Pitfalls in peer support programs should promote hesitancy

Sometimes getting by shouldn’t involve help from our friends — but if it does, that aid should come with a considerable disclaimer, researchers from the University of Exeter Medical School insist.

A recent study supported by the likes of the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care in the South West Peninsula (PenCLAHRC) and conducted by the university’s cohort explores the ins and outs of the peer support schema — a popular social prescription administered across the treatment spectrum. Ultimately, providers should proceed with caution when suggesting peer support to patients, the study team concluded.

"Peer support schemes can be extremely beneficial, but it is imperative that they are handled with sensitivity and understanding,” said Nicky Britten, PhD, from the University of Exeter Medical School, in a news release. “There's a lot of talk about how the recipients of this support benefit, but we have to remember that the 'mentors' themselves may have a serious illness, and they may encounter negative feelings such as rejection in some instances. We need to ensure support is available to help them through that."

Researchers analyzed the findings of 25 papers, each dealing with the impact that peer support programs had/have on patients navigating chronic conditions from various locations around the world (the UK, the US, Canada and Australia). What they found was that while peer-to-peer programs intend to reinstate value in life following a difficult diagnosis, they can oftentimes promote feelings of isolation in that patients can share little commonality aside from their illness. Mentors particularly have high risk for emotional entanglement.

"These schemes are billed as peer-to-peer, but there is an intrinsic imbalance in the fact that one person is receiving the service, and the other is delivering, and may have varying degrees of training to prepare them for that role,” Britten concluded. “That can reproduce some of the hierarchical relationship between a patient and a healthcare professional, and any tension arising form that needs to be managed carefully. This type of support is extremely valuable, and clearly has an important role to play in healthcare. But in order for it to be a positive experience for all involved, it is crucial that the impact on both the "mentor" and the recipient is considered, and that health care providers avoid a 'one size fits all' approach."

The study will be published in the July edition of the journal Patient Education and Counseling.