Peer support services remain poorly understood by many mental health service providers. In this study we explored the views of people who use peer led support groups. We asked how adding peer support groups changed, balanced, or augmented the use of conventional mental health services. Participants were 43 adults attending 4 peer led support groups for depression/bipolar disorder. Data consisted of observations of all 43 participants interacting in their group, in-depth interviews of 20 participants, and results from 2 standardized questionnaires to ballpark the level of symptom severity relative to other groups. Through constant comparative analysis, 12 categories emerged. The most salient features of our findings consisted of the shared perception that groups promoted recovery and augmented conventional services. Members felt acceptance due to their shared diagnoses. Groups provided an experience of community in which recovery skills could be practiced, practical advice received, and hope and empowerment encouraged. Groups appeared to provide participants with important support and healing unavailable from psychotherapy and psychiatry. Peer support groups appeared to be an important addition and sometimes an adequate substitute for psychotherapy and/or psychiatry. Further research is indicated and quantitative students should build on the insights of qualitative studies in developing their protocols.


Peer Support, Bipolar Disorder, Depression, Group Psychotherapy, Peer Counseling, Mood Disorders, Grounded Theory, Constant Comparative Analysis, Mutual Aid

Author Bio(s)

Joe Behler, PsyD, is in private practice in Edgewood, Kentucky. He obtained a master’s degree in Clinical Psychology from Xavier University in Ohio and a doctoral degree in Clinical Psychology from the Union Institute and University. He is a licensed Clinical Psychologist in Kentucky. He has worked in Ohio, Kentucky, and Indiana at hospitals and residential treatment facilities for children, social service agencies and early childhood centers, domestic relations court, community mental health centers, and in private practice. He is interested in psychotherapeutic interventions for depression, anxiety, and neurodevelopmental disorders, peer support, family therapy, and collaborative partnerships with health care providers.

Dr. Allen Daniels is an independent behavioral healthcare consultant and also serves as Senior Study Director for Westat and consulting Clinical Director for InfoMC. He has been Professor of Clinical Psychiatry and Public Health Sciences at the University of Cincinnati, College of Medicine. He has also served as the Executive Vice President and Director of Scientific Affairs for the Depression and Bipolar Support Alliance (DBSA). He is a graduate of The University of Chicago School of Social Services Administration, and The University of Cincinnati College of Education. He has extensively published in the area of behavioral health policy including: managed care and group practice operations, quality improvement and clinical outcomes, behavioral healthcare workforce development, behavioral health and primary care integration, and peer support and person-centered care. Dr. Daniels served on the National Advisory Committee for SAMHSA’s Center for Mental Health Services. He is active on a number of other boards and professional organizations.

Jennifer L. Scott, PsyD, ABPP is a licensed and board certified clinical psychologist. She received her doctoral degree in Clinical Psychology, along with a graduate certificate in Organizational Concepts and Management, from Xavier University in Cincinnati, Ohio. She is full-time faculty in the graduate college at Union Institute & University and has been recognized at state and local levels for excellence as a practitioner and educator. She has published and presented scholarly work in the areas of psychological assessment, professional ethics, clinical supervision, self-care, and teaching in technology mediated learning environments. Dr. Scott also maintains a private psychology practice, providing clinical assessment and consultation services to rural and marginalized communities in southwestern Ohio.

Lewis Mehl-Madrona, MD, PhD, is Faculty at the Family Medicine Residency at Eastern Maine Medical Center and is Associate Professor of Family Medicine at the University of New England. He is also Executive Director of Coyote Institute in Orono, Maine. He is board-certified in family medicine, geriatric medicine, and psychiatry, and has a Ph.D. in clinical psychology with a specialization in neuropsychology. He is a graduate of Stanford University School of Medicine, the Psychological Studies Institute in Palo Alto, the narrative studies post-graduate program at Massey University, Palmerston North, New Zealand, and completed his residencies in family medicine and in psychiatry at the University of Vermont College of Medicine. He is interested in narrative medicine, indigenous knowledge, and the incorporation of indigenous ideas into contemporary health care. Correspondence regarding this article can also be addressed directly to: Dr. Mehl-Madrona, 802-451-0311, mehlmadrona@gmail.com, fax 207-973-6109, address: Coyote Institute, P.O. Box 39, Orono, ME 04473.

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