Eight More Areas That Peer Support Specialists Are Getting Increasingly Involved In

Peer support is recognized as a valuable element in a growing number of clinical and social service settings.  The incorporation of paid peer support providers, often referred to as “Peer Support Specialists” seems to follow after programs and clinical areas find that they want more predictable and integrated peer support provided as part of their programming.  The expansion of Medicaid to pay for Peer Support Specialists has also helped.

It is difficult to see where the expansion of Peer Support Specialists will stop.  Illness is by its nature, unpleasant and usually unsettling.  Treatment almost always involves someone who has special education and training and who earns income by providing care, raising the question of trust.  The process of recovering from an illness almost always involves more than what the clinician is involved in.  Having Peer Support Specialists in virtually every clinical setting only makes sense, and will lead to better outcomes, either in terms of recovery or in the experience of recovery. 

It will take years for our system to incorporate these roles everywhere, but in the meantime, it falls to the rest of us to pioneer these new applications of peer support and Peer Support Specialists and document how they help.  Consider the following areas where peer support has been embraced and the involvement of Peer Support Specialists has either started or will likely start soon:

A.     Autism. There has been a number of applications of individual and group peer support programs for children, adolescents and adults with autism.  Most of the research has been qualitative, but supports the idea that peer support is beneficial for this group (Duerksen, Besney, Ames, & McMorris, 2021; McCurdy & Cole, 2014).  It is difficult to find published reports of interventions by Peer Support Specialists for this population, but there are calls for the development of these positions, based on their success in mental health (Shea, et al., 2022).

B.      Loneliness and Social Isolation.  In 2023, the US Surgeon General identified social isolation and loneliness as a serious health concern.  Peer support is a natural intervention to address these challenges and has been used to build social support in a number of at-risk populations including older adults and low-income adults (Fuller et al., 2022; Galvez-Hernandez, González-de Paz, & Muntaner, 2022).  Peer Support Specialists have been providing social support interventions within mental health contexts, but we are starting to see them take a leadership role in providing interventions to address loneliness and isolation outside of mental health populations (Eliacin et al., 2023).

C.    Diabetes.  Diabetes is a common chronic illness that has both behavioral and medical elements.  Peer support and peer coaching has been used successfully in many settings to build social support and success in developing healthy behavioral/diet elements, resulting in better medical outcomes and improved quality of life (Lichtmen et al, 2020; Verma, 2022).  There has been some use of Peer Support Specialists in diabetes care, but no published studies focusing on that group.

D.    Dementia Care and Support for Family Caregivers.  Peer support interventions have been used successfully to address the support needs of adults with early dementia (Sullivan et al, 2022) and caregivers for people with dementia (Carter, Monaghan, & Santin, 2020).  It is difficult to find published studies of interventions by Peer Support Specialists, but given the wide use of peer support, particularly for caregivers, it seems likely that the involvement of Peer Support Specialists will evolve to address this important need.

E.     Cardiac Rehabilitation.  Similar to diabetes care, peer support has been integrated into cardiac rehabilitation in a number of settings, with evidence that it results in better rehabilitation (Ebrahimi et al., 2021). There have been efforts to develop specialized peer support providers including “peer mentors” and “peer advisors”, though these were typically volunteer positions.  These mentors and advisors receive special training and supervision and provide individualized peer support (Carroll, Rankin, & Cooper, 2007; Clark et al., 2012). It is difficult to find any mention of Peer Support Specialists providing cardiac rehabilitation interventions but it appears likely that these specialist roles of peer mentor will evolve into Peer Support Specialist positions. 

F.     Healthy Lifestyle Interventions.  There is growing interest in healthy lifestyle interventions for both medical and mental health conditions.  Exercise, diet, time in nature, social engagement, etc. have all been incorporated in treatment programs to promote wellness.  Peer-led versions of these interventions started appearing in healthy lifestyle programs for adults with serious mental illness (Aschbrenner, Naslund, & Bartels, 2016), as well as in diabetes care (Samudera, Efendi, & Indarwati, 2021). Peer Support Specialists are a natural fit for promoting these behaviors, and we can see their involvement growing as these interventions spread to other clinical and non-clinical populations (Chatterjee, Prinz, Gerdes, & Martinez, 2021).

G.    Perinatal Health.  Peer support interventions have been used to address a variety of needs around pregnancy and birth, including post-partum depression, loss of a child, and simply coping with the challenges of pregnancy and parenthood (Boyle, Mutch, Barber, Carroll, & Dean, 2015; Leger & Letourneau, 2015). While many of the interventions involved volunteers, there have been some that involved paid peer support providers (Carter, Cust, & Boath, 2018).

H.    Criminal Justice – Re-Entry.  Peer support specialists have become more active in working with people involved in the justice system.  Sometimes they are referred to as ‘peer navigators’ (Portillo, S., Goldberg, V., & Taxman, F. S., 2017) or ‘peer reentry specialists’ (Reingle, Gonzalez, Rana, Jetelina, & Roberts, 2019). Among Peer Support Specialists, there is a subspecialty developing, often referred to as ‘Forensic Peer Support’, with specialized training and even specialized credentials in some states.  Despite these developments, there are still significant challenges in the expansion of these services, given the different way the criminal justice system sees “recovery” (Adams & Lincoln, 2021).

  

REFERENCES

Adams, W. E., & Lincoln, A. K. (2021). Barriers to and facilitators of implementing peer support services for criminal justice–involved individuals. Psychiatric services, 72(6), 626-632.

