What is Peer Support?

Thank you to M.W. for submitting the question, “What is peer support?”

I've been working in peer support for almost 20 years, long before I even knew it had a name. Over the years, many people have asked me to explain what peer support really is. Interestingly, it’s often harder to explain what it isn't.

As peer support continues to gain recognition, especially in mental health and substance use supports, its value is becoming increasingly clear. More people are seeing the power of shared lived experiences in fostering empathy, connection, and healing. However, despite this growing awareness, there are still plenty of misconceptions. So, let’s dive in and explore what peer support truly is—and what it isn’t—while debunking some common myths along the way, shall we?

Peer support offers tremendous benefits that depending on the individual’s preferences, can be used alongside or, in some cases, in place of clinical treatment like therapy and psychiatric care. Peer support is about honouring a person’s voice and choice. It doesn’t follow a hierarchical model where one person holds authority over the other. Instead, it’s a relationship built on equality, where both individuals are on the same level.

In clinical practice, disagreeing with a practitioner can sometimes be seen as non-compliance or resistance to treatment. However, in peer support, what might be labelled as "non-compliance" is viewed as an important act of self-advocacy. Peer support encourages individuals to take ownership of their own journeys, making choices that align with their personal values and needs.
Rather than simply following prescribed advice, individuals are empowered to voice their concerns, question suggestions, and make decisions that feel right for them—fostering autonomy and active participation in their own wellness.

At its core, peer support is an approach to helping individuals navigate life challenges through mutual understanding, shared experiences, and empathy. A peer supporter is typically someone who has lived experience with a particular issue—whether it’s mental health issues and/or substance use challenges, and who has walked the road to healing. This lived experience equips them to support others who are on a similar path.

Peer support can happen in a variety of settings, ranging from formal environments like mental health organizations to more informal spaces such as community groups or online platforms, even in local cafes. In my own experience, I’ve offered peer support through the arts, both in group settings and one-on-one. The unique blend of creative expression and peer support offers a powerful avenue for healing, allowing individuals to process emotions and experiences in a non-verbal, often more intuitive way. The impact of art on someone’s healing journey is profound and multi-faceted—so much so that it deserves its own dedicated exploration. Creative activities can serve as a bridge to deeper self-awareness, emotional release, and connection with others, offering people a new lens through which to view their recovery and growth. But more about that in a future blog post!

Becoming a mental health peer support worker requires much more than simply having lived experience. While personal experience with mental health challenges is the foundation of peer support, it doesn’t automatically qualify someone to work in this role. In fact, substantial training and education are necessary to ensure peer support workers can effectively and ethically support others, walking by their side through both crises and successes.

The Mental Health Commission of Canada has established guidelines that outline best practices for peer support work, ensuring that it is safe, ethical, and impactful. These guidelines provide a framework for how peer support workers should operate, focusing on key principles like mutual respect, empowerment, and confidentiality.

For those looking to enter the field, Peer Support Canada offers a certification process that ensures peer support workers meet professional standards. Certification involves completing approved training programs, demonstrating core competencies, and maintaining ongoing professional development. This rigorous process equips peer support workers with essential skills, such as active listening, boundary setting, and crisis de-escalation.

While not all peer support workers hold formal degrees, many come from diverse educational backgrounds. Some even hold advanced degrees, including Master’s degrees in fields like social work, psychology, or counselling. Though lived experience remains at the heart of peer support, the combination of formal training, certification, and education ensures that peer support workers are well-prepared to offer high-quality, compassionate, empathetic support.

To be a certified* peer support worker through Peer Support Canada, a person must demonstrate skills and abilities within the following competencies:

1. Interpersonal Relations
   Interacts in a manner that honours the dignity of others and strives to build positive respectful relationships. Strives to make others feel comfortable and conveys genuine interest in their peer. Even in a difficult or tense situation strives to maintain a level of respect and consideration for the other.
   

