Peer support
Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other. It commonly refers to an initiative consisting of trained supporters, and can take a number of forms such as peer mentoring
Peer mentoring
Peer mentoring is a form of mentorship that takes place in learning environments such as schools, usually between an older more experienced student and a new student. Peer mentors should not be confused with prefects...

, listening, or counseling. Peer support is also used to refer to initiatives where colleagues, members of self help organizations and others meet as equals to give each other support on a reciprocal basis. Peer
Peer may refer to:*People who are equal in such respects as age, education or social class etc., as in peer group*A member of the peerage, a system of honours or nobility in various countries*A variant of Peter in Scandinavic and Dutch languages...

in this case is taken to imply that each person has no more expertise as a supporter than the other and the relationship is one of equality.

A peer has "been there, done that" and can relate to others who are now in a similar situation. Trained peer support workers
Peer support specialist
-Peer Recovery Support Specialist:A Peer Recovery Support Specialist is an occupational title for a person who has progressed in their own recovery from alcohol or other drug abuse or mental disorder and is willing to self-identify as a peer and work to assist other individuals with chemical...

 are required to obtain Continuing Education
Continuing education
Continuing education is an all-encompassing term within a broad spectrum of post-secondary learning activities and programs. The term is used mainly in the United States and Canada...

 Units, like all other clinical staff.

Underlying theory

The effectiveness of peer support is believed to derive from a variety of psychosocial
For a concept to be psychosocial means it relates to one's psychological development in, and interaction with, a social environment. The individual needs not be fully aware of this relationship with his or her environment. It was first commonly used by psychologist Erik Erikson in his stages of...

 processes described best by Mark Salzer in 2002: social support, experiential knowledge, social learning theory, social comparison theory
Social comparison theory
Social comparison theory is a theory initially proposed by social psychologist Leon Festinger in 1954. It explains how individuals evaluate their own opinions and desires by comparing themselves to others.- Basic framework :...

 and the helper-therapy principle
Helper theory
Helper theory or the helper therapy principle is a model, first described in 1965 by Frank Riessman, attempting to explain the therapeutic effect for both people in a "helper" and "helpee" relationship within self-help/mutual-aid support groups...

  • Social support
    Social support
    Social support can be defined and measured in many ways. It can loosely be defined as feeling that one is cared for by and has assistance available from other people and that one is part of a supportive social network...

     is the existence of positive psychosocial interactions with others with whom there is mutual trust and concern. Positive relationships contribute to positive adjustment and buffer against stressors and adversities by offering emotional support (esteem, attachment, and reassurance), instrumental support (material goods and services), and information support (advice, guidance, and feedback).

  • Experiential knowledge
    Experiential knowledge
    Experiential knowledge is knowledge gained through experience as opposed to a priori knowledge. In the philosophy of mind, the phrase often refers to knowledge that can only be acquired through experience, such as, for example, the knowledge of what it is like to see colours, which could not be...

     is specialized information and perspectives that people obtain from living through a particular experience such as substance abuse
    Substance abuse
    A substance-related disorder is an umbrella term used to describe several different conditions associated with several different substances .A substance related disorder is a condition in which an individual uses or abuses a...

    , a physical disability
    A disability may be physical, cognitive, mental, sensory, emotional, developmental or some combination of these.Many people would rather be referred to as a person with a disability instead of handicapped...

    , chronic physical or mental illness, or a traumatic event such as combat, a natural disaster
    Natural disaster
    A natural disaster is the effect of a natural hazard . It leads to financial, environmental or human losses...

    , domestic violence
    Domestic violence
    Domestic violence, also known as domestic abuse, spousal abuse, battering, family violence, and intimate partner violence , is broadly defined as a pattern of abusive behaviors by one or both partners in an intimate relationship such as marriage, dating, family, or cohabitation...

     or a violent crime
    Violent crime
    A violent crime or crime of violence is a crime in which the offender uses or threatens to use violent force upon the victim. This entails both crimes in which the violent act is the objective, such as murder, as well as crimes in which violence is the means to an end, such as robbery. Violent...

