The role of self-disclosure by peer mentors: Using personal narratives in depression care.
C Truong, J Gallo, D Roter and 1 others
PMID 30791990WHAT IT FOUND
Trained peer mentors working with older adults mostly used personal stories to reframe problems, model self-care, share resources, and build rapport.
Rarely, a mentor talked at length about her own distress. The study did not test whether this improved depression.
Key findings
01Four themes emerged; the largest, 45.1% of episodes, used disclosure for counseling techniques: reframing perspectives (17.3%), modeling positive behaviors (14.2%), offering specific self-care skills (10.4%), and sharing information about resources (3.3%).
02Peers used disclosure to establish similarity in 31.8% of episodes and to mirror the client's struggles in 23.1% of episodes.
03Only two episodes were self-focused, lengthy disclosures unrelated to the client; in both, the peer later shifted to the client's own story.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 3 peer mentors, all women, provided the disclosure examples, and 23 clients were analysed, so the themes may not represent other mentors, clients, or settings. The study analysed recorded talk; it did not test whether self-disclosure improved depression, alliance, or self-care. Resource limits restricted coding to three recordings per client, and the coding system focused on disclosure with emotional or medical relevance, so disclosures in ordinary social conversation may be missing. Themes were developed by the research team and disagreements were resolved by consensus, so the categories depend on researcher interpretation. The authors' previous quantitative analysis associated increased self-disclosure with worsening client depression over time, so these qualitative patterns cannot be read as proof of benefit.
Declared interests
The supplied article text gives no author conflict-of-interest declaration. The supplied publication types indicate NIH extramural research support.
The easy way to misread this
Do not read these themes as proof that peer self-disclosure improves depression. The study analysed recordings from 23 clients and 3 peer mentors and reported no outcome effect. The authors' previous quantitative analysis associated increased self-disclosure with worsening client depression over time.