The stepped model of peer provision practice: capturing the dynamics of peer support work in action

Abstract

Purpose In recent years, the employment of peer providers (PPs) has grown with the wider acceptance of lived experience expertise in recovery-oriented service provision. Although its effectiveness, theoretical foundations and factors influencing outcomes have been studied, a framework accounting for the dynamics of the PP–peer relationship has yet to be formulated. The purpose of this paper is to employ a qualitative approach to explore the journeys undertaken by PPs with their peers and form it into a cohesive framework of understanding. Design/methodology/approach In-depth interviews were conducted with PPs who were employed specifically to use their lived experience in supporting someone through mental distress. These interviews were recorded, transcribed and coded using a framework approach. To enhance rigour, this framework was verified with the latter author and three other participants recruited after data analysis. Findings A stepped model of peer provision practice was crafted to capture the non-linearity of recovery, as well as the PP–peer relationship. This model is founded upon trust in the milieu of shared experience and involves: creating a safe place – a stage of building trust and rapport to a point where a PP is given permission to enter into their peer’s headspace; a working partnership – stage of setting and working towards goals collaboratively; and stepping out – a stage marked by the termination of the PP–peer relationship. Originality/value This paper proposes a tangible framework underpinning the dynamics of peer provision practice, which furthers our understanding and complements current practice models in peer provision services.

Recovery processes within peer provision: testing the CHIME model using a mixed methods design

“…In Stage 1, the participants were recruited through PPs who had participated in an earlier phase of the study which explored the views of PPs on how they facilitated their peers' recoveries (Zeng and Chung, 2019). The researcher left the contact information with the PPs who had been interviewed in the previous study.…”

“…In Stage 1, participants were interviewed in the place of their choice for between 45 min and one and a half hours. Following written informed consent, the first author (GZ) asked semi-structured questions based around the CHIME framework (Leamy et al, 2011) and the stepped model of peer provision (Zeng and Chung, 2019). The participants were asked to describe their encounter with their PP and how that had helped them in their personal recoveries (Table 2)…”

“…It included closed-and open-ended questions. The participants were presented with a summary of the three-staged process described in a previous paper (Zeng and Chung, 2019). These stages (creating a safe place, working partnership and stepping out) were designed to describe PP practice as a non-linear relationship between the PP and their peer.…”

“…It assumes that a person with similar experience can offer a form of support which offers something different to the traditional helping professions (Gillard, 2019). Individuals are "formally employed to use their lived experience explicitly and intentionally to instil hope and afford practical assistance" (Zeng and Chung, 2019) to persons experiencing mental health challenges. Various terminologies have been used to describe formal peer support (e.g.…”

“…The dissonance between outcomes sanctioned by funders and recovery-oriented outcomes attests to the need for examining outcomes that accurately reflect recovery processes rather than clinical outcomes. Following from a previous qualitative study which led to the formulation of a stepped model of peer provision (Zeng and Chung, 2019), this study purports to determine the usefulness of the CHIME framework in describing the work of PPs. To do so, a mixed-methods study was used to triangulate the experience of peers in their work with PPs and give depth to the results.…”