Peer support is a way of relating to someone through shared humanity and core commonalities with the goal to offer and/or receive support. Simply being human, there are things we have in common: having parents, acquiring the skills to communicate, adjusting to the changes in our environment and being a part of society – even these, the most basic aspects of our lives can be used to create a connection with someone.
We belong to many peer groups (classmates, work colleagues, friends etc.) and in its widest form peer support can be used in most settings, because we are surrounded by people we could consider our peers. While supporting someone close to us is a learnable skill, it is also a rather natural part of our everyday interactions. We often find ourselves listening and offering help without realising it. Peer support can take place between any two people in a peer group in different situations, be it in person or online.
Peer support in the mental health field is offered by an individual who has a lived experience of trauma, psychiatric diagnosis and/or emotional distress, after doing some work with their experience and learning the core principles of peer support. The commonalities in mental health peer support can vary – you may share a diagnosis of a particular mental health problem or a difficult experience such as losing a loved one, divorce, work or relationship related struggles, etc.
In peer support the views and experiences of all the people involved are equally valued, there is no promoting a certain method or way of thinking. How much support a member of the peer group gives and receives depends on what feels right for them at that moment.
1.2. What does a peer supporter do?
A peer supporter can have different ways of providing support that depend on their individual competencies and the situation. At the core of any peer support relationship there is the connection as equals with the purpose of aiding in the recovery process of the recuperating party.Here are some examples of how peer support can be implemented:
- Providing support through listening and conversation
- Offering practical help with everyday tasks
- Sharing parts of the supporters’ own lived experience
- Advocating for people in recovery
- Sharing resources for finding help, information
- Teaching self-care skills
- Building communities and support networks
- Leading peer support groups
- Formulating a unique recovery plan with the peer
- Managing peer support projects
1.3. Skills of a peer supporter
In both formal (as a part of projects, in organisations, at events) and informal settings (within their personal peer groups), peer supporters are generally expected to be skilled in communication, have the ability to listen actively and show empathy in relation to the peer. Acting as a peer supporter will increase these skills and many others, as the person encounters various situations and issues and gets to practice their competencies.
Here is a set of basic skills that a peer supporter should have:
- Building Interpersonal Relations
They interact in a manner that honours the dignity of others and strives to create positive respectful relationships. They show genuine interest in their peers. Even in a difficult or tense situation they strive to maintain a level of respect and consideration for the other.
They are sensitive to what the other person might be feeling, show non-judgmental empathy, and respond in a manner that is equal, genuine, and personal. They self-disclose their own experience selectively and in a manner that ensures the relationship remains peer focused.
They listen with empathy and without judgement, holding their peers in unconditional high regard. They use different communication styles and skills to improve their understanding and adapt the style and tone of communication to suit the peer and the situation. They communicate using recovery language (using the words a person uses to describe themselves, their experience and what has helped) and emphasise the strengths of their peers.
- Critical Thinking
They engage in empathic listening (definition and explanation can be found under the topic Communication Skills, section 6.3 – Empathic Listening) to better understand a situation and recognize that there is more than one way to look at an issue. They consider the possible implications or outcomes of their actions and, when asked, will help peers to explore the outcome or possible consequences of various options. They demonstrate good judgement in respecting the limits and boundaries of their role.
- Inspiring Hope
They operate from a sense of hope, expressing confidence that others will be successful in their own personal journeys of recovery. They strive to model realistic optimism and a belief that even in difficult situations positive choices can be made.
- Self-Management & Resiliency
They understand the importance of self-care and stress management and use the practices that work best for them to remain healthy while supporting others. They strive to maintain calm and diffuse stressful or challenging situations.
- Flexibility & Adaptability
They are open to new ideas, deal comfortably with ambiguity, and adjust plans or behaviours to better suit the given situation. They are willing to be open-minded and compromise when needed.
- Self-Awareness & Confidence
They interact in a manner that demonstrates a balance of self-confidence with openness to the thoughts and opinions of others. They self-reflect and understand that personal thoughts and attitudes can influence their behaviour and actions.
- Taking Initiative & Committing
They are dependable and carry tasks out to completion. They demonstrate good judgement, knowing when insight or assistance should be requested from another and are trustworthy when working independently.
