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Armstrong Institute for Patient Safety and Quality

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Potential Challenges and How to Address

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It is important to learn about the potential challenges other organizations or programs have faced and how they dealt with them. What might your challenges be and are there potential solutions? Below are some challenges from existing programs. This list is not comprehensive and not all peer support programs will face such challenges:

  • Program resistance: Sometimes a person will resist and make it hard to start your program. If this is a key person with influence, find out their concerns and use creative means to address them
  • Adequate peer supporter recruitment: At times, it can be hard to recruit the needed number of peer supporters. Programs use a variety of methods to recruit and boost their numbers.
  • Retaining volunteers: Keeping volunteers in the program takes time and effort. While most volunteers are personally motivated, having a strong personal relationship with other program leaders and staff may increase their desire to stay with the program.

"It's mostly by word of mouth…There's actually a little piece of the website there that talks about the volunteer group and has a bio of all of us who are on there and how we got started and what things we do and what things we're interested in, so certainly [it is] there if anybody has an interest."

- Quote from a program leader

  • Managing volunteers: Volunteers need to be trained, supervised, and supported. Occasionally, they will need to be counseled or even released from the program.

"On the relationship end of things, I would say volunteers are like a garden. I mean, it's like what I said to you before, and you really have to know your volunteers. And you have to take good care of them. You can't just plant them and walk away."

- Quote from a program leader

  • Matching options: Peer support programs offer a variety of people with many different conditions and needs. Sometimes it may not be possible to match a participant with one of your supporters. You might have to be flexible when looking for a good match. Many programs have geographic challenges; one option is to conduct support sessions through an online video chat (Google hangout, Skype, or by phone).

"…when we make a match, we can make it based on the criteria that the parent is looking for. And it’s not always based on disability, but sometimes it’s based on some issue that the child is facing because of that disability…"

- Quote from a program leader

  • Fixing a poor match: Despite the best efforts of all concerned, sometimes a match will not work. Ensure a process is in place to connect the participant with another supporter. For example, the peer supporters may let the program leader know that the match is not working well, and the leader can then match the participant with another supporter.

"I think once or twice we’ve had some matches that did not go really well… I could recall one event where the support parent actually came to me and said, “This is way out of my league.” And we assisted them in finding some more formal resources."

- Quote from a program leader

  • Breaking program boundaries: Support programs may at some point have problems with boundaries they have set for the supporter-participant relationship. It is vital that supporters clearly understand the limits of their role. Many programs highlight the importance of boundaries and train peer supporters in different ways to manage participants who overstep these boundaries and to avoid such boundary issues themselves. Despite these safeguards, boundary issues may arise and must be managed.

    Since peer supporters may have had to grapple with a health problem or personal issue that might be ongoing or recurrent, they may also be in need of periodic support. Guidance must be provided to them on who they can turn to for support– for example, encouraging them to connect with the program leader, see their physician or receive support outside of the program. They should not seek such support from the participants assigned to them.
  • Maintaining quality and following the plan: As programs are conducted, it can become challenging to ensure everyone follows these program policies and recommended practices. This may pose a risk to the quality of your program. Even in smaller programs there needs to be a process in place to monitor quality and address any problems.
Example: Weight Watchers has a standard procedure for every participant that includes: A needs assessment; a wellness treatment plan; short and long term goals, and, plans to meet those goals. Upon meeting with participants, the goals and progress made towards reaching them is updated in individual counseling notes.
 
  • Managing expectation: Some participants may not experience benefits from peer support, or their expectations may differ from those offered by the program. At times, peer supporters may be disappointed if the participants are not engaged in program activities or lack the motivation to make desired changes to cope with their problems. It is important that program leaders remain aware of these possible scenarios and have relevant strategies in place that can resolve the potential negative effects of peer support on program participants and peer supporters.
  • Doubt about benefit of peer support: Professional staff may not see the benefit of peer support. Moreover, health care professionals may doubt the value of the program (which may limit referral to services). Therefore, educating and engaging your referral base is an important early step when starting your program.

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Updated: March 2018