From Research to Practice: Developing a Toolkit for Peer Support Workers

SOPHIE WILSON Birmingham Voluntary Service Council

Peer Support Workers (PSWs) - people who use their own lived experience to support others facing similar challenges - are becoming an increasingly important part of health and community services. Across the UK, peer roles are now found in a wide range of settings, including mental health services, homelessness support, and substance misuse services.

The growth of peer support work reflects a wider recognition that lived experience offers a unique and valuable form of knowledge. People who have navigated difficult circumstances themselves can often build trust, offer hope, and connect with individuals in ways that traditional services sometimes struggle to achieve.

However, while peer roles are expanding rapidly, implementing them well is not always straightforward. My doctoral study explored how PSW roles are implemented within voluntary and community sector (VCS) organisations working across mental health, homelessness and substance misuse services. The research was supported by two NIHR career development awards, which enabled both the fieldwork and the time required to complete the study.

The funding made it possible to undertake a long-term exploration of how PSWs develop within real-world organisational contexts.

Studying peer support in the voluntary sector

Much of the existing research on peer support has focused on statutory services such as NHS mental health teams. Yet many peer roles are delivered through voluntary and community organisations, which often play a critical role in supporting people experiencing complex and overlapping challenges.

These organisations frequently work with individuals experiencing multiple disadvantages, including mental ill health, homelessness, and substance misuse. They also tend to operate in ways that are more flexible and community-oriented than statutory services.

At the same time, VCS organisations often work at smaller scales and within tighter funding environments. This can shape how new roles are introduced, supported and sustained.

My research followed the development of peer roles within two VCS organisations over an extended period. Through interviews, observations and ongoing focus groups with participants to discuss emerging findings, the study explored how peer roles were implemented in practice and how organisations navigated the opportunities and challenges that came with introducing lived experience into service delivery.

What the research revealed

One of the key insights from the study was that implementing peer support involves much more than creating a new job role. Instead, successful implementation depends on a combination of factors related to individuals, services and organisations.

One important theme that emerged was the proximity of lived experience. PSWs enter roles at different stages of their recovery or life journey. Some may have moved some distance from the experiences they draw upon, while others may still be closely connected to the circumstances they have lived through.

Organisations often need to think carefully about how PSWs are supported in using their experiences in ways that are safe, sustainable and empowering.

A second theme concerned the relevance of lived experience to the role. PSW is built on the idea that lived experience can offer a powerful basis for connection, trust and hope. However, the research found that in practice the concept of “lived experience” is sometimes treated very broadly. In some organisations, any experience of mental health difficulty was seen as sufficient for a peer role, regardless of how closely it related to the experiences of the people being supported. This could create situations where PSWs felt ill-equipped to respond to the complexity of the issues they encountered.

For example, someone with experience of common mental health challenges might find themselves supporting individuals who had experienced repeated hospitalisation or multiple and overlapping needs such as homelessness or substance misuse. While peer workers do not need to have identical experiences to those they support, the study suggests that careful thought needs to be given to how lived experience relates to the context of the role. Considering the relevance of lived experience – and supporting PSWs to use it safely and meaningfully – is therefore an important part of implementing PSW roles effectively.

These insights highlighted that implementing peers support work is not simply about recruiting people with lived experience, but about creating the right conditions within services and organisations for that experience to be used in meaningful ways.

A third insight concerned the importance of organisational context. The research showed that PSWs do not operate in isolation; they are shaped by the wider environment in which they are introduced. Organisations that were able to support PSWs effectively tended to invest in key enabling factors such as appropriate training, regular supervision, and access to wellbeing support. These structures helped PSWs to reflect on how they were drawing on their lived experience and to manage the emotional demands of the role.

The study also highlighted the importance of organisational understanding of the PSW role. Where teams and managers had a clear understanding of what peer support involved – and how lived experience contributed to service delivery – PSWs were more likely to feel integrated within teams. In contrast, where the purpose of the role was less clearly understood, PSWs sometimes experienced role confusion, blurred boundaries, or uncertainty about expectations. Ensuring that the wider organisation understands and values the distinct contribution of lived experience was therefore found to be an important factor in supporting PSWs to work effectively.