2. Demeanour
   Is sensitive to what another might be feeling, demonstrates a capacity for non-judgmental empathy, and responds from an equal, genuine, and sharing point of view. Selectively self-discloses own experience in a manner that ensures the relationship remains peer focused.
   

3. Communication
   Listens with empathy and without judgment, holding their peers in unconditional high regard. Uses communication styles and skills to improve understanding and adapts the style and tone of communication to suit the listener and the situation. Communicates using recovery language and emphasizes the strengths of their peers.
   

4. Critical Thinking
   Engages in active listening skills to better understand a situation and recognizes that there is more than one way to look at an issue. Considers the possible implications or outcomes of their actions and, when asked, will help peers to explore the outcome or possible consequences of various options. Demonstrates good judgment in respecting the limits and boundaries of their role.
   

5. Hope
   Operates from a sense of hope expressing confidence that others will be successful in their own personal journeys of recovery. Strives to model realistic optimism and a belief that even in difficult situations positive choices can be made.
   

6. Self-Management & Resiliency
   Understands the importance of self-care and stress management and models the practices that work best for them to remain healthy while supporting others. Strives to maintain calm and diffuse stressful or challenging situations.
   

7. Flexibility & Adaptability
   Is open to new ideas, deals comfortably with ambiguity, and adjusts plans or behaviours to better suit a given situation. Is willing to be open-minded and compromises when needed.
   

8. Self-Awareness & Confidence
   Interacts in a manner that demonstrates a balance of self-confidence with openness to the thoughts and opinions of others. Self-reflects and understands that personal thoughts and attitudes can influence their behaviour and actions.
   

9. Initiative & Commitment
   Is dependable and carries tasks through to completion. Demonstrates good judgment knowing when insight or assistance should be requested from another and are trustworthy when working independently.
   

10. Teamwork
    Shares knowledge, ideas and resources with team members in a cooperative and collaborative manner. Strives to fulfill their role and responsibility within the team while respecting the roles and responsibilities of the other team members.
    

11. Continuous Learning & Development
    Strives to approach life and work in a curious manner, identifies areas where personal growth may be helpful, and takes advantage of opportunities to learn and develop. Recognizes the value of on-going personal growth and skill development and maintains a connection with a peer support community as a resource to stay ‘grounded’ in the work of authentic peer support.
    

In a nutshell, peer support is:

• Empowerment: The goal is to foster self-agency, with individuals gaining confidence in their ability to manage their own wellness.

• Mutuality: It is a two-way relationship where learning and support are exchanged.

• Non-judgmental support: There is an emphasis on empathy, acceptance, and understanding.

• Lived experience as a resource: The experiences of both peer supporters and those they support are central to the process.

• Voluntary participation: Unlike some forms of clinical care, peer support is not imposed on individuals.

So, now that you know what peer support is, expectations of peer support workers and their training, let’s talk about what peer support isn’t.

What Peer Support Is Not

Peer Support is NOT Therapy or Counselling: While peer support can have therapeutic effects, it is fundamentally different from therapy or counselling. Unlike clinical settings, peer support does not involve clinical diagnoses or therapeutic techniques. Peer support is focused on sharing lived experiences and offering mutual support rather than providing formal mental health assessments or structured therapeutic interventions.

In many peer support settings, there is no requirement to complete detailed intake forms or disclose a specific diagnosis. Participants have the freedom to share their experiences at their own pace and discretion. This aspect of peer support emphasizes personal choice and autonomy, allowing individuals to engage in conversations and support without the pressure of formal clinical processes. The aim is to create a safe and supportive environment where people can connect based on shared experiences and mutual understanding, rather than through a clinical framework.-

Peer Support is NOT a Cure-All. While peer support plays a crucial role in the journey toward mental wellness and healing, it is not a comprehensive solution on its own. It is one valuable piece of a larger puzzle that for some often includes various forms of care and support. Peer support offers unique benefits, such as shared understanding, empathy, and a sense of community. However, individuals seeking mental wellness may also need to engage in other practices and treatments, such as therapy, medication, or medical care, depending on their specific needs. In essence, while peer support can be a powerful and supportive element of healing, it is most effective when integrated with other strategies and resources, tailored to each person's holistic needs and goals.