    , sexual abuse
    Sexual abuse
    Sexual abuse, also referred to as molestation, is the forcing of undesired sexual behavior by one person upon another. When that force is immediate, of short duration, or infrequent, it is called sexual assault. The offender is referred to as a sexual abuser or molester...

    , or imprisonment
    Incarceration is the detention of a person in prison, typically as punishment for a crime .People are most commonly incarcerated upon suspicion or conviction of committing a crime, and different jurisdictions have differing laws governing the function of incarceration within a larger system of...

    . Experiential knowledge tends to be unique and pragmatic and when shared contributes to solving problems and improving quality of life
    Quality of life
    The term quality of life is used to evaluate the general well-being of individuals and societies. The term is used in a wide range of contexts, including the fields of international development, healthcare, and politics. Quality of life should not be confused with the concept of standard of...


  • Social learning theory
    Social learning theory
    -Theory:Social learning theory is derived from the work of Albert Bandura which proposed that social learning occurred through four main stages of imitation:* close contact* imitation of superiors* understanding of concepts* role model behavior...

     postulates that peers, because they have undergone and survived relevant experiences, are more credible role model
    Role model
    The term role model generally means any "person who serves as an example, whose behaviour is emulated by others".The term first appeared in Robert K. Merton's socialization research of medical students...

    s for others. Interactions with peers who are successfully coping with their experiences or illness are more likely to result in positive behavior change
    Behavior change
    Many health conditions are caused by risk behaviors, such as problem drinking, substance use, smoking, reckless driving, overeating, or unprotected sexual intercourse. The key question in health behavior research is how to predict and modify the adoption and maintenance of health behaviors....


  • Social comparison means that individuals are more comfortable interacting with others who share common characteristics with themselves, such as a psychiatric illness, in order to establish a sense of normalcy. By interacting with others who are perceived to be better than them, peers are given a sense of optimism
    The Oxford English Dictionary defines optimism as having "hopefulness and confidence about the future or successful outcome of something; a tendency to take a favourable or hopeful view." The word is originally derived from the Latin optimum, meaning "best." Being optimistic, in the typical sense...

     and something to strive toward.

  • The helper-therapy principle proposes that there are four significant benefits to those who provide peer support: (a) increased sense of interpersonal competence as a result of making an impact on another person's life; (b) development of a sense of equality in giving and taking between himself or herself and others; (c) helper gains new personally-relevant knowledge while helping; and (d) the helper receives social approval from the person they help, and others.

Peer mentoring

Peer mentoring takes place in learning environments such as schools, usually between an older more experienced student and a new student. Peer mentors appear mainly in secondary school
Secondary school
Secondary school is a term used to describe an educational institution where the final stage of schooling, known as secondary education and usually compulsory up to a specified age, takes place...

s where students moving up from primary schools may need assistance in settling in to the whole new schedule and lifestyle of secondary school life. Peer mentoring is also used in the workplace as a means of orienting new employees. New employees who are paired with a peer mentor are twice as likely to remain in their job than those who do not receive mentorship.

Peer listening

This form of peer support is widely used within schools. Peer supporters are trained, normally from within schools or universities, or sometimes by outside organizations, such as Childline
ChildLine is a free 24 hour counselling service for children and young people up to 18 in the UK provided by the NSPCC. ChildLine deals with any issue which causes distress or concern, common issues dealt with include child abuse, bullying, parental separation or divorce, pregnancy and substance...

's CHIPS (Childline In Partnership With Schools) program, to be "active listeners
Active listening
Active listening is a communication technique that requires the listener to understand, interpret, and evaluate what they hear. The ability to listen actively can improve personal relationships through reducing conflicts, strengthening cooperation, and fostering understanding.When interacting,...

". Within schools, peer supporters are normally available at break or lunch times.

Peer mediation

Peer mediation is a means of handling incidents of bullying by bringing the victim and the bully together under mediation
Mediation, as used in law, is a form of alternative dispute resolution , a way of resolving disputes between two or more parties. A third party, the mediator, assists the parties to negotiate their own settlement...

 by one of their peers.

Peer helper in sports

A peer helper in sports works with young adults in sports such as football
Football may refer to one of a number of team sports which all involve, to varying degrees, kicking a ball with the foot to score a goal. The most popular of these sports worldwide is association football, more commonly known as just "football" or "soccer"...

