Peer Support is a structured relationship where a trained worker or volunteer, who has gone through a process of recovery, assists other people with mental health and/or addiction issues to identify and achieve life goals as part of their own recovery process.
“ Peer support is ... the pillar of self-help and the recovery process. It is the process by which like-minded individuals with similar experiences — who have travelled or are travelling the road — encourage and support each other to continue the healing. Those who have experienced the illness, the system, the clinical process, the drugs and the obstacles are in the best position to share knowledge gained by lived experience.” (Roy Muise, “Peer Support,” Position Paper, Canadian Coalition of Alternative Mental Health Resources, 2007, www.ccamhr.ca.)
A peer support model built into a physical activity program can support recovery for participants and peer leaders alike. It can provide an opportunity for peers to gain valuable leadership experience, as well as contribute to the sustainability and success of the program.
What is the role of peer support?
As a peer support worker, your role is to promote empowerment and self-determination of others through non-judgmental listening. You help with person-centred goal setting, problem solving, assessing crisis-risk and offering referrals to other community supports. You serve as a mentor and emotional support provider.
A core element of the FRESH physical activity program, created by Gerstein on Bloor as part of the Minding Our Bodies pilot phase, was the hiring and training of peer workers to provide individualized support to participants. FRESH workers also assisted with gym groups, nutrition and team sports. The FRESH worker job description describes their role:
“FRESH workers provide one-on-one peer support to individuals who have used our services during a crisis and are now living in the community continuing their recovery process. The FRESH worker assists individuals to meet their goals for physical activity, exercise and social involvement.”
At Haldimand-Norfolk Resource Centre, peer leaders provided encouragement to participants: “Participants are also Centre members — you know them — so, if somebody does have a weakness and you do see them do something really well, you can give them a pat on the back.” (Peer specialist)
“If [their] number, say on a bowling game is good, they can be proud of that, but they can also be proud that everyone else thought they did a good job.” (Peer specialist)
Planning for success – the peer perspective is key
"Nothing about us without us!" is a slogan adopted by mental health consumer/survivors to communicate the idea that no policy decisions should be made by any representative without the full and direct participation of members of the group most affected by that policy. By the same token, decision-making about a physical activity program for people with mental illness should include those who are most likely to participate. Involving peers in the planning process will lead to greater participant satisfaction.
The Canadian Mental Health Association, Thunder Bay Branch, began planning their physical activity program by conducting a focus group with clients. It helped the program manager to understand individual and systemic barriers, current perceptions and attitudes toward physical activity, and areas of potential interest with respect to physical activity.
Modeling to motivate
It is clear that peer support can act as the glue that holds a group together: “I think since they’re going back, I’m going back. A couple more people say, if they’re going, I’m going to go and it’s just that constant thing. Then you and you make this group and you make fun of it and you come out and joke that you’re dying and you’re never going to make it through this and you make fun of it. It all just kind of grabs together and it gels people” (Participant, Haldimand-Norfolk Resource Centre)
Peers lead by example, demonstrating introductory skills and/or promoting the program through word of mouth. “They tend to be ones who are more the cheerleaders for other people. They seem to already have that, ‘Let’s get people going and moving and involved.’”(Program manager, Haldimand-Norfolk Resource Centre)
Peer leaders can add a layer of continuity to a program. CMHA Thunder Bay found in their pilot program that the peer leaders had fewer turnovers than the staff component of the program. Looking back, this pilot site found common characteristics in peer leaders for their program. They were outgoing, passionate about wanting to feel healthier themselves, had skill sets complementary to those needed in the program and had existing strong rapport with staff.
“I can think of an individual who has helped a lot with the educational part and the changes in her and her sense of confidence because she is the one who made the contact, arranged for the education session, and so her confidence and her pride in herself over doing it increased....” (Staff leader, CMHA Thunder Bay)
Some programs include a leadership training component for peer leaders. At CMHA Thunder Bay, “Interested consumers submitted an application to become a peer leader. Leadership training for members was delivered by the Thunder Bay & District Health Unit physical activity promoter. This shared service delivery model was consistent with their overall agency approach to programming. In particular, the training addressed, in a one-day training, the eight topics of: administration, recruitment, retention, skill development, peer leadership, health education, evaluation, sustainability. As well, attention was paid to determining what aspect of the program each was interested in, such as recruiting participants, behind the scenes keeping statistics, or calling around for educational pieces. In addition, the training included an orientation to the MOB website, as well as an overview of what was in the MOB Toolkit for program leaders’ use. There were monthly meetings of the entire MOB team which helped in planning activities and addressing any challenges.”
At the Gerstein Centre in Toronto, two part-time peer workers were hired to work one-on-one with five to ten participants, as well as work in group sessions at Gerstein on Bloor with 40–60 individuals. A pre-training questionnaire was developed.
Training for the FRESH program included the following:
- Participation in a Boundless Adventure camping trip
- Mental Health Awareness
- Trouble Shooting
- Safety in the Community
- Basic Principles of Physical Activity
- Power Imbalance
- Boundary Setting
- WRAP (Wellness Recovery Action Plan)
See the Resource Library for materials related to peer training.
Graduates of program sessions can be an important source of peer leaders and a good resource to help sustain your program. Individuals may want to stay connected with the program for their own support needs, but can be ready to start developing their leadership skills. If participants are enthusiastic and show signs of wanting to be more involved, consider asking them to shadow other leaders and gradually assume some of their responsibilities.
Being a leader: part of the journey to recovery
Of the three peer workers hired by the Gerstein Centre for their FRESH program, one person gained the confidence to move on and find full-time work elsewhere. Another person was able to get her life back on track: “We had a woman staying here who was in really rough shape. She had just lost her kids and she started to get better and towards the end of her stay, became a participant and really did well in the program. She then became a FRESH worker so she went from staying here, to becoming a participant to becoming a FRESH worker. She did get her kids back and did identify, not just the FRESH program, but the whole process of being here from participant to FRESH worker... really helped her get her kids back.” (Case manager, Gerstein Centre)
Challenges to recovery
Keep in mind that there may be times when peer leaders will be dealing with their own recovery. Consider putting contingency plans in place to support them and to reduce the impact on the other participants.
- Going to the Experts: Peer Support and Chronic Disease Self-Management
- Why Peer Support Is Like a Box of Chocolates
- Diabetes and Mental Health Peer Support Project