working with peer workers should aim to create a safe space and help a person build a connection with them, or if that is not possible, with someone else, to build trust. These themes are demonstrated in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e below.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePotential ways forward\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWays forward\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParticipant Comments\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cem\u003eProfessionals and Peer Worders working together\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eNeed to integrate lived experience and psychological knowledge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;Well, I don\u0026rsquo;t know what to say. And I don\u0026rsquo;t really know what to do, but let\u0026rsquo;s work it out together.\u0026rdquo; (FG1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eCould employ a peer worker, or psychologist and peer worker together, or a psychology role in workplace injury as an ally\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;I think they should all employ peer worker for at least, you know, two days a week or something, who will teach them this stuff and show them the way.\u0026rdquo; (FG1)\u003c/p\u003e \u003cp\u003e\u0026ldquo;I\u0026rsquo;m wondering if the psychologist couldn\u0026rsquo;t be almost the ally in trying to understand perhaps psychological injury in the workplace for a peer worker because they\u0026rsquo;re the ones who who\u0026rsquo;ve got that opportunity to really deeply understand and be able to report that back.\u0026rdquo; (FG1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eSee peer worker as a conduit between the person and clinician /psychologist to create a connection\u003c/b\u003e \u003cem\u003e(a key point on peer worker value vis a vis a psychologist)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;Value of peer worker is like the conduit between the person that requires a service, to the actual clinician to ensure that connection happens. To make sure that it's working. It's not just going to be this tokenistic, \u0026lsquo;I'm just going to go in there and vent and then I think I've resolved things\u0026rsquo;, but nothing's actually really happening\u0026hellip;that's where the value of the peer support worker will be. It's harder because we're restricted by if the person gives consent\u0026hellip;The resolution is, you know, hopefully that we can actually get people to be able to see these good psychologists.\u0026rdquo; (FG2)\u003c/p\u003e \u003cp\u003e\u0026ldquo;I just think that like having a peer worker can also reduce that power dynamic as well between the psychologist and then you know the person involved in it. Also just knowing that someone else may have similar lived experience can make someone more comfortable about opening up about their experiences too. Peer workers, alongside with psychologists? Yeah, and then learning from each other.\u0026rdquo; (FG2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eSupport needs of peer workers\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026ldquo;I think it\u0026rsquo;s absolutely vital that there\u0026rsquo;s support available. But it doesn\u0026rsquo;t necessarily need to be psychologist. It needs to be professionals who are trained in specifically this area and trauma informed care and also it needs to be accessible and free and at the time that we need it and not limited to the usual six sessions.\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003ePeer workers see the need for support but not necessarily from psychologists\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eNeed to find the right psychologist\u003c/b\u003e (importance of word of mouth/relatability)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;I don\u0026rsquo;t think all psychologists are bad; but finding those psychologists that are prepared to\u0026hellip;stretch the boundaries a little bit in terms of their professional code of conduct\u0026hellip;be able to relate to the person.\u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eConfidentiality\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;\u0026hellip;it needs to be confidential as well. And there needs to be a breaking down of the stigma of actually seeing a psychologists or allied health person\u0026hellip;it\u0026rsquo;s really difficult for some people to actually say \u0026lsquo;Well, I\u0026rsquo;m struggling\u0026rsquo; or \u0026lsquo;I need a bit of support.\u0026rsquo; \u0026rdquo; (FG3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eThere needs to be an opportunity for a connection to be made and trust to be developed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;The psychologist needs to be truthful for themselves that if they can\u0026rsquo;t connect with the person that they need to try and get them to connect with someone else, not just lead them on\u0026hellip;. because specially if you\u0026rsquo;ve come from that domestic violence\u0026hellip;you\u0026rsquo;ve lost all that trust, so you want to be able to trust somebody again. So that\u0026rsquo;s really, really important.