Peer support


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, reflective listening, or counseling. Peer support is also used to refer to initiatives where colleagues, members of self-help organizations and others meet, in person or online, as equals to give each other connection and support on a reciprocal basis.
Peer support is distinct from other forms of social support in that the source of support is a peer, a person who is similar in fundamental ways to the recipient of the support; their relationship is one of equality. A peer is in a position to offer support by virtue of relevant experience: he or she has "been there, done that" and can relate to others who are now in a similar situation. Trained peer support workers such as peer support specialists and peer counselors receive special training and are required to obtain Continuing Education Units, like clinical staff. Some other trained peer support workers may also be law-enforcement personnel and firefighters as well as emergency medical responders The social peer support also offers an online system
of distributed expertise, interactivity, social distance and control, which may promote
disclosure of personal problems.

Underlying theory

Peer support has been shown to be effective in substance use and related behaviour, treatment engagement, and ameliorating risk behaviours associated with HIV and hepatitis C, and empowering people with mental illness and improving their quality of life. Its effectiveness is believed to derive from a variety of psychosocial processes first described by Mark Salzer and colleagues in 2002: social support, experiential knowledge, social learning theory, social comparison theory, the helper-therapy principle, and self-determination theory.
  • 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, instrumental support, companionship and information support.
  • 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: increased sense of interpersonal competence as a result of making an impact on another person's life; development of a sense of equality in giving and taking between himself or herself and others; helper gains new personally-relevant knowledge while helping; and the helper receives social approval from the person they help, and others.
  • Self-determination means that individuals have the right to determine their own future—people are more likely to act on their own decisions rather than decisions made by others for them.

    In schools and education

Peer mentoring

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.

Peer listening

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 program, to be "active listeners". Within schools, peer supporters are normally available at break or lunch times.

Peer mediation

Peer mediation is a means of handling incidents of bullying by bringing the victim and the bully together under mediation by one of their peers.

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, emotional support, training support, and social support.

In health

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 increasingly being offered through digital health like text messaging and smartphone apps. 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. The role of peer workers in mental health services was the subject of a conference in London in April 2012, jointly organized 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. By matching users with individuals of similar live experience, digital peer-supports platforms like Supportiv, co-founded by Pouria Mojabi, aim to increase emotional openness and reduce stigma. A review found that peer support could aid recovery, symptoms of depression, and self-belief. It found that service users valued peer support workers, and that peer support workers themselves had improved wellness and recovery. There is considerable variety in the ways that peer support is defined and conceptualized as it relates to mental health services. In some cases, clinicians, psychiatrists, and other staff who do not necessarily have their own experiences of receiving psychiatric treatment are being trained, often by psychiatric survivors, in peer support as an approach to building relationships that are genuine, mutual, and non-coercive.

For anxiety and depression

In Canada, the LEAF 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 with 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.
Several studies have shown that peer support reduces fear during stressful situations such as combat and domestic violence and may mitigate post-traumatic stress disorder. The 1982 Vietnam-Era Veterans Adjustment Survey showed that PTSD was highest in those men and women who lacked positive social support from family, friends, and society in general.

For first responders

Peer support programs have also been implemented to address stress and psychological trauma among law-enforcement personnel and firefighters as well as emergency medical responders. Peer support is an important component of the critical incident stress management program used to alleviate stress and trauma among disaster first responders.

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 survivors of domestic violence and for women in prison.
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 , , and . A study of 470 amputee survivors of war-related violence in six countries showed that nearly one hundred percent said they had benefited from peer support.
A peer support program operated by the in Burundi with support from the Center for International Stabilization and Recovery and Action on Armed Violence has assisted survivors of war-related violence, including women with disabilities, and female ex-combatants since 2010. A similar program in Rwanda works with survivors of the Rwandan genocide. Peer support has been recommended as a fundamental part of victim assistance programs for survivors of war-related violence.
A 1984 study on the impact of peer support and support groups for victims of domestic violence showed that 146 battered women found women's peer support groups the most helpful source of a range of available treatments. The women in these groups appeared to give direct advice and to act as role models. A 1986 study on 70 adolescent mothers considered to be at risk for domestic violence showed that peer support improved cognitive problem-solving skills, self-reinforcement, and parenting competence.
Pandora's Aquarium, an online support group operating as part of Pandora's Project, offers peer support to survivors of rape and sexual abuse and their friends and family.