Lending a Healing Hand: Peer Support
By Karen Badger, PHD, MSW
“Sometimes in our lives, we all have pain, we all have sorrow….Lean on me, when you’re not strong, and I’ll be your friend, I’ll help you carry on.”
These words by singer/songwriter Bill Withers seem to resonate with many of us. Lean on Me quickly became a number one hit in the 1970’s and has been recorded and performed by many others since then. The lyrics offer listeners the ideas of support during times of struggle, connection to another to share overwhelming burdens, and the vision to “carry on.” These lyrics embody the importance of receiving support from others, particularly during times of crisis, and are fitting as a description of the essence of peer support.
Peer support is used in relation to many health conditions, such as chronic pain, cancer, cardiac issues, substance abuse, as well as burn injury. Those in the burn community have varied levels of involvement with peer support. Burn survivors or their family/friend support persons who elect to be peer supporters for other burn survivors or their loved ones provide a distinctive type of support—peer supporters have had a personal experience with burn injury and what recovery involves; they’ve been there themselves. Peer support has been described as a resource for emotional, instructional, or informational support, or, in some cases, practical or instrumental support (for example, supplying magazines while in the hospital, providing transportation to clinic appointments, or picking up a prescription) (Solomon, 2004). Receiving support from someone who is further along on their recovery journey from a burn injury can be helpful in restoring connections with others, as well as providing motivation and hope, useful for adaptation to injury.
The Phoenix Society’s mission includes building connections among those in the burn community and establishing and strengthening resources available to burn survivors and their supporters, including peer support. In the past couple of years several studies conducted by the University of Kentucky with the support of the Phoenix Society have focused on furthering our understanding of peer support. We want to thank the burn survivors who have participated in these efforts and, in appreciation, share in this article a brief overview of some of our findings.
INTERVIEWS AT WORLD BURN CONGRESS: MEANING OF PEER SUPPORT IN RECOVERY
To those who have recently returned from the World Burn Congress (WBC) 2009 in New York City, describing the importance and power of peer support may seem unnecessary or even beyond words since it was so much a part of that experience. WBC offers burn survivors, their supporters, and others in the burn community an opportunity to give and receive support from one another, gain knowledge about burn recovery, and strengthen skills to aid in healing and adjustment while being part of a caring, authentic, and accepting community. However, those in the burn care community who have been unable to attend WBC may not have the same experience or knowledge of peer support. How might peer support be described by burn survivors? How would its influence on healing and adjustment be explained?
To document and better understand the meaning of peer support in burn recovery, my colleague and I interviewed 30 burn survivors (19 males and 11 females) during the 2007 World WBC in Vancouver, British Columbia. Three broad themes emerged from those interviews:
- High regard of peer support. Those burn survivors interviewed rated talking to other burn survivors as “very important” in their recovery (average rating = 9.29 on scale of 1 to 10). (Twenty-five of the 30 survivors with whom we spoke had previous encounters with peer support prior to WBC.) These interviews showed a high regard for peer support. The survivors described feeling empowered as a result of the education and information they received from their fellow burn survivors. They also spoke of the importance of being able to hear actual accounts of how others were managing issues, such as reactions to their burns and adjustment to appearance and life changes. They benefitted from being able to observe how other burn survivors carry and present themselves in public.
- Providing hope. The ability to see an example of someone else who had rebuilt his or her life and overcome many of the challenges of the injury was a source of hope for most of the burn survivors interviewed. For many, contact with peers provided real examples of life progressing beyond the burn injury in a way that was fulfilling and positive. For some burn survivors, observing others’ success made recovery seem in reach—more so than words of encouragement without an example. Some described the peer support as aiding in increasing self-esteem and shifting from a personal view of “victim” to “survivor.”
- Experiencing belonging. The majority of the burn survivors interviewed spoke about feeling more trusting of others, more connected to someone, and better accepted or understood because of interactions with another burn survivor. They described the support they received from fellow burn survivors to be different compared to that received from family, friends, and healthcare professionals. Some survivors shared experiences of beginning conversations with other burn survivors already feeling a certain amount of trust or acceptance because of the shared experience of the burn. Burn survivors receiving support could identify with the positives of survivorship, which helped them feel a sense of belonging and less isolated.
