||The examples and perspective in this article may not represent a worldwide view of the subject. (April 2013)|
Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other. It commonly refers to an initiative consisting of trained supporters, and can take a number of forms such as peer mentoring, listening, or counseling. Peer support is also used to refer to initiatives where colleagues, members of self-help organizations and others meet as equals to give each other support on a reciprocal basis. Peer in this case is taken to imply that each person has no more expertise as a supporter than the other and the relationship is one of equality.
The effectiveness of peer support is believed to derive from a variety of psychosocial processes described best by Mark Salzer in 2002: social support, experiential knowledge, social learning theory, social comparison theory and the helper-therapy principle.
- Social support is the existence of positive psychosocial interactions with others with whom there is mutual trust and concern. Positive relationships contribute to positive adjustment and buffer against stressors and adversities by offering emotional support (esteem, attachment, and reassurance), instrumental support (material goods and services), and information support (advice, guidance, and feedback).
- Experiential knowledge is specialized information and perspectives that people obtain from living through a particular experience such as substance abuse, a physical disability, chronic physical or mental illness, or a traumatic event such as combat, a natural disaster, domestic violence or a violent crime, sexual abuse, or imprisonment. Experiential knowledge tends to be unique and pragmatic and when shared contributes to solving problems and improving quality of life.
- Social learning theory postulates that peers, because they have undergone and survived relevant experiences, are more credible role models for others. Interactions with peers who are successfully coping with their experiences or illness are more likely to result in positive behavior change.
- Social comparison means that individuals are more comfortable interacting with others who share common characteristics with themselves, such as a psychiatric illness, in order to establish a sense of normalcy. By interacting with others who are perceived to be better than them, peers are given a sense of optimism and something to strive toward.
- The helper-therapy principle proposes that there are four significant benefits to those who provide peer support: (a) increased sense of interpersonal competence as a result of making an impact on another person's life; (b) development of a sense of equality in giving and taking between himself or herself and others; (c) helper gains new personally-relevant knowledge while helping; and (d) the helper receives social approval from the person they help, and others.
Peer support in schools and education
Peer mentoring takes place in learning environments such as schools, usually between an older more experienced student and a new student. Peer mentors appear mainly in secondary schools where students moving up from primary schools may need assistance in settling into the whole new schedule and lifestyle of secondary school life. Peer mentoring is also used in the workplace as a means of orienting new employees. New employees who are paired with a peer mentor are twice as likely to remain in their job than those who do not receive mentorship.
This form of peer support is widely used within schools. Peer supporters are trained, normally from within schools or universities, or sometimes by outside organizations, such as Childline's CHIPS (Childline In Partnership With Schools) program, to be "active listeners". Within schools, peer supporters are normally available at break or lunch times.
Peer helper in sports
A peer helper in sports works with young adults in sports such as football, soccer, track, volleyball, baseball, cheerleading, swimming, and basketball. They may provide help with game tactics (e.g. keeping your eye on the ball), emotional support, training support, and social support.
Peer support in mental health
Peer support can occur within, outside or around traditional mental health services and programs, between two people or in groups. Peer support is a key concept in the recovery approach and in consumer-operated services programs. Consumers/clients of mental health programs have also formed non-profit self-help organizations, and serve to support each other and to challenge associated stigma and discrimination. Organizations that offer peer support services for people with mental health problems include Fountain House, Emotions Anonymous, the Depression and Bipolar Support Alliance (DBSA), GROW, Wildflowers' Movement and Recovery International. The role of peer workers in mental health services was the subject of a conference in London in April 2012, jointly organised by the Centre for Mental Health and the NHS Confederation. Research has shown that peer-run self-help groups yield improvement in psychiatric symptoms resulting in decreased hospitalization, larger social support networks and enhanced self-esteem and social functioning. Organizations such as the Samaritans, Nightline, and Aware provide peer support to people in emotional distress.
Peer support in addiction
Twelve-step programs for overcoming substance misuse and other addiction recovery groups are often based on peer support. Since the 1930s Alcoholics Anonymous has promoted peer support between new members and their sponsors: "The process of sponsorship is this: an alcoholic who has made some progress in the recovery program shares that experience on a continuous, individual basis with another alcoholic who is attempting to attain or maintain sobriety through AA." Other addiction recovery programs rely on peer support without following the twelve-step model.
