Abstract
Peer-delivered services for individuals with psychiatric conditions have proliferated over the past three decades. The values and principles underlying peer support have been explored, but we lack an understanding of its mechanisms of action. To shed light on the processes of peer support, we conducted a study with individuals who had received substantial individual peer support. We completed individual interviews, audiotaped, transcribed, and examined them using a thematic analysis approach. Our analyses suggest that individual peer support provided various practical, emotional, and social supports which were perceived as beneficial. Participants valued having someone to rely on, a friend, and someone to socialize with. We, however, found that individuals’ expectations of peer support did not always comport with available services. Participants viewed peer support as especially valuable because of the opportunity for a non-treatment based, normalizing relationship. We conclude that peer support complements rather than supplants needed traditional mental health services.
Notes
All names have been changed to preserve participant anonymity. “Heather” is a fictitious name given to this study participant.
References
Campbell, J. (2005). The historical and philosophical development of peer run support programs. In S. Clay, B. Schell, P. Corrigan, & R. Ralph (Eds.), On our own, together: Peer programs for people with mental illness (pp. 17–66). Nashville, TN: Vanderbilt University Press.
Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. London: Sage.
Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. E. (2014). Peer support services for individuals with serious mental illnesses: Assessing the evidence. Psychiatric Services, 65(4), 429–441. doi:10.1176/appi.ps.201300244.
Clay, S., Schell, B., Corrigan, P., & Ralph, R. (2005). On our own together: Peer programs for people with mental illness. Nashville, TN: Vanderbilt University Press.
Cohen, S., Mermelstein, R., Kamarck, T., & Hoberman, H. (1985). Measuring the functional components of social support. In I. Sarason & B. Sarason (Eds.), Social support: Theory, research and applications (pp. 73–94). The Hague: Martinus Nijhoff.
Cook, J. A., Copeland, M. E., Jonikas, J. A., Hamilton, M.M., Razzano, L.A., Grey, D. D., … Boyd, S. (2012a). Results of a randomized controlled trial of mental illness self-management using Wellness Recovery Action Planning. Schizophrenia Bulletin, 38(4), 881–891. doi:10.1093/schbul/sbr01.
Cook, J. A., Steigman, P., Pickett, S., Diehl, S., Fox, A., Shipley, P., … Burke-Miller, J. K. (2012b). Randomized controlled trial of peer-led recovery education using Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES). Schizophrenia Research, 136 (1–3), 36–42. doi:10.1016/j.schres.2011.10.016.
Copeland, M., & Mead, S. (2004). Report of the moving ahead study. Waterbury, VT: State Department of Mental Health and Mental Retardation.
Corrigan, P. W., Mueser, K. T., Bond, G. R., Drake, R. E., & Solomon, P. (2008). Peer Services and Supports. Principles and practice of psychiatric rehabilitation: an empirical approach (pp. 359–378). New York: The Guilford Press.
Davidson, L., Chinman, M., Sells, D., & Rowe, M. (2006). Peer support among adults with serious mental illness: A report from the field. Schizophrenia Bulletin, 32(3), 443–450. doi:10.1093/schbul/sbj043.
Deegan, P. (1996, September). Recovery and the conspiracy of hope. Paper presented at the There’s a person in here: The sixth annual mental health services conference of Australia and New Zealand, Brisbane, Australia.
Gartner, A., & Riessman, F. E. (1984). The self-help revolution. New York: Human Sciences.
Harrington, S. (2012). Personal communication about the use of practical supports in peer support to facilitate engagement and bonding.
Holter, M. C., Mowbray, C. T., Bellamy, C. D., MacFarlane, P., & Dukarski, J. (2004). Critical ingredients of consumer run services: Results of a national survey. Community Mental Health Journal, 40(1), 47–63. doi:10.1023/b:comh.0000015217.65613.46.
Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9–16. doi:10.1037/a0022186.
Johnsen, M., Teague, G., & Mc Donel Herr, E. (2005). Common ingredients as a fidelity measure for peer-run programs. In S. Clay, B. Schell, P. W. Corrigan, & R. O. Ralph (Eds.), On our own together: Peer programs for people with mental illness (pp. 213–238). Nashville, TN: Vanderbilt University Press.
Lehman, A. (1983). The well-being of chronic mental patients: Assessing their quality of life. Archives of General Psychiatry, 40(4), 369–373. doi:10.1001/archpsyc.1983.01790040023003.