\u0026rdquo; (FG2)\u003c/p\u003e \u003cp\u003e\u0026ldquo;It\u0026rsquo;s brought up a lot for me and maybe it\u0026rsquo;s something that can\u0026rsquo;t wait until my supervision session. So, I\u0026rsquo;ve sought out somebody that I trust in a clinician, whether that\u0026rsquo;s an OT, psychologist, a mental health nurse, or whoever it is. And I\u0026rsquo;ll talk to them about, you know, what was brought up, how it affected me and have that debrief session.\u0026rdquo; (FG4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eIt is important that there is trust and professional respect for the peer worker role\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e[In the example below a psychologist attended a session with a peer worker and the psychologist found out more about how to ask questions, which led to respect between colleagues and a better understanding of the peer role]\u003c/p\u003e \u003cp\u003e\u0026ldquo;It's very much trust and respect for me. I remember one of the services I was in, I was asked by a rather bombastic psychologist if they could sit in on one of my family meetings and I sort of hesitantly said yes, OK. And he sat there, almost agog and at the end of it, when it all finished\u0026hellip;he said, \u0026lsquo;Oh my God, I've never thought of things like that. You know, the questions that you've asked, can I use those as well?\u0026rsquo;\u0026hellip;after that he became\u0026hellip;very much a confidante, much better. He trusted me and respected my role, and I think that's what's so very hard for peer workers to get in a clinical situation. And it's not something that psychologists seem to. It's that we have to prove ourselves before they'll give us the same respect that they feel that they have and just, I just don't think they kind of see us as on the same level.\u0026rdquo; (FG4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eThe Issue of trauma is important for psychologists to understand when working alongside peer workers\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;The issue of trauma is a really important thing for psychologists to understand. Obviously, the people they\u0026rsquo;re working with, but also around how peer workers might work with people and respond. So pretty fundamental for the peer worker, who may have experienced trauma as well.\u0026rdquo; (FG4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026bull; \u003cb\u003eWhat peer workers would like psychologists to understand\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u0026ldquo;\u0026hellip;what I really want psychologists to know and then understand is that peer workers are working in a system that pathologises and stigmatises the tools of their trade\u0026hellip;Peer workers may present requiring an understanding of the physical limitations they live with, and this requires a significant self-care gaze and an understanding of the physical implications of stress and fear. It can be helpful for some peer workers to explore the structural context of their family violence. Peer workers thrive on transparency. Ask the peer worker what they want and need and that would be helpful to explore. There are big emotions. This does not make the peer worker unprofessional. If this occurs it may be that you have created a safe place for the peer worker. The peer worker may be experiencing psychological pain\u0026hellip;this same pain also drives the delivery of best practice peer work\u0026hellip;peer worker will pick up on assumptions made about their role\u0026hellip;modern day pioneers of a transparent, compassionate, respectful, dignified, optimistic practice\u0026hellip;is powerful. The systems peer workers work in may diminish that power and create the need to seek psychological support, but the premise and delivery of best practice peer work is powerful beyond measure. It is the system that has brought the peer worker to you\u0026rdquo; (FG4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eThe context that peer workers work in\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eUse\u003c/b\u003e \u003cb\u003erelationship building skills\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;Psychology can help support people by listening and validating.\u0026rdquo; (FG4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eo \u003cb\u003eConcern that psychologists not be threatened by peer workers\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ldquo;Tell the psychologist not to be frightened of peer workers because a number of people that I\u0026rsquo;ve worked with who have gone to see psychologists have actually stopped because they wanted peer support. That was what was valuable to them. That was what was healing for them.