Facilitating peer support

When physicians come together to support each other and share their experiences, they help create a psychologically safe work environment where they can provide the best possible patient care. This page provides guidance and tools for facilitating formal and informal physician peer support, whether in person or virtually.

What is peer support?

Peer support involves a supportive relationship between people who have a lived experience in common. In its guidelines for the practice and training of peer support, the Mental Health Commission of Canada defines it as “a system of giving and receiving help founded on key principles of respect, shared responsibility, and mutual agreement of what is helpful. Peer support is not based on psychiatric models and diagnostic criteria. It is about understanding another’s situation empathically through the shared experience of emotional and psychological pain.”

Peer support provides non-clinical emotional support to people experiencing emotional distress with the goal being to improve their mental health and help them recover through empowerment and hope.

Peer support may be informal (involving supportive conversations between peers who have not been formally trained) or formal (where individuals are specifically trained to provide support). It can be delivered one-on-one or in group settings. 

How to provide informal one-on-one peer support

Here are some tips if you think a colleague could use some support:

• Be available. Suggest a time and space to meet, listen and talk if needed.
• Provide the person with a safe zone to express their thoughts.
• Listen actively, openly and non-judgmentally, and encourage discussion.
• Be kind, empathetic and understanding, and share your experience so the person doesn’t feel alone. 
• Speak from the heart and share insight and knowledge gained through your experience.
• Encourage the person to seek help even if they feel fine.
• Stimulate conversation by asking, "I’ve noticed X or Y in you. How can I help?”

How to create and lead a formal peer support program

These tips from the Canadian Patient Safety Institute on how to create a psychologically safe workplace can help you establish a formal peer support program (PSP) in your organization:

• Commit to enacting policies and processes to support safer work practices. 
• Assemble a strong organizational planning team.
• Establish clear goals for the PSP and get support from senior management.
• Institute a policy that outlines exactly what the PSP will be, the types of issues it will support, and how it will be structured and implemented.
• Clearly outline everyone’s responsibilities, especially those of supervisors — they often play an important role in encouraging an individual to seek support or referring them to the PSP.
• Implement a nomination process for peer supporters. The peer support team should include:
  • Clinical and non-clinical physicians from a variety of practice areas and with a range of practice statuses and years in practice. 
  • People who are able and willing to understand how a peer feels and what they are going through, and are willing to share their own stories if appropriate. 
• Once identified, provide recruits with formal peer support training so they have the knowledge and skills to connect with people, provide support, maintain confidentiality and respond to potential crises. 
• Decide how physicians will learn about and connect with the PSP. 

How to conduct a formal peer support group

The following tips, adapted from Session Lab’s overview of essential facilitation skills, can help those tasked with leading formal peer support groups:

• Design, plan and organize common objectives for peer support sessions.
• Start and end the sessions on time.
• Introduce yourself and welcome all members of the group. 
• Set the context and explain the ground rules with clear guidelines and instructions to promote a safe, inclusive environment that fosters connection among participants.
• Stay neutral as you kick off the conversations.
• Throughout the session, use verbal tools (probing, paraphrasing, summarizing) and non-verbal skills (nodding, maintaining and engaged posture and facial expression) to keep the discussion moving.
• Highlight points of consensus, manage group dynamics and conflict, and summarize key takeaways. 
• Intervene when necessary and help the group clarify outcomes.
• Watch timing and energy levels and keep the environment supportive to ensure productive discussions.
• Demonstrate empathy, active listening and flexibility.

Notes for virtual facilitators

Virtual meetings can present additional challenges: participants may be more easily distracted and it can be more difficult to pick up on physical cues or body language. In addition to the general tips above, the following can help you keep virtual groups engaged and productive:

• Keep the discussion focused, varied and not too information heavy. 
• Incorporate movement to inject fun or energy into the group. Encourage people to get up from their computers and stretch, or try online energizers. See this list from Session Lab for energizers that work well in online settings. 

Visit the links below for more best practice guidelines, tools and resources that physicians and health care leaders can use to facilitate peer support.

Topics

Peer support Policies, standards and best practices Relationships