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Emery H, Matthews A, Duggan M. "A little bit of hope goes a long way": Exploring the role of peer workers in alcohol and other drug rehabilitation services. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 163:209408. [PMID: 38763216 DOI: 10.1016/j.josat.2024.209408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/11/2024] [Accepted: 05/14/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Peer workers operating within health care settings can offer unique perspectives based on their own lived experience. Within alcohol and other drug (AOD) rehabilitation services, the potential value of peer work is becoming increasingly recognised. This qualitative study aimed to evaluate a newly implemented peer worker program located across three rehabilitation services in Tasmania, Australia. METHODS Online interviews were conducted with eight clients, seven peer workers, and five non-peer worker employees with varied experience with peer worker programs. All interviews were audio-recorded and transcribed verbatim. RESULTS Guided by an overarching exploratory-descriptive methodological framework, thematic analysis generated three overarching themes: 1) Enhancing and supporting client experiences (what peer workers did in their role to improve client experiences, 2) Changing experiences with AOD rehabilitation (the unique benefits and changes that peer work brings to AOD rehabilitation services) and 3) Finding organizational value (how defining peer work and the feasibility of the peer worker role was challenged by different organizational factors). Overall, peer work was viewed as a positive addition to all rehabilitation services that was able to enhance client experiences through various mechanisms, such as by sharing their own stories, assisting with understanding, and creating safety. Peer work was also able to create change in AOD services, by instilling hope and reducing stigma. However, ongoing challenges with defining the peer worker role in a way that offers organizational recognition and financial security remain. CONCLUSION Peer workers offer a unique and valuable perspective when working within rehabilitation services. Through their own lived experience peer workers were able to support clients and assist them in their recovery. These findings highlight the potential benefit of peer work programs within AOD rehabilitation services.
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Affiliation(s)
- Holly Emery
- School of Psychological Sciences, University of Tasmania, Launceston, Australia.
| | - Allison Matthews
- School of Psychological Sciences, University of Tasmania, Hobart, Australia.
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Cha BS, Borghouts J, Eikey E, Mukamel DB, Schueller SM, Sorkin DH, Stadnick NA, Zhao X, Zheng K, Schneider ML. Variability in the Integration of Peers in a Multi-site Digital Mental Health Innovation Project. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:226-239. [PMID: 38246948 PMCID: PMC10850170 DOI: 10.1007/s10488-023-01331-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/23/2024]
Abstract
Peer support specialists ("peers") who have the lived experience of, and are in recovery from, mental health challenges are increasingly being integrated into mental health care as a reimbursable service across the US. This study describes the ways peers were integrated into Help@Hand, a multi-site innovation project that engaged peers throughout efforts to develop and offer digital mental health interventions across counties/cities ("sites") in California. Using a mixed methods design, we collected quantitative data via quarterly online surveys, and qualitative data via semi-annual semi-structured phone interviews with key informants from Help@Hand sites. Quantitative data were summarized as descriptive findings and qualitative data from interviews were analyzed using rapid qualitative analysis methods. In the final analytic phase, interview quotes were used to illustrate the complex realities underlying quantitative responses. 117 quarterly surveys and 46 semi-annual interviews were completed by key informants from 14 sites between September 2020 and January 2023. Peers were integrated across diverse activities for support and implementation of digital mental health interventions, including development of training and educational materials (78.6% of sites), community outreach (64.3%), technology testing (85.7%), technology piloting (90.9%), digital literacy training (71.4%), device distribution (63.6%), technical assistance (72.7%), and cross-site collaboration (66.7%). Peer-engaged activities shifted over time, reflecting project phases. Peer-provided digital literacy training and technology-related support were key ingredients for project implementations. This study indicates the wide range of ways peers can be integrated into digital mental health intervention implementations. Considering contextual readiness for peer integration may enhance their engagement into programmatic activities.
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Affiliation(s)
- Biblia S Cha
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA.
- School of Medicine, University of California, Irvine, 100 Theory, Suite 120, Irvine, CA, 92697, USA.
