An update on the growing evidence base for peer support

2017 ◽  
Vol 21 (3) ◽  
pp. 161-167 ◽  
Author(s):  
Chyrell Bellamy ◽  
Timothy Schmutte ◽  
Larry Davidson
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Clinical Outcomes ◽  
Peer Support ◽  
Support Services ◽  
Evidence Base ◽  
Current Evidence ◽  
Content Type ◽  
Current Evidence Base ◽  
Peer Support Services

Purpose As peer support services have become increasingly used in mental health settings as a recovery-oriented practice, so has the body of published research on this approach to care. The purpose of this paper is to provide an update on the current evidence base for peer support for adults with mental illness in two domains: mental health and recovery, and physical health and wellness. Design/methodology/approach To provide a robust, non-redundant, and up-to-date review, first the authors searched for meta-analyses and systematic reviews. Second, the authors found individual studies not included in any of the reviews. Findings Peer services are generally equally effective to services provided by non-peer paraprofessionals on traditional clinical outcomes. Although some studies found peer services to be effective at reducing hospitalization rates and symptom severity, as a whole, the current evidence base is confounded by heterogeneity in programmatic characteristics and methodological shortcomings. On the other hand, the evidence is stronger for peer support services having more of a positive impact on levels of hope, empowerment, and quality of life. Research limitations/implications In addition to the need for further high-quality research on peer support in mental and physical health domains, the authors also question whether measures of hope, empowerment, and integration into the community are more relevant to recovery than traditional clinical outcomes. Originality/value This paper provides an original, robust, and up-to-date review of the evidence for peer services.

scholarly journals Capturing the value of peer support: measuring recovery-oriented services

2019 ◽  
Vol 18 (3) ◽  
pp. 180-187
Author(s):  
Stacey L. Barrenger ◽  
Victoria Stanhope ◽  
Emma Miller
Keyword(s):  
Clinical Outcomes ◽  
Peer Support ◽  
Support Services ◽  
Outcome Measurement ◽  
Evidence Base ◽  
Content Type ◽  
Evaluation Approach ◽  
The People ◽  
Starting Point ◽  
Peer Support Services

Purpose The purpose of this paper is to examine the gap between recovery-oriented processes and clinical outcomes in peer support, an exemplar of recovery-oriented services, and offer suggestions for bridging this gap. Design/methodology/approach This viewpoint is a brief review of literature on peer support services and gaps in outcome measurement towards building an evidence base for recovery-oriented services. Findings Clinical outcomes like hospitalizations or symptoms remain a focus of research, practice and policy in recovery-oriented services and contribute to a mixed evidence base for peer support services, in which recovery-oriented outcomes like empowerment, self-efficacy and hopefulness have more evidentiary support. One approach is to identify the theoretical underpinnings of peer support services and the corresponding change mechanisms in models that would make these recovery-oriented outcomes mediators or process outcomes. A better starting point is to consider which outcomes are valued by the people who use services and develop an evaluation approach according to those stated goals. User driven measurement approaches and more participatory types of research can improve both the quality and impact of health and mental health services. Originality/value This viewpoint provides a brief review of peer support services and the challenges of outcome measurement in establishing an evidence base and recommends user driven measurement as a starting point in evaluation of recovery-oriented services.

Peer support services: state of the workforce-state of the field in the USA

2017 ◽  
Vol 21 (3) ◽  
pp. 168-175 ◽  
Author(s):  
E. Sally Rogers
Keyword(s):  
Mental Health ◽  
Peer Support ◽  
Support Services ◽  
Central Component ◽  
Self Disclosure ◽  
Content Type ◽  
Peer Support Services ◽  
The Usa ◽  
Peer Specialists ◽  
Core Conditions

Purpose Peer support and other consumer-provided services have burgeoned within the USA during the past 30 years and are now a central component of mental health services nationally. However, their growth has been uneven and somewhat dependent on state initiatives, policies, and funding. Recent programs have matured along myriad paths, resulting in a variety of program typologies, service structures, and funding streams, but with common values, missions, and principles. The paper aims to discuss these issues. Design/methodology/approach The landscape of peer specialist services in the USA, as well as innovations afoot, is reviewed. The empirical information that speaks to the efficacy of peer support and the need to better understand the mechanisms by which it is effective is described. Findings Although peer support has grown exponentially across the USA, its growth has been uneven. Evidence suggests that peer specialists experience role ambiguity within many existing programs and systems. Though the empirical evidence for peer services has grown, research has been most favorable for manualized, group interventions. There is still a need to better understand how individual peer support is beneficial and effective, and how individual peer support can best be utilized to promote the best outcomes for those served. Research limitations/implications In order for the workforce of peer support specialists to continue to grow and for services to be responsive and innovative, we need to better understand the mechanisms by which peer support is beneficial and how it can be structured and delivered to promote the best outcomes for those served. The “core conditions” of helping relationships promulgated decades ago by Rogers along with research on self-disclosure may be useful frameworks for understanding and researching the effectiveness of peer support. Practical implications More research is needed to better understand the effectiveness of peer support services and how best to insure that they are well-integrated into the mental health programs and systems in which they serve. Originality/value There is a need to understand why peer support is effective and how best to sustain peer specialists in their roles within the mental health system.

