Integrating Peer-Provided Services: A Quasi-experimental Study of Recovery Orientation, Confidence, and Empowerment

Department of Psychiatry, Yale University, New Haven, Connecticut, USA.
Psychiatric services (Washington, D.C.) (Impact Factor: 2.41). 12/2008; 59(11):1307-14. DOI: 10.1176/
Source: PubMed


Peer-provided mental health services have become increasingly prominent in recent years, despite a lack of evidence of beneficial impact. The study presented here compared the effectiveness of the Vet-to-Vet program, a peer education and support program, and standard care without peer support on measures of recovery orientation, confidence, and empowerment.
Participants were recruited in two consecutive cohorts between 2002 and 2006, one before the implementation of the Vet-to-Vet program in June 2002 (cohort 1; N=78) and one after (cohort 2; N=218). Follow-up interviews were conducted at one, three, and nine months. There were few baseline differences between the cohorts. Intention-to-treat analyses compared cohorts on changes over time on measures of recovery orientation, confidence, and empowerment. A third cohort (cohort 2-V) was constructed that consisted of the subset of participants from the second cohort who directly participated in more than ten Vet-to-Vet sessions since the last research interview (N=102). Comparisons between this cohort and the first cohort constitute as-treated analyses.
In the intention-to-treat analyses, the Vet-to-Vet cohort scored significantly higher on measures of empowerment. In the as-treated analyses, significant differences favoring the Vet-to-Vet cohort were observed on both empowerment and confidence. Secondary analyses of clinical measures showed significant differences favoring the cohorts 2 and 2-V on measures of functioning and on alcohol use.
These data suggest that participation in peer support may enhance personal well-being, as measured by both recovery-oriented and more traditional clinical measures.

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    • "They can be employed in different roles, such as working on assertive community teams, as outreach counselors, recovery group facilitators in psychiatric hospital wards, and so forth (Solomon, 2004; Repper & Carter, 2011). Studies on peer providers reveal that they experience significant recovery processes related to enhanced sense of well-being, vocational rehabilitation, social empowerment, and acquired skills involved in peer roles (Cook et al., 2012; Hutchinson et al., 2006; Moran, Russinova, Gidugu, et al., 2012; Resnick & Rosenheck, 2008; Salzer & Shear, 2002), as well as personal subjective benefits to self-esteem, interpersonal relationships, and spirituality (Moran, Russinova, Gidugu, et al., 2012; Mowbray, Moxley, & Collins, 1998). Such benefits to recovery may be comparable with positive psychological processes also experienced in the general population (i.e., individuals not diagnosed with severe mental illnesses). "
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    • "Published literature on person-centered care, treatment engagement, and recovery-oriented approaches has by guest on January 20, 2015 Downloaded from started to show that involving service users in care processes results in better outcomes (Resnick & Rosenheck, 2008; Sidani, 2008; Warner, 2010). "
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