Aschbrenner, K. A., Naslund, J. A., & Bartels, S. J. (2016). A mixed methods study of peer-to-peer support in a group-based lifestyle intervention for adults with serious mental illness. Psychiatric rehabilitation journal, 39(4), 328.

 Boyle, F. M., Mutch, A. J., Barber, E. A., Carroll, C., & Dean, J. H. (2015). Supporting parents following pregnancy loss: a cross-sectional study of telephone peer supporters. BMC pregnancy and childbirth, 15, 1-10.

 Carroll, D. L., Rankin, S. H., & Cooper, B. A. (2007). The effects of a collaborative peer advisor/advanced practice nurse intervention: cardiac rehabilitation participation and rehospitalization in older adults after a cardiac event. Journal of Cardiovascular Nursing, 22(4), 313-319.

 Carter, R., Cust, F., & Boath, E. (2018). Peer support workers’ experiences of supporting women with postnatal depression: a constant comparative exploration. Journal of reproductive and infant psychology, 36(2), 168-176.

 Carter, G., Monaghan, C., & Santin, O. (2020). What is known from the existing literature about peer support interventions for carers of individuals living with dementia: A scoping review. Health & social care in the community, 28(4), 1134-1151.

 Chatterjee, A., Prinz, A., Gerdes, M., & Martinez, S. (2021). Digital interventions on healthy lifestyle management: systematic review. Journal of medical Internet research, 23(11), e26931.

Clark, A. M., Munday, C., McLaughlin, D., Catto, S., McLaren, A., & MacIntyre, P. D. (2012). Peer support to promote physical activity after completion of centre-based cardiac rehabilitation: evaluation of access and effects. European Journal of Cardiovascular Nursing, 11(4), 388-395.

 Duerksen, K., Besney, R., Ames, M., & McMorris, C. A. (2021). Supporting autistic adults in postsecondary settings: A systematic review of peer mentorship programs. Autism in Adulthood, 3(1), 85-99.

 Ebrahimi, H., Abbasi, A., Bagheri, H., Basirinezhad, M. H., Shakeri, S., & Mohammadpourhodki, R. (2021). The role of peer support education model on the quality of life and self-care behaviors of patients with myocardial infarction. Patient Education and Counseling, 104(1), 130-135.

 Eliacin, J., Patterson, S. M., Mendez, D. M., Burgess, D. J., Traylor, M. H., Borden, M. Y., ... & Matthias, M. S. (2023). Findings from a Peer-Facilitated, Social Isolation Intervention in the Veterans Health Administration Healthcare System: A Mixed-Methods, Pilot Feasibility Study. Journal of general internal medicine, 38(16), 3460-3471.

 Fuller, S. M., Kotwal, A. A., Tha, S. H., Hill, D., Perissinotto, C., & Myers, J. J. (2022). Key Elements and mechanisms of a peer-support intervention to reduce loneliness and isolation among low-income older adults: a qualitative implementation science study. Journal of Applied Gerontology, 41(12), 2574-2582.

 Galvez-Hernandez, P., González-de Paz, L., & Muntaner, C. (2022). Primary care-based interventions addressing social isolation and loneliness in older people: a scoping review. BMJ open, 12(2), e057729.

 Leger, J., & Letourneau, N. (2015). New mothers and postpartum depression: a narrative review of peer support intervention studies. Health & social care in the community, 23(4), 337-348.

 Litchman, M. L., Oser, T. K., Hodgson, L., Heyman, M., Walker, H. R., Deroze, P., ... & Warshaw, H. (2020). In-person and technology-mediated peer support in diabetes care: a systematic review of reviews and gap analysis. The Diabetes Educator, 46(3), 230-241.

 McCurdy, E. E., & Cole, C. L. (2014). Use of a peer support intervention for promoting academic engagement of students with autism in general education settings. Journal of autism and developmental disorders, 44, 883-893.

 Portillo, S., Goldberg, V., & Taxman, F. S. (2017). Mental health peer navigators: Working with criminal justice–involved populations. The Prison Journal, 97(3), 318-341.

 Reingle Gonzalez, J. M., Rana, R. E., Jetelina, K. K., & Roberts, M. H. (2019). The value of lived experience with the criminal justice system: A qualitative study of peer re-entry specialists. International journal of offender therapy and comparative criminology, 63(10), 1861-1875.

 Samudera, W. S., Efendi, F., & Indarwati, R. (2021). Effect of community and peer support based healthy lifestyle program (CP-HELP) on self care behavior and fasting blood glucose in patient with type 2 Diabetes Mellitus. Journal of Diabetes & Metabolic Disorders, 20, 193-199.

Shea, L. L., Wong, M. Y., Song, W., Kaplan, K., Uppal, D., & Salzer, M. S. (2022). Autistic-delivered peer support: A feasibility study. Journal of Autism and Developmental Disorders, 1-14.

 Sullivan, M. P., Williams, V., Grillo, A., McKee-Jackson, R., Camic, P. M., Windle, G., ... & Rare Dementia Support (RDS) Research Team. (2022). Peer support for people living with rare or young onset dementia: An integrative review. Dementia, 21(8), 2700-2726.

 Verma, I., Gopaldasani, V., Jain, V., Chauhan, S., Chawla, R., Verma, P. K., & Hosseinzadeh, H. (2022). The impact of peer coach-led type 2 diabetes mellitus interventions on glycaemic control and self-management outcomes: A systematic review and meta-analysis. Primary care diabetes, 16(6), 719-735
 

KEY WORDS: Peer Support Specialist, Peer Support Training, Peer Support Certification, Peer Support Jobs