Peer support for anxiety and depression
In Canada, the LEAF (Living Effectively with Anxiety and Fear) Program is a peer-led support group for cognitive-behavioral therapy of persons with mild to moderate panic disorders.
In a 2011 meta-analysis of seven randomized trials that compared a peer support intervention to group cognitive-behavioral therapy in patients suffering from depression, peer support interventions were found to improve depression symptoms more than usual care alone and results may be comparable to those of group cognitive behavioral therapy. These findings suggest that peer support interventions have the potential to be effective components of depression care, and they support the inclusion of peer support in recovery-oriented mental health treatment.
Peer support in chronic illness
Peer support has been beneficial for many people living with diabetes. Diabetes encompasses all aspects of people's lives, often for decades. Support from peers can offer emotional, social, and practical assistance that helps people do the things they need to do to stay healthy. Peer support groups for diabetics complement and enhance other health care services.
Peer support for first responders
Peer support programs have also been implemented to address stress and psychological trauma among law-enforcement personnel and firefighters. Peer support is an important component of the critical incident stress management program used to alleviate stress and trauma among disaster first responders.
Peer support for people with disabilities
Peer support is considered to be a key component of the independent living movement and has been widely used by organizations that work with people with disabilities, including the Amputee Coalition of America (ACA) and Survivor Corps. Since 1998 the ACA has operated a National Peer Network for survivors of limb loss. The Blinded Veterans Association has recently launched Operation Peer Support (OPS), a program designed to support men and women returning to the US blinded or experiencing significant visual impairment in connection with their military service. Peer support has also benefited survivors of traumatic brain injury and their families. There is also FacingDisability for Families Facing Spinal Cord Injuries, which has a peer counseling program in addition to 1,000 videos drawn from interviews of people with spinal cord injuries, their families, caregivers and experts.
Survivor Corps defines peer support for trauma survivors as "Encouragement and assistance provided by a colleague who has overcome similar difficulties to engender self-confidence and autonomy and to enable the survivor to make his or her own decisions and implement them." Peer support is a fundamental strategy in the rehabilitation of landmine survivors in Afghanistan, Bosnia, El Salvador and Vietnam. A study of 470 amputees in six countries showed that nearly one hundred percent said they had benefited from peer support.
Peer support for survivors of trauma
Peer support has been used to help survivors of trauma, such as refugees, cope with stress and deal with difficult living conditions. Peer support is integral to the services provided by the National Center for Trauma-Informed Care. Other programs have been designed for female victims of domestic violence and for women in prison.
Peer support for veterans and their families
Several programs exist that provide peer support for military veterans in the US and Canada. In 2010 the Military Women to Women Peer Support Group was established in Helena, MT.
The Tragedy Assistance Program for Survivors (TAPS) provides peer support, crisis care, casualty casework assistance, and grief and trauma resources for families of members of the US military. Operation Peer Support (OPS) is a program for US military veterans who were blinded or have significant visual impairment.
In January 2013 Senator Patty Murray, Chairman of the United States Senate Committee on Veterans' Affairs, sponsored an amendment of the National Defense Authorization Act (S.3254) that would require peer counseling as part of a comprehensive suicide prevention program for US veterans.
- Certified Peer Support Specialist
- Lay community counsellor
- Peer mentoring
- Person centered planning
- Self-help groups for mental health
- Shery Mead, David Hilton, Laurie Curtis, "Peer Support: A Theoretical Perspective."
- Salzer, Mark (2002). "Consumer-delivered services as a best practice in mental health care and the development of practice guidelines". Psychiatric rehabilitation skills 6: 355–382..
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- From Salzer and Shear, S. L. (2002), p. 282.
- Steve Grbac, "How to implement a ‘Peer Support’ program in a P-6 School,” Scotch College Junior School, Melbourne Australia, June 2008.
- Kaye, Sharon; Jordan-Evans (2005). Love 'Em or Lose Em: Getting Good People to Stay. San Francisco: Berrett-Koehler Publishers, Inc. p. 117. ISBN 978-1-57675-327-9.
- Helen Cowie, Patti Wallace, Peer Support in Action: From Bystanding to Standing By, Sage Publications Ltd; 1st edition February 2001; ISBN 0-7619-6353-7
- Sandy Hazouri, Miriam Smith McLaughlin, Peer listening in the middle school: training activities for students. Educational Media Corp., 1991. ISBN 978-0-932796-34-9
- Chrissan Moldrich and J.D. Carpentieri, "Every school should have one: How peer support schemes make schools better," ChildLine, January 2008, ISBN 0-9524948-8-4.
