Peer Support Fundamentals

Photography by Alicia Thurston Photography

You might have heard that Peer Support is a powerful tool in the breast cancer community, but do you know why? Hot off of a recent Rethink workshop, we’re breaking down the tools and skills needed for being a peer supporter and why that matters to young women in the breast cancer community. 

What is Peer Support?

Peer support is an approach to counselling that originated in the 1960s in academic institutions in the U.S., where new students were offered support in all matters relating to university life, by existing students. In the 70s, the method was taken up by the Independent Living movement and used by people with disabilities to provide support to others with disabilities. Nowadays, the term and modality are used almost exclusively in the context of health-related issues. As with other counselling methods, it is the people seeking support (in this case those with cancer), who determine the need for support and what they hope to get from their supporter in the duration of the process and relationship. Peer support can be done formally through a program, over the phone, in groups or one-to-one, and online through chat platforms. It can also be informal if you are a member of a group where people have similar experiences, or someone is referred to you through a mutual experience. For example, someone may have asked you if you would be willing to speak to a friend of a friend who was just diagnosed.

Why Try Peer Support?

Going through a traumatic experience like cancer can be isolating and alienating, especially for a younger person given their stage of life. Having the ability to connect with someone who has walked in your shoes and can relate to some of the bigger feelings you are experiencing can in and of itself help. Peer supporters can practice active listening skills and share what worked for themselves and aspects of their story, which may diffuse some of the challenging emotions just by holding space for someone else or bearing witness to the trauma.

What are the underlying values of peer support?

The most important underlying principle of peer support is that the wishes, opinions and values of the individuals seeking support are respected and not judged. Other guiding principals include:

  • Peer support is empowering. It reflects the strength of both parties. Support is about compassion, rather than pity or sympathy.
  • Peer support cannot fix a person; fixing presupposes that the person is broken!
  • Peer support opens the door to other forms of support. It is not an end in itself; it is an invitation to ongoing self-help and initiative.
  • The most powerful mechanism of peer support is listening; the peer supporter becomes skilled at listening to someone they support, acknowledging their stories and their feelings.
  • Peer support is not judgmental; the supporter knows that there are many ways to manage the challenges of cancer. There is a deep belief that everyone knows what’s best for themselves.
  • A peer supporter is skilled at telling aspects of their own story in a manner that is helpful to the person they are supporting, when they ask about it. If it doesn’t arise, you can ask if it would be helpful to hear about aspects of your story.
  • Peer supporters are well embedded in the larger cancer community.
  • Peer support is not about giving advice of any kind (medical, legal, psychological, etc.). It is about supporting someone in forging their own paths through the challenges of breast cancer diagnosis and treatment, which is ultimately far more empowering than advice!
  • Peer support is based on a strong foundation of confidentiality. The stories of the people we support must be kept strictly confidential and not shared with the wider breast cancer community.
What are the skills needed?

One model for understanding the peer support role is similar to one a hotel concierge plays. This person is very experienced with the city, its resources and opportunities yet doesn’t makes assumptions. They support visitors in making their own decisions by asking questions that help to clarify what the guest is looking for. For example, before recommending a restaurant to a guest, a concierge asks questions like: What sort of food do you like? What sort of evening are you planning (romantic, family time, theatre date)? What is your price range? The concierge knows leaves their personal choice out of it. A SKILLFUL PEER SUPPORTER:

  • Knows that there are different ways to cope with cancer
  • Uses humour sparingly, only by invitation and never in a way that makes the person feel that they are being made fun of
  • Is ready to learn from others
  • Has a natural and respectful curiosity about others
  • Uses active listening techniques
  • Asks open-ended questions e.g. “Can you tell me more about that experience?”
  • Uses encouraging statements to support the conversation
    • Uh-hum
    • I see…
    • Yes…
    • Right…
    • Go on…
    • I’m with you
  • Sits comfortably with silences
Parking Your Beliefs & Baggage

We all have beliefs and values that guide our lives. Our beliefs and values are acquired and absorbed throughout our lives, starting from a young age. Many beliefs that we hold are helpful. Becoming a peer supporter reflects a whole range of beliefs, including the beliefs that people can support one another and that people can help themselves. Some beliefs are subtle and deeply held and we may not be consciously aware of them. Coping with illness may bring many of these to the surface. Whenever we use the word should, we are reflecting a belief that we hold. The concern with beliefs is that when they are challenged in a conversation, we often stop listening well. The other concern is that the person will feel that we have made a judgment that they are doing something wrong or incorrectly. Baggage is more personal than beliefs. Baggage reflects our own experience. Someone seeking support may remind us of someone we know, and we may make judgments based on our own history. For example, a woman may remind you of your sister and you may assume that, just like your sister, she is stubborn (sweet, mischievous, difficult, etc.). As soon as we make assumptions, we rob the other person of their experience, we become poor listeners and we shut down to their story. Baggage hooks us and we may not even realize it right away. The usual sign of being hooked is that we stop listening well and start having a separate conversation inside our heads. Being able to hold space for someone means coming to the conversation without the beliefs we hold about cancer and the personal baggage that has presence in our lives. This may make us vulnerable and unsettled but it also fosters connection with the person we are supporting.

How Self-Care Plays A Role

Self-care is the foundation for providing support to other people. Many people who are interested in helping other people are often not so good at taking care of themselves, especially when there are so many other demands and responsibilities in your life. Self-care is an important part of recovering from cancer and an important skill that peer supporters need to foster in themselves. When people do not take care of themselves, they can develop compassion fatigue. This is the feeling of distress that can come from witnessing the suffering of other people and feeling helpless. Some refer to this as burnout, but I prefer compassion fatigue because it reminds us of why we are supporting others in the first place (because we care) and secondly there are things that we can do to repair ourselves (address the fatigue). The first step in preventing compassion fatigue is being familiar with how you experience stress. This enables you to more easily recognize it and address it early. Then it is important to have a plan in place that you can use to take care of yourself.  

To join the Rethink Young Women’s Network and get more information about our next Peer Support Fundamentals Workshop, click here.

Shawna Rich-Ginsberg is a trained counselor and Rethink’s Senior Manager of Support & Education Programs. She has presented at international conferences on a variety of psychosocial oncology-related topics including: models of peer support, talking to children about cancer and building a legacy when faced with end of life care decisions. Currently she is in the process of obtaining her Master’s in Social Work from Laurier University.  

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