Getting By With a Little Help From Your Friends

Two women sit on a bench outside talking and laughing

Laughter: The Best Medicine — Peer Support Specialist Sarah Oury (Right) shares a story with Veteran Naomi Winley at the San Diego VA.

“Calm down.”

Apparently, that’s the one thing you don’t want to say to someone who’s come to you seeking solace and advice, but whose emotions are getting a bit escalated as they talk about the pain and anger they’re feeling inside.

“De-escalating someone is an art,” said Sarah Oury, a former Army captain who now works as a peer support specialist at the San Diego VA. Her job is to provide comfort, support and hope to fellow Veterans suffering with post traumatic stress disorder and other mental health challenges.

A Little Respect

“I find that when the Veteran feels respected and heard, the anger begins to disappear,” she explained. “Some people are good at it; some aren’t. I needed people to be really good at it with me, because I was carrying around a lot of anger after I left the military in 2006. I was diagnosed with PTSD. But people at the VA helped me, they were there for me and now I’m trying to help other Veterans like me.”

There are 11 peer support specialists at San Diego and roughly 800 at VA sites nationwide. They represent VA’s newest and perhaps most promising strategy to get Veterans struggling with mental issues to come in for help.

“You shouldn’t have to navigate your way through the VA health care system by yourself,” Oury said. “You need a guide. You need an advocate. That’s what I’m here for.”

Oury said her primary job is to simply share her personal story with her clients. “It can be very therapeutic for them and for you,” she observed. “Doing this job helps you work on your own self-recovery. Because recovery is never a done deal, it’s always an ongoing process. I’m still mending some of my own relationships.”

 I find that when the Veteran feels respected and heard, the anger begins to disappear. 

A Unique Approach

“Peer support specialists are unique, because they’re the only health care providers in VA who are trained to use their own life experiences to help their clients,” explained Dr. Christine Rufener, a staff psychologist who runs the peer support program at San Diego. “As a psychologist, I’m not able to do that because of ethical issues related to doctor-client boundaries.

“Your peer support specialist,” she added, “is someone who’s made it to the other side. They’ve recovered from their own mental health challenges, so they’re in a position to instill hope.”

‘Hope’ is something Phil Clough is just now beginning to get a grip on. The Navy Veteran was the victim of military sexual trauma back in the 1980’s and spent years drinking and drugging to numb the pain.

“I kept a secret for nearly 30 years and it almost killed me,” he said. “I put it in a box somewhere in the back of my head and tried to keep the box closed. I buried it.”

Clough admits he was near the end of his rope when he finally decided enough was enough.

“When I came to the VA for help, I was shattered,” he said. “I was suicidal. I was homicidal. I had a lot of anger.”

But then a peer support specialist named Eric showed up at his side.

A woman sitting at an office desk

Dr. Christine Rufener

All The King’s Horses

“When I first met Eric, we talked for about an hour,” Clough said. “When I come to the VA now, the first person I ask for is Eric.”

The Navy Veteran said he now has three peer support specialists who are helping him stay on course during his treatment program at the VA.

“I do what they tell me to do,” he said. “If they tell me to go see my counselor, I go see my counselor. If they tell me to go to group therapy, I go to group therapy. They put me touch with the right people who can help me.”

He added: “They did the one thing that all the king’s horses and all the king’s men couldn’t do. They put me back together. I still have a long way to go. I’m damaged. But if I need them I know they’ll always be there for me.”

And when you’re a peer support specialist, ‘being there’ sometimes involves more than just showing up for work at the office.

“In some cases I’ll actually go out to the Veteran’s house,” said Sarah Oury. “Sometimes, when you’re that depressed, you can’t even get out of bed. So you certainly can’t get yourself in to the VA. Someone needs to come to you. If that’s what it takes, that’s what I’ll do.”

Avoiding Burn Out

Christine Rufener said this kind of dedication, however, can be a double-edged sword.

“These are highly motivated people,” she observed. “They got the help they needed from VA and now they’re very motivated to help other Veterans. But this is not easy work. It can be stressful, which is why we continue to support them. They receive personalized, individual supervision from psychologists who ensure they are taking care of themselves while they’re taking care of others.

“Let’s face it,” she added. “This kind of work can take a toll on you.”

Rufener said peer support specialists undergo 80 hours of training and must pass an exam before they can begin counseling fellow Veterans. “These are full-time positions,” she said. “There are no specific educational requirements, but this is challenging work and it takes a special kind of person to do it.”

Of course, every ambitious new initiative that gets launched is going to have some wrinkles that need ironing out, right? So is there anything about VA’s peer support program Rufener would change if she had the chance?

“Yes,” she said. “I’d hire more peer support specialists.”

To find out about a career in VA’s Peer Support Program, visit

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