Aug. 7, 2025
What Is Peer Support and Why It Matters
What is peer support—and why does it matter so much in high-stress jobs? In this episode, you’ll learn how it works, what it’s not, and why it’s saving lives on the front lines.
Ever wonder what peer support actually is—and why it seems like everyone’s talking about it lately?
Too many departments are using the term without really knowing what it means—or how to make it work. Worse, some well-meaning programs fail because they weren’t clearly defined or supported.
And if you’re thinking of starting a team—or you already have one that feels stuck—there’s a good chance the problem isn’t the people. It’s the lack of clarity, training, or purpose.
In this episode, I break down what peer support is, what it isn’t, and why it matters more than ever for first responders, medical professionals, and anyone working in a high-stress profession.
BY THE TIME YOU FINISH LISTENING, YOU’LL DISCOVER:
- What peer support is—and why it’s not the same as being a good friend
- The difference between Crisis Intervention Peer Support (CISM) and Comprehensive Peer Support
- The practical steps to build or improve a peer support program that actually helps
Whether you’re just getting started or trying to level up your existing team, this episode gives you a roadmap to do it right.
OTHER LINKS MENTIONED IN THIS EPISODE:
Schedule a free discovery call
QPR Suicide Intervention Training
CISM and Peer Support Training Info
Citations:
Jessica N. Jeruzal, Lori L. Boland, Monica S. Frazer, Jonathan W. Kamrud, Russell N. Myers, Charles J. Lick & Andrew C. Stevens (2018): Emergency Medical Services Provider Perspectives on Pediatric Calls: A Qualitative Study, Prehospital Emergency Care, DOI: 10.1080/10903127.2018.1551450
(2025, May 7). A Qualitative Study on the Design and Implementation of a First Responder Operational Stress Injury Clinic. PubMed Central. Retrieved August 2, 2025, from https://pmc.ncbi.nlm.nih.gov/articles/PMC12059418
(ND). A Day Like No Other: A Case Study of the Las Vegas Mass Shooting. New Mexico Department of Homeland Security & Emergency Management. Retrieved August 2, 2025, from https://nmdhsem2024-cf.rtscustomer.com/wp-content/uploads/2024/03/Las-Vegas-Mass-Shooting-Case-Study-by-NV-Hospital-Association-2018.pdf
(2025, January 15). Frank Leto—Success Stories from FDNY’s Counseling Service Unit | S5 E3. First Responder Center for Excellence. Retrieved August 2, 2025, from https://www.respondertv.com/s5-e3-success-stories-from-fdnys-counseling-service-unit-wit
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Connect with Bart
LinkedIn: linkedin.com/in/bartleger
Facebook Page: facebook.com/survivingyourshift
Website: survivingyourshift.com
Want to find out how I can help you build a peer support program in your organization or provide training? Schedule a no-obligation call or Zoom meeting with me here.
Let's learn to thrive, not just survive!
WEBVTT
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Do you ever wonder what Peer Support actually is and why is everyone talking about it? I mean, you're hearing the term more and more in firehouses and hospitals and police departments and just about every high-stress workplace is talking about it.
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You hear it at the conferences that you go to, but what does it really mean? What does it look like in action? And most importantly, does it actually help? These are questions that a lot of departments, a lot of organizations are asking. Is it worth the money? Is it worth the effort? So today, what I'm doing is I'm breaking down what Peer Support is, what it's not, and why I believe it's saving careers and lives in frontline professions just like yours.
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Whether you're thinking about starting a Peer Support team or improving the one you already have, this episode's for you.
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Welcome to Surviving Your Shift, your go-to resource for building strong, peer support teams in high-stress professions. I'm your host, Bart Leger, board-certified in traumatic stress with over 25 years of experience supporting and training professionals in frontline and emergency roles.
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Whether you're looking to start a peer support team, learn new skills, or bring training to your organization, this show will equip you with practical tools to save lives and careers.
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Hey friends, welcome back. I've been a first responder, a peer supporter, and a crisis intervention trainer with things like critical incident stress management. I'll be using some acronyms on this episode like CISM, and that stands for critical incident stress management, QPR. That stands for question, persuade, refer. Where that's our suicide intervention protocol. So, I've been doing this for more than 25 years, and I've worked with hundreds of departments across the country, helping them to build effective peer support programs that I believe and I've seen actually make a difference.
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Here's what I've learned. Peer support can change everything if it's done right. Now, not every workplace gets it right. Some think peer support is just a feel-good program. Others are launching something with good intentions, but really without a clear structure, and then they find it fizzles out. So today, what we're going to do is we're going to go back to the basics.
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Talk about what is peer support.