, soccer, track
Track and field
Track and field is a sport comprising various competitive athletic contests based around the activities of running, jumping and throwing. The name of the sport derives from the venue for the competitions: a stadium which features an oval running track surrounding a grassy area...

, volleyball
Volleyball is a team sport in which two teams of six players are separated by a net. Each team tries to score points by grounding a ball on the other team's court under organized rules.The complete rules are extensive...

, baseball
Baseball is a bat-and-ball sport played between two teams of nine players each. The aim is to score runs by hitting a thrown ball with a bat and touching a series of four bases arranged at the corners of a ninety-foot diamond...

, cheerleading
Cheerleading is a physical activity, sometimes a competitive sport, based on organized routines, usually ranging from one to three minutes, which contain the components of tumbling, dance, jumps, cheers, and stunting to direct spectators of events to cheer on sports teams at games or to participate...

, swimming
Swimming (sport)
Swimming is a sport governed by the Fédération Internationale de Natation .-History: Competitive swimming in Europe began around 1800 BCE, mostly in the form of the freestyle. In 1873 Steve Bowyer introduced the trudgen to Western swimming competitions, after copying the front crawl used by Native...

, and basketball
Basketball is a team sport in which two teams of five players try to score points by throwing or "shooting" a ball through the top of a basketball hoop while following a set of rules...

. They may provide help with game tactics (e.g. keeping your eye on the ball), emotional support, training support, and social support.

Peer support in mental health

Psychiatric survivors movement
The psychiatric survivors movement is a diverse association of individuals who are either currently clients of mental health services , or who consider themselves survivors of interventions by psychiatry, or who identify themselves as ex-patients of mental health services...

 of mental health programs group together to form non-profit self-help organizations, and serve to support each other and to challenge associated stigma
Social stigma
Social stigma is the severe disapproval of or discontent with a person on the grounds of characteristics that distinguish them from other members of a society.Almost all stigma is based on a person differing from social or cultural norms...

 and discrimination. Organizations that offer peer support services for people with mental health problems include Fountain House, Emotions Anonymous
Emotions Anonymous
Emotions Anonymous is a twelve-step program for recovery from mental and emotional illness. there were approximately 1,100 EA groups active in the United States. EA is the largest of three organizations that have adapted the Twelve Steps of Alcoholics Anonymous to create a program for people...

, the Depression and Bipolar Support Alliance
Depression and Bipolar Support Alliance
The Depression and Bipolar Support Alliance is a non-profit organization providing support groups for people with depression or bipolar disorder as well as their friends and family. DBSA's scope, also includes outreach, education and advocacy regarding depression and bipolar disorder...

GROW is a peer support and mutual-aid organization for recovery from, and prevention of, serious mental illness. GROW was founded in Sydney, Australia in 1957 by Father Cornelius B. "Con" Keogh, a Roman Catholic priest, and psychiatric patients who sought help with their mental illness in...

, and Recovery International. Research has shown that peer-run self-help groups yield improvement in psychiatric symptoms resulting in decreased hospitalization, larger social support networks and enhanced self-esteem
Self-esteem is a term in psychology to reflect a person's overall evaluation or appraisal of his or her own worth. Self-esteem encompasses beliefs and emotions such as triumph, despair, pride and shame: some would distinguish how 'the self-concept is what we think about the self; self-esteem, the...

 and social functioning. Organizations such as the Samaritans
Samaritans (charity)
Samaritans is a registered charity aimed at providing emotional support to anyone in emotional distress or at risk of suicide throughout the United Kingdom and Ireland, often through their telephone helpline. The name comes from the Biblical parable of the Good Samaritan, though the organisation...

, Nightline
Nightline (student service)
Nightline is the name given to various confidential and anonymous overnight listening, emotional support, information, and supplies services, run by students for students at universities around the world...

, and Aware
Aware (voluntary organisation)
Aware is a voluntary organisation based in Ireland which aims to assist people affected by depression.-Helpline:The Aware Helpline is a non directive listening service for people who experience depression and concerned family and friends. The Helpline offers a non judgemental listening ear to...

 provide peer support to people in emotional distress.