scholarly journals Encouraging the implementation of clinical standards into practice

2000 ◽  
Vol 24 (3) ◽  
pp. 90-93 ◽  
Author(s):  
Claire Palmer ◽  
Paul Lelliott
Keyword(s):  
Mental Health ◽  
Evidence Base ◽  
Current Evidence ◽  
Routine Practice ◽  
Clinical Standards ◽  
Current Evidence Base

The articles by Geddes & Wessely (2000, this issue) and Lelliott (2000, this issue) describe the current evidence base and guidelines from which clinical standards can be developed in mental health. They highlight some of the issues and complexity surrounding the development of standards. It could be argued, however, that an even greater challenge lies in getting clinical standards used in routine practice.

Can analytical psychology be applied to the therapeutic community?

2020 ◽  
Vol 41 (3/4) ◽  
pp. 101-111
Author(s):  
Andrew John Howe
Keyword(s):  
Group Psychotherapy ◽  
Group Work ◽  
Design Methodology ◽  
Therapeutic Community ◽  
Evidence Base ◽  
Analytical Psychology ◽  
Current Evidence ◽  
Content Type ◽  
Current Evidence Base ◽  
Modern Work

Purpose The purpose of this paper is to investigate the theoretical potential of applying Jungian/analytical psychology concepts to a contemporary therapeutic community (TC) within the national health service. Design/methodology/approach A literature review concerning a Jungian understanding of group psychotherapy and TCs was undertaken. A summary and discussion of a detailed written account of a previous Jungian TC was then conducted. A comparison between a modern-day TC and Jungian approaches was then conducted with an ending discussion on the feasibility of incorporating Jungian ideas into modern work. Findings While Jung is thought to have a wholly negative view of groups and group psychotherapy, this was not found in the case. Furthermore, post-Jungian authors have attempted to use ideas from analytical psychology in their group work. While there are some aspects that could be implemented with relative ease in the modern TC, a complete shift into this different way of working would be a challenge and its current evidence base would not support this. Originality/value To the best of author’s knowledge, there are no other academic papers that have considered this subject.

Short report: A quantitative methodological review of participant characteristics in the literature testing mental health interventions for youth with autism spectrum disorder

Autism ◽  
2021 ◽  
pp. 136236132110564
Author(s):  
Kelsey S Dickson ◽  
Megan Ledoux Galligan ◽  
Ho Lok
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Evidence Base ◽  
Autism Spectrum ◽  
Health Interventions ◽  
Current Evidence ◽  
Health Treatment ◽  
Current Evidence Base ◽  
Mental Health Interventions ◽  
Treatment Research

There have been significant efforts to develop, adapt, and test interventions targeting the co-occurring mental health conditions common among autistic youth, with several extant narrative and systematic reviews demonstrating the efficacy of these interventions. Yet, a methodological analysis of the literature testing these interventions, particularly the characteristics of the participant samples comprising this evidence base, is needed to contextualize our current understanding of treatment effects and highlight current gaps in the current evidence base to inform future research. This systematic quantitative methodology review characterized participants included in the mental health treatment research for autistic youth. One hundred and thirty-one articles testing mental health interventions for autism spectrum disorder were coded for youth, caregiver, and provider participant demographics. Findings indicated limited representation of females, transition age youth, racial/ethnic minority groups, and youth diverse in cognitive functioning and co-occurring mental health symptoms or conditions. Limited inclusion of providers’ representative of the clinical workforce was also noted. These results illuminate several critical gaps in the current evidence base for mental health interventions for autistic youth and provide recommendations for future research directions. Lay abstract Previous research has highlighted the importance of mental health treatment for autistic youth. In that research base, most studies focus on demonstrating the efficacy of a particular intervention with a sample of autistic youth. However, understanding the characteristics of samples used within these studies (i.e. demographics) is an important avenue for expanding this research to a more diverse, representative sample of autistic youth in community settings. As such, the current review examined and characterized participants included within mental health treatment research. We coded studies for various demographics among the youth sample, caregivers, and providers participants. Results indicated that while efforts have been made to increase diversity in research, very few studies including transition-aged youth, those identifying as female, and/or those identifying as non-Caucasian. Clinically, a few studies included youth with lower cognitive abilities and/or those with specific mental health problems (e.g. trauma and depression) or more than one co-occurring mental health conditions. Overall, our results highlight several critical gaps in our current evidence base regarding mental health treatment for autistic youth, including the limited clinical representativeness of both provider and child participants.

