National Practice Guidelines for Peer Support Specialists and Supervisors

Foglesong, Dana; Knowles, Kelsey; Cronise, Rita; Wolf, Jessica; Edwards, Jonathan P.

doi:10.1176/appi.ps.202000901

Cited by 12 publications

(4 citation statements)

References 8 publications

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“…Barriers to peer support being implemented effectively included a lack of time, resources, and appropriate funding, and a lack of recognised PSW certification. Policy, research and campaign groups have advocated implementation approaches in line with these findings, for example, ImROC (implementing Recovery through Organisational Change) [ 14 , 68 ], who support peer support implementation globally and international competence frameworks from New Zealand [ 69 , 70 ], outline recovery focus as a core principle of peer support and emphasise the importance of training and ongoing professional development; peer support practice guidelines in the USA outline the importance of and give guidelines for supervision [ 71 ]. Formalised career pathways for PSWs [ 72 ] may help to address some of the identified barriers to effective implementation of peer support work, although these are still early in their development [ 68 ].…”

Section: Discussionmentioning

confidence: 99%

The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review

Cooper,

Saunders,

Greenburgh

et al. 2024

BMC Med

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Background Peer support for mental health is recommended across international policy guidance and provision. Our systematic umbrella review summarises evidence on the effectiveness, implementation, and experiences of paid peer support approaches for mental health. Methods We searched MEDLINE, EMBASE, PsycINFO, The Campbell Collaboration, and The Cochrane Database of Systematic Reviews (2012–2022) for reviews of paid peer support interventions for mental health. The AMSTAR2 assessed quality. Results were synthesised narratively, with implementation reported using the CFIR (Consolidated Framework for Implementation Research). The protocol was registered with PROSPERO (registration number: CRD42022362099). Results We included 35 reviews (426 primary studies, n = 95–40,927 participants): systematic reviews with (n = 13) or without (n = 13) meta-analysis, or with qualitative synthesis (n = 3), scoping reviews (n = 6). Most reviews were low or critically low (97%) quality, one review was high quality. Effectiveness was investigated in 23 reviews. Results were mixed; there was some evidence from meta-analyses that peer support may improve depression symptoms (particularly perinatal depression), self-efficacy, and recovery. Factors promoting successful implementation, investigated in 9 reviews, included adequate training and supervision, a recovery-oriented workplace, strong leadership, and a supportive and trusting workplace culture with effective collaboration. Barriers included lack of time, resources and funding, and lack of recognised peer support worker (PSW) certification. Experiences of peer support were explored in 11 reviews, with 3 overarching themes: (i) what the PSW role can bring, including recovery and improved wellbeing for service users and PSWs; (ii) confusion over the PSW role, including role ambiguity and unclear boundaries; and (iii) organisational challenges and impact, including low pay, negative non-peer staff attitudes, and lack of support and training. Conclusions Peer support may be effective at improving some clinical outcomes, self-efficacy, and recovery. Certain populations, e.g. perinatal populations, may especially benefit from peer support. Potential strategies to successfully implement PSWs include co-production, clearly defined PSW roles, a receptive hierarchical structure and staff, appropriate PSW and staff training with clinical and/or peer supervision alongside safeguarding. Services could benefit from clear, coproduced, setting specific implementation guidelines for PSW. PSW roles tend to be poorly defined and associations between PSW intervention content and impacts need further investigation. Future research should reflect the priorities of providers/service users involved in peer support.

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Section: Discussionmentioning

confidence: 99%

The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review

Cooper,

Saunders,

Greenburgh

et al. 2024

BMC Med

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“…Peer Approaches to Substances in Early Psychosis Programs promotes nonjudgmental exploration, matching lived/living SU (or related) experiences to validate individuals, explore SU risks together, employ harm reduction strategies, connect to substance-free community activities, and promote positive social network expansion. Each of these activities aligns with peer support values, practices, and core competencies (Foglesong et al, 2022; Substance Abuse and Mental Health Services Administration, 2018). The toolkit and associated training are promising for improving peer specialist confidence and competence in supporting clients to make informed decisions and develop and achieve SU-related goals.…”

Section: Conclusion and Implications For Practicementioning

confidence: 99%

Substance use approaches among peer support specialists in community mental health early psychosis programs.