\u0026rdquo; (FG4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003e[Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e: Potential ways forward]\u003c/h2\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cdiv id=\"Sec27\" class=\"Section2\"\u003e \u003ch2\u003eThe importance of psychological safety for peer workers in the workplace\u003c/h2\u003e \u003cp\u003eParticipants in this study spoke of the importance of the organisational culture in which they worked for creating psychological safety in their role. Organisational culture means the values, norms and shared behaviours of the organisations in which a person works that impact their experience in the workplace, and a psychologically safe workplace is \u0026ldquo;one in which employees feel safe to voice ideas, willingly seek feedback, provide honest feedback, collaborate, take risks and experiment\u0026rdquo; (Newman et al, 2017, p.521). Participants\u0026rsquo; comments also reflect the importance of organisational climate (that is, their perception of the psychological impact a workplace has on their functioning and well-being (Reeves et al, 2024; MHLEPQ \u0026amp; QLEWN, 2024). Both of these concepts are known to be profoundly important to support inclusion of peer workers in mental health organisations, to achieve systems reform, and promote recovery-aligned care models (Jones et al, 2020). A psychologically safe workspace is also important more broadly for promoting greater work participation, increased job satisfaction, and social inclusion (Hunt et al, 2021). Applied specifically to peer workers, \u0026ldquo;Provision of psychologically safe environments for peer workers underlies their self-perception of being valued. Creating a space where a peer worker feels comfortable to share aspects of their story and utilise this experience to support others is crucial to effectively executing the peer role and promoting worker sustainability\u0026rdquo; (Reeves et al, 2024, p.1258). However, significant challenges exist in valuing of lived experience knowledge and expertise, particularly within multi-disciplinary mental health settings and traditional clinical mental health service systems (Lawn et al, 2024).\u003c/p\u003e \u003cp\u003eAn Australian study by Reeves et al. (2024) involving interviews with 18 peer workers currently working in mental health services is one of the few to examine psychological safety for this workforce. They found that factors relating to organisational culture and climate were a central theme. They highlighted the perceived harm of negative organisational climate for peer workers, and the importance of leadership, language, education within the workplace about the peer work role, and supervision aligned with peer values and needs. In particular, they emphasised that, \u0026ldquo;A leader\u0026rsquo;s ability to provide support through professional supervision, lived experience specific training and education on the peer role was considered to facilitate overall understanding and acceptance among non-peer colleagues highlighting the need for consistency from leadership at all levels of the organisation to support and value expertise brought by peer workers\u0026rdquo; (Reeves et al, 2024, p.1259).\u003c/p\u003e \u003cp\u003eAnother Australian study examining psychological safety of peer workers, involving three focus groups (n\u0026thinsp;=\u0026thinsp;21 participants) and a statewide survey (n\u0026thinsp;=\u0026thinsp;43 participants) found that, \u0026ldquo;Peer workers identified how exposure to psychosocial hazards led to feelings of further marginalisation, victimisation, disempowerment, othering, and exclusion and that these emotions could and do trigger past trauma.\u0026rdquo; (MHLEPQ \u0026amp; QLEWN, 2024, p.28)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section2\"\u003e \u003ch2\u003eEducation about the peer worker role and how psychologists can support them\u003c/h2\u003e \u003cp\u003ePsychologists play an important role in supporting people who are impacted by DFV, including victim survivors, family members and peer workers. The current research has highlighted the need to educate the public and other professionals about how psychologists can help people affected by DFV, for example by providing trauma-informed care, advocating for systemic change and educating the public on the psychological impacts of DFV. Not all psychologists work within a medical model, with many using a holistic approach that considers psychological, biological, cultural and social factors (APS, 2025). In an Australian survey of psychologists most (78%) reported extensively integrating these different factors into their practice (APS, 2025).\u003c/p\u003e \u003cp\u003eNonetheless, there are gaps in the training of psychologists, with 20% of psychologists and 20% of psychology students reporting no formal education on working with DFV survivors (APS, 2025). Recent research suggests that more can be done to help train psychologists and other health professionals to provide best-practice care to those who have experienced DFV (Marsden, Humphreys \u0026amp; Hegarty, 2021, 2024). In an Australian survey, 75% registered psychologists reported completing some form of training to work with clients experiencing DFV; of these, one-quarter undertook training lasting five to ten hours, 24% completed training of less than five hours, while 17% completed comprehensive training programs of 40 or more hours. Among psychology students, 39% had been taught about DFV to some extent, while 41% had been taught very little (APS, 2025). Greater resources and training are needed to ensure that psychologists and other professionals can provide best-practice trauma-informed care to people impacted by DFV (APS, 2025). The APS has advocated to expand trauma-informed training for psychologists and health professionals to improve support for DFV survivors (APS, 2024a, 2025). There is a need also to highlight the ways that psychologists can work with peer workers and to continue efforts to educate psychologists (e.g., APS, 2024b) and other professionals about the important role of peer workers in mental health.