This thread is hosted somewhat incongruously by the 'Mediumship' forum. The notion/principle concerning spirit-guides, however, is one that applies to us all, mediums, psychics and non-sensitives alike.
Those fortunate to have conscious awareness of a helper, or helpers may be, or may be becoming, mediums but in terms of spirit-guides there's nothing obviously special just for them. Some mediums are aware they are being supported, maybe even directed, but a personal spirit guide may provide support very different from that provided by their helper(s), supported and/or directed in ways the medium may not be aware of.
There's a frequent misunderstanding concerning psychic awareness/sensitivity and the 'spirit-side' support of that situation. It's evident there's a similar, frequent misunderstanding about psychic awareness/sensitivity and mediumship.
It would be very helpful to hear more from a range of evidential, teaching or healing mediums able to explain clearly their own awareness of whomever is around and supporting them.