“The peer workers, they get it” – how lived experience expertise strengthens therapeutic alliances and alcohol and other drug treatment-seeking in the hospital setting

Abstract

Introduction and aims

Despite a long history of the adoption of a peer workforce in alcohol and other drug treatment service provision, there is limited peer reviewed literature on the benefits of peer worker role integration in the hospital setting. Our qualitative study explored the perceptions of people with lived experience of problematic alcohol and other drugs use and their experiences of peer worker roles in the hospital setting.

Design and methods

Twenty semi-structured interviews with people who experienced problematic alcohol and other drug use. Transcripts were thematically analyzed and guided by a broad interest in a therapeutic alliance.

Results

We identified four themes related to how lived experience expertise within a peer worker role strengthened therapeutic alliances: (i) by building trust and credibility; (i) by building hope; (iii) the ability to approach informally; and (iv) in continuing to be accessible long term.

Discussion and conclusion

The results partly echo earlier literature, however highlight two innovative aspects that relate to lived experience expertise that maintain therapeutic alliances in the hospital setting being, firstly, the ability to approach informally, and secondly, an opportunity for longer-term engagement. In Australia at present there is a window of opportunity to better integrate peer workers into clinical care models, and as such our results have implications for how policy makers might better approach peer worker integration and configuration to improve treatment-seeking intentions both within and beyond the hospital setting.

Keywords:

• Alcohol and other drug treatment
• peer worker
• lived experience
• clinical care model
• hospital setting
• qualitative

Acknowledgement

The authors confirm that the research adheres to the journal’s ethical guidelines and includes information on how informed consent and ethics board approval was obtained.

Disclosure statement

TL and SN have received untied research funding from Sequirus to study prescription opioid harms. SN is a named investigator on a buprenorphine depot study funded by Indivior.

Additional information

Funding

The work was funded by National Centre for Healthy Ageing, Living Labs Program 2021, Pilot Round Application (# LLP21- 7695323607). Suzanne Nielsen is the recipient of an NHMRC Research Fellowship (#1163961).