| | - Judith Borghouts
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Elizabeth Eikey
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, CA, USA
- The Design Lab, University of California, San Diego, San Diego, CA, USA
| | - Dana B Mukamel
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Stephen M Schueller
- Department of Informatics, University of California, Irvine, Irvine, CA, USA
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Dara H Sorkin
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Nicole A Stadnick
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Dissemination and Implementation Science Center, UC San Diego Altman Clinical and Translational Research Institute, La Jolla, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Xin Zhao
- Department of General Internal Medicine, University of California, Irvine, Irvine, CA, USA
| | - Kai Zheng
- Department of Informatics, University of California, Irvine, Irvine, CA, USA
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von Peter S, Kraemer UM, Cubellis L, Fehler G, Ruiz‐Pérez G, Schmidt D, Ziegenhagen J, Kuesel M, Ackers S, Mahlke C, Nugent L, Heuer I. Implementing peer support work in mental health care in Germany: The methodological framework of the collaborative, participatory, mixed-methods study (ImpPeer-Psy5). Health Expect 2024; 27:e13938. [PMID: 39102703 PMCID: PMC10729536 DOI: 10.1111/hex.13938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/24/2023] [Accepted: 12/01/2023] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Starting in the 1990s in the United States, individuals with lived experience of mental health crises and recovery have been employed as peer support workers (PSWs) internationally. However, the implementation of PSW in clinical contexts remains challenging. METHODS This manuscript presents and discusses the methodological framework of the ImpPeer-Psy5 study on the PSW implementation in the German mental healthcare sector. This study used a mixed-methods and collaborative research approach, as well as participatory research strategies. After describing the study design, populations, teamwork and assessments, the epistemic challenges of its methodological framework will be critically discussed and how it has iteratively shaped the object of study. DISCUSSION AND PRACTICAL IMPLICATIONS The healthcare, policy and funding context of PSW implementation as well as the study's methodological framework have differently influenced the ways in which the implementation of PSW has been conceived in this study. The choice of a collaborative or participatory methodological framework is advised to better align research questions and procedures to the specific needs and challenges of PSWs and other stakeholders concerned with PSW implementation. PATIENT AND PUBLIC CONTRIBUTION The research team of the ImpPeer-Psy5 study was collaboratively staffed by a portion of researchers who also identify as users or survivors of psychiatric services. A nonprofit organization for the training of PSWs served as a practice partner throughout the research process. Different participatory formats involve a significant number of diverse stakeholders relevant to PSW implementation.
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Affiliation(s)
- Sebastian von Peter
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Ute Maria Kraemer
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Lauren Cubellis
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Georgia Fehler
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Guillermo Ruiz‐Pérez
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Daniela Schmidt
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Jenny Ziegenhagen
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | - Madeleine Kuesel
- Brandenburg Medical School, Centre of Mental HealtPsychiatry and PsychotherapyImmanuel Klinik RüdersdorfNeuruppinGermany
| | | | - Candelaria Mahlke
- Department of PsychiatryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Lena Nugent
- Department of PsychiatryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Imke Heuer
- Department of PsychiatryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
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Kim SY, Kweon YR. The Poetry of Recovery in Peer Support Workers with Mental Illness: An Interpretative Phenomenological Analysis. Healthcare (Basel) 2024; 12:123. [PMID: 38255012 PMCID: PMC10815389 DOI: 10.3390/healthcare12020123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/25/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
This study was conducted to investigate and understand various aspects related to participants' experiences in peer support activities, with a particular focus on their personal growth and the influence of these activities on their lives. In this qualitative study, peer support workers with mental illness were the main subjects, and they were recruited from G Metropolitan City, South Korea. The study used purposive sampling, guided by recommendations from peer support worker support organizations. A total of five participants were selected using purposive sampling to ensure maximum variability in the sample. Data collection involved semi-structured individual interviews, and data analysis was conducted using the interpretative phenomenological analysis (IPA) method. Following the IPA procedure for data analysis, the study revealed six themes that encapsulated the recovery experiences of peer support workers with mental illness: (1) Facing confusion and challenges, (2) Rising and refining myself, (3) Navigating the paths of relationships, (4) Gazing at the desired horizons, (5) Awakening the inner hero, and (6) Standing as a person who cherishes life. This research underscores the positive impact of peer support activities on individuals who have faced mental health challenges. It emphasizes the significance of self-discovery, the development of supportive relationships, and the aspiration for a brighter future. These findings contribute to the expanding body of knowledge regarding the benefits of peer support in the context of mental health recovery.
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Affiliation(s)
- Su-Yeon Kim
- Department of Nursing, Honam University, Gwangju 62399, Republic of Korea;
| | - Young-Ran Kweon
- Department of Nursing, Chonnam National University, Gwangju 61469, Republic of Korea
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Janoušková M, Vlčková K, Harcuba V, Klučková T, Motlová J, Bankovská Motlová L. The Challenges of Inter-role Conflicts for Peer Support Workers. Psychiatr Serv 2022; 73:1424-1427. [PMID: 35538749 DOI: 10.1176/appi.ps.202100566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The definitions of the roles of peer support workers (PSWs) are unclear, creating one of the main challenges to PSWs' successful involvement in mental health care. In this empirical qualitative study conducted in the Czech Republic, four common roles of PSWs (N=15) were identified: friend, professional, staff member, and expert-by-experience. Conflicts were observed between the roles of friend and professional and between staff member and expert-by-experience. These conflicts may have a detrimental effect on the PSWs' well-being. The authors therefore call on organizations to prioritize regular supervision, team education, clear definition of the PSW position within an organization, and the destigmatization of people with mental illness in mental health services.
