Making Recovery Real: Improving Employment Outcomes Using Peer

Support Services

What is Peer Support?

Peer Support is a system of giving and receiving support, information, and guidance, founded on the key principles of respect, shared responsibility, and mutual agreement.

Peer Support is about understanding another’s situation empathically through the shared experience of emotional and psychological pain.

What Peer Support is Not• Peer Support is not based on

psychiatric models or diagnostic criteria

• Peer Support is not intended to replace any existing mental health services, but rather is an opportunity to enrich the provision of mental health services through the direct participation and expertise of peers.

Principles of Peer Support

2 Major Principles:

Peer Principle• Peer relationships tend to involve greater reciprocity

& mutuality, encouraging each participant to be the giver as well as the receiver of support

Helper’s Principle• Helping is therapeutic—the person who is helping

benefits as well…is truly a 2 for 1 deal

Formalized peer support is based on the concept of educating, training and employing peer specialist workers whose primary initial qualification is their lived experience of mental health problems and recovery.

Why it Works?

A man falls into a hole so deep he can’t get out. A doctor walks by, and the man calls for help. The doctor writes a prescription, tosses it into the hole, and walks on. A priest walks by, and the man tries again. The priest writes a prayer, tosses it into the hole, and walks on. Finally a friend walks by, and again the man asks for help. To his surprise, the friend jumps in with him. “Why did you do that?” the man asks. “Now we’re both in the hole.” “Yes,” the friend responds. “But I’ve been in this hole before, and I know the way out.”

Why it Works?• Research tells us that the quality of the

relationship is the most influential component of mental health treatment

• We know that recovery occurs along a “change continuum,” – Peers are especially adept at moving folks along the continuum by offering hope, motivation, and living proof that treatment works and recovery is possible.

• Peer Support works because the process of sharing common experiences readily leads to the formation of trusting relationships

How Do We Know?• Research shows that participation in

peer/mutual support yields improvement in psychiatric symptoms and decreased hospitalization, larger social support networks and enhanced self-esteem & social functioning.

• Research also tells us that participation in peer/mutual support improves communication with providers—that is individuals report an easier time communicating with their doctor and clinical team and are more willing to take medications and learn ways to cope with side effects.

(Galanter, 1988; Kennedy, 1990; Kurtz, 1988; Carpinello, Knight, & Janis, 1991; Markowitz, DeMassi, Knight, & Solka, 1996.)

Role of Peer SpecialistProvide Direct Services:Primary responsibility of the peer

specialist is to provide direct services designed to assist consumers in regaining control over their own lives and control over their recovery processes.

Role of Peer SpecialistServe as Change Agents:Act as change agents in the mental

health system by providing professional, clinical, and administrative colleagues with their unique insight into mental illness and what makes recovery possible.

Direct Services: Specific Roles for Peers

• Establish & lead mutual support groups which expose members to successful role models, offer information on coping strategies & survival skills, and present an alternative worldview to assist persons in making sense of their experiences.

Direct Services: Specific Roles for Peers• Array of Vocational Support Services

– Support the vocational choices consumers make and assist them in overcoming job-related anxiety.

– Assist consumers in building social skills in the community that will enhance job acquisition and tenure.

– Assist consumers in learning to use tools that will support their employment efforts

• Attend treatment team meetings to promote consumer's use of self-directed recovery tools.

Direct Services: Specific Roles for Peers• Array of Educational Services—these

assist peers in understanding themselves, their environment, how to manage aspects of daily living– problem solving techniques– how to identify and combat negative

self-talk– how to identify and overcome fears.

Specific Roles for Peers• Array of Health & Wellness Tools

– Assist consumers in creating a Wellness Recovery Action Plan (WRAP).

– Creating Advanced Directives– how to identify and overcome fears.

Specific Roles for Peers

Skills that Support Job Retention:

• Social Functioning & Interpersonal Difficulties

Specific Roles for Peers• Utilize personal experiences

– Benefits and drawbacks of disclosure in workplace

– Discuss & Brainstorm possible job accommodations

– Building skills for coping with potential work problems

Peers As Change Agents• Assist non-consumer staff in

identifying program environments that are conducive to recovery; lend unique insight into mental illness and what makes recovery possible.

• Attend treatment team meetings to promote consumer's use of self-directed recovery tools.

The Ideal Peer Support Specialist• Certified• Able to model competency and utilize coping

skills• Well grounded in recovery culture• Comfortable sharing own experiences • Personal sense of self-worth that allows for

honesty and assertiveness in• relationships• Desire for self-improvement and willingness to

engage actively in personal growth• Desire to help people but without “rescuing”

tendencies• Like working with a variety of people and have an

appreciation of individual differences