COVID-19 ​Caregiver Collaborative: Peer Support Helps Care Providers Cope

Added on May 5, 2020

COVID-19 ​Caregiver Collaborative: Peer Support Helps Care Providers Cope
By Diana Mahoney


– Peer support increases health care providers’ social connectedness and offers an emotional safety net for processing emotions associated with COVID-19.

– Peer outreach can be in the form of a call or text message, or it can be integrated into established work processes, such as briefings, huddles, or operational meetings.

– Empathic listening, validation, and positive reframing can help care providers process and normalize the range of emotions they are experiencing on the front lines of care during the COVID-19 pandemic.

“Bring your loving presence to a colleague.” That is the overarching principle of peer support, according to Dr. Jo Shapiro, professor of Otolaryngology, Head and Neck Surgery, at Harvard Medical School.

During a recent COVID-19 Caregiver Collaborative discussion, Dr. Shapiro, who is also Senior Faculty for the Center for Medical Simulation in Boston, stressed that peer support does not have to be a formal program to achieve its desired objective, which is to increase social connectedness and provide an emotional safety net in challenging environments.

“Peer support is about proactively reaching out to people, helping them connect with their own coping mechanisms,” Dr. Shapiro explained. It is also about helping peers get additional help when their own coping strategies are not enough. Possibilities include connecting them with mental health, chaplaincy, social work, or risk management services. “Peer supporters can both destigmatize and facilitate access to further resources,” she said.

On a very informal level, peer support can take the form of a phone call, a text message, or another type of outreach. At the organizational level, it can be integrated into established work processes, such as briefings and debriefings, daily check-ins, and operational meetings, by asking such questions as “What are some challenges you’re facing?” “What have been some emotional reactions you’ve been feeling?” “What is helping you cope with these stressors?”

These questions are especially relevant to clinicians on the front lines of care during the COVID-19 pandemic, many of whom are struggling under the immense weight of the physical and psychological burden associated with the overwhelming workload, uncertainties about the disease and its treatment, concerns about their own and their families’ safety, and feeling inadequately prepared to deal with the scope of patient and family suffering. The range of emotions is expansive, including grief, guilt, fear, and anger, as well as gratitude, Dr. Shapiro said. “Peer support can create a psychologically safe space to share these emotions,” she noted.

Some of the most effective peer support skills and strategies include empathic listening, validation, and positive reframing. “Deep, empathic listening and validation help a lot, especially coming from a peer who truly understands. When a colleague says something like ‘Yes, I’ve actually noticed that myself,’ it helps normalize the emotions, and that is really important,” Dr. Shapiro said. Reframing negative emotions into something positive is also helpful. “This is about taking the same emotions and then helping reframe how they fit in. An example is saying ‘You are having these feelings because you are human, because you care, not because you are weak or different,’ or ‘You said you feel inadequate, which makes sense given the immense challenges of these current circumstances. I wonder if you’d also take a moment to reflect on all the good that you are doing.’”

Another valuable support tool is helping people connect with their own coping mechanisms. “We can ask questions like ‘What helps you in times of stress generally?’ ‘What’s your support system?’ ‘What do you do for self-care?’ These are not things we usually ask our colleagues about, but it’s an easy thing to do,” Dr. Shapiro said.

“Even before the pandemic, we were seeing a cultural shift with all the data around physician burnout and even suicide. We know health care provider well-being matters deeply,” said Dr. Shapiro. While there are still many barriers, she said, there are also enablers, including proactive, peer-to-peer outreach. “We have to see the stress that health care providers feel as an occupational condition, and then be proactive in trying to support people through it. We don’t want to wait until they come to us saying ‘I can’t do this,’ or to have them experience burnout, PTSD, or worse because they didn’t get the help they needed. Peer support is a way of connecting us together as a community, so no one has to bear the stress alone.”

For additional information on ways to support clinicians and other front-line caregivers, see Press Ganey’s COVID-19 resources webpage.