HEALTH & WELLNESS
The value of presence: Cop2Cop‘ being there’ for you
CHERIE CASTELLANO Cop2Cop
Recently Cop2Cop partnered with international experts in peer support research and program evaluation to explore if our peer work was effective using an external group from the University of North Carolina Chapel Hill Global Peers for Progress Institute at the Gillings School of Public Health. A two-year study of Cop2Cop and other peer programs yielded significant findings about the value of presence.
Here is a preview of these findings( for the full report, visit www. njspba. com): Abstract
• Objective:“ Being there” takes on considerable importance amidst recognition of the substantial deleterious effects of social isolation and loneliness. Presence /“ being there” may be important features of the many contributions of peer support to health and wellbeing. This study sought to understand how peer support may enhance a sense of presence.
• Methods: Review of contact data for years 2015-2016 from telephonic peer support services of Rutgers Health University Behavioral Health Care; structured interviews with peer supporters and clients.
• Results: Features of peer support that convey presence include 24 / 7 availability, structure of peer support around shared cultural roles – e. g., Cop2Cop, Mom2Mom, rather than shared diagnoses, training of supporters to provide setting for clients’ open expression of feelings, and structural features such as IT systems that facilitate continuity by enabling those answering a call to refer to information from previous calls. Impacts include client reports of being understood, not being judged and being cared for by follow-up, even through routine contact, such as voicemails.
Highlights from the report
“ Being there” must be among the most common clichés in discussion of social support, stressors and human behavior. However, recent attention to the health effects of loneliness and social isolation suggests greater attention to what it means to be there. The influence of social isolation, being as lethal as smoking cigarettes or obesity, make this a serious conversation.
Peer support provided by community health workers, lay health advisors and individuals with a number of other titles has been shown to play influential roles in health and the health care delivery system. If those who have someone they can talk to about personal matters and call on for a favor( a simple indicator of connection) are better able to address a variety of life’ s challenges, then peer support may provide benefits through its most fundamental features.
A remarkable study examined the benefits of minimal communications to individuals at high risk for suicide( by virtue of hospitalization for depression or suicidal precautions) but who refused or discontinued post-discharge follow-up. Out of 843
individuals( 56 percent female), 389 received periodic contact by routine letters, and 454 received no further contact. Contact entailed:
“… regular communications, in the form of a short letter, from the research staff member who had interviewed them in the hospital. Each contact letter was simply an expression of concern that the person was getting along all right and invited a response if the patient wished to send one. The schedule for these contacts was monthly for four months, then every two months for eight months, and finally every three months for four years – a total of five years and 24 contacts.”
The difference in survival in the two groups was significant over the first two years but then became nonsignificant as the frequency of letters declined. Even such minimal contact as a brief, monthly letter of“ concern,” fading to bimonthly and quarterly, can reduce suicides among high-risk groups. Suggesting that it was the contact itself that was important, its effects declined as it became less frequent.
The background observations described here suggest the importance in peer support of the fundamental value of connection. Here we provide observations to further recognition of the importance of“ being there,” and how best to convey such presence, drawn from evaluations of telephone peer support programs conducted by Rutgers Health University Behavioral Health Care( RHUBHC).
The RHUBHC peer support programs are guided by the Reciprocal Peer Support model emphasizing four key steps in the process of peer support: Connections and Pure Presence; Information Gathering and Risk Assessment; Case Management and Goal Setting; and Resilience, Affirmation and Praise.
Peer supporters identified being“ trained to listen” as a key part of providing support to their clients and a safe space for the unfiltered expression of negative emotions. They help their clients to problem solve, offering suggestions but not judgment. If services exist to help with the problem, the peer supporter will provide referrals. The ability often to provide same-day referrals to clients in need enhances the sense that the peer supporter cares about their wellbeing. Additionally, providing encouragement and affirmation that the client is doing the best they can also conveys acceptance and promotes resilience.
Building rapport based on a shared lived experience also conveys a sense of credibility, in that callers trust advice and perspectives they are given because that advice and those perspectives come from someone with a similar life experience. In the words of one client, the advice given to her by the peer supporter was trusted because“ she has a special needs kid also, so she will think what I think.” At times, peer supporters reported also being supported by their clients, creating a reciprocal peer support relationship.
Prior to calling, clients reported not knowing what to expect.
CONTINUED ON PAGE 88 www. njcopsmagazine. com ■ MAY 2018 87