Peer support workers

In SAMHSA’s core principles for peer workers, being recovery-oriented means holding out hope to the people you serve.

Peer recovery support is always directed by the person receiving it, and taking part is always their choice.

SAMHSA calls the relationship between the peer worker and the peer the foundation of peer support.

Peer support uses a strength-based approach that emphasizes physical and psychological safety.

Peers in the study used their stories strategically, choosing what to share to inspire and mentor, not just to tell their history.

• Keep the focus on the other person
• Share the hope and what helped, more than the hardest details
• Bring it back to them: “What might work for you?”

You get to decide what parts of your story are shared, with whom, and when. Some things may stay private forever, and that’s okay.

Your recovery keeps growing, and so does your story. It’s fine to revisit what you share as you change.

If sharing leaves you shaky or low for days, that’s useful information. Talk with your supervisor about other ways to connect that ask less of you.

Reviews describe prejudice and negative attitudes from non-peer staff, and doubts about whether peer roles are “real” jobs.

Peer workers with lived experience of drug use described extra emotional labour and unequal working conditions compared with non-peer staff.

Low pay and hours came up across many studies of peer workers.

Researchers recommend in-work training and support around job insecurity for peer workers.

Some peer workers found it hard to manage the transition from being a patient to being a peer support worker — sometimes in the same services.

Peer workers in a UK study felt valued, empowered and connected, but could find it hard to adjust to the demands of the job after their first optimism.

Peer support is voluntary and person-directed. Tasks that pressure or monitor people can clash with those values.

• Ask how the task fits your job description
• Name your concern calmly: “I want to keep the trust I’ve built”
• Bring it to supervision or a peer supervisor

Being part of a standalone peer team, and supervision, helped peer workers in one UK study.

Researchers call for mental health professionals and peer workers to form an alliance to address barriers to peer roles.

Agree ahead of time how you’ll handle it. A simple “I’ll let you decide whether to say hi” protects their privacy and yours.

If people you support attend your usual group, you might look for another group, a different time, or online options, so you can still share freely.

• Follow your organization’s rules on personal numbers and social media
• Set hours when you’re not available, and share crisis numbers for those times
• Keep personal accounts private if you can

Mutual connection is part of peer work, but your role still carries responsibility. Talk with your supervisor when a relationship feels like it’s shifting.

Keep your own therapist, sponsor, group, friends or faith community separate from work, so you have places where you’re only you.

• Changes in sleep or appetite
• Pulling away from people
• Old thoughts or urges coming back
• Feeling flat, irritable or on edge most days

Write them down in a wellness plan, along with who you’ll reach out to.

Recovery isn’t a straight line. Taking time off, getting more support, or a return of symptoms doesn’t make you a fraud.

Job control, feedback and recognition were linked with better experiences for peer workers. It’s reasonable to ask for flexible scheduling or a change in tasks when you need it.

You may have known them well and shared parts of their story. Allow yourself to grieve, and ask your workplace for time and support.

A personal trauma history is linked with somewhat more secondary traumatic stress among helpers. Extra support after these losses makes sense.

Hearing about others’ trauma can cause stress reactions in helpers. It’s a known risk of the work.

Operators with lived experience on an overdose response line named meaning, purpose and peer connection as drivers of fulfilment.

Access to supervision from a senior peer worker was linked with more positive workplace experiences.

Being part of a standalone peer worker team was supportive for peer workers in a UK study.

Social support, job control, feedback, and rewards and recognition were all linked with better workplace experiences for peer workers.

Training, supervision, pay and relationships with non-peer staff were named as key factors for strong peer support programs.

Good working relationships with non-peer staff and other peers were among the positive experiences peer workers reported.

The N.A.P.S. National Practice Guidelines for Peer Specialists and Supervisors help supervisors understand the core values of mutual support and manage the complexities of a non-clinical role.

Clinician attitudes and workplace culture were the most common negative part of the job for peer workers in one survey.

• Ask for the peer worker’s view in team meetings
• Avoid labels that reduce people to diagnoses
• Treat lived experience as expertise, not as a weakness

You might be proud of how far your loved one has come. You can also gently check in when work seems to be weighing on them.

Free, confidential support 24/7 for mental health, substance use and more. You can also chat at 988lifeline.org.

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