Matching clients to CBT self-help resources

2010 ◽  
pp. 113-120 ◽  
Author(s):  
Rebeca Martinez ◽  
Chris Williams
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Research And Development ◽  
Evidence Base ◽  
Current Evidence ◽  
Shared Decision ◽  
Mental Health Difficulty ◽  
Self Help ◽  
Current Thinking ◽  
Current Evidence Base

Chapter 9 addresses the range of factors that may inform shared decision making following assessment. Several of these draw upon the current evidence base surrounding the type of mental health difficulty for which self-help CBT is effective, and echo conclusions reached within other chapters in this title and, at times, challenge current thinking concerning LI working. This highlights how there is still much to learn regarding the application of the LI approach, which will hopefully stimulate further research and development in this area.

scholarly journals Combining technical and expert-by-experience knowledge in the quest for personal recovery from bipolar disorder: a qualitative study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Samson Tse ◽  
Winnie W. Y. Yuen ◽  
Greg Murray ◽  
Larry Davidson ◽  
Queenie Lai ◽  
...  
Keyword(s):  
Mental Health ◽  
Bipolar Disorder ◽  
Knowledge Sharing ◽  
Peer Support ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Support Services ◽  
Role Models ◽  
Peer Support Services ◽  
The Way

Abstract Background Knowledge construction is a form of communication in which people can work individually or collaboratively. Peer support services have been adopted by the public psychiatric and social welfare service as a regular form of intervention since 2015 in Hong Kong. Peer-based services can help people with bipolar disorder (BD) deal with the implications of the diagnosis, the way in which individuals with BD receive treatment, and the lifestyle changes that take place as a result of the diagnosis. Through a qualitative paradigm, this study aims to examine how individuals with BD use technical and expert-by-experience knowledge. Methods A total of 32 clients of mental health services were recruited from hospitals, Integrated Community Centers for Mental Wellness, and non-governmental organizations. They participated in semi-structured individual interviews. All interviews were recorded, transcribed verbatim, and analyzed using thematic analysis with the aid of NVivo. The findings were verified by peer researchers. Results Three main themes are presented in this article, including how clients made sense of the knowledge provided by mental health professionals and peer support workers (PSWs), critical perspectives about peer support services, and the way in which the services are more than knowledge transfer alone. Participants generally indicated that knowledge sharing revolved around three experiences: mood changes, medications, and sense of hope. Nevertheless, an empathic understanding of the clients’ experience was more important than the sharing of knowledge. Some clients perceived medication as the chief means to recovery, so PSWs were not useful for them. However, PSW role models had an effect beyond mere knowledge transmission, as they could promote clients’ pursuit of functional recovery goals. Conclusions The present study has improved our understanding of knowledge sharing between clients with BD and health professionals or PSWs, which should take place in an empathic and hope-instilling manner. It has also emphasized the value of the presence of a role model who can speak convincingly with clients to facilitate recovery. The present findings can be used to improve the care of people with BD by generating important guidance with regard to enhancing the knowledge exchange between clients and health practitioners.

scholarly journals The Gut Microbiome and Mental Health: What Should We Tell Our Patients?: Le microbiote Intestinal et la Santé Mentale : que Devrions-Nous dire à nos Patients?

2019 ◽  
Vol 64 (11) ◽  
pp. 747-760 ◽  
Author(s):  
Mary I. Butler ◽  
Sabrina Mörkl ◽  
Kiran V. Sandhu ◽  
John F. Cryan ◽  
Timothy G. Dinan
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Psychiatric Disorders ◽  
Gut Microbiome ◽  
Treatment Strategies ◽  
Health Benefit ◽  
Evidence Base ◽  
Autism Spectrum ◽  
Current Evidence ◽  
Current Evidence Base

The gut microbiome as a potential therapeutic target for mental illness is a hot topic in psychiatry. Trillions of bacteria reside in the human gut and have been shown to play a crucial role in gut–brain communication through an influence on neural, immune, and endocrine pathways. Patients with various psychiatric disorders including depression, bipolar disorder, schizophrenia, and autism spectrum disorder have been shown to have significant differences in the composition of their gut microbiome. Enhancing beneficial bacteria in the gut, for example, through the use of probiotics, prebiotics, or dietary change, has the potential to improve mood and reduce anxiety in both healthy people and patient groups. Much attention is being given to this subject in the general media, and patients are becoming increasingly interested in the potential to treat mental illness with microbiome-based therapies. It is imperative that those working with people with mental illness are aware of the rationale and current evidence base for such treatment strategies. In this review, we provide an overview of the gut microbiome, what it is, and what it does in relation to gut–brain communication and psychological function. We describe the fundamental principles and basic techniques used in microbiome–gut–brain axis research in an accessible way for a clinician audience. We summarize the current evidence in relation to microbiome-based strategies for various psychiatric disorders and provide some practical advice that can be given to patients seeking to try a probiotic for mental health benefit.