PERCEPTIONS OF THE VALUE OF PEER SUPPORT
For another study, in 2008 a survey was mailed to a random sample of burn survivors who were members of the Phoenix Society. It explored their views about the services offered by the Phoenix Society, as well as the degree to which survivors valued peer support and how it was associated with aspects of the burn survivors’ recovery. Ninety-five surveys were returned.
The burn survivors rated the World Burn Congress as the highest valued service; Burn Support News receiving the second highest rating. The Survivors Offering Assistance in Recovery (SOAR) program, as well as informal peer support encounters, also received high value ratings. Burn survivors were also asked to rate their perceptions of the value of peer support in relation to recovery from their burns. Peer support was highly valued overall by the burn survivors who responded. They gave ratings indicating high importance to statements that peer support helped them cope with injuries, helped them develop hope for the future, and allowed them to talk to others about their injuries.
Those who reported higher perceived value of peer support also reported higher levels of social comfort, greater life satisfaction, and better quality of life, which included mood, relationships, intimacy, and body image.
It must be noted that although these positive associations were statistically significant and there is an association between peer support and these other variables, the nature of the study design does not allow us to draw conclusions that peer support caused these higher levels—they are only associations. However, these findings are in the same vein as those in other studies that have reported positive attitudes and satisfaction of burn survivors speaking to or interacting with other burn survivors for support (Bennett, 2007; Chedekel & Tolias, 2001). Additionally, a study of teenagers in burn camp concluded that peer interactions can help adolescent burn survivors feel accepted, promote insight, and increase confidence (Williams et al., 2004). We can also turn to studies that have been done in relation to health problems other than burns and find evidence of positive changes in behavior and increased quality of life for those who received peer support. Although studies of the power and effectiveness of peer support for burn survivors are still relatively few in number, some beginning evidence and many anecdotal accounts of burn survivors suggest that peer support may be an important recovery resource.
We appreciate the opportunity to be able to be part of the endeavor to learn more about peer support and its meaning and role in healing from burn injuries and again thank the burn survivors who have participated in the studies summarized here and in other studies. There is still work to be done in this area, and it is an exciting time for peer support in burn care. As some of you may know, the American Burn Association (ABA) and the Phoenix Society have worked together to establish a joint Aftercare Reintegration Committee (ARC), composed of burn survivors, their supporters, healthcare professionals, firefighters, and researchers, whose mission is to develop standards of aftercare for those touched by burn injury, specifically in the areas of recovery and community re-entry. Peer support has been chosen as one of the priority areas of focus for the committee.
The need for peer support resources was also underscored by the results of a survey distributed by ARC members at the 2008 ABA national conference. The 123 healthcare professionals who responded at that time indicated that it was highly important (9.6 on a 10-point scale) for burn survivors and their family members to be informed of peer support resources. The ARC will work on developing guidelines for peer support, creating more resources and greater access to peer support services for burn survivors and their support persons who want to utilize the support.
If you are a burn survivor or family/friend support person who is not yet involved but wants to get connected to peer support, contact the Phoenix Society to learn what peer support services are available at your treatment center or in your area. More and more hospitals are establishing SOAR programs through the Phoenix Society or have their own support group or peer support options in place. Local support resources can also be found on the Resource Locator page of the Phoenix Society website. The Society also offers an on-line weekly peer support chat that can be accessed through the site. Visit http://www.phoenix-society for more information.
Bennett, B.K. (2007). Peer support in the burn center. Journal of Burn Care & Research, 28(2), 364.
Chedekel, D.S., & Tolias, C.L. (2001). Adolescents’ perceptions of participation in a burn patient support group. Journal of Burn Care & Research, 22(4), 304-306.
Solomon, P. (2004). Peer support/peer provided services underlying processes, benefits, and critical ingredients. Psychiatric Rehabilitation Journal, 27(4), 392-401.
Williams, N.R., et al. (2004). Creating a social work link to the burn community: A research team goes to burn camp. Social Work in Health Care, 38(3), 81-103.
Karen Badger, PhD, MSW, is an assistant professor and director of undergraduate studies in the College of Social Work at the University of Kentucky, Lexington.