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Why does it matter? And how we can use it to actually help the people we serve and we work with.
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At its core, peer supports when someone with a shared experience and someone who understands the unique stressors of your job comes alongside another person and offers support, offers encouragement and perspective.
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And this could be a medic sitting down with another medic after a rough pediatric call. A correctional officer checking in on a teammate after a violent incident. Or a nurse noticing that their co-worker hasn't been themselves lately and asking,"Do you want to talk?" Peer support is peer-to-peer. It's horizontal. It's not top-down.
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After one particularly tough pediatric call, a Canadian paramedic didn't call her EAP.
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What she did was she called another medic who had been on the job for a number of years.
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That ought to tell us something.
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A 2019 qualitative study found that the first thing providers do after a difficult child call is to seek out another medic they trust.
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Peer support is built on 3 main pillars. 1. Shared Experience.
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This is probably the most important thing. 2. Empathetic presence. Everyone who's there, there for you. Someone that knows that you're there to listen to them and offer some support. And then number three, listening with a purpose. I mean, you're there to lower their stress response. You're there to help them get back to a level of adaptive functioning. So let's break it down. The shared experience means you're not just offering sympathy, you know, it's not just sucks to be you.
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You get it because you've lived it. I mean, that's really powerful. And then the empathetic presence is about just showing up, sitting with someone in their struggle.
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Without trying to fix it. You know, I find we're, we're, we tend to be fixers. Those in first response, those in the medical profession, you know, we, someone comes to us and they want us to fix it. And as far as our job is concerned, you know, really that's what we're there for. But when it comes to peer support, we're, we're not there to fix them. You know, like I always say, you send me someone that's broken, I'll give you back someone that's broken. I'm not here to fix them. And I'm not here to offer platitudes.
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I'm not here to try to fix their problem. I'm just here for an empathetic presence and hopefully listen to them and, and help them to get back to work. And then listening with a purpose means you're trained to recognize signs of trouble. You know, we're not just, you know, there as a shoulder to lean on.
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We're there with a purpose.
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We've been trained to look for those flags and flags and offer appropriate support and refer them to a higher level of care.
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If that's warranted, if that's, if that's needed. No, it doesn't have to be complicated. It's often a simple conversation that starts with, Hey, I've noticed something seems a little off with you. So I'm here to say, Hey, I'm here to talk and let's go grab a cup of coffee. Let's, uh, let's go sit on the tailboard. Let's just, let's just sit down, sit down and talk.
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But it's got to be intentional.
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That's what separates true peer support from just being a good friend. And we all need support.
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We all need our community. We all need friends. But peer support goes beyond just being a coworker, just being a good friend. It's intentional. We're there to support them. We're there to support them and we've been trained to do it properly.
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Now let's look at what peer support is not. And I want to be really clear about this because I've seen a lot of well-meaning but peer support is not a complaint session. We have to be careful about this. While peers should feel comfortable getting things off their chest, peer support's not primarily a vehicle just to gripe about administration or working conditions or that boneheaded policy that just came out.
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Researchers were evaluating a first responder clinic in Ottawa.
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What they found was that even the best clinical resources weren't used when the first responders weren't sure about confidentiality. Peer said they'd rather suffer in silence than risk their commander finding out. I think you know what I'm talking about. That's what happens when peer support drifts into gripe sessions or it loses clear boundaries. Another thing that peer support is not.
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It's not a substitute for therapy. EAP's employee assistance programs are there for a reason. They have, hopefully, well-trained counselors, well-trained mental health professionals who are there and we trust have dealt with whatever population that is coming to them. EAP's employee assistance programs are there for a reason. We know that peer support is not a substitute for therapy. I recommend at least once a year take advantage of your EAP and just go talk to somebody. Also, it's not a one-size-fits-all. Every peer support program will look a little bit different depending upon your organization, whether it's a police department, hospital, military. EAP, I know I do a lot of training for the military and it looks a little bit different than it does in a typical first responder organization. But it still has a purpose and it fits their population and they have their policy and they know what they're doing. Another thing, now this is the one that gets a lot of people, especially administration. They come back from a conference and they heard about peer support. They say,"You know, we need to check off this box." It's not a feel-good checkbox that looks nice on paper. Our job's not to diagnose.
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You don't preach. You don't tell someone what to do. And you don't try to be a counselor.
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That's outside the scope of peer support. Even if you're a licensed mental health professional, if you're called in for a critical incident, or if you're a peer, you're primarily there to lower their stress level and help them get back to adaptive functioning.
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Look at it like this. You're a bridge, not the destination.
