Client advisory councils

Client advisory councils (or consumer councils or service user councils) are opportunities to include and involve people who regularly use the service.

The main purpose is to improve the overall quality of services and service delivery and contribute towards improvement of services so that they are more welcoming and inclusive of clients in the organisation, operations and policies processes.  An important goal of client councils is sustaining and improving effective and good quality user-friendly services.

In some countries (such as the UK, France or the Netherlands), public health laws require agencies to have clients’ involvement through client advisory groups.

A user council can be set up in different ways.  Users can be elected or selected to sit alongside staff representatives and managers.  User councils can also be open to all users who wish to participate along with staff members or managers.

Range of peer support activities

“For some people working at a front desk of a service, opening the door, serving a coffee, is a enormous  achievement. 
From where they might come, for what they do. They deserve respect."

Jason Farrell






There are many sorts of activities that we could consider as some kind of peer support:
it is any type of collaboration that contributes towards the concept of meaningful involvement.

It can be:

  • very professional, independent self-governing agencies that are completely run by peers
  • initiatives that are fully independent in their operations, but are supported by a service
  • advisory councils or consumer groups
  • situations where peers are recruited for specific tasks
  • and even voluntary contributions and support from peers in a service could be considered (basic) peer support.

Peer work can be part of larger initiative comprising many other activities.  It can be the centrepiece around which other activities revolve, or it can stand on its own.  Examples from both ends of the spectrum are a self-mobilised organisation and a ‘client advisory council’.

Peer education

On this website, we will use the term peer education to describe the educational process which includes a substantial distinction and distance between the educator and educated (for instance, teacher-pupil, professional expert-young person).

Difference between peer support and peer education
Within the concept of peer involvement, two terms and methods are often mentioned:  peer education and peer support work. The terms are often used for different methods, sometimes misinterpreted, and all-in-all often lead to confusion.  We will try to avoid this confusion.

The 1995 Trimbos Institute manual on Peer Support, describes the difference between peer support and education like this:

“Although the concepts of peer support and peer education have a lot in common, there are important differences, too.  An important one is that peer education implies and emphasises a disparity between the educator and the educated.  For instance, AIDS prevention projects for drug users are based on the idea that in peer education it is the task of the educator to teach other drug users the rules of safer use and safer sex.

Within the concept of peer support,

  • the idea of mutual support is prevailing
  • The emphasis is more on community and equality, in a flat level of hierarchy setting
  • is a broader concept than education. .... It also can imply creating better conditions for safer use and safer sex, for instance by distributing syringes and needles.

Because of this element of equality and the broader range of the concept, Peer Support fits well in the work of a drug user self-organisation, especially of an interest group.”



Peer Support

The term ‘peer support’ was introduced in the drugs field in the mid-1990s through the use of the 1994 peer support manual by the Trimbos Institute and has been widely used ever since.

This online resource also focuses on peer support:  collaboration between community members and an agency, aiming at meaningful involvement of peers and based on the principles of mutuality and empowerment. see: WHAT IS.....?/Key principles

We will use the term peer support when the method:

  • means that peers undertake more actions/tasks than education only (provision of information).  Peer support can, for instance, include actions to starting self-organising or to strengthen empowerment)
  • aims at individual behaviours, self-esteem and cultural norms, but may also include advocacy to address barriers protecting one’s health and the creation of an enabling environment.
  • has a strong emphasis on the mutuality of the process.  This means individuals who learn from each other and people who support each other, not necessarily in only passing on information or in order to change someone’s behaviour, but probably also in addressing the wider environment and context.



Peer involvement


This online resource is dedicated to the inclusion and participation of meaningful peer involvement.  It describes different aspects and methods and puts meaningful involvement of peers at the heart of the development of policies and the provision of services.
The involvement can vary from client advisory boards, peer employment and  peer-based training to high-profile advocacy networks.

The English term “peer” refers to  ‘equal’:  “…a person who belongs to the same social group as another person or group. The social group may be based on age, sex, sexual orientation, occupation, socio-economic and/or health status, etc.” (Peer Education Training of Trainers Manual, UN Interagency Group on Young People’s Health 2003)

A peer is one that is of equal standing and the basic ‘likeness to’ is essential in peer work.

Peer work in the social and health field is characterised by the following components (Toronto Harm Reduction Task Force)

  • Peers are self-nominated or selected by members of their peer group(s).
  • Peers are volunteers or may receive compensation for their involvement.
  • Peers receive need-based, goal-directed and experiential skill training from a qualified peer trainers.
  • Peers are supervised on a regular basis.
  • Involvement grows with experience. The more experience the peers have, the more they are involved in the selection, training, and supervision of other peers.



Concepts of peer involvement

(based on a model developed by Canadian HIV/AIDS Legal Network)

pyramid of involvementThe model ‘A pyramid of involvement’ shows the different stages of participation, with increasing levels of involvement towards the top of the pyramid.





When we apply this model, we should distinguish the various types of peer work concepts as follows:

  1. At the top of the pyramid, autonomous self mobilisation: an organisation that is actively involved in decision-making in policy and service design (‘Decision-makers’ level).
  2. Peer support, aiming at meaningful involvement collaborations between user initiatives and agencies (‘Experts’ and ‘Implementers’ levels).
  3. Peer education that aims at involving peers as voices of the target group. (‘Speakers’ and Contributors’ levels).
  4. Peer audience to be involved as a target group in, for example, health campaigns and social marketing (‘Target audiences’ level).