Lloyd-Evans, B., Mayo-Wilson, E., Harrison, B., Istead, H. Brown, E., Pilling. S., … Kendall, T. (2014). A systematic review and meta-analysis of randomized controlled trials of peer support for people with severe mental illness. BMC Psychiatry, 14(39), 14–39. doi:10.1186/1471-244X-14-39.
MacCallum, J., & Beltman, S. (2002). Role models for young people: What makes an effective role model program. Hobart: Australian Clearing House for Youth Studies.
Mead, S., & MacNeil, C. (2006). Peer support: What makes it unique? International Journal of Psychosocial Rehabilitation, 10(2), 29–37.
Miyamoto, Y., & Sono, T. (2012). Lessons from peer support among individuals with mental health difficulties: A review of the literature. Clinical Practice and Epidemiology in Mental Health, 8, 22–29. doi:10.2174/1745017901208010022.
Moran, G., Russinova, R., Gidugu, V., Yim, J. Y., & Sprague, C. (2012). Benefits and mechanisms of recovery among peer providers with psychiatric illnesses. Qualitative Health Research, 22(3), 304–319. doi:10.1177/1049732311420578.
Nicholson, N. (2012). A review of social isolation. A Journal of Primary Prevention, 33(2–3), 137–152. doi:10.1007/s10935-012-0271-2.
Pitt, V., Lowe, D., Hill, S., Prictor, M., Hetrick, S. E., Ryan, R., & Berends, L. (2013). Consumer-providers of care for adult clients of statutory mental health services. Cochrane Database of Systematic Reviews, 2013, 3. doi:10.1002/14651858.CD004807.pub2.
Riessman, F. (1998). Ten self-help principles. Perspectives, 3(2). Retrieved from http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=358
Rogers, C. R. (1956). Client-centered theory. Journal of Counseling Psychology, 3(2), 115–120. doi:10.1037/h0046548.
Rogers, E. S., Kash-MacDonald, M., & Brucker, D. (2009). Systematic review of peer delivered services literature 1989–2009. Boston: Boston University, Center for Psychiatric Rehabilitation.
Rogers, E. S., Maru, M., Johnson, G., Cohee, J. & Hinkel, J. (2012). The effects of peer support services for individuals with psychiatric disabilities experiencing a civil commitment: Results of a randomized trial. Boston University: Center for Psychiatric Rehabilitation. (unpublished manuscript)
Russinova, Z., Rogers, E. S., Cook, K., Ellison, M. L., & Lyass, A. (2013). Conceptualization and measurement of mental health providers’ recovery-promoting competence: The Recovery Promoting Relationships Scale (RPRS). Psychiatric Rehabilitation Journal, 36(1), 7–14.
Salem, D. A., Gant, L., & Campbell, R. (1998). The initiation of mutual-help groups within residential treatment settings. Community Mental Health Journal, 34(4), 419–429. doi:10.1023/a:1018744225397.
Sells, D., Black, R., Davidson, L., & Rowe, M. (2008). Beyond generic support: The incidence and impact of invalidation within peer-based and traditional treatment for clients with severe mental illness. Psychiatric Services, 59(11), 1322–1327. doi:10.1176/appi.ps.59.11.1322.
Sells, D., Davidson, L., Jewell, C., Falzer, P., & Rowe, M. (2006). The treatment relationship in peer-based and regular case management services for clients with severe mental illness. Psychiatric Services, 57(8), 1179–1184.
Solomon, P. (2004). Peer support/peer provided services: Underlying processes, benefits, and critical ingredients. Psychiatric Rehabilitation Journal, 27(4), 392–401. doi:10.2975/27.2004.392.401.
Van Gestel-Timmermans, H., Brouwers, E. P., Van Assen, M., & van Nieuwenhuizen, C. (2012). Effects of a peer-run course on recovery from serious mental illness: A randomized controlled trial. Psychiatric Services, 63(1), 54–60. doi:10.1176/appi.ps.201000450.
Acknowledgments
Funding for this study was provided by the National Institute on Disability and Rehabilitation Research and the Substance Abuse and Mental Health Administration to the Center for Psychiatric Rehabilitation.
Conflict of interest
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gidugu, V., Rogers, E.S., Harrington, S. et al. Individual Peer Support: A Qualitative Study of Mechanisms of Its Effectiveness. Community Ment Health J 51, 445–452 (2015). https://doi.org/10.1007/s10597-014-9801-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-014-9801-0