Peer support in addiction

Twelve-step programs for overcoming substance misuse and other addiction recovery groups
Addiction recovery groups
Addiction recovery groups are voluntary associations of people who share a common desire to overcome drug addiction. Different groups use different methods, ranging from completely secular to explicitly spiritual. One survey of members found active involvement in any addiction recovery group...

 are often based on peer support. Alcoholics Anonymous
Alcoholics Anonymous
Alcoholics Anonymous is an international mutual aid movement which says its "primary purpose is to stay sober and help other alcoholics achieve sobriety." Now claiming more than 2 million members, AA was founded in 1935 by Bill Wilson and Dr. Bob Smith in Akron, Ohio...

 promotes peer support between new members and their sponsors: "The process of sponsorship is this: an alcoholic who has made some progress in the recovery
Recovery model
The Recovery Model as it applies to mental health is an approach to mental disorder or substance dependence that emphasizes and supports each individual's potential for recovery...

 program shares that experience on a continuous, individual basis with another alcoholic who is attempting to attain or maintain sobriety through AA." Other addiction recovery programs rely on peer support without following the twelve-step model.

Peer support for anxiety and depression

In Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...

, the LEAF (Living Effectively with Anxiety and Fear) Program is a peer-led support group for cognitive-behavioral therapy of persons with mild to moderate panic disorder
Panic disorder
Panic disorder is an anxiety disorder characterized by recurring severe panic attacks. It may also include significant behavioral change lasting at least a month and of ongoing worry about the implications or concern about having other attacks. The latter are called anticipatory attacks...


In a 2011 meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...

 of seven randomized trials that compared a peer support intervention to group cognitive-behavioral therapy in patients suffering from depression, peer support interventions were found to improve depression symptoms more than usual care alone and results may be comparable to those of group cognitive behavioral therapy. These findings suggest that peer support interventions have the potential to be effective components of depression care, and they support the inclusion of peer support in recovery-oriented mental health treatment.

Peer support in chronic illness

Peer support has been beneficial for many people living with diabetes. Diabetes encompasses all aspects of people's lives, often for decades. Support from peers can offer emotional, social, and practical assistance that helps people do the things they need to do to stay healthy. Peer support groups for diabetics complement and enhance other health care services.

Peer support has also been provided for people with cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

 and HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

. The Breast Cancer Network of Strength trains peer counselors to work with breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...


Peer support for first responders

Peer support programs have also been implemented to address stress
Stress (biology)
Stress is a term in psychology and biology, borrowed from physics and engineering and first used in the biological context in the 1930s, which has in more recent decades become commonly used in popular parlance...

 and psychological trauma
Psychological trauma
Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event...

 among law-enforcement personnel and firefighters. Peer support is an important component of the critical incident stress management
Critical Incident Stress Management
Critical incident stress management is an adaptive short term helping process that focuses solely on an immediate and identifiable problem. It spans pre-incident preparedness to acute crisis to post-crisis follow up. Its stated purpose is to enable people to return to their daily routine more...

 program used to alleviate stress and trauma among disaster first responders.

Peer support for people with disabilities

Peer support is considered to be a key component of the independent living
Independent living
Independent living, as seen by its advocates, is a philosophy, a way of looking at disability and society, and a worldwide movement of people with disabilities working for self-determination, self-respect and equal opportunities...

 movement and has been widely used by organizations that work with people with disabilities, including the Amputee Coalition of America
Amputee Coalition of America
The Amputee Coalition of America is a nonprofit organization based in Knoxville, Tennessee, United States of America. ACA's mission is to reach out to people with limb loss and empower them through education, support and advocacy.-Outreach programs:...

 (ACA) and Survivor Corps. Since 1998 the ACA has operated a National Peer Network for survivors of limb loss
Amputation is the removal of a body extremity by trauma, prolonged constriction, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for...