Peer Support is NOT Crisis intervention. Crisis workers are equipped with specialized skills and resources to manage urgent and high-risk situations safely and effectively. They have the training to assess risk, provide immediate support, and connect individuals with the appropriate level of care. While peer supporters play a critical role in ongoing support and healing, they are part of a broader system of care that includes these specialized professionals. Ensuring that individuals in crisis receive the right type of support and intervention is vital for their safety and well-being.

Peer Support is Not Hierarchical: In contrast to traditional professional services, where there is often an expert-client dynamic, peer support operates on a foundation of equality and mutual benefit. In clinical settings, there is a clear distinction between the practitioner, who holds specialized knowledge, and the client, who is seeking that expertise. This hierarchical structure can sometimes create a power imbalance.

Peer support, however, is built on a relationship of equals. Both the peer supporter and the individual seeking support share common experiences and engage in mutual dialogue. The goal is to foster a collaborative environment where both parties contribute to the conversation and support each other. This non-hierarchical approach allows for a more balanced and empowering exchange, where the emphasis is on shared experiences and personal growth rather than professional authority.

This egalitarian model promotes a sense of connection and trust, as it acknowledges the value of each person’s perspective. It encourages openness and reciprocity, helping individuals feel more supported and understood, while also allowing them to contribute their own insights and experiences to the relationship. In peer support, the focus is on building a supportive partnership where both individuals benefit from the shared journey. It’s all about two people walking a path together.

Throughout my extensive experience in the mental health field, where I’ve worn many different hates, I have consistently identified as a person with lived experience. This openness in addition to my peer support role has occasionally resulted in condescension from individuals in higher positions, who may not fully recognize or appreciate the unique value and perspective that peer support offers.

Myth #1: Peer Support is Unprofessional and Unreliable

Fact: Peer support is grounded in extensive training and ethical guidelines. The Mental Health Commission of Canada provides clear guidelines for peer support practice, and Peer Support Canada offers certification that ensures peer supporters meet professional standards. Research indicates that peer support can be highly effective; a review by Chinman et al. (2014) found that peer support has positive outcomes, including reduced hospitalization rates and improved social functioning.

Myth #2: Peer Support is Only for People with Severe Mental Health Issues

Fact: Peer support is beneficial for anyone who needs it! It can assist anyone facing life challenges, such as stress, grief, burnout, depression, trauma, gender identity, etc. The broad applicability of peer support is supported by various studies and practices showing that it helps individuals across different stages of mental health and recovery (Repper & Carter, 2011).

Myth #3: Peer Support is Just a Friendly Chat

Fact: While peer support is more informal than clinical therapy, it is not merely a casual conversation. It involves structured frameworks and intentional support strategies. Peer supporters are trained in communication skills, ethical practices, and coping strategies. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), peer support is an evidence-based practice that includes purposeful, empathetic interactions aimed at fostering empowerment and recovery.

Myth #4: Peer Support Encourages Dependency

Fact: Peer support is designed to empower individuals rather than foster dependency. The goal is to help people build their own resilience and self-management skills. Research by Davidson et al. (2006) highlights that peer support often leads to increased self-efficacy and improved personal autonomy, countering the notion that it promotes reliance on others.

Myth #5: Peer Support Workers Are Not Qualified

Fact: Many peer support workers undergo rigorous training and certification. For example, certification programs by Peer Support Canada and other organizations ensure that peer supporters are well-prepared to provide effective support. While not all peer supporters have formal degrees, some hold advanced degrees, demonstrating that they come from diverse and qualified backgrounds.