Self-initiated expatriation and older women: composing a further life

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Barbara Myers ◽  
Kaye Thorn ◽  
Noeleen Doherty
Keyword(s):  
Older Women ◽  
Exploratory Study ◽  
Qualitative Methodology ◽  
Life Story ◽  
Evidence Base ◽  
Current Evidence ◽  
Content Type ◽  
Current Evidence Base ◽  
Career Model ◽  
Life Story Interviews

PurposeResearch into self-initiated expatriation (SIE) has increased exponentially, although the focus of these investigations has been on professional workers, and little has been gender specific. The purpose of this research therefore is to explore the career and personal motivations for SIE through the novel lens of older women. In this exploratory study, SIE and socio-emotional selectivity motivation theories (SSTs) are used, in addition to the Kaleidoscope Career Model (KCM), to understand the reasons these women have taken this path.Design/methodology/approachThe paper employs a qualitative methodology, drawing on in-depth life story interviews with 21 women aged 50 or more who had taken a SIE. A five-step narrative process using a story-telling approach was the method of analysis.FindingsThe findings show important contradictions to the extant literature. Career dissatisfaction and escape are key motivations for these women. Further, contrary to SST, these women were seeking novelty–new places and new experiences. These women were also seeking authenticity as suggested by KCM, but also challenge was to the fore–not in the career domain, but in the personal domain. Their motivations for SIE extend beyond the current evidence base and understanding of the phenomena.Originality/valueThe contributions include new insights into the motivational drivers for SIE for these older women and the importance of timing as facilitators of SIE. The SIE nomenclature is broadened through the inclusion of older women and beyond professional spheres. An initial framework of a more integrated model is developed from this exploratory study and presented as a basis for beginning to understand the phenomenon of older women undertaking SIE.

The development of safer walking technology: a review

2015 ◽  
Vol 9 (2) ◽  
pp. 100-115 ◽  
Author(s):  
Esmé Wood ◽  
Gillian Ward ◽  
John Woolham
Keyword(s):  
Decision Making ◽  
Social Care ◽  
Evidence Base ◽  
Current Evidence ◽  
Content Type ◽  
People With Dementia ◽  
Published Evidence ◽  
Health And Social Care ◽  
Current Evidence Base ◽  
The Right

Purpose – The purpose of this paper is to gain a greater understanding of the development of safer walking technology for people with dementia through contemporary literature. Design/methodology/approach – A two stage systematic approach to searching the literature was adopted. Initially this involved searching the literature to gain a broad overview of the development of safer walking technology and the context in which it has been developed. Then, this literature was examined in detail to look at published evidence surrounding the use of safer walking technology by people with dementia. These articles were quality appraised and a meta ethnographic approach taken to synthesis of the findings. Findings – There is a small but growing body of literature within this field. Whilst there is only limited evidence to support the use of safer walking technologies for people with dementia, the evidence to date indicates great potential for its use. If provided with the right support and guidance, safer walking technology has the potential to increase freedoms and independence for people with dementia; gaining them improved access to outdoor spaces and environments to support their health and wellbeing. However, if the safer walking technology continues to be associated with only risk management it will not achieve this potential. Research limitations/implications – The published literature within this field is small and has limited generalisability as much of it was generated in recent years has been by the same small research teams, often reusing data sets. There is also very little research that examines the experience of actually using safer walking technology and even less which explores the views of people with dementia. It is evident that a greater breadth and depth of knowledge is needed within this field to develop a clearer understanding of how this technology is used and perceived by all stakeholders concerned. In particular the literature would benefit from greater consideration of the views and experiences of people with dementia themselves. Practical implications – For many people with dementia, health and social care professionals can play an important role in ensuring appropriate assessment and support in the decision-making process when using safer walking technology. However, greater support is needed in decision making for all people with dementia, especially those people not currently engaged with specialist services. Therefore greater awareness of the benefits and limitations of this technology is needed by all health and social care professionals as well as the general public. Originality/value – At the time of conducting this review the author is unaware of any other systematic search of literature or overview of research on the use of safer walking technology and its use by people with dementia. Despite this safer walking technology is growing in popularity, commonly recommended by health and social care practitioners and often marketed and purchased directly by people with dementia and their families. This review offers an insight into the development of the technology and the current evidence base for its use.

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