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Your role is to listen, to normalize, support and, when needed, connect them to resources. And then, here's the big one, it's not about you. I mean, you may relate. You may have been through similar things that you're hearing about from the person who's talking to you.
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But peer support is about being there for someone else. It's not the time to tell war stories.
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Please don't turn the focus back on yourself. It also isn't a replacement for organizational culture change. This is so, so important. If we expect to have well-adjusted people working with us, it needs to be a culture change. We can't just wave a magic wand or we can't just throw a program at people.
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It has to be that culture that gets changed. And peer support works best when leadership supports It protects the confidentiality of the program and encourages people to reach out without fear of retaliation.
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And hopefully, we can lower that stigma of reaching out for help.
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the next thing I want to talk about is the difference between crisis intervention peer support and what I call comprehensive peer support. I'm going to talk about two models you've probably heard of or maybe trying to figure out the difference between. Okay. In terms of peer support. There's really two basic types of peer support. The first is what we call the crisis intervention peer support like CISM. It's event driven. Crisis intervention is designed to help individuals, groups cope after what we call a critical incident.
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That could be anything that rises to the level that threatens to overwhelm individuals on the team or maybe even an entire team's ability to cope. Think of mass casualty events, line of duty deaths, suicide, events that are calls that involve children or traumatic scenes. After the 2017 Las Vegas mass shooting, the VA rolled in mobile counseling buses staffed by trained peer counselors and they spent weeks offering psychological first aid to exhausted hospital staff.
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Crisis intervention peer support uses highly structured response models like the safer R. We teach that in the assisting individuals in crisis or the interactive group models like defusing and most people know the term debriefing. CISM trained peer supporters work alongside mental health professionals. Peer support is peer driven but it's mental health led. And what these mental health professionals do is they make sure that everyone stays on the reservation, that everyone stays in their lane and does no harm. I mean, this is super important to have this type of peer support team. And if your department or organization doesn't have a plan for critical incidents, that's something to fix fast. But it only scratches the surface.
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Because let's be honest, most of the stress we carry isn't from one major event. It's chronic, it's cumulative and it builds up over time. And that's where comprehensive peer support comes in. Comprehensive peer support is for everyday life. In my business, it's also for the big stuff. It's not just for the big stuff. It's about being there when someone's overwhelmed with family issues, wrestling with things like burnout, maybe struggling with addiction or going through a divorce, or maybe they're having difficulty with their teenagers, or maybe just hitting emotional exhaustion from the daily grind.
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It could also be occupational stress. Let me take for instance the New York Fire Department.
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FDNY's counseling service unit grew from a handful of firefighters after 9/11 to more than 300 active peer counselors today. And what they do is they handle everything from divorce stress to retirement anxiety.
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And this model takes on a proactive approach. It includes ongoing check ins. They have wellness conversations, resilience building. This could be in the form of teaching stress management skills, helping peers see what happened from a different perspective.
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And that's really important.
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Because sometimes we just have to look at what's happened in a different way. Also, they help people find the positive and learn how to grow from the experience. And things like that.
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Also, navigating personal, professional challenges and helping peers connect. Here's where your peer support can be a liaison. They can help peers connect with chaplains, with therapists, or EAPs. And in a strong program, team members are trained not just for crisis intervention, but also in active listening, emotional first aid, suicide awareness, things like QPR, assist. They can help with setting boundaries, confidentiality, ethics, cultural awareness, and also systems for referral. The goal is to create a culture where asking for help is normal and where people don't wait until the wheels come off to reach out.
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In short, crisis intervention peer support is the ER, if you will. Comprehensive peer support is primary care. You need both, but they serve different roles.
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And then, why does support matter? Why does, why, why do we do peer support and why it works?
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Let's, let's get down to it. Why does peer support matter so much?
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Now, here's the, here's the research and here's what experience tells us. It builds trust across the team. It encourages early help seeking.
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It reduces sick days and turnover. And it prevents suicide. The U. S. Air Force's peer-led suicide prevention program was linked to a 33% drop in the service-wide suicide rate.
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It also helps increase employee retention. I mentioned in last week's episode, the Johns Hopkins RISE program. It saves roughly $1. 8 million a year.
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That's about $22, 500 per nurse.
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And what it does is it cuts turnover and unscheduled absences. Good peer support programs also boost morale and job satisfaction. Higher levels of firefighter peer support correlate with lower occupational stress scores in multiple studies. And there have been other studies in different occupations. And I believe, and I've seen this, it saves careers.
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And this isn't just theory.
