Peer Support Specialists May Offer Unique Support for People with Psychiatric Disabilities in Finding and Keeping Jobs

A study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

People with psychiatric disabilities have conditions such as depression, bipolar disorder, anxiety disorders, or schizophrenia. Previous research has shown that these individuals may have difficulty finding and keeping jobs. Peer support specialists, also known as recovery coaches, are trained professionals who have personal experience living with psychiatric disabilities. Peer support specialists can help people with psychiatric disabilities to set employment goals, engage in job searches, and cope with setbacks. Because they have personal experience of their own with psychiatric disabilities, peer support specialists may be able to connect to their clients in a unique way. In a recent NIDILRR-funded study, researchers asked clients with psychiatric disabilities who have worked with peer support specialists to describe these relationships. The researchers wanted to find out what qualities clients valued in their relationships with their peer support specialists.

Researchers at the Rehabilitation Research and Training Center on Improving Employment Outcomes for Individuals with Psychiatric Disabilities interviewed 13 people with psychiatric disabilities who were involved in a larger study about job-related peer support. All of the participants were clients of local mental health agencies, and all of them had participated in at least ten one-on-one meetings with peer support specialists during the six months before the interview. The participants all had job-related goals, and most were unemployed at the time of the interview. During these sessions, peer support specialists focused on the skills needed to meet job-related goals but did not provide clinical services.

Each participant had one interview. During the interviews, the researchers asked the participants to describe their experiences working with their peer support specialists, from before their first session to their most recent interactions. The participants were asked what they expected to gain from working with the peer support specialists, and whether or not the peer support specialists met their expectations. The participants were also asked about the relationships they had with the peer support specialists and what kinds of support they received when working toward their job-related goals.

Participants mentioned three important aspects of their relationships with peer support specialists. These were:

• Building core connections: The participants described how connecting with another individual living with a psychiatric disability helped them to feel less alone and more comfortable with themselves. The participants described their relationships with peer support specialists as “equal” relationships where they felt the peer support specialist truly empathized with challenges in their lives instead of judging or pitying them. They also described the peer support specialists as role models who demonstrated that they could be successfully employed. One participant said, “You just feel like who you are. And it feels good to feel like who you are.”
• Versatile approach: The participants appreciated that their peer support specialists could be flexible and adapt to support them during difficult life situations. For example, they were glad when peer support specialists agreed to make last-minute schedule changes or meet by phone if the participant was unable to travel to a meeting place. The participants also felt it was important that the peer support specialist could talk with them about life circumstances unrelated to their job goals. However, they also expected the peer support specialists to know how to help them with work-related challenges.
• Emotional support: The participants felt that they received a great deal of emotional support from peer support specialists. They described how peer support specialists helped them keep a positive attitude, recognize their strengths, and stay hopeful about the future.

The authors noted that peer support specialists may be able to build a strong bond with clients and can provide critical supports to achieve job-related goals. While mental health clinicians without disabilities can effectively support their clients, peer support specialists have their own personal experiences living with a psychiatric disability, which they can strategically share with clients to establish rapport and demonstrate possibilities for success. These experiences may include encountering negative or judgmental attitudes toward psychiatric disabilities, and that awareness may lead peer support specialists to offer a more open and empathic relationship where clients can share without fear of judgement. The peer support specialist also does not focus on mental health treatment or evaluation, so they may be able to build more of an equal and open relationship with their client than a mental health clinician.

The authors noted that peer support specialists can play an important role in job-related services for people with psychiatric disabilities. Hallmarks of the peer support relationship include empathy, respect, genuineness, and a flexible, nonjudgmental approach. The strong interpersonal connections that result from this relationship may lead to improved vocational outcomes for individuals with psychiatric disabilities. Peer support specialists providing job-related supports may benefit from specific training on self-disclosure as well as modeling recovery and employment success. This type of training may complement their skills and knowledge about work and highlight their expertise on living with psychiatric disabilities. Future research may be useful to examine the impact of peer support specialists on employment outcomes and job satisfaction for people with psychiatric disabilities.

To Learn More

The RRTC on Improving Employment Outcomes for Individuals with Psychiatric Disabilities focused on vocational peer support during the 2009-2014 grant cycle. It introduced vocational peer support in its Spring 2014 newsletter. A training program for peer support specialists is now available from the Center’s bookstore.

Research In Focus highlighted research on supporting peer providers in community mental health settings in February 2017 and peer support for psychiatric advance directives in September 2017.

To Learn More About this Study

Balogun-Mwangi, O., Rogers, E.S., Maru, M, and Magee, C. (2017) Vocational peer support: Results of a qualitative study. Journal of Behavioral Health Services and Research. This article is available from the NARIC collection under Accession Number J78086.

This project was also supported by the Substance Abuse and Mental Health Services Administration (SAMHSA).