Klodnick,

LaPelusa,

Reznik

et al. 2024

Psychiatric Rehabilitation Journal

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Objective: Substance use (SU) is common among adolescents and young adults, including those experiencing early psychosis. Coordinated Specialty Care (CSC), a community-based multidisciplinary team-based service model, is increasingly used to support people experiencing first-episode psychosis. In addition to prescribers, clinicians, and vocational specialists, CSC includes peer support specialists who use their own living/lived experience with mental health and treatment to engage and support young people with their recovery goals. Peer support is also foundational in SU recovery. However, little is known about how peer support specialists navigate client SU in CSC. The purpose of this article is to detail CSC peer support SU practice. Method: Informed by community-based participatory research methods, a PhD-level qualitative researcher and a former peer support specialist conducted virtual interviews with 20 CSC peer support specialists. A multidisciplinary team including researchers with lived mental health experiences thematically coded interview transcripts. Results: A spectrum of CSC peer support specialist SU responses emerged: (a) leverages lived SU experiences; (b) does not explore SU with clients; (c) shares client SU information with the CSC team; (d) educates, mentors, and advocates; (e) shares SU consequences and/or challenges substance use; (f) nonjudgmental, nondirective SU exploration; and (g) promotes harm reduction. Conclusions and Implications for Practice: CSC peer specialist SU practice is influenced by several contextual tensions that must be better understood and addressed in future research to improve peer SU practice. Study findings speak to practice nuances that are helpful for CSC peer support training and supervision. Impact and ImplicationsThis study finds that peer support specialists on early psychosis Coordinated Specialty Care teams vary in their experiences with substance use (SU) recovery as well as their perceptions of and responses to client SU. Training in nonjudgmental SU exploration, harm reduction strategies, and SU recovery story matching with client SU perceptions may increase peer specialist effectiveness in validating and supporting clients with their SU goals.

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“…Barriers to peer support being implemented effectively included a lack of time, resources, and appropriate funding, and a lack of recognised PSW certification. Policy, research and campaign groups have advocated implementation approaches in line with these findings, for example, ImROC (implementing Recovery through Organisational Change) [15,67], who support peer support implementation globally and international competence frameworks from New Zealand [68,69], outline recovery-focus as a core principle of peer support and emphasise the importance of training and ongoing professional development; peer support practice guidelines in the USA outline the importance of and give guidelines for supervision [70]. Formalised career pathways for PSWs [71] may help to address some of the identified barriers to effective implementation of peer support work, although these are still early in their development [67].…”

Section: Benefitmentioning

confidence: 99%

The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review

Cooper,

Saunders,

Greenburgh

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Peer support for mental health is recommended across international policy guidance and provision and has recently been expanded in countries including the UK. We conducted a systematic umbrella review, summarising the evidence from published reviews of the: 1) effectiveness, 2) implementation, and 3) experiences of paid peer support approaches for mental health. Methods: We searched MEDLINE, EMBASE, PsycINFO, The Campbell Collaboration, and The Cochrane Database of Systematic Reviews (from January 2012-November 2022) for published reviews of paid peer support interventions for mental health. Review quality was assessed using the AMSTAR2. Results were synthesised narratively, with implementation reported in accordance with the Consolidated Framework for Implementation Research (CFIR). Results: We included 35 reviews: systematic reviews with (n=13) or without (n=13) meta-analysis, systematic reviews with qualitative synthesis (n=3), and scoping reviews (n=6). The reviews included 426 primary studies and between 95-40,927 participants. Most reviews were low or critically low (97%) quality, one review was high quality. Effectiveness was investigated in 23 reviews. While results were mixed, there was some evidence from meta-analyses that peer support may improve depression symptoms (particularly in perinatal depression), self-efficacy, and recovery. Factors promoting successful implementation, investigated in 9 reviews, included adequate training and supervision, a recovery-oriented workplace, strong leadership, and a supportive and trusting workplace culture with effective collaboration. Barriers to implementation included lack of time, resources and funding, and a lack of recognised PSW certification. Experiences of peer support were explored in 11 reviews, with 3 overarching themes: i) what the peer support role could contribute, including recovery and improved wellbeing for both service users and peer support workers (PSWs); ii) confusion over the PSW role, including role ambiguity and unclear boundaries; and iii) organisational challenges, including low pay for PSWs, negative non-peer staff attitudes, and lack of support and training. Discussion: Peer support may be effective at improving some clinical outcomes, self-efficacy, and recovery outcomes for some people. Evidence suggests that certain populations, such as perinatal populations, may especially benefit from peer support. Potential strategies to successfully implement PSWs in healthcare settings include coproduction, with clearly defined PSW roles, a receptive hierarchical structure and staff, strong leadership, and appropriate PSW and staff training with clinical and/or peer supervision alongside safeguarding. Services could also benefit from clear, coproduced, setting specific implementation guidelines for PSW. PSW roles tend to be poorly defined and associations between content of PSW interventions and their impacts needs further investigation. Future research in this area should reflect the priorities of those directly involved in peer support, either as providers or service users.

show abstract

National Practice Guidelines for Peer Support Specialists and Supervisors

Cited by 12 publications

References 8 publications

The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review

The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review

Substance use approaches among peer support specialists in community mental health early psychosis programs.

The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review

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