She Cried after Realizing She Has Support: Practices of Peer Mentors in a Substance Use Treatment Intervention

Family peer mentors (FPMs) are parents and guardians who have successfully navigated substance use and child welfare involvement and are employed to support parents and families with similar challenges. FPMs are an essential component within Ohio START, a child welfare substance use intervention that focuses on caseworkers, substance use treatment providers, and FPMs collaborating to support parents identified as struggling with substance use, keep children with their parents, and reunite families. Although FPMs are influential for parents participating in START, little is known about how specifically FPMs support families. The purpose of this study was to understand how START FPMs support clients with different journeys toward sobriety.

The descriptive qualitative case study used weekly contact logs for 117 families spanning ten FPMS and three Ohio counties. Counties were selected by FPM and supervisor longevity in their positions and parents ranging in timely completion of substance use treatment. Contact logs documented the at least weekly direct contact visits between FPMs and parents and were input in a data collection portal for the broader Ohio START evaluation. Logs were coded in Atlas.TI. Using codebook thematic analysis, contact logs were coded and organized into themes based on SAMHSA definitions of types of peer support between FPMs and families.

Eight specific types of peer support emerged in the data. Engaging relationships included making space for the peer and facilitating kind and attentive communication such as “active listening and allow[ing] a safe space.” Linking to resources required educating peers about services and the system, providing transportation, and attending appointments. Supporting recovery planning included identifying sobriety goals and barriers including “encourag[ing] to find a recovery path that will work for her.” Supporting collaboration required working in partnership with the treatment team to facilitate services and case planning. Providing skill building allowed FPMs to engage parents in substance use treatment such as identifying triggers to use, challenging thought patterns, and developing coping strategies. Providing support gave families encouragement: “I want [child] to be able to have both his parents healthy and in recovery.” Managing crises addressed relapse and safety concerns through listening, identifying consequences and plans to recover, and documentation. Sharing lived experiences included peers discussing their own recovery journey to educate families, build rapport, and provide hope including, “FPM shared lived experience about how I have had to work on myself in order to be a good parent.”

As evidenced by results, FPMs offer a unique method of supporting parents and families impacted by substance use and child welfare involvement. These results have important implications for policy, practice, and research. Practice and policy should consider the unique supports offered by FPMs and implement similar supportive practices within caseworker engagement with families. Communities should also consider how informal support networks and sober-friendly activities can move families with a history of substance use toward recovery. Research should continue exploring the types and frequency of support provided, considering comparatively how support looks different depending on treatment outcomes, regions, child age, and substances used.