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec29\" class=\"Section2\"\u003e \u003ch2\u003ePeer workers and psychologists working together\u003c/h2\u003e \u003cp\u003eThe findings of this study suggest there is value in mutuality of education and awareness raising about the role and scope of practice for both peer workers and psychologists to promote greater understanding, opportunities to work together more effectively and an invitation for psychologists to advocate for and champion the work of peer workers in DFV services. For example, a UK study involving interviews with four psychologists and five peer workers about their co-delivery of a trauma support program for healthcare workers experiencing potentially traumatic events (Teo et al. 2025) found that such an approach fostered a more compassionate workplace culture. It did this by reducing stigma and encouraging help-seeking behaviours, enhanced peer workers\u0026rsquo; professional growth and enhanced confidence. It also enabled more efficient use of workforce resources by enabling both peer workers and psychologists to take on the more cases that aligned better with their scope and skillsets.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStrengths and limitations\u003c/h3\u003e\n\u003cp\u003eStrengths of this research were the collaborative partnership established from the outset. Together, we identified the knowledge gap, determined the focus group process and questions, undertook data analyses and reporting processes that valued expertise of all involved, with equity, and continually reflected upon potential biases that we each brought to the research. Lived experience facilitation of focus groups, and the mutuality and safety this created for participants (being able to speak freely without APS researchers present) was also a strength.\u003c/p\u003e \u003cp\u003eSeveral limitations should be noted. The research involved a relatively small Australian convenience sample. First Nations and culturally diverse perspectives were not explored and would be an important area for further research. Most participants identified as female (two were men); hence, the views of other groups may not be reflected in the results. Two of the four focus groups were mixed gender groups (one male in each) which meant some participants may not have spoken up as much as they might have in gender-specific groups. More detailed information about participants\u0026rsquo; peer work experiences, training and supervision experiences, and differing roles and expertise levels were not explored. This research did not include the views of psychologists about their contact with peer workers, including the distinction between a therapeutic intervention and a wellbeing check. Further research is suggested, including regarding a distinction between the contribution of psychologists in providing therapeutic interventions versus having a more supportive, wellbeing-based role in supporting peer workers.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis Australian study on DFV and the support needs and experiences of peer workers indicates that, while peer work and psychology may differ in their scope of practice and approaches to support delivery, there are several practical next steps for enhancing their interactions and increased opportunities to working together. Fundamental is the need for more education and training for all workers supporting people with experiences of DFV, including peer workers and psychologists, so that ill-informed responses to peer workers\u0026rsquo; support needs do not cause harm, stifle help-seeking, and inadvertently stigmatise them. Addressing these concerns is essential to creating psychologically safe trauma-informed workplaces for this important and emerging peer workforce.\u003c/p\u003e"},{"header":"List of abbreviations","content":"\u003cp\u003eAUD Australian Dollars\u003c/p\u003e\u003cp\u003eAIFS Australian Institute of Family Studies\u003c/p\u003e\u003cp\u003eAIHW Australian Institute of Health and Welfare\u003c/p\u003e\u003cp\u003eANROWS Australia's National Research Organisation for Women's Safety\u003c/p\u003e\u003cp\u003eAPS Australian Psychological Society\u003c/p\u003e\u003cp\u003eCCV Coroner’s Court of Victoria\u003c/p\u003e\u003cp\u003eDSS Department of Social Services\u003c/p\u003e\u003cp\u003eDFV Domestic and Family Violence\u003c/p\u003e\u003cp\u003eGVRN Gendered Violence Research Network\u003c/p\u003e\u003cp\u003eICP International Council of Psychologists\u003c/p\u003e\u003cp\u003eLEA Lived Experience Australia\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA Participant Information Sheet was provided, and consent was confirmed with each participant prior to commencement of focus groups. This research was approved by the Flinders University Human Research Ethics Committee (No.8004) in accordance with the Declaration of Helsinki.