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Peer support occurs when people provide knowledge, experience, emotional, social or practical help to each other[1]. It commonly refers to an initiative consisting of trained supporters, and can take a number of forms such as Peer mentoring, 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 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. Most often, these professionals are required to obtain Continuing Education Units, like all other clinical staff.

Underlying theory

The effectiveness of peer support is believed to derive from a variety of psychosocial processes described best by Phyllis Solomon in 2004[2]: social support, experiential knowledge, social learning theory, social comparison theory and the helper-therapy principle.

  • Social support is the existence of positive psychosocial interactions with others with whom there is mutual trust and concern[3]. 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)[4].
  • Social learning theory postulates that peers, because they have undergone and survived relevant experiences, are more credible role models for others. Interactions with peers who are successfully coping with their experiences or illness are more likely to result in positive behavior change[6].
  • 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 and something to strive toward[7].
  • The helper-therapy principle proposes that there are four significant benefits to those who provide peer support[8][9]: (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[10].

Peer support in schools and education

Peer mentoring

Peer mentoring takes place in learning environments such as schools, usually between an older more experienced student and a new student[11]. Peer mentors appear mainly in secondary schools where students moving up from Junior/Primary schools may need assistance in settling in at the whole new schedule and lifestyle of secondary school life.

Peer listening

This form of peer support is widely used within schools[12][13]. Peer supporters are trained, normally from within schools or universities, or sometimes by outside organizations, such as Childline's CHIPS (Childline In Partnership With Schools) program[14], to be "active listeners"[15]. 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 by one of their peers[16][17][18][19].

Peer helper in sports

A peer helper in sports works with young adults in sports such as football, soccer, track, volleyball, baseball, cheerleading, swimming, and basketball. They may provide help with game tactics (e.g. keeping your eye on the ball), emotional support, training support, and social support[20].

Peer support in mental health

Consumers/clients of mental health programs group together to form non-profit organizations, and serve to support each other and to challenge associated stigma and discrimination[21][22]. Organizations that offer peer support services for people with mental health problems include Fountain House, Emotions Anonymous, the Depression and Bipolar Support Alliance (DBSA), GROW, 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 and social functioning[23][24].

Peer support programs have also been implemented to address stress and trauma among law enforcement personnel[25][26] and firefighters[27]. Peer support is an important component of the Critical incident stress management program used to alleviate stress and trauma among disaster first responders[28].

Peer support for survivors of trauma

Peer counseling has been used to help survivors of trauma[29], such as refugees, cope with stress[30] and deal with difficult living conditions[31]. Peer support is integral to the services provided by the National Center for Trauma-Informed Care. Other programs have been designed for female victims of domestic violence[32] and for women in prison[33].

Peer support for veterans and their families

Several programs exist that provide peer support for military veterans in the US[34][35] and Canada[36][37][38].

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.

Peer support in addiction

Twelve-step programs for overcoming substance misuse are often based on peer support[39]. Alcoholics Anonymous 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 program shares that experience on a continuous, individual basis with another alcoholic who is attempting to attain or maintain sobriety through AA[40]."

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[41]. Peer support complements and enhances other health care services[42].

Peer support has also been provided for people with cancer[43] and HIV[44][45][46]. The Breast Cancer Network of Strength trains peer counselors to work with breast cancer survivors[47].

Peer support for people with disabilities

Peer support has been widely used by organizations that work with people with disabilities, including the Amputee Coalition of America and Survivor Corps. Since 1998 the ACA has operated a National Peer Network for survivors of limb loss.

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 and autonomy and enable the survivor to make his or her own decisions and to implement them[48]." Peer support is a fundamental strategy in the rehabilitation of landmine survivors[49].

