“…These theories have been inferred rather than empirically tested within the domain of self-help groups. The lack of testing within this context is due to the culture of self-help groups that make traditional research methodologies difficult to employ (Kingree & Ruback, 1994). This section will describe each of these theories in relation to peer support.…”
Section: Underlying Psychosocial Processes Of Peer Supportmentioning
The article defines peer support/peer provided services; discusses the underlying psychosocial processes of these services; and delineates the benefits to peer providers, individuals receiving services, and mental health service delivery system. Based on these theoretical processes and research, the critical ingredients of peer provided services, critical characteristics of peer providers, and mental health system principles for achieving maximum benefits are discussed, along with the level of empirical evidence for establishing these elements.
“…These theories have been inferred rather than empirically tested within the domain of self-help groups. The lack of testing within this context is due to the culture of self-help groups that make traditional research methodologies difficult to employ (Kingree & Ruback, 1994). This section will describe each of these theories in relation to peer support.…”
Section: Underlying Psychosocial Processes Of Peer Supportmentioning
The article defines peer support/peer provided services; discusses the underlying psychosocial processes of these services; and delineates the benefits to peer providers, individuals receiving services, and mental health service delivery system. Based on these theoretical processes and research, the critical ingredients of peer provided services, critical characteristics of peer providers, and mental health system principles for achieving maximum benefits are discussed, along with the level of empirical evidence for establishing these elements.
“…Previous articles have discussed several processes that may be potent in consumer operated services (Chamberlin et al, 1996;Davidson et al, 1999;Kingree & Ruback, 1994;McFadden, Seidman, & Rappaport, 1992;Young & Williams, 1988). Prominent among these is extended social support that comes from peers, social comparisons in this supportive setting, diminished self-stigma, and improved interpersonal skills.…”
Previous research suggests that consumer operated services facilitate recovery from serious mental illness. In part I of this series, we analyzed the content of the GROW program, one example of a consumer operated service, and identified several processes that Growers believe assists in recovery. In this paper, we review the qualitative interviews of 57 Growers to determine what actual participants in GROW acknowledge are important processes for recovery. We also used the interviews to identify the elements of recovery according to these Growers. Growers identified self-reliance, industriousness, and self-esteem as key ingredients of recovery. Recovery was distinguished into a process-an ongoing life experience-versus an outcome, a feeling of being cured or having overcome the disorder. The most prominent element of GROW that facilitated recovery was the support of peers. Gaining a sense of personal value was also fostered by GROW and believed to be important for recovery. The paper ends with a discussion of the implications of these findings for the ongoing development of consumer operated services and their impact on recovery.
“…It has been argued that the effectiveness of peer support in mental health services should be evaluated with consistent measures that meaningfully capture what it is actually likely to achieve, such as improvements in subjective distress and psychosocial outcomes including hope and optimism, life satisfaction, wellness, con dence, connectedness, community empowerment and social support [95][96][97][98]. Aside from appropriate outcome measures, effectiveness research for community-based peer support is additionally complicated by the challenge of identifying appropriate methodologies to capture impact in the context of uid attendance at small scale groups, support based on spontaneous human relationships, and ethical opposition to randomising people to receive no support [22,84,99]. This review found limited randomised controlled trial evidence for a short-term, statistically signi cant reduction in symptoms of postnatal depression after a 4-12 week period of one-to-one [59,100] or group peer support [75], but not for anxiety, and there was no evidence about antenatal depression or other mental health di culties.…”
Background
Peer support has been suggested as an alternative or complement to professional support for mothers with perinatal mental health difficulties. The aim of this realist review was to synthesise the evidence on perinatal mental health peer support programmes outside mental health services, to understand what is it about community-based perinatal mental health peer support that works, for whom, in what circumstances, in what respects, and why.
Methods
Applying realist methodology, an initial theoretical model was tested against evidence from empirical studies. 29 empirical studies were included, covering 22 antenatal and postnatal mental health interventions that offered one-to-one or group peer support, in person or by telephone. Data extraction identified the configurations of contexts (C), mechanisms (M) and outcomes (O) relevant to mothers’ use of peer support and to the positive and negative effects of using peer support.
Results
13 C-M-O configurations explained take-up of peer support. These were based on mothers’ perceptions that peer support would offer empathetic understanding and non-judgemental acceptance outside their social circle; their relationships with primary health professionals; their cultural background and perspectives on mental health; their desire for professional support; overcoming barriers; the format of the support; and the use of volunteers. A further 13 C-M-O configurations explained positive impact on mothers. These were based on receiving empathetic listening, acceptance, affirmation and normalisation; peers sharing ideas about self-care, coping, and services; peers using therapeutic techniques; the opportunity to give support to others; meaningful social relationships with volunteers and other mothers; and other benefits of attending a group. There were 8 C-M-O configurations explaining negative impact. These were based on lack of validation; self-criticism from downward and upward social comparison; a culture of negativity; peers being judgemental or directive; not feeling heard; peer support as a stressful social relationship; and distress at endings.
Conclusions
Peer support works in complex ways that are affected by personal and social contexts. Applying insights from this review could enable programmes to train peer supporters to maximise the benefits and minimise potential risks, and to devise new ways of reaching mothers who do not currently engage with peer support.
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