- Joel H. Brown, Marianne D'Emidio-Caston, Bonnie Benard, Resilience Education, Corwin Press, 2001. ISBN 978-0-7619-7626-4
- Cheryl Sanders (Editor), Gary D. Phye (Editor), Bullying: Implications for the Classroom, Academic Press; 1st edition May 14, 2004; ISBN 0-12-617955-7.
- "Creating a Positive Climate: Peer Mediation; What Works in Preventing School Violence."
- Cremin, Hilary, Peer Mediation: Citizenship and Social Inclusion in Action. Maidenhead: Open University Press, September 2007; ISBN 0-335-22111-4.
- Thompson, S. M., "Peer mediation: A peaceful solution." School Counselor, 1996, 44:151-154.
- John DeMarco, Peer helping skills: a leader's guide to training peer helpers and peer tutors for middle and high school. Hazelden Publishing, 1993. ISBN 978-1-56246-090-7
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- Campbell, J. The Consumer-Operated Services Program (COSP) Multisite study, Missouri Institute of Mental Health, St. Louis, 2010.
- Ochocka, J., Janzen, R., & Nelson, G. (2002). "Sharing Power and Knowledge: Professional and Mental Health Consumer/Survivor Researchers Working Together in a Participatory Action Research Project." Psychiatric Rehabilitation Journal, 25(4), 379.
- Shery Mead and Cheryl MacNeil, "Peer Support: What Makes It Unique?", December 2004.
- Davidson. I., Chinman. M. J.. Kloos. B., Weingarten, R., Stayner. D. A., & Tebes. J. K. (1999). "Peer support among individuals with severe mental illness: A review of the evidence." Clinical Psychology: Science and Practice, 6(2), 165-187.
- "Peer Support Research: A Promising New Approach."
- Jean Campbell and Judy Leaver, "Emerging New Practices in Organized Peer Support," National Association of State Mental Health Program Directors (NASMHPD) and the National Technical Assistance Center for State Mental Health Planning (NTAC), March 2003, p. 17.
- Center for Substance Abuse Treatment, "What are Peer Recovery Support Services?" HHS Publication No. (SMA) 09-4454. Rockville, MD: Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 2009.
- "Questions & Answers on Sponsorship," Alcoholics Anonymous World Services, Inc. 2005, p. 7.
- Sherman, B. R., L. M. Sanders, et al. (1998). Addiction and pregnancy: empowering recovery through peer counseling. Westport, Conn., Praeger.
- Colombo Plan Drug Advisory Programme. (2003). Development of family and peer support groups: a handbook on addiction recovery issues. CPDAP, Colombo.
- Shelley Jones, "The LEAF Program: Peer-led Group CBT," Visions: BC's Mental Health and Addictions Journal, Vol 6, no. 1 2009, pp. 16-17.
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- Carol A. Brownson & Michele Heisler, 2009. "The Role of Peer Support in Diabetes Care and Self-Management," The Patient: Patient-Centered Outcomes Research, Wolters Kluwer Health; Adis, vol. 2(1), pages 5-17.
- Michelle Heisler, "Building Peer Support Programs to Manage Chronic Disease: Seven Models for Success," California Healthcare Foundation, December 2006.
- Peer Support Network, an internet-based peer support service for newly diagnosed cancer patients, cancer survivors and their caregivers.
- Peer Adherence Support Manual, A Manual for Program Managers and Supervisors of Peer Workers; Harlem Adherence to Treatment Study, Harlem Hospital Peer Support for HIV Treatment Adherence, 2003.
- AIDS Information Center, Uganda
- Fidaner C, Eser SY, Parkin DM (2001), Peer to Peer. HIV & AIDS Peer Educators Trainers' Guide for IMPACT Implementing Agencies in Nigeria. Family Health International.
- BCNS's Breast Cancer Survivor Match Program
- Rachelle Katz, Daniel I. Cohen and Ronnie M. Hirsh, Cop to Cop: A Peer Support Training Manual for the Law Enforcement Officer, Peer Support Press; 2nd edition, January 1, 2000. ISBN 978-0-9669496-3-6
- Grauwiler, Peggy; Barocas, Briana; Mills, Linda G, "Police peer support programs: current knowledge and practice," International Journal of Emergency Mental Health, vol. 10, no. 1, pp. 27-38, Winter 2008.