See also


  1. Shery Mead, David Hilton, Laurie Curtis, "Peer Support: A Theoretical Perspective."
  2. Solomon, Phyllis (2004). "Peer support/peer provided services underlying processes, benefits, and critical ingredients". Psychiatric rehabilitation journal 27 (4): 392–401. doi:10.2975/27.2004.392.401. ISSN 1095-158X. PMID 15222150..
  3. Sarason, I., Levine, H., Basham, R., & Sarason, B. (1983). "Assessing social support: The social support questionnaire." Journal of Personality and Social Psychology, 44, 127–139.
  4. Solomon, 2004, p. 394.
  5. Shubert, M., & Borkman, T. (1994). "Identifying the experiential knowledge developed within a self-help group." In T. Powell (Ed.) Understanding the self-help organization. Thousand Oaks: Sage.
  6. Salzer, M., & Shear, S. L. (2002). "Identifying consumer-provider benefits in evaluations of consumer-delivered services." Psychiatric Rehabilitation Journal, 25, 281–288.
  7. Festinger, L. (1954). "A theory of social comparison processes." Human Relations, 7, 117–140.
  8. Riessman, F. (1965). "The 'Helper-therapy' principle." Social Work, 10, 27-32,
  9. Skovholt, T M. (1974). "The client as helper: A means to promote psychological growth." Counseling Psychologist, 43, 58-64
  10. From Salzer and Shear, S. L. (2002), p. 282.
  11. Steve Grbac, "How to implement a ‘Peer Support’ program in a P-6 School,” Scotch College Junior School, Melbourne Australia, June 2008.
  12. Helen Cowie, Patti Wallace, Peer Support in Action: From Bystanding to Standing By, Sage Publications Ltd; 1st edition February 2001; ISBN 0-7619-6353-7
  13. Sandy Hazouri, Miriam Smith McLaughlin, Peer listening in the middle school: training activities for students. Educational Media Corp., 1991. ISBN 978-0-932796-34-9
  14. Chrissan Moldrich and J.D. Carpentieri, "Every school should have one: How peer support schemes make schools better," ChildLine, January 2008, ISBN 0-9524948-8-4.
  15. Joel H. Brown, Marianne D'Emidio-Caston, Bonnie Benard, Resilience Education, Corwin Press, 2001. ISBN 978-0-7619-7626-4
  16. Cheryl Sanders (Editor), Gary D. Phye (Editor), Bullying: Implications for the Classroom, Academic Press; 1st edition May 14, 2004; ISBN 0-12-617955-7.
  17. "Creating a Positive Climate: Peer Mediation; What Works in Preventing School Violence."
  18. Cremin, Hilary, Peer Mediation: Citizenship and Social Inclusion in Action. Maidenhead: Open University Press, September 2007; ISBN 0-335-22111-4.
  19. Thompson, S. M., "Peer mediation: A peaceful solution." School Counselor, 1996, 44:151-154.
  20. John DeMarco, Peer helping skills: a leader's guide to training peer helpers and peer tutors for middle and high school. Hazelden Publishing, 1993. ISBN 978-1-56246-090-7
  21. Shery Mead and Cheryl MacNeil, "Peer Support: What Makes It Unique?", December 2004.
  22. Davidson. I., Chinman. M. J.. Kloos. B., Weingarten, R., Stayner. D. A., & Tebes. J. K. (1999). "Peer support among individuals with severe mental illness: A review of the evidence." Clinical Psychology: Science and Practice, 6(2), 165-187.
  23. "Peer Support Research: A Promising New Approach."
  24. Jean Campbell and Judy Leaver, "Emerging New Practices in Organized Peer Support," National Association of State Mental Health Program Directors (NASMHPD) and the National Technical Assistance Center for State Mental Health Planning (NTAC), March 2003, p. 17.
  25. Rachelle Katz, Daniel I. Cohen and Ronnie M. Hirsh, Cop to Cop: A Peer Support Training Manual for the Law Enforcement Officer, Peer Support Press; 2nd edition, January 1, 2000. ISBN 978-0-9669496-3-6
  26. Grauwiler, Peggy; Barocas, Briana; Mills, Linda G, "Police peer support programs: current knowledge and practice," International Journal of Emergency Mental Health, vol. 10, no. 1, pp. 27-38, Winter 2008.
