Liminality in the occupational identity of mental health peer support workers: A qualitative study.
Alan Simpson, Candice Oster, Eimear Muir-Cochrane
PMID 28548455WHAT IT FOUND
Peer support workers described their identity as 'liminal', stuck between being staff, friends, and service users.
This ambiguity helped build trust with patients but caused distress at the end of support and confusion about boundaries with clinical teams.
Key findings
01Peer support workers and service users both viewed the worker's dual identity as 'liminal', existing between the roles of staff member, friend, and fellow service user.
02The 'friend-like' nature of the relationship facilitated openness and trust, allowing service users to confide in workers who were not perceived as part of the clinical hierarchy.
03The ambiguity of the role led to negative outcomes, including distress for both parties when the support ended and difficulty for workers in maintaining professional boundaries.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study involved only eight peer support workers and twelve service users, limiting the generalizability of the themes. All PSWs were new to the role; more experienced workers might have developed different strategies for managing identity boundaries. The study was conducted within a specific pilot RCT context, so the findings may not apply to established, long-term peer support services. Quotes from focus groups were not attributed to specific individuals due to transcription issues, which may obscure individual variations in experience.
Declared interests
No specific conflicts of interest or funding sources were reported in the provided text.
The easy way to misread this
Do not conclude that peer support is ineffective or harmful because of the reported distress and boundary issues. The study describes the subjective experience of identity formation in a small, new workforce, not the clinical efficacy of the intervention for patient outcomes.