Peer Support and Self-Help
Peer support, mutual support groups, and self-help approaches contribute greatly to recovery from abuse and trauma. These approaches are recognized as promising and/or evidence-based practices.
Facts and Discussion Points:
1--Individuals who have resolved previous traumatic reactions are more resilient to disasters and should be viewed as valuable resources for disaster-stricken communities.1
2--By joining together, consumers have power and a voice that not only impact their individual treatment but attitudes toward and treatment of all consumers. This power has increased under the motto “Nothing About Us Without Us.”2
3--In its priority set of evidence-based practices for adults, New York State includes self-help and peer-support education and treatment for Posttraumatic Stress Disorder. As an example of evidence-based practice,3,4 self-help is a lifelong support that is beneficial to the sustained management of many health conditions.5,6,7 In response to the catastrophic events of 9-11-01, New York utilizes current research for the most effective treatments.8
4--The role of peer support and mutual support groups is of fundamental importance for many women survivors. Resources such as transportation, meeting space, funding for information resources, drop-in centers, and alternative peer-run crisis support centers are necessary for such “informal” networks to thrive. These networks provide a larger community of peers, and also greatly enhance healing.9
5--Many communities lack adequate peer advocacy services or peer support systems that can assist a trauma survivor in obtaining the necessary information or help to avert crisis or hospitalization. Without information as to which therapeutic approaches work best, it is difficult to advocate for trauma survivors or to control the therapeutic process.10
6--Peer support and self-help are useful and cost-effective tools in helping survivors overcome the shame that often accompanies trauma, and these tools also provide leadership, motivation and guidance.
7--Peer support and self-help are characterized by the following:
* People experience themselves and their relationships across multiple roles.
* People have the opportunity to de-construct and re-construct their mental health story within the context of these multiple roles and relationships.
* People can express concern about coercive mental health practices without fear of retaliation.
* As rights issues emerge, they may be viewed as political rather than personally pathologized (e.g., the effects of trauma and abuse).
* People can practice “help” as both the receiver and the giver.
* As peer support becomes an adjunct/alternative to traditional practice, people find they need less intensive professional treatment.
* As people feel confident in their ability to help others, their sense of self-efficacy strengthens (many go back to work).
* People begin to make meaning of their experience outside the traditional rubric of mental health/mental illness (i.e. symptoms of trauma and abuse are no longer seen as personal pathology but rather as understandable reactions to the trauma).
* People build relationships that establish new ways of understanding their experiences.
* Peer communities develop norms, rituals, language, and outcomes from these new practices that may ultimately inform future direction for mental health services.11
1---Teach trauma survivors how to support each other. They can often be more helpful to each other than professional helpers through mutual understanding of their experience.10
2---Create means for consumers to feel supported through support groups, newsletters, conferences, warmlines (a support phone line). Train volunteers who are survivors to coordinate peer support services.10
3---Provide training for survivors that includes understanding of their own illness, better control of the therapeutic process, creating a positive attitude, meditation, and ways of managing symptoms. Teach techniques that deal with PTSD (i.e. focusing on something other than the trauma or flashbacks, using imagery, keeping a journal, listening to tapes, reading materials, enjoying self, and experiencing pleasure).10
4---Create support groups for sharing and discussing ways survivors have found to help themselves. Topics could include work, school, volunteering, supportive friends and family, participation in treatment programs.10
5---Develop a Web site in each state to provide information and education about trauma. This could be a project for graduate students.10
6---Develop “Trauma Information Centers.” Make materials available for self-education, including books and other materials that provide survivors with tools to manage their own symptoms in non-traditional ways and in ways others have found helpful.10
7---Develop cost-effective, comprehensive peer-professional alliances in support of a trauma-preparedness support system. Such alliances provide a “surge buffer” to prevent relapse/crises among vulnerable people in the event of subsequent local traumas or mass disasters.
8---The facts on peer support fit with new ways of thinking about crisis, elimination of seclusion and restraint, minimizing the need for professional intervention with substance abuse, the Olmstead Act (in terms of least restrictive environment), and awareness of the effects of violence in relation to mental health.
Peer Support and Self Help References
1. Goode, E. (November 20, 2001). Treatment can ease lingering trauma of September 11. Science Times, The New York Times.
2. Greenley, D., Barton, J., Hennings, B., Marquez, L. B., & Michaelis, P. (March 31, 2001). Promoting partnerships with consumers: An experiential report and “how to” guide. The Women and Mental Health Study Site of Dane County School of Social Work, University of Wisconsin-Madison.
3. Carpinello, S. E., Knight, E. L., Markowitz, F. E., et al. (2000). The development of the mental health confidence sale: A measure of self-efficacy in individuals diagnosed with mental disorders. Psychiatric Rehabilitation Journal, 23:236-242.
4. Segal, S. P., Silverman, C., & Temkin, T. (1995). Measuring empowerment in client-run self-help agencies. Community Mental Health Journal, 31:215-227.
5. Borkman, T. J. (1997). A selected look at self-help groups in the United States. Health and Social Care in the Community, 5:357-364.
6. Kurtz, L. F. (1997). Self-help and support groups: A handbook for practitioners. Thousand Oaks, California: Sage.
7. Vogel, H. S., Knight, E., Laudet, A. B., et al. (1998). Double trouble in recovery: Self-help for people with dual diagnoses. Psychiatric Rehabilitation Journal, 21:356-362.
8. Carpinello, S. E., Rosenberg, L., Stone, J., Schwager, M., & Felton, C. J. (February 2002). New York State’s campaign to implement evidence-based practices for people with serious mental disorders. Psychiatric Services.
9. Deegan, P. E. (July 13-16, 1994). Dare to vision: Shaping the national mental health agenda on abuse in the lives of women labeled with mental illness: A keynote address. Center for Mental Health Services Conference on Women, Abuse and Mental Health. Washington, DC.
10. Jennings, A., Ralph, R. O. (June 1997). In their own words: Trauma survivors and professionals they trust tell what hurts, what helps, and what is needed for trauma services. Maine Trauma Advisory Groups Report. Maine Department of Behavioral and Developmental Services. Augusta, ME.
11. S. Mead (personal communication, April 2002).