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Affiliation(s)
- Miroslava Janoušková
- Third Faculty of Medicine, Charles University (all authors), and Center for Palliative Care (Vlčková), Prague
| | - Karolína Vlčková
- Third Faculty of Medicine, Charles University (all authors), and Center for Palliative Care (Vlčková), Prague
| | - Vojtěch Harcuba
- Third Faculty of Medicine, Charles University (all authors), and Center for Palliative Care (Vlčková), Prague
| | - Tereza Klučková
- Third Faculty of Medicine, Charles University (all authors), and Center for Palliative Care (Vlčková), Prague
| | - Julie Motlová
- Third Faculty of Medicine, Charles University (all authors), and Center for Palliative Care (Vlčková), Prague
| | - Lucie Bankovská Motlová
- Third Faculty of Medicine, Charles University (all authors), and Center for Palliative Care (Vlčková), Prague
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Evolvement of Peer Support Workers' Roles in Psychiatric Hospitals: A Longitudinal Qualitative Observation Study. Community Ment Health J 2021; 57:589-597. [PMID: 33367956 PMCID: PMC7904537 DOI: 10.1007/s10597-020-00741-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 10/31/2020] [Indexed: 01/15/2023]
Abstract
Peer support workers (PSWs) use their experiential knowledge and specific skills to support patients in their recovery process. The aim of our study was to examine the integration and role-finding process of PSWs in adult psychiatric hospitals in Germany. We conducted open nonparticipant observations of 25 multiprofessional team meetings and 5 transregional peer support worker meetings over a period of six months. The data were analyzed using qualitative content analysis. Regarding the integration of PSWs into multiprofessional teams, we identified three subcategories: "Features of success," "challenges" and "positioning between team and patients." Concerning the PSWs' roles, we developed two subcategories: "Offers" and "self-perception." The PSWs' specific roles within a multiprofessional mental healthcare team evolve in a process over a longer period of time. This role-finding process should be supported by a framework role description which leaves sufficient freedom for individual development. Regular opportunities for mutual exchange among PSWs can help to address specific support needs at different points in time.
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Migoya-Borja M, Delgado-Gómez D, Carmona-Camacho R, Porras-Segovia A, López-Moriñigo JD, Sánchez-Alonso M, Albarracín García L, Guerra N, Barrigón ML, Alegría M, Baca-García E. Feasibility of a Virtual Reality-Based Psychoeducational Tool (VRight) for Depressive Patients. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 23:246-252. [DOI: 10.1089/cyber.2019.0497] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Marta Migoya-Borja
- Department of Psychiatry, University Hospital Jimenez Díaz Foundation, Madrid, Spain
| | | | | | | | | | | | | | - Nuria Guerra
- Department of Psychiatry, University Hospital Jimenez Díaz Foundation, Madrid, Spain
| | - María Luisa Barrigón
- Department of Psychiatry, University Hospital Jimenez Díaz Foundation, Madrid, Spain
- Department of Psychiatry, Madrid Autonomous University, Madrid, Spain
| | - Margarita Alegría
- Massachusetts General Hospital, Disparities Research Unit and Harvard Medical School, Boston, Massachusetts
| | - Enrique Baca-García
- Department of Psychiatry, University Hospital Jimenez Díaz Foundation, Madrid, Spain
- Department of Psychiatry, Madrid Autonomous University, Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, Mostoles, Spain
- Department of Psychiatry, General Hospital of Villalba, Madrid, Spain
- Department of Psychiatry, University Hospital Infanta Elena, Valdemoro, Spain
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Barr KR, Townsend ML, Grenyer BFS. Using peer workers with lived experience to support the treatment of borderline personality disorder: a qualitative study of consumer, carer and clinician perspectives. Borderline Personal Disord Emot Dysregul 2020; 7:20. [PMID: 32884819 PMCID: PMC7465429 DOI: 10.1186/s40479-020-00135-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/03/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Peer support is a recovery oriented approach where consumers and carers are introduced to people with lived experience of the disorder who have recovered. Paid roles within health services for such consumer peer workers and carer peer workers (or 'specialists') are increasingly common. To date specific studies on such peer support for consumers with borderline personality disorder (BPD) and their carers has not been conducted. METHODS This qualitative study used interviews to explore perceptions and models of peer support for BPD from the perspectives of 12 consumers, 12 carers, and 12 mental health professionals. Participant responses were analyzed using reflexive thematic analysis within a phenomenological methodology. RESULTS All groups described how consumer peer workers may provide hope, connection, and validation to a consumer's lived experience. Offering both traditional mental health treatment plus peer support, and giving consumers choice regarding a consumer peer worker was welcomed. Differences in opinion were found regarding the consumer peer worker's role in relation to the mental health team, including whether consumer peer workers should access medical records. Perspectives differed regarding the consumer peer worker and carer peer worker positions, highlighting potential role confusion. Carers discussed the value of receiving support from carer peer workers and consumer peer workers. Mental health professionals described how consumer peer workers can experience workplace stigma and problems with boundary setting, and acknowledged a need for peer workers to be valued by having a duty of care and confidentiality code to follow and be offered supervision. CONCLUSIONS Two models of peer support for BPD emerged: an integrated model where consumer peer workers work within the mental health team, and a complementary model where consumer peer workers are separate from the mental health team. Based on these findings we provide recommendations for services to help support such peer work for consumers with BPD and their carers.
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Affiliation(s)
- Karlen R Barr
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW Australia
| | - Michelle L Townsend
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW Australia
| | - Brin F S Grenyer
- School of Psychology and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW Australia
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