Peer Support Key to Sustaining Recovery
A longstanding tradition in the addiction recovery community, peer support groups also help people with mental health disorders. Research findings now illustrate their benefits.
Good peer-support groups insist on confidentiality and anonymity—a feature that benefits members but challenges researchers who want to collect data and contact subjects for follow-up studies. Studies of groups' effectiveness often have methodological shortcomings. For example, the studies tend to be retrospective rather than prospective, and they may lack randomized control groups. Some studies are based on small sample sizes, and many rely on self-reports rather than unbiased observation.
Yet there is enough anecdotal evidence of the benefits of peer support groups to warrant more rigorous studies of their effectiveness. And despite their overall limitations, the available findings are too promising to ignore. For example, research indicates that active participation in any type of peer support group increases the likelihood that members will abstain from alcohol and nonprescription drugs. Furthermore, abstinence rates increase with greater group participation (SAMHSA Fact Sheet)
The Surgeon General's report on mental health concludes that a "number of controlled studies have demonstrated benefits for consumers participating in self-help" and that "participation in self-help groups has been found to lessen feelings of isolation, increase practical knowledge, and sustain coping efforts."
Because they are informal organizations led by nonprofessionals, peer support groups by definition do not offer services that are expected from treatment providers, such as the following:
Screening potential members based on assessment criteria
Keeping medical records
Referring members to specialized or emergency care
Offering formal training for group leaders
Follow up with people who drop out of the group
Taking other steps to lower attrition
In addition, operations of peer support groups are not regulated by law, and newcomers to such groups might get guidance that contradicts their treatment plan. For instance, a person with a co-occurring disorder who attends an AA group might be told that taking a prescription pain medication violates the group's norms for full sobriety. While this is not the official position of AA, misinformed members might offer such advice or suppress conversation about the need to take medication. Preventing and avoiding such misguided attempts is a major reason for the existence of Double Trouble in Recovery (the peer recovery group for people with co-occurring mental health and substance use disorders).
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Peer support programs are essential because they are often the one constant that people experience as they move between the other points on the continuum of care. People with a co-occurring disorder may receive treatment in inpatient and outpatient settings. They may see a variety of professionals-psychiatrists, psychologists, social workers, chemical dependency counselors, and paraprofessionals-and interact with peer counselors with various levels of recovery from mental health and substance use disorders. Additionally, people in recovery often find that their personal relationships shift as they withdraw from friendships that were based on drinking or using drugs.
In the midst of all this change, peer-supported recovery programs offer a constant link to the shared experience of recovery from a co-occurring disorder. Double Trouble in Recovery in particular offers a continuing care option for people with co-occurring disorders as they move through multiple hospitalizations, trial and error in medication management, and referrals to housing and employment services.
Excerpted from How to Start a Double Trouble in Recovery Group: A Guide for Professionals. Hazelden, 2010.