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePlans for publication were described in the Participant Information Sheet and consent was contained within the consent to participate process. No identifiable data was collected. All direct quotes were de-identified to ensure removal of any potentially identifiable references to specific people, services or locations.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analysed during the current study are not publicly available due to it being owned by Lived Experience Australia and used with permission for the current study. The dataset is available from Lived Experience Australia on reasonable request ([email protected]).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSL, VS-R, KC, AM and JA have no competing interests to declare. SL holds a research position at Flinders University and also a management role at Lived Experience Australia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was funded in-kind by Lived Experience Australia and the APS, with each contributing funds towards participant honoraria and VS-R\u0026rsquo;s involvement as a lived experience researcher.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSL: Conceptualization, Data Curation, Methodology, Investigation, Project Administration, Resources, Funding Acquisition, Writing \u0026ndash; Original Draft, Writing \u0026ndash; Review and Editing.\u003c/p\u003e\n\u003cp\u003eVS-R: Data curation, Writing \u0026ndash; Review and Editing.\u003c/p\u003e\n\u003cp\u003eKC: Data Curation, Methodology, Writing \u0026ndash; Original Draft, Writing \u0026ndash; Review and Editing\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAM: Data Curation, Methodology, Writing \u0026ndash; Original Draft, Writing \u0026ndash; Review and Editing\u003c/p\u003e\n\u003cp\u003eJA: Data Curation, Methodology, , Writing \u0026ndash; Original Draft, Writing \u0026ndash; Review and Editing. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe wish to thank the peer workers who contributed their lived experience expertise to this research. We express our appreciation to Dr Zena Burgess, CEO of the APS, for her commitment to this topic. We also acknowledge the early contributions made by former members of the APS research team, Dr Zara Lasater and Dr Vinita Godhino.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAustralian Institute of Family Studies (AIFS). Safeguarding worker wellbeing for remote delivery of domestic and family violence support. Melbourne, Australia: AIFS, 2023. https://aifs.gov.au/resources/short-articles/safeguarding-worker-wellbeing-remote-delivery-domestic-and-family-violence. 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Melbourne: APS, 2017. https://psychology.org.au/inpsych/2017/april/burke Accessed 26 January 2026.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCoroners Court of Victoria (CCV). Experience of family violence among people who suicided 2009\u0026ndash;20016. Melbourne, Australia: CCV, 2024. https://www.coronerscourt.vic.gov.au/sites/default/files/2024-09/Coroners%20Court%20of%20Victoria%20Experience%20of%20family%20violence%20among%20people%20who%20suicided%202009-20016.pdf Accessed 26 January 2026.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCortis N, Blaxland M, Breckenridge J, Valentine K. Mahoney N, Chung D, Cordier R, Chen Y, Green D. National Survey of Workers in the Domestic, Family and Sexual Violence Sectors. Sydney, Australia: UNSW, 2018. https://doi.org/10.26190/5B5AB1C0E110F\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDavidson L, Carr E, Bellamy C, Tondora J, Fossey E, Styron T, Davidson M, Elsamra S. 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Nova Science Publishers, 2020. https://novapublishers.com/shop/victims-of-violence-support-challenges-and-outcomes/ Accessed 26 January 2026.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHancock N, Berry B, Banfield M, Pike-Rowney G, Scanlan JN, Norris S. Peer Worker-Supported Transition from Hospital to Home-Outcomes for Service Users. International Journal of Environmental Research and Public Health. 2022;19(5):2743. doi: 10.3390/ijerph19052743.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHeidegger, M. Being and Time; Harper \u0026amp; Row: New York, NY, USA, 1962.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHesse-Biber S. Leavy P. The Practice of Qualitative Research, 2nd ed. Thousand Oaks, CA, USA: SAGE Publications, 2011.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHunt DF, Bailey J, Lennox BR, Crofts M, Vincent C. Enhancing psychological safety in mental health services. International Journal of Mental Health Systems 2021; 15(1):33\u0026ndash;50. doi:10.1186/s13033-021-00439-1 .