Emotional Exhaustion Among Peer Recovery Coaches Supporting Individuals with Substance Use Disorders

Background and Purpose

Peer recovery coaches (PRCs) have been one of the largest substance use service growth areas over the last decade. PRCs are providers with lived experience in substance use recovery trained to provide informational, emotional, and instrumental support to people with alcohol or other drug problems (White, 2009). PRCs work in various settings, including community mental health, healthcare, and criminal legal system settings. They improve treatment engagement, retention, and client satisfaction (Eddie et al., 2019). However, the work can be challenging, as PRCs support vulnerable populations while maintaining their own recovery (Mendoza et al., 2016). Concurrent COVID-19 and drug overdose crises have introduced new stresses, leaving PRCs particularly vulnerable to professional burnout. This study examines rates and correlates of emotional exhaustion among PRCs in Michigan.

Methods

Data were collected through web-based surveys with recovery coaches in Michigan (N=266) from July-September 2021. Participants were recruited through online and email advertisements sent to all Michigan providers who received federal or state funding for peer recovery services. Measures included demographics (age, gender, race, rural/urban community, and years of experience working as a PRC), workplace belongingness, role clarity, attitudes toward clients, and personal stresses related to COVID-19. Emotional exhaustion was assessed using the abbreviated Maslach Burnout Inventory (Maslach et al., 1996). Multiple linear regression was used to identify factors associated with greater emotional exhaustion.

Results

Emotional exhaustion scores ranged from 0 to 18 (Mean=5.80, SD=4.71); 35.3% of PRCs met the threshold for moderate to high burnout (i.e., Scores ≥7). The multiple regression model was significant (F(10, 266) = 12.85, R²=.616, p<.001). PRCs who lived in rural areas (b=1.572, p=.018), had more years working as a peer PRC (b=.756, p=.004), and reported greater personal stresses related to COVID-19 (b=.729, p<.001) reported greater emotional exhaustion. Participants who reported greater workplace belongingness (b=-.099, p<.001) and role clarity (b=-.187, p=.039) reported lower emotional exhaustion.

Conclusions and Implications

PRCs are frontline positions that can be emotionally taxing, particularly with the COVID-19 pandemic, high prevalence of drug overdoses, and recent staffing shortages. Results indicate concerning levels of emotional exhaustion among PRCs. Coaches working in rural settings, in the field longer, and acutely impacted by COVID-19 may be more vulnerable to emotional exhaustion. Findings suggest workplace belongingness and greater role clarity may protect PRCs from burnout. PRCs provide a wide range of services, and their roles are sometimes not well defined (Eddie et al., 2019). Supervisors should help PRCs establish a clear understanding of their role and help other staff understand the work of PRCs (White, 2006). Supervisors can also promote workplace belongingness by implementing recovery-oriented workplace policies (Abraham et al., 2021) and creating opportunities for PRCs to collaborate with other staff. Efforts to prevent burnout among PRCs will aid in the retention of PRCs in the workforce, decrease the organizational costs of turnover, and improve the quality of care for people with substance use disorders.