They share knowledge, ideas and resources with team members in a cooperative and collaborative manner. They strive to fulfil their role and responsibility within the team while respecting the roles and responsibilities of the other team members.
- Continuous Learning & Development
They strive to approach life and work with curiosity, identify areas where personal growth may be helpful, and take advantage of opportunities to learn and develop. They recognize the value of on-going personal growth and skill development and maintain a connection with a peer support community as a resource to stay ‘grounded’ in the work of authentic peer support.
Source: Peer Support Canada
It is important to note that while these are all useful skills to develop and use in peer support, we all have our strengths and weaknesses and there is no perfect peer supporter. Rather than attempting to be great at everything, it is best to apply the capabilities you already have and keep an open mind towards learning other skills that would be helpful. Aside from offering support to those that need it, peer supporters are usually also there for each other and help other peer supporters to manage their shortcomings.
1.4. Contexts for peer support
The type of peer support used is often influenced by the context where it takes place and the other way around. For example, peer support group meetings can not be held spontaneously at a random location. In public areas it can be very difficult to talk about more painful topics and time restrictions naturally hinder longer discussions. It’s normally up to the peer supporter to be aware of the possibilities and limits of the situation they are in and to adjust them accordingly by moving to a different space, setting up a new meeting and, when lacking the time and energy to properly be there for the person needing help, introducing them to another peer supporter.
Here are some of the situations and places where peer support can take place:
- Informal peer support – occurs naturally and can happen literally anywhere. It only takes two people sharing a moment in order to find something they have in common and establish a connection.
- Clubhouse/walk-in centre – due to their social recreational focus, they provide the space and opportunities for people with shared experiences to meet and discuss those experiences.
- Self-help, mutual peer support – often takes place in peer-run organisations, activities and programs. United by a common goal, the people participating already have a reason to communicate and perhaps some awareness of each other’s troubles. Between members of groups working towards some achievement, peer support is a voluntary, natural and reciprocal action, but also a necessary tool for the stability and wellbeing of the team.
- Peer-run services within community settings (either in a group or one-to-one) focusing on topics such as education, employment, mental health, advocacy, are usually the context for most formal and intentional peer support by offering peer support groups and having volunteers ready to offer assistance to those that may need it.
- Workplace peer support – informal peer support employees with lived experience are selected and prepared to provide peer support to other employees within their workplace. Informal peer support takes place between colleagues naturally, as they share their difficulties, concerns and achievements with each other.
- Community setting clinical peer support – peer support workers are selected to provide support to patients/clients that utilise clinical services, e.g., outpatient, A.C.T. (Assertive Community Treatment) teams, case management, counselling, offering valuable insights into the client side of the process.
- Clinical/conventional mental health system – In the clinical settings, with inpatient/outpatient services, like multidisciplinary groups, recovery centres, or rehabilitation centres, emergency rooms, acute wards, peers can also be involved in offering support. There, peer support often takes place in groups or as informal connections between people using the same services.
1.5. Types of peer support
When learning about peer support, you might get the feeling that you have already been practising it without being aware of it. And you are probably right – listening to someone when they open up to you, giving them your time and attention, offering some kind words or advice are all important parts of peer support.
Peer support can take many shapes, with the informal ones happening spontaneously and naturally, especially when people witness one another in difficult moments and do their best to offer some comfort, and the more formal ones in organisations and public services, for which peer supporters may need a special certification and training.
In the graph below you can see several types of peer support, from the most informal to the most formal. What makes them different from each other are the contexts where they happen, and aspects like the following:
- Does the support occur spontaneously or is intentional?
- The degree of structure around the support – is it talking to an acquaintance about your concerns or do you need to make an appointment; is it a natural and reciprocal part of a conversation or a mental health service?
- Is it an everyday occurrence or do the peer supporters have to get a certification in order to practice it?
- Is it a casual, unplanned process or are there clear organisational rules and standards around the practice of peer support?
- Can it take place whenever, wherever or is it bound to specific settings like a mental health centre or one’s workplace?
Review of literature on peer support (in the Journal of Mental Health, 2011): click here to open it
A Handbook For Individuals Working in Peer Roles, by Sera Davidow of the Western Mass Recovery Learning Community: click here to open it