Best Practice Framework
2. Getting Started
Once up and running, a successful peer support program will take on a life of its own and continue to evolve to meet the changing needs of those involved. To get a program started, however, requires some preliminary planning and an initial design that generates enough interest and enthusiasm to get the program underway. This means identifying needs amongst the potential users of the program and choosing a basic program design that will best address those needs.
A well-designed peer support program will also be a sustainable one – a program that lasts beyond the initial flush of enthusiasm.
2.1 Needs Analysis and Research
The success of any program depends critically on addressing the needs of those involved, so the starting point for planning a peer support program must be to assess the needs of those who are potentially to be served by the program.
You may feel that you already know this information about your members or the group you are hoping to get involved, but the most appropriate design of a peer support program will depend on a range of factors about those who may be using the program such as:
- Age,
- Education level,
- Gender,
- Work occupation and situation,
- Location,
- Languages spoken,
- Access to technology (phone, Internet),
- Mobility,
- Physical wellbeing, and
- Emotional wellbeing.
This type of demographic information is important because it impacts the choice of the best type of peer support – for example if many of the potential users of the system work during business hours, then a support group program that meets during the day on weekdays will be of little use to them. Language is another important issue to consider. The Cancer Council estimates that approximately 23% of Victorians diagnosed with cancer speak a language other than English.
Information about potential users of the support program can be obtained by:
- Survey - stand alone, or included with general organisational communications (eg newsletters),
- Conducting one or more focus groups,
- Face-to-face or telephone interviews,
- Interviews with clinicians and/or other health professionals.
Online surveys can be a quick and effective way to collect this type of information if you have access to an existing mailing list of relevant people. An online survey can be set up simply using software such as Zoomerang[i] or Survey Monkey[ii]. Even if your needs analysis is done informally by a series of conversations with relevant people, it will ensure that the program as finally implemented is designed for users if their needs are sought and recorded at the start.
Based on the needs analysis, you should be able to work out:
- What problems do people with a specific chronic illness or condition face that could be addressed by (additional) peer support?
- Approximately how many people would be interested in giving and/or receiving peer support?
- What is the demographic picture of the people who are interested i.e. where do they live, when are they available to give or receive support, what is their familiarity with technology, are there disability factors to consider?
- Who should be involved in the program (at least initially) - do you wish to support only people with a chronic illness, or also carers or other family members?
Key factors for successful needs analysis are:
- In designing your program, have you taken demographic data into account?
- In designing your program, have you consulted with relevant stakeholders?
- Would the creation of a new program duplicate the programs offered by other organisations?
2.2 Choosing the best program form for your organisation
Having established what people with a chronic illness are looking for by way of peer support, the next question is what type of program your organisation should choose. This depends not only on the peers themselves, but also on the capacity of your organisation (including personnel, financial and other resources).
The following table describes some of the general advantages and potential pitfalls of different forms of peer support.
Support Groups Some organisations run peer support programs that consist of a series of workshops or meetings of a small group of members, usually running for approximately eight sessions. Other peer support groups are ongoing and may even operate more as social events simply providing an opportunity for networking. |
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| Advantages | Potential Pitfalls |
| Repeated face to face contact promotes trust and sharing of experiences. | Requires access to a central meeting place with appropriate facilities. |
| Gives any individual group member access to a range of peer views on any specific topic or issue. | Can require a regular time commitment at a specific location and hence busy people may be reluctant to get involved. |
| Allows longer-term exploration of issues over a series of meetings. | Requires a “critical mass” of participants and hence less likely to be available in regional areas. |
| Provides a positive role model. | Can be difficult to find peer facilitators. |
| Informal social events can provide a non-threatening way for new people to become involved. | |
There is a range of Internet-based options for peer support. The minimum effort system is one based on email with a list of subscribers (such as Yahoo Groups). For a larger group of users, and more diverse discussions, a full online forum web site could be appropriate. |
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| Advantages | Potential Pitfalls |
| The main advantage of online peer support is that such systems are user-driven so the topics that have most attention are by definition those of most interest. | Only accessible to those with the skills and facilities necessary to use the Internet. |
| The online nature provides immediacy of support at times that suit the users. | Online options have all the potential pitfalls of online interactions generally. You can never be 100% sure who you are communicating with. |
| Can provide support independent of physical location, so suitable for supporting a wide geographical spread of members, or members whose mobility is limited. | There is a significant level of investment in time and skilled resources to get an online peer support system up and running. |
| It’s cheap to run once established. No postage, printing, copying, phone calls, travel… | Requires peers with the maturity, time and skills to take on the role of moderator. |
Telephone peer support programs Telephone peer support programs typically operate by a co-ordinator matching a volunteer with a compatible peer. The volunteer then calls the peer at prearranged times for a series of conversations exploring issues that the peer is experiencing. Most organisations require phone records to be kept by the volunteer and specify a maximum limit to the number of calls to be made. Informal peer support also often takes place over the telephone. |
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| Advantages | Potential Pitfalls |
| Flexible location and flexible time to suit individual pairs of volunteers and peers. | Can be confused with emergency support and counselling. Calls are to be made by the volunteer at pre-arranged times. |
| Largely self managed, so encourages self direction and addresses issues of specific relevance to the peer. | Inappropriate advice or disclosure can be a problem in this type of support where interactions are not monitored. |
Whilst these three options provide the basic types of peer support programs in operation, the options are only limited by your imagination in what might be best to meet the particular needs and circumstances of the group you wish to support. Many organisations build programs that are a combination of types of support as in the following example.
This program includes a wide range of events and programs including support groups, newsletters, social events, camps during school holidays and leadership training. The events are a combination of opportunities for networking for peers plus advice from health professionals.
On the other hand, don’t feel as if you need to design a complex, multi-faceted program in the first instance. Never underestimate the benefits of simply providing a forum where peers can get together, socialise with people with whom they have something in common - and share their stories of living with a chronic illness. Not all interactions need to be heavily structured and managed.
Once you have completed a needs analysis and chosen the initial form that your peer support program will take, it is good practice to prepare a written statement of purpose and a set of values that will guide your program design and activities. Depending on the statutory form of your organisation, the statement of purpose may be a legally binding document[iv].
Having a statement of purpose will avoid confusion both within the program and to ‘outsiders’ and hence may be useful when you seek funding or other assistance. Such a statement needs to specify, where appropriate, if the program involves only those individuals who have/had the chronic illness and whether carers can also be included. It would also be worthwhile to include a statement indicating that ‘the peer support program recognises that volunteers who have/had a chronic illness are in an unique position, different from that of the health professionals, to provide assistance and empathy to another individual who also has the illness’. Guiding values are likely to include such qualities as empowering, supporting and partnering.
Key factors for success in choosing the form of your peer support program are:
- Is the form of your program the best option to cater for the needs of your target population?
- Is the structure of your program within the resources of your organisation?
- Does your program complement the activities and goals of your organisation?
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