\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIbrahim N, Thompson D, Nixdorf R, Kalha J, Mpango R, Moran G, Mueller-Stierlin A, Ryan G, Mahlke C, Shamba D, Puschner B, Repper J, Slade MA. A systematic review of influences on implementation of peer support work for adults with mental health problems. Social Psychiatry and Psychiatric Epidemiology 2021;55(3):285\u0026ndash;293. doi:10.1007/s00127-019-01739-1.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInternational Council of Psychologists (ICP). What do psychology and psychologists offer humanity? Seattle, WA, USA: ICP Inc., 2020. https://icpweb.org/psychologists-worldwide-unite-statement-on-the-value-of-psychology-to-humanity/ Accessed 26 January 2026.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJones N, Teague GB, Wolf J, Rosen C. Organizational climate and support among peer specialists working in Peer-Run, Hybrid and Conventional Mental Health settings. Administration and Policy in Mental Health and Mental Health Services Research 2020;47(1):150\u0026ndash;167. doi:10.1007/s10488-019-00980-9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim J, Chesworth B, Franchino-Olsen H, Macy R.J. A Scoping Review of Vicarious Trauma Interventions for Service Providers Working With People Who Have Experienced Traumatic Events. Trauma, Violence \u0026amp; Abuse 2021;23(5):1437\u0026ndash;1460. https://doi.org/10.1177/1524838021991310\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKing AJ, Simmons MB. A systematic review of the attributes and outcomes of peer work and guidelines for reporting studies of peer interventions. Psychiatric Services 2018;69(9):961\u0026ndash;977. doi: 10.1176/appi.ps.201700564.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKnox L, Karantzas G, Ferguson E. The Role of Attachment, Insecurity, and Stress in Partner Maltreatment: A Meta-Analysis. Trauma Violence Abuse 2024;25(1):721\u0026ndash;737. doi: 10.1177/15248380231161012.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKPMG. The Cost of Violence against Women and their Children in Australia. 2016. https://www.dss.gov.au/women/publications-articles/reducing-violence/the-cost-of-violence-against-women-and-theirchildren-in-australia-may-2016 Accessed 26 January 2026.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLawn S, Smith A, Hunter K. Mental health peer support for hospital avoidance and early discharge: an Australian example of consumer driven and operated service. Journal of Mental Health 2008;17(5):498\u0026ndash;508. https://doi.org/10.1080/09638230701530242\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLived Experience Australia. Consumer and Carer Experiences of Psychology Services in Australia. Adelaide: Lived Experience Australia, 2021. https://www.livedexperienceaustralia.com.au/_files/ugd/07109d_2814e70b9ef94966949a7a283f29ed3f.pdf?index=true Accessed 26 January 2026.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLived Experience Australia. Shared Advocacy Spaces. Adelaide: Lived Experience Australia, 2025. https://6f044093-f272-427f-b749-e2aef1d4ae8d.filesusr.com/ugd/07109d_f262308248634f269aec1abb568dbf00.pdf?index=true Accessed 30 January 2026.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarsden S, Humphreys C, Hegarty K. Women survivors\u0026rsquo; accounts of seeing psychologists: Harm or benefit? 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Interpretative Phenomenological Analysis: A Constructive Approach in Qualitative Research. IOSR Journal of Humanities and Social Science (IOSR-JHSS). 2022;27(3):39\u0026ndash;45. doi: 10.9790/0837-2703083945.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMutschler C, Bellamy C, Davidson L, Lichtenstein S, Kidd S. Implementation of peer support in mental health services: a systematic review of the literature. Psychological Services. 2022;19(2):360\u0026ndash;374. doi: 10.1037/ser0000531.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNewman A, Donohue R, Eva N. Psychological safety: a systematic review of the literature. Human Resource Management Review 2017;27(3):521\u0026ndash;535. https://doi.org/10.1016/j.hrmr.2017.01.001.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePfitzner N, Fitz-Gibbon K, True J. When staying home isn\u0026rsquo;t safe: Australian practitioner experiences of responding to intimate partner violence during COVID-19 restrictions. Journal of Gender Based Violence 2022;6(2):297\u0026ndash;314. https://doi.org/10.1332/239868021X16420024310873\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eReeves V, Loughhead M, Halpin MA, Proctor N. \u0026ldquo;Do I feel safe here?\u0026rdquo; Organisational climate and mental health peer worker experience. BMC Health Service Research 2024; 24:1255\u0026ndash;1262. https://doi.org/10.1186/s12913-024-11765-8\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTeoh KR, Lishman E, Page A, Donnelly O. The perspectives of peer practitioners and psychologists on the effectiveness of a trauma support programme for healthcare workers. Journal of Work-Applied Management 2025; Ahead-of-print. https://doi.org/10.1108/JWAM-01-2025-0014\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003evan Manen, M. Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. Ontario, CA, USA: State University of New York Press, 1990.