How Does Peer Support Work in the Context of Homelessness?

Western University
September 06, 2018

In this bi-weekly blog series, I explore recent research on homelessness, and what it means for the provision of services to prevent or end homelessness. Read the first blog here


Peer support has been used across various sectors for decades. For example, within health care in general, there exist very clear definitions and models of peer support. Within HIV care in particular, there are national standards of peer support drawing on two decades of research. While the inclusion of lived experience in homelessness services, planning, and policy-making has increased significantly over the past several years, peer support in the sector still exists primarily in small pockets of expertise. There is a need to translate the inclusion of peers and best practices in the engagement of lived experience across the sector as a whole.

To do this effectively, one important element is to understand how peer support actually works. That is, what is the mechanism of change behind peer support? What are the important elements of a peer support program? What are the predicated outcomes of peer support programs?

To begin to answer these questions, Stephanie Barker, Nick Maguire, Felicity Bishop and Lusia Stopa conducted a study with 20 peers and 20 professionals to identify a common viewpoint on the effective elements of peer support. They started with 43 statements on peer support derived from research and experts and used a Q Sort methodology and factor analysis to determine consensus agreement with the statements. The researchers looked at results from peers and professionals both separately and combined to note common and differing opinions across the two groups.

Peers and professionals agreed on the following elements of peer support:

  • Effective peer support involves peers developing trust with clients (and respecting confidentiality)
  • Peers need their own support through supervision
  • Peers provide emotional support, social support, and empathy (through listening)
  • Peer support isn’t helpful if it’s driven by the need to repay a debt
  • Peers don’t need to be experts in local service options
  • Peers need to manage their emotions and have support to cope with their own struggles

Training of peer supporters was highlighted, but it was clearly distinguished that this training is related to the peer role and to assist the peer in maintaining their own wellbeing, rather than specific training in mental health or addiction counselling. The professionals in particular identified the value of peer supporters being active in their own recovery.

Ultimately, this research found that significant potential exists in peer supporters being role models. While this contains a risk of peer supporters overall as opposed to model struggles, a good network of supervision and support for the supporters can mitigate this risk. This lays the foundation of a peer support model that is intentional and unidirectional, meaning that the peer supporter provides mentorship to those still living the experience of homelessness.

Dr. Abe Oudshoorn is an Assistant Professor in the Arthur Labatt Family School of Nursing at Western University.  Having worked as a nurse with people experiencing homelessness, Abe’s research focuses on health, homelessness prevention, mental health, and poverty.  Outside of the University, Abe is on the Steering Committee of the London Homeless Coalition and is a board member with the United Way of London & Middlesex.

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The analysis and interpretations contained in the blog posts are those of the individual contributors and do not necessarily represent the views of the Canadian Observatory on Homelessness.