Taken together, these findings suggested that PSW implementation cannot be understood solely at the level of individual workers. Instead, it requires a broader perspective that considers how organisations create the conditions in which peer roles can thrive.

Developing the PEERS in Practice framework

While conducting the research, I found that the few existing frameworks for implementing PSW focus primarily on organisational structures within statutory mental health services. Although these frameworks provide valuable guidance, they do not always fully capture the dynamics of PSW within VCS organisations working across multiple social and health issues.

To address this, the research led to the development of a multi-dimensional implementation framework that considers PSW across three interconnected levels:

• Individual level – how peer workers draw on their lived experience and how they are supported in their roles
• Service level – how peer roles are integrated within teams and service delivery models
• Organisational level – how culture, leadership and structures shape the implementation of peer support

Across these levels, the framework identifies five core domains necessary for successful PSW implementation.

P – Purpose: This domain focuses on establishing an organisational commitment to lived experience; shared values around recovery, empowerment, and inclusion and clarity about why PSW roles are being introduced.

E – Establishment: This domain focuses on preparing organisations and teams for the introduction of PSW roles. Key elements include: organisational readiness, policies and procedures supporting lived experience roles, leadership commitment and organisational culture that values experiential knowledge.

E – Engagement: Engagement relates to the initial entry of PSWs into organisations. Key components include: recruitment processes tailored to lived experience roles, induction and onboarding, training and early-stage support and relationship-building with colleagues.

R – Real-World Practice: This domain addresses the everyday realities of working as a PSW. Key aspects include supervision and reflective practice, integration within teams, emotional labour and wellbeing and navigating boundaries and self-disclosure.

S – Success: The final domain focuses on sustaining and recognising PSW roles. This includes: recognising PSW contributions, supporting professional development, maintaining supportive organisational cultures and ensuring the long-term sustainability of peer roles.

Building on this framework, I have since developed the PEERS in Practice self-assessment toolkit. The aim of the toolkit is to provide organisations with a practical way to reflect on how peer roles are implemented within their services. Rather than prescribing a single model of peer support, the tool encourages organisations to consider their own context and assess how well different elements of peer support are working in practice.

Turning research into practical learning

One of my motivations for developing the toolkit was to ensure that the insights from the research could be used beyond academic audiences.

Organisations implementing peer roles often face similar questions:

• How can we support peer workers to draw on their lived experience safely and effectively?
• How should peer roles be integrated within existing teams?
• How can organisations maintain the distinct value of lived experience while operating within professional service environments?

The PEERS in Practice self-assessment tool is designed to help organisations reflect on these questions and identify areas where further development may be needed.

By translating research findings into a practical resource, the aim is to support VCS organisations working across mental health, homelessness and substance misuse services to strengthen the way peer roles are implemented.

Reflections on the research journey

Undertaking this research reinforced the importance of studying how innovations are implemented in real-world contexts.

Policies and service models often appear straightforward on paper, but in practice their success depends on the relationships, cultures and organisational environments within which they operate.

The NIHR funding that supported this work made it possible to undertake a long-term study that followed peer roles as they evolved over time. This depth of engagement allowed the research to capture the complexities of implementation in ways that shorter projects may not have been able to do.

Perhaps the most important lesson from the research is that PSW is not simply a new workforce role. It represents a different way of recognising knowledge and expertise within services.

As peer roles continue to expand across health and community services, supporting them effectively will require organisations to think not only about job descriptions and training, but about how lived experience is valued and embedded within organisational practice.

Tools such as the PEERS in Practice self-assessment framework aim to support organisations in reflecting on these questions and strengthening the way PSW is implemented in practice.

You can access the toolkit here:

PEERS in Practice Toolkit for Peer Support Roles

Further Information:

Sophie Wilson was funded by a Three Schools' Mental Health Career Development Award. Project Title: “AM I READY FOR THIS?” Early experiences of Peer Support Workers starting employment in voluntary sector frontline services