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWalters C, Lawn S, Maghidman M, Solich H, McDonald, E, Stevenson T, Sheers C, Simic N, Harms J, Petrakis M. Goodyear M. Mental Health Family Carer Co-Researchers: Co-Production Principles to Elevate Lived-Expertise in Research. Research on Social Work Practice 2025;0(0). https://doi.org/10.1177/10497315251316833\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Domestic and Family Violence, Peer Workers, Lived Experience, Psychologists, Psychological Safety, Mental Health Services, Mental Health Support, Safety, Workplaces, Organisational Culture","lastPublishedDoi":"10.21203/rs.3.rs-8678852/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8678852/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDomestic and family violence (DFV) is a significant issue worldwide. Victim-survivors often engage mental health workers to assist with their recovery, including lived experience peer workers who are an important group increasingly being employed across many types of services, providing support underpinned by mutuality, equality and reciprocity, drawing on their own lived experiences. No studies have investigated peer worker perspectives and experiences regarding their support needs when working with people who have experienced or are experiencing DFV and the support psychologists might provide.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis Australian study employed four qualitative focus groups with lived experience mental health and suicide prevention peer workers. Participants shared perspectives about their support needs when working with people who have experienced DFV, the potential role of psychologists and other professionals in supporting peer workers\u0026rsquo; wellbeing at work, and what they need to promote psychologically safe workplaces that value their lived experience expertise. Lived experience researchers, psychological scientists and psychologists worked collaboratively to analyse data using descriptive thematic analysis methods.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eParticipants included 20 peer workers (18 women / 2 men), working across diverse mental health and suicide prevention service roles in psychosocial and clinical settings. One overarching theme of \u0026lsquo;safety\u0026rsquo; and three subthemes were identified. Safety was seen both as an issue for people that peer workers support as well as psychological safety for themselves in the workplace. Participants spoke about challenges in navigating differences in the expertise, knowledge and practice of peer workers as compared to psychologists and other professionals as part of supporting peer workers\u0026rsquo; wellbeing at work. Participants identified needs as individuals and within organisational culture, practice, and service systems, including greater acknowledgement of their role and expertise, more attention to privacy and confidentiality, education and training for psychologists and other professionals about lived experience peer work, and more explicit focus on DFV within peer workers education and training, peer group reflection and supervision.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eFindings underscore the need for more education and training for all workers supporting people with DFV experiences, including peer workers and psychologists. Addressing these concerns is essential to create psychologically safe workplaces for this important workforce.\u003c/p\u003e\u003ch2\u003eTrial registration\u003c/h2\u003e \u003cp\u003eNot applicable\u003c/p\u003e","manuscriptTitle":"Promoting psychologically safe workplaces for peer workers supporting people who experience domestic and family violence: peer perspectives and the potential role of psychologists","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-27 04:25:41","doi":"10.21203/rs.3.rs-8678852/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-03-27T06:40:20+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-07T11:50:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"151167802202559890638387511161235288746","date":"2026-03-05T18:07:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"305520450307650352515225649925363918727","date":"2026-03-03T18:08:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"270757139555992690170408989437012713894","date":"2026-03-02T07:56:47+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-24T19:58:17+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-23T10:03:31+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-30T17:18:17+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-30T02:06:25+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2026-01-30T02:00:36+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5126f2ca-6a9f-44ac-bcbe-41589c4464c3","owner":[],"postedDate":"February 27th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-27T04:25:41+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-27 04:25:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8678852","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8678852","identity":"rs-8678852","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}