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Organizations like Johns Hopkins, the U. S. military, fire service networks, law enforcement agencies across the country are investing heavily in peer support because the ROI is measurable. Here's a quote from the cost-benefit analysis of a support program for nursing staff in the Journal of Patient Safety. And that was back in 2020. Here's what they said. Our Markov model shows that RISE prevents enough turnover and unscheduled leave to save about$1. 8 million a year, returning nearly $3 for every one spent on the program. I know I'm citing and quoting quite a bit. Don't worry. I'll have citations and these sources in the show notes.
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But beyond the numbers, peer support works simply because it's human. You can have a great EAP program, but if no one trusts it, no one's calling. A peer walking up and saying, I've been there. You're not alone.
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Let's talk. Can open the door to life-changing help. So, how do we do it? How do we build? Or how do we strengthen a peer support team? Let me give you some practical steps. So, today, if you're listening and you're thinking, All right, this sounds great, but how do we start something like this? Or, we already have a team, but it feels like it's not really helping. So, let's look at some next steps. If you're starting fresh, number one, get leadership buy-in. I can't stress enough how important this is. If leadership doesn't believe in the program, it won't survive. They don't have to run it, but they need to support Number two, choose the right people. Peer supporters should be respected, emotionally stable.
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They should be good listeners.
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Not just the most senior person or the most vocal. They're not always the outgoing ones. One way to get the right people is to have the rank and file let you know who they'd feel comfortable talking with. These would be the people who are already trusted. Obviously, not every one of these would be good candidates, but it's a starting point. You know, I've seen peer support programs explode on the launch pad because administration chose their favorites to be on the team. You know, these were often viewed as plants and peers were afraid they were a direct pipeline to the top brass. Number three, get them trained. Invest in solid training. Training like CISM, Critical Incident Stress Management. There are many, many trainings. There's the Assisting Individuals, there's Group, there are the Advanced, uh, there's Peer Paracounseling.
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There are a number of CISM trainings that, that we can do for you. There's also suicide intervention programs like QPR or ASSIST or Basic Peer Support programs. One of the things that, that I, that I call, that I do, is the Comprehensive Peer Support, where we, we deal with more of the everyday life issues.
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Important thing is, don't wing it. Don't just put a team together and say, "Go help. They need to be trained." Next, set some clear boundaries and procedures. Set policy. Set your procedures. You know, who handles what? When do you refer?
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How is confidentiality handled?
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What's your documentation policy?
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And then, number five, promote the team. You know, people won't use a team that they don't know exists. Introduce the team.
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Share bios. Keep their presence visible. Always talk about it.
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It's not about it. The goal is to have the Peer Support team top of mind if anything goes wrong in a person's life or they just feel like they need to speak to someone. And if you already have a team, what I recommend is, try to figure out what's working and what's not.
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Are your members burned out? Is the team trusted? Do people actually use it? And then another thing, and then another thing... this is very, very important is provide ongoing training. I've known way too many teams who were trained five years ago, and they've never had any in-service training. They've never done any ongoing scenario work just to keep their skills fresh.
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And something happens, and people can't remember what to do.
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So provide ongoing training.
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Peer Support isn't just a one and done. Just like we train in scenarios at the range, fire tactics, or EMS skills. This takes refreshers because Peer Support is a perishable skill.
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We want to keep your team now.
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We want to keep our team well.
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So create space for team wellness. Peer Supporters carry a lot. They hear a lot. And make sure that they're cared for too.
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Peer Support for Peer Support for Peer Supporters is a thing, and it matters. And then, collect feedback. Collect stories. Because maybe there's going to be an administration change, and Peer Support is not top of mind for them. And they're wondering, is it still worth it? You need to be always collecting stories. Now, we don't necessarily, we don't want you to use names, but to say,"We have served 263 people this past year. We can document that X amount of jobs were saved because people stayed on the job after a critical incident." And these are things that really, really matter. That's the return on investment. So track the impact your team is making. Even small wins matter. So, if you're feeling fired up to start or maybe to strengthen a peer support program where you work, I'd love to help you do that. Go to StressCareDoc.com/consultation, and schedule a free discovery call. Whether you're a chief, an ER nurse, a dispatcher, an officer, or a chaplain. If you want to serve your people better, we can build something that works. And if this episode gave you clarity, would you share it with someone else on your team, or share it with someone else who might be interested? It's at survivingyourshift.com/33. And don't worry, I'll have all these links in the show notes. Peer Support works best when it spreads. You never know who needs to hear it. Thanks for hanging out with me today on Surviving Your Shift. Today we broke down what peer support really is, the difference between crisis intervention and comprehensive care, and how to start building a culture where no one struggles alone. Come back next time, and we're going to be looking at the signs your department needs a peer support team. So until then, God bless, and have a great day.
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