Myth #6: Peer Support is Only Effective in Group Settings

Fact: Peer support is effective in both group and one-on-one settings. Individual peer support can provide personalized and focused assistance tailored to a person’s specific needs. Studies have shown that both group and individual peer support can lead to positive outcomes, including improved mental health and increased engagement in recovery processes.

Myth #7: Peer Support Involves Sharing Confidential Information Publicly

Fact: Confidentiality is a core principle of peer support. Peer supporters are trained to respect privacy and maintain confidentiality. Ethical guidelines and training programs emphasize the importance of protecting personal information and ensuring that discussions within peer support remain private and secure.

The Research on Peer Support

Several studies have highlighted the efficacy of peer support in mental health and substance use support. The Substance Abuse and Mental Health Services Administration (SAMHSA) identifies peer support as an evidence-based practice. Research from Mental Health America and other institutions has shown that peer support leads to increased engagement in treatment, reduced relapse rates in addiction recovery, and higher overall satisfaction with mental health care.

One notable study published in the journal Psychiatric Services found that individuals with mental health conditions who participated in peer support programs experienced lower re-hospitalization rates and improved social functioning compared to those who only received traditional care. Another systematic review by Repper and Carter (2011) highlighted the benefits of peer support in promoting hope, reducing stigma, and increasing self-management for mental health service users.

Here are some additional Canadian research findings on peer support:

• Mental Health Commission of Canada (MHCC) Research:

  • Report: “A Literature Review of Peer Support in Mental Health and Addictions” (2013)

  • Summary: This comprehensive review by the MHCC highlights the effectiveness of peer support in improving mental health outcomes. The report shows that peer support can reduce hospitalizations, improve social functioning, and enhance overall well-being. It emphasizes the role of peer support in fostering recovery and empowerment through shared lived experiences.

  • Source: Mental Health Commission of Canada
    

• Canadian Peer Support Certification Project:

  • Study: “Peer Support Certification: Building a Competency-Based Framework” (2016)

  • Summary: This project focuses on developing a certification framework for peer support workers in Canada. The study demonstrates that structured training and certification improve the quality and consistency of peer support services, ensuring that peer support workers are well-equipped to offer effective assistance. The certification process is shown to enhance the professional credibility of peer support roles.

  • Source: Peer Support Canada
    

• University of Ottawa Research:

  • Study: “The Impact of Peer Support on Recovery from Mental Illness” (2015)

  • Summary: This study conducted by researchers at the University of Ottawa explores the impact of peer support on individuals recovering from mental illness. Findings indicate that peer support contributes significantly to improved recovery outcomes, including increased self-esteem, better coping skills, and enhanced social integration. Participants reported feeling more understood and less isolated through peer support relationships.

  • Source: University of Ottawa Research Publications
    

• CAMH (Centre for Addiction and Mental Health) Evaluation:

  • Report: “Evaluating Peer Support in Mental Health and Addictions” (2017)

  • Summary: The CAMH evaluation examines various peer support programs across Canada. The report finds that peer support programs lead to positive outcomes such as increased engagement in recovery activities, improved emotional well-being, and stronger social support networks. It underscores the value of peer support in complementing traditional treatment approaches.

  • Source: CAMH

These studies and reports highlight the significant benefits of peer support in the Canadian context, demonstrating its effectiveness in enhancing mental health outcomes and supporting recovery.

The sense of shared understanding and connection that peer support provides can be life-changing for many individuals, including myself. Whether as a standalone resource or part of a broader care plan, peer support offers an accessible and compassionate path toward well-being.

If you would like me to include your own thoughts and experiences with peer support below or you have more questions, you can send an email using the contact information below.

* Please note that not all peer support workers are certified, and each peer support organization or agency may have its own set of requirements and standards for their workers.

References:

- Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. E. (2014). Peer Support Services for Individuals with Serious Mental Illnesses: Assessing the Evidence. Psychiatric Services, 65(4), 429-441.