  27. Dowdall-Thomae, Cynthia; Culliney, Sean; Piechura, Jeff, "Peer Support Action Plan: Northwest Fire and Rescue," International Journal of Emergency Mental Health, vol. 11, no. 3, pp. 177-184, Summer 2009.
  28. Jones, Norma S C; Majied, Kamilah, "Disaster mental health: a critical incident stress management program (CISM) to mitigate compassion fatigue," Journal of Emergency Management, vol. 7, no. 4, pp. 17-23, July/August 2009.
  29. Project ABLE's Trauma Survivor Peer Support Project in Oregon
  30. Josi Salem-Pickartz, 2008: Strengthening community mental health resources by training refugees as peer counsellors – a manual for trainers, Intervention, The War Trauma Foundation and the Al Himaya Foundation for Trauma Recovery, Growth and Resilience.
  31. Nancy Baron, On the road to peace of mind War Trauma Foundation, 2009. ISSN 1571–8883.
  32. Fearday F.L., Cape A.L., "A voice for traumatized women: inclusion and mutual support." Psychiatric Rehabilitation Journal, 2004 Winter;27(3):258-65.
  33. Blanchette, K., Eljdupovic-Guzina, G. (1998). "Results of a pilot study of the Peer Support Program for Women Offenders." Edmonton, Research Branch, Correctional Service of Canada.
  34. Statewide Advocacy for Veterans' Empowerment (SAVE)
  35. Resnick, Sandra Gail; Rosenheck, Robert A: "Integrating peer-provided services: a quasi-experimental study of recovery orientation, confidence, and empowerment," Psychiatric Services, vol. 59, no. 11, pp. 1307-1314, November 2008.
  36. The Operational Stress Injury Social Support (OSISS) Program for Canadian Veterans. See also "Evaluation of the OSISS Peer Support Network," Dept. of National Defence and Veterans Affairs Canada, January 2005.
  37. Heber, A., Grenier, S., Richardson, D., Darte, K. (2006). "Combining Clinical Treatment and Peer Support: A Unique Approach to Overcoming Stigma and Delivering Care." In Human Dimensions in Military Operations – Military Leaders’ Strategies for Addressing Stress and Psychological Support; Neuilly-sur-Seine, France, Canadian Department Of National Defence.
  38. Richardson, J. D., K. Darte, et al. (2008). "Operational Stress Injury Social Support: a Canadian innovation in professional peer support." Can Mil J 9: 57-64.
  39. Center for Substance Abuse Treatment, "What are Peer Recovery Support Services?" HHS Publication No. (SMA) 09-4454. Rockville, MD: Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 2009.
  40. "Questions & Answers on Sponsorship," Alcoholics Anonymous World Services, Inc. 2005, p. 7.
  41. Carol A. Brownson & Michele Heisler, 2009. "The Role of Peer Support in Diabetes Care and Self-Management," The Patient: Patient-Centered Outcomes Research, Wolters Kluwer Health; Adis, vol. 2(1), pages 5-17.
  42. Michelle Heisler, "Building Peer Support Programs to Manage Chronic Disease: Seven Models for Success," California Healthcare Foundation, December 2006.
  43. Peer Support Network, an internet-based peer support service for newly diagnosed cancer patients, cancer survivors and their caregivers.
  44. Peer Adherence Support Manual, A Manual for Program Managers and Supervisors of Peer Workers; Harlem Adherence to Treatment Study, Harlem Hospital Peer Support for HIV Treatment Adherence, 2003.
  45. AIDS Information Center, Uganda
  46. Fidaner C, Eser SY, Parkin DM (2001), Peer to Peer. HIV & AIDS Peer Educators Trainers' Guide for IMPACT Implementing Agencies in Nigeria. Family Health International.
  47. BCNS's Breast Cancer Survivor Match Program
  48. Jerry White, I Will Not Be Broken, (published in paperback as Getting Up When Life Knocks You Down,).
  49. Kenneth Rutherford, "Peer-to-Peer Support Vital to Survivors," Journal of ERW and Mine Action, Issue 14.2, Summer 2010, p. 5.

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