. The Blinded Veterans Association
Blinded Veterans Association
The Blinded Veterans Association is a U.S non-profit organization that was established to "help veterans and their families meet and overcome the challenges of blindness"....

 has recently launched Operation Peer Support (OPS), a program designed to support men and women returning to the US blinded or experiencing significant visual impairment
Visual impairment
Visual impairment is vision loss to such a degree as to qualify as an additional support need through a significant limitation of visual capability resulting from either disease, trauma, or congenital or degenerative conditions that cannot be corrected by conventional means, such as refractive...

 in connection with their military service. Peer support has also benefited survivors of traumatic brain injury
Traumatic brain injury
Traumatic brain injury , also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism , or other features...

 and their families.

Survivor Corps defines peer support for trauma survivors as "Encouragement and assistance provided by a colleague who has overcome similar difficulties to engender self-confidence
The socio-psychological concept of self-confidence relates to self-assuredness in one's personal judgment, ability, power, etc., sometimes manifested excessively.Being confident in yourself is infectious if you present yourself well, others will want to follow in your foot steps towards...

 and autonomy and to enable the survivor to make his or her own decisions and implement them." Peer support is a fundamental strategy in the rehabilitation of landmine survivors in Afghanistan, Bosnia, El Salvador and Vietnam. A study of 470 amputees in six countries showed that nearly one hundred percent said they had benefited from peer support.

Peer support for survivors of trauma

Peer support has been used to help survivors of trauma, such as refugee
A refugee is a person who outside her country of origin or habitual residence because she has suffered persecution on account of race, religion, nationality, political opinion, or because she is a member of a persecuted 'social group'. Such a person may be referred to as an 'asylum seeker' until...

s, cope with stress and deal with difficult living conditions. Peer support is integral to the services provided by the National Center for Trauma-Informed Care
National Center for Trauma-Informed Care
The National Center for Trauma-Informed Care is a United States based medical charity, funded by the Center for Mental Health Services . Created in 2005, it assists publicly-funded agencies, programs, and services in making the important cultural shift to a more trauma-informed environment — an...

. Other programs have been designed for female victims of domestic violence and for women in prison.

Pandora's Aquarium, an online support group operating as part of Pandora's Project
Pandora's Project
Pandora's Project is 501 nonprofit organization that provides support to survivors of sexual assault. It provides a lending library,support forum, healing retreats, and other resources to survivors and their supporters and is entirely volunteer run. The support forum, Pandora's Aquarium, has...

, offers peer support to survivors of rape
Rape is a type of sexual assault usually involving sexual intercourse, which is initiated by one or more persons against another person without that person's consent. The act may be carried out by physical force, coercion, abuse of authority or with a person who is incapable of valid consent. The...

 and sexual abuse and their friends and family.

Peer support for veterans and their families

Several programs exist that provide peer support for military veteran
A veteran is a person who has had long service or experience in a particular occupation or field; " A veteran of ..."...

s in the US and Canada. In 2010 the Military Women to Women Peer Support Group was established in Helena, MT.

The Tragedy Assistance Program for Survivors (TAPS) provides peer support, crisis care, casualty casework assistance, and grief and trauma resources for families of members of the US military. Operation Peer Support (OPS) is a program for US military veterans who were blinded or have significant visual impairment.

See also

  • Certified Peer Support Specialist
  • Lay community counsellor
    Lay community counsellor
    A Lay Community Counsellor is a member of a community who is trained to provide a specific service or to perform certain limited activities within that community.-Transitory Communities:...

  • Peer mentoring
    Peer mentoring
    Peer mentoring is a form of mentorship that takes place in learning environments such as schools, usually between an older more experienced student and a new student. Peer mentors should not be confused with prefects...

  • Person centered planning
  • Self-determination
    Self-determination is the principle in international law that nations have the right to freely choose their sovereignty and international political status with no external compulsion or external interference...

  • Self-help
    Self-help, or self-improvement, is a self-guided improvement—economically, intellectually, or emotionally—often with a substantial psychological basis. There are many different self-help movements and each has its own focus, techniques, associated beliefs, proponents and in some cases, leaders...

  • Self-help groups for mental health
    Self-help groups for mental health
    Self-help groups for mental health are voluntary associations of people who share a common desire to overcome mental illness or otherwise increase their level of cognitive or emotional wellbeing. There are several international mental health self-help organizations including Emotions Anonymous, the...

External links

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