Ongoing Monitoring, Supervision and Support

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1. Retention and Turnover of Peer Supporters

2. Ongoing Monitoring, Supervision and Support

Ongoing Monitoring, Supervision and Support

It is unrealistic to expect to get everything right before starting a peer support program. Many issues are uncontrollable, and what peer supporters encounter in the field is very likely to differ from what was being addressed in the pre-program training. Therefore, successful peer support relies on monitoring the program’s delivery, providing ongoing training/on-the-job training, creating incentives and trouble-shooting problems. These can keep peer supporters involved and also provide general maintenance to sustain and improve a peer support program.

Soliciting feedback from peer supporters as well as those receiving peer support can help detect delivery issues and intervene to address these issues. Additionally, arranging regular meetings with a designated program staff (e.g., a nurse) and conducting refresher training courses can enhance peer supporters’ ability and confidence to continue providing effective peer support.

It is important to remember that supervision is as important as training. Both training and ongoing supervision promote correct information and a channel of influence. It is also an important aspect of preventing burnout as peer support can be stressful for the peer supporter, and peer supporters need ready access to supervision, back-up, and meeting opportunities to discuss work with each other. Supervision is a responsible way to monitor and act upon any problems that may occur in the program (e.g., matching problems between peer supporter and patient, boundary issues).

Characteristics of good supervision and support of for peer supporters include:

• Ongoing support: Routine, structured check-ins, 24/7 back-up and information check-ins that occur regularly over time.
• Regular check-ins: Examples include: weekly group teleconference with project coordinator and other peer supporters; one-on-one, biweekly face-to-face meetings with project coordinator; monthly one-on-one with the project staff and other peer supporters.
• Back-up support: Offering peer supporters the contact information of their supervisors.
• Continuing education and on-the-job training: Enriching peer supporter skill sets and providing opportunities for personal advancement.
• Supportive supervision: Two-way communication that is constructive, motivational, and reflective of the peer supporter’s value added in a collaborative work relationship.

Frequency and format of check-in meetings will depend on the timing and nature of the program (e.g., volunteer vs. staff-based peer supporters; starting a program vs. continuing a program; part-time vs. full-time peer supporters).

Practical aspects of supervision include performance evaluations (commonly found in the staff model), review of contact notes, and updates on progress of participants. Contact notes can be especially helpful in tracking peer support delivery by capturing the timing and duration of each individual/group contact made, discussion topics between peer supporters and participants, follow-up actions required, and other notes/ issues (e.g., emotional distress). Supportive aspects of communication involve attention to emotional well-being and maintaining open lines of communication. It is also helpful to create facility space and other logistic support for peer supporters.

Several approaches to supervision may be taken:

• Individual: one-on-one with a supervisor and a peer supporter
• Group: one supervisor and a whole team
• Peer-to-peer: a head peer supporter supervises the other peer supporters

There are also various mediums of supervision, such as face-to-face, over the phone, text messages, and by email. Regardless of the supervision approach and medium, it is important to communicate clearly about the expectations and responsibilities of all staff involved.

Key areas for supervisor training include:

• The foundation (i.e., what is peer support, roles and responsibilities of peer supporters and supervisor, organizational policy and protocols)
• Recruitment, selection and training of peer supporters (i.e., organizational process)
• Facilitation of optimal peer supporter-participant relationship (i.e., recruitment of participant, coordination of the matching process between peer supporter and participant)
• Monitoring of progress, evaluation of performance, and ability to provide constructive feedback (i.e., process and tools)
• Organizational management skills (i.e., internal advocacy, conflict resolution, team collaboration)
• Methods of communication, facilitation and problem-solving