Using the web to provide peer support for emotional health and wellbeing

This is a write up of my thoughts, experience and findings from the In Petto conference  ‘Exploring Online Peer to Peer Support’ in Antwerp. I attended this, along with a volunteer peer advisor last November.

Structures and systems for providing online peer support.

At the conference we were focusing in more depth on peer support and how this could be given online.  Before giving our own workshop, we heard from a range of other organisations, each with quite different ways of offering peer support online.

Using online tools to support offline conversations and counselling.

The presentation given by Jo Van Hecke was interesting by it’s differences to a lot of the other projects being spoken about. Although the young people can share their learning and creations online, youth workers only uses online tools while sitting next to whoever they are working with – often as a way of starting offline conversations and counselling sessions. He spoke of using Ning networks to teach 8-12 year olds digital literacy, using tools like Google maps to encourage users to create a picture of their environment, including where their friends live and areas where they feel safe or get into trouble. Tools like Timerine enable them to work with young people on a timeline of their lives – using pictures and music if words are too hard to find. I asked him if he would ever consider providing services virtually, without sitting side by side with the young person involved, and he said never – that wouldn’t fit with what they were trying to do.

Young people giving peer support to users online whilst themselves being supported to do so ‘face to face’.

One of the things that can’t fail to strike you about SHare In Trust is the acronym and web address they use! In fact, it’s quite an impressive story. Young people came up with the name and, rather than vetoing it under government pressure, they stuck with it and have developed a whole structure around it – ‘Shit with your parents’, ‘Shit at school’, ‘Emoshit’ etc. Genuine user consultation in action.

Their basic structure of peer support seemed similar to that of TheSite.org peer advisors. Volunteer peer advisors provide online support to users, whilst being trained and supported by a project leader/manager. I asked whether peer advisors work virtually or in an office. Their volunteers work in an office, sitting next to a project leader. This seems to be mainly because of the age of those providing support – sometimes as young as 15. It was also because of the types of issues that they deal with. Advisors give peer support on a a range of topics, including those that they might be struggling with themselves – self harm was given as an example of a common area of concern for advisors and users.  As they are sometimes supporting a peer advisor who currently self harms to give peer advice on self harm to a user, it sounds like they must have to be very careful that the situation does not harm or trigger either party.

Interestingly, they also mentioned that parents will  bring their children from all over Belgium to work as peer advisors, presumably recognising the benefit that it offers them as well. The motivation for involvement and benefits in taking part for the peer advisors themselves is something that is sometimes missed out of discussion about peer support. I look at it in my presentation but it is interesting to see it so obviously here too.

Peer support in a virtual environment, where volunteers themselves work virtually as well.

Similar in many ways to our live chat service was the experiences of a volunteer who spoke about the work she does with Save the Children Finland. She signs in to a Habbo hotel community and moderates a chat room within the hotel where users can chat to her as well as supporting each other. She said that she felt one of the main reasons users come into the chat room is loneliness and that a lot of the support offered is about company and feeling part of a community. She doesn’t find that people often bring really big issues into the chat – she said she thinks this is because the Habbo using community are quite young, and that users might take bigger issues to some of their other online services.

She mentioned that one of the difficulties she faced was that she herself didn’t feel part of a community of volunteer advisors. I thought this was interesting as this is also one of the challenges we have faced when supporting volunteers who not only give support to peers in an online environment, but also work virtually themselves.

Peer support organised by peers with no external input from ‘experts’

One of the most interesting and perhaps challenging presentations was from Stopzelfmoord (StopSuicide). The two young people who set up this service were 15 and 16. They worked on it for a couple of hours a day each, giving peer support through a chat room. They were asked a number of questions by youth workers and peers in the room – ‘How do you decide when someone needs further support?’, ‘Who do you turn to yourselves when you need more support?’, ‘What happens when someone you know contacts you?’, ‘Have you considered working with other organisations?’, ‘How are you funded?’.

Their replies were that they used their gut feeling to decide when to pass someone on, that they spoke to each other to work out what to say to someone who needed it, or if they were struggling emotionally, that they spoke to their friends online just like they spoke to someone they didn’t know, that they did not want to work with other organisations as that would mean working with adults (and they did not think their users wanted that), and that they did not need funding as they used a free chat service on their website.

These young people were taking online the most informal of types of peer support and offering it to peers who were not their friends. They seemed to get an increasing number of contacts and repeat users so it was obviously a service that individuals appreciated. In fact, what they are offering is probably similar to the informal, uncaptured peer support that goes on between online friends through Facebook, msn, Skype, mobile and on many other online platforms all the time within friendships.

However, it certainly felt like some of the sentiment within the conference room was that, by ‘formalising’ the support that they are giving into a ‘Stop Suicide’ website, there should perhaps be more thought about what services they were offering, ensuring that they made it clear what they could and could not offer users and understand the risks involved, particularly when users needed more support that they could offer. But perhaps this was the complex ‘adult’ additions that they were trying to avoid. Should these be taken into account? Is ‘peer support’ within the context of a larger organisation which also contains non peers and experts somehow better or safer? Is is a problem that peers setting up their own service might not ‘know what they don’t know’ about the difficulties of offering support in a formal way? Do these questions undermine the idea of peer support in the first place? Does it depend on what type of support users are led to expect from a service? Are users always able to understand the different types of support offered?

Peer support on TheSite.org

In creating my presentation and workshop for the conference, I found myself identifying a range of different types of peer support that can be found on TheSite.org. You can see the presentation that Jenna Winter (a peer advisor – photographed) and I ran here.

Our workshop was at the end of the second day and, after having listened to the discussions and questions about where peer support is appropriate I found myself increasingly focusing on the hybrid nature of the peer advisor project, the fact that it brings together the ‘friend or peer’ and the ‘expert’ to provide an answer which provides our users with the beneficial elements of both – as well as an answer which is confidential, personalised and time bound. As you will see on the presentation slides, this isn’t by any means the only type of peer support on TheSite.org, but it is the one right for askTheSite users. This brings me back to the importance of understanding the types of support an online service can provide in order to identify which are appropriate and when. I explore the types of service TheSite.org provides in my previous blog.

Skills and Training

The range of projects we heard from highlighted how ‘peer support’ isn’t a simple concept. It’s one that can be interpreted and delivered in a range of ways. It isn’t something that can be easily defined, apart from in a very general way. One of the things I asked a lot of the projects was about the training they offered – what skills did they think that peer advisors needed in order to be able to offer support within their program. At TheSite.org, while our peer advisors are trained in some technical skills – an ability to research online or to use software, a lot of the training is in enhancing their personal skills of communication and empathy. These personal skills are things that we would presumably find to some degree  in everyone offering peer support whether formally or informally. Perhaps some further collaboration and discussion about the basic skills and character attributes needed to offer peer support would be a good way of finding common ground in a such a diverse area. It would also offer excellent opportunities for sharing good practice and training techniques – something I am always interested in!