Accelerating Best Practices in Peer Support Around the World

Program Development Guide

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.

Supervision Model

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.


Solutions to Problems Encountered with Peer Supporters
Organizations that are considering starting peer support programs have, at times, expressed concerns about the ability of peer supporters to conduct the work that’s expected of them. Peers for Progress surveyed our grantee projects and asked them to share examples of problems they encountered along with their solutions. Despite frequent concerns, serious errors were actually quite rare. Common themes of issues identified include:

  • Misinformation
  • Breaches of trust
  • Incompatibility between client and peer supporter
  • Overly directive support

Peer supporters genuinely want to help others! It’s up to the programs to provide the necessary supervision and guidance to address emerging problems and ensure consistent quality of care. The lessons from the grantees suggested applying the P.R. principles when dealing with problems encountered with peer supporters:

  • Being proactive in terms of providing back-up and regular check-ins
  • Being responsive to the feedback from peer supporters and program participants.

Read the complete brief to learn more.

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



Peers for Progress's Providing Ongoing Supportive Supervision This presentation provides an overview of ongoing supervision and support for peer supporters. It also introduces the roles of supervisors and key aspects of training them. Examples and resources are included.
Migrant Health Promotion’s Supervision Manual This manual provides basic guidelines to supervisors of Promotora de Salud Programs. It is a good example for training supervisors/program managers of peer support programs.
Peer Support Guide: Whole Health and Wellness This manual highlights the purpose of supervision for peer support services serving those in recovery, along with the processes for setting up a relationship between the supervisor and the peer support for Whole Health and Wellness Coach Program.
Peer Support for HIV Treatment Adherence by the Harlem Adherence to Treatment Study: On-the job Training (pg.18); Supervision and Support (pg.23) The section of this manual addresses key aspects of ongoing training, supervision, and retention for HIV peer support programs.
iADAPT Project’s Community Health Worker Resources This project at the Morehouse School of Medicine includes handouts and interview scripts to help community health workers provide peer support to people with diabetes.
2012 SBM: Tracking the Intervention (pg. 167) This presentation uses Peers for Progress grantee projects in California, Alabama, and Michigan as examples to introduce how to track diabetes peer support delivery.
Puentes hacia una mejor vida/Bridges to a better life: Group sign-in sheet; successful contacts form attempted contacts form (English); Group activity contact form (Spanish); One-on-one visit form and One-on-one visit form (English and Spanish) Peers for Progress grantee project in San Diego, CA shares monitoring materials. Each mode of delivery has its contact form.
ENCOURAGE: Contact log Peers for Progress grantee project in rural Alabama shares their monitoring form. The log captures the length of contact and topic(s) discussed with a focus on goal setting.
PLEASED: Group direct observation form; Encounter note #1-in person; Encounter note#2- Behavioral goal setting (ppt. slides); and Encounter note #3- by phone Peers for Progress grantee project in Michigan shares their monitoring tools. Each note captures a different mode of delivery.
Australasian Peers for Progress Diabetes Project: Group contact form; and Individual contact form per participant per month Peers for Progress grantee project in Australia shares their monitoring tools. The forms capture the topic(s) discussed, modes of delivery, and reason for contact.
Coaching for Life: Patient contact log for each interaction Peers for Progress grantee project in San Francisco shares their monitoring tool. This log captures the mode of delivery, and topic(s) discussed with a focus on action planning.
Alivio CES contact note and sample monitoring report Peers for Progress project at the Alivio Medical Center in Chicago shares our monitoring tools. It is specifically designed with the intention to be integrated into the electronic medical record.
The University of Kansas Community Tool Box- Chapter 15.2: Provide Supervision for Staff and Volunteers; Chapter 15.3: Providing Support for Staff and Volunteers This section features guidance and basic steps for supervising and supporting volunteers.


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