Cultivating Connections: An Interprofessional Peer Support Model

Peer support, which has been used for decades in behavioral health care for patients, has gained increased recognition as an approach that can also help health care professionals. Research shows that support offered by a peer—someone who shares a similar lived experience or similar role—can play an important part in mitigating experienced stress or distress for health care professionals. Peer supporters draw on their own lived and shared experience, including responsibilities, to identify what might be helpful to offer colleagues who may be stressed, in distress, or experiencing a crisis. This type of social support emphasizes a psychological sense of belonging, psychological safety, feeling cared for, and feeling connected to a reliable network of colleagues. Four elements of peer support have been identified as helping to modify the burnout response (7): listening, providing encouragement, providing companionship, and offering tangible aid. Programs that train physicians in such techniques to provide one-to-one support for their peers (8, 9) are increasingly recognized as effective in fostering individual resilience and coping (8–10).

While peer support among colleagues of the same profession is found to be useful, less is known about peer support between colleagues from different professions. It is important to consider the value of interprofessional peer support, especially given the interprofessional nature of work in behavioral health care teams. Integrated behavioral health care models offer even more opportunities to interact with other health professions. Such models typically include teams composed of primary care physicians, psychiatrists, mental health care clinicians, nurses, physician assistants, and others who work closely to treat mental health problems in the primary care setting. Given that integrated models have been shown to be helpful in patient care (11), we can expect increasing delivery of care using this model. The following demonstrates how a pilot peer support program was expanded to include various professions to address the growing rates of stress and burnout.

In early 2020, the authors, who represent diversity in terms of experiences and expertise, piloted peer support programs for physicians and faculty scientists at two medical schools in the northeastern United States (12). One of these programs, described in this Open Forum, is titled ONE 2 ONE 2 CARE, where “CARE” refers to “Colleagues Aligning to Respond With Empathy.” ONE 2 ONE 2 CARE was designed to train physicians and faculty scientists in peer support techniques to provide onsite, in-the-moment support for fellow colleagues who appear stressed or in distress and send the message that giving and receiving help can be a norm and an expectation in the workplace culture. “Peer-ness” is based on role and shared challenges, vulnerabilities, and experiences in that role. The program is based on communication skills, peer support, and social support principles, including the emotional, informational, and instrumental support that is often perceived as beneficial when a person is under stress or appears in or near crisis. Peer supporters attend a 2-hour training followed by monthly sessions, where they learn skills to offer support, including tangible support such as sharing wellness resources and how to navigate based on the needs. We initially piloted training 31 medical school physicians and faculty scientists, and once the training was shown to be feasible and acceptable, we expanded to train pharmacists, dentists, physical therapists, occupational therapists, nurses, and psychiatric rehabilitation practitioners. In total, we trained 84 peer supporters (53 additional peer supporters in addition to the original 31 trained).

The training includes both didactic and experiential components. Trainees are guided to learn to follow the Peer Support Encounter Flow Checklist (online supplement) and engage in structured exercises to clarify their role as peer supporter, recognize listening blocks, and practice applying skills and receiving feedback. Trainees appreciate learning new ways of helping others, as evidenced by this feedback:

“It’s meaningful to feel like […] there’s a chance to help in a different way that we’re not used to, and in a more official kind of capacity and more just that feeling that may be able to contribute in a different way.”

“I think that’s part of the grooming, that I wanted for myself and I think that it actually helped tremendously in the interpersonal communication skills […] how to communicate better [in a] more supportive way.”

Trained peer supporters receive organizational support to perform this role. Formal interactions are structured through regular meetings and debriefing sessions, ensuring that peer supporters have dedicated time to focus on their responsibilities. This dedicated time helps manage their workload and prevents the additional duties from contributing to burnout. Peer supporters can contact the trainers for problem solving, debriefing, and support.

Recognizing the importance of support for those providing peer support, the organization has established internal support systems to ensure that peer supporters themselves have access to the resources they need. The peer supporter monthly sessions provide a safe space for peer supporters to share their experiences, seek advice, and receive encouragement, thus fostering a supportive environment. Trained peer supporters who attend the monthly meetings share the number and types of encounters during monthly meetings and share experiences without any identifying information to maintain confidentiality. They are provided access to resources, and they then also share these resources at faculty and staff meetings. During these meetings, they can also anonymously discuss any peer support encounter they may have experienced so that all in attendance can learn from the experiences of one another. The monthly meetings focus on specific topics related to emerging needs and ideas generated by peer supporters. These have included realizing the importance of active listening as well as how difficult it can be to resist the urge to try to “fix” the peer’s problem as opposed to listening and providing perspective.

Many peer supporters found that they started using the skills in other contexts, such as with students, other members of the health care team, patients, and even family members. For example, one participant said, “I think it makes a big difference when you’re able to communicate in the right way and help people out and […] I think it comes in handy with […] all levels of people that we work with.”

Peer supporters learn to respond to a very human need for connection that transcends different health care specialties and roles. Discussing the differences in the types of stressors experienced by all provides an opportunity to learn about the reality of one another’s challenges as well as many of the workplace and work-life stressors that most encounter. These observations show that peer support programs may be feasible for integrated behavioral health care programs. The peer support program could offer opportunities to foster a deeper understanding of commonalities all encounter to build connection and a culture of wellness.

Health care delivery is marked by intense stress, long hours, and significant emotional toll, which can lead to burnout and mental health challenges. Peer support provides a space where supported individuals can share experiences, gain emotional support, and develop coping strategies. Peer support programs seem logical for employee wellness. By fostering resilience, peer support programs ensure that the workforce offers high-quality services. This holistic peer support model leverages the power of shared experiences and mutual support, creating a network that spans different health care settings. Peer support can take many forms, from formalized programs with structured interactions to informal networks that encourage regular check-ins. Implementation of the peer support model may lead to a cultural shift where seeking and providing support becomes a normalized and integral part of the health care environment. This broader adoption of peer support not only addresses immediate mental health needs but also builds a resilient health care workforce.

The U.S. Surgeon General has issued a call to action (2) to address burnout, isolation, and loneliness. Our interprofessional peer support experience continues to teach us that health care team members have similar needs for support in the workplace. Integrated behavioral health care delivery models can provide ideal workplace settings to develop interprofessional peer support programs to improve mental health and reduce isolation in the workplace. Organizational leadership may consider establishing programs so that behavioral health care teams work in environments that facilitate support to positively affect quality of life and increase sense of connection and belonging.