Integrating peer-provided services: a quasi-experimental study of recovery orientation, confidence, and empowerment

Psychiatr Serv. 2008 Nov;59(11):1307-14. doi: 10.1176/ps.2008.59.11.1307.


Objective: Peer-provided mental health services have become increasingly prominent in recent years, despite a lack of evidence of beneficial impact. The study presented here compared the effectiveness of the Vet-to-Vet program, a peer education and support program, and standard care without peer support on measures of recovery orientation, confidence, and empowerment.

Methods: Participants were recruited in two consecutive cohorts between 2002 and 2006, one before the implementation of the Vet-to-Vet program in June 2002 (cohort 1; N=78) and one after (cohort 2; N=218). Follow-up interviews were conducted at one, three, and nine months. There were few baseline differences between the cohorts. Intention-to-treat analyses compared cohorts on changes over time on measures of recovery orientation, confidence, and empowerment. A third cohort (cohort 2-V) was constructed that consisted of the subset of participants from the second cohort who directly participated in more than ten Vet-to-Vet sessions since the last research interview (N=102). Comparisons between this cohort and the first cohort constitute as-treated analyses.

Results: In the intention-to-treat analyses, the Vet-to-Vet cohort scored significantly higher on measures of empowerment. In the as-treated analyses, significant differences favoring the Vet-to-Vet cohort were observed on both empowerment and confidence. Secondary analyses of clinical measures showed significant differences favoring the cohorts 2 and 2-V on measures of functioning and on alcohol use.

Conclusions: These data suggest that participation in peer support may enhance personal well-being, as measured by both recovery-oriented and more traditional clinical measures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Mental Disorders / rehabilitation*
  • Mental Health Services*
  • Middle Aged
  • Outcome Assessment, Health Care
  • Peer Group*
  • Self Efficacy*
  • Veterans / psychology