- Dowdall-Thomae, Cynthia; Culliney, Sean; Piechura, Jeff, "Peer Support Action Plan: Northwest Fire and Rescue," International Journal of Emergency Mental Health, vol. 11, no. 3, pp. 177-184, Summer 2009.
- Jones, Norma S C; Majied, Kamilah, "Disaster mental health: a critical incident stress management program (CISM) to mitigate compassion fatigue," Journal of Emergency Management, vol. 7, no. 4, pp. 17-23, July/August 2009.
- Hibbard MR, Cantor J, Charatz H, Rosenthal R, Ashman T, Gundersen N, et al. "Peer support in the community: Initial findings of a mentoring program for individuals with traumatic brain injury and their families." The Journal of head trauma rehabilitation, 2002;17(2):112.
- Jerry White, I Will Not Be Broken, (published in paperback as Getting Up When Life Knocks You Down,).
- Ken Rutherford, "Peer-to-Peer Support Vital to Survivors," Journal of ERW and Mine Action, Issue 14.2, Summer 2010, p. 5.
- Beth Sperber Richie, Angela Ferguson, Zahabia Adamaly, Dalia El-Khoury, Maria Gomez, "Paths to Recovery: Coordinated and Comprehensive Care for Landmine Survivors," Journal of Mine Action Dec 2002, 6.3: 66-69.
- Macauley C, Townsend M, Freeman M, Maxwell B. “Peer Support and Recovery from Limb Loss in Post-Conflict Settings,” Journal of ERW and Mine Action, Issue 15.2, Summer 2011, pp. 17-20.
- Macauley, C. "Peer Support and Trauma Recovery," Journal of ERW and Mine Action, Issue 15.1, Spring 2011, pp. 14-17.
- Project ABLE's Trauma Survivor Peer Support Project in Oregon
- Josi Salem-Pickartz, 2008: Strengthening community mental health resources by training refugees as peer counsellors – a manual for trainers, Intervention, The War Trauma Foundation and the Al Himaya Foundation for Trauma Recovery, Growth and Resilience.
- Nancy Baron, On the road to peace of mind War Trauma Foundation, 2009. ISSN 1571–8883.
- Fearday F.L., Cape A.L., "A voice for traumatized women: inclusion and mutual support." Psychiatric Rehabilitation Journal, 2004 Winter;27(3):258-65.
- Blanchette, K., Eljdupovic-Guzina, G. (1998). "Results of a pilot study of the Peer Support Program for Women Offenders." Edmonton, Research Branch, Correctional Service of Canada.
- "Pandora's Aquarium". pandys.org. 2011 [last update]. Retrieved August 29, 2011.
- Vets4Vets, a non-partisan organization dedicated to helping Iraq and Afghanistan-era veterans to heal from the psychological injuries of war through the use of peer support.
- Statewide Advocacy for Veterans' Empowerment (SAVE)
- Resnick, Sandra Gail; Rosenheck, Robert A: "Integrating peer-provided services: a quasi-experimental study of recovery orientation, confidence, and empowerment," Psychiatric Services, vol. 59, no. 11, pp. 1307-1314, November 2008.
- The Operational Stress Injury Social Support (OSISS) Program for Canadian Veterans. See also "Evaluation of the OSISS Peer Support Network," Dept. of National Defence and Veterans Affairs Canada, January 2005.
- Heber, A., Grenier, S., Richardson, D., Darte, K. (2006). "Combining Clinical Treatment and Peer Support: A Unique Approach to Overcoming Stigma and Delivering Care." In Human Dimensions in Military Operations – Military Leaders’ Strategies for Addressing Stress and Psychological Support; Neuilly-sur-Seine, France, Canadian Department Of National Defence.
- Richardson, J. D., K. Darte, et al. (2008). "Operational Stress Injury Social Support: a Canadian innovation in professional peer support." Can Mil J 9: 57-64.
- Eve Byron, "Helena area is home to 1st ‘Military Women to Women Peer Support Group’ for those with PTSD," Independent Record, The Billings Gazette, August 3, 2010.
- "MILITARY SUICIDE: Murray Effort to Create Standardized Suicide Prevention Program Signed into Law by President Obama."