Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD USA.
Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Patient Educ Couns. 2019 Jul;102(7):1273-1279. doi: 10.1016/j.pec.2019.02.006. Epub 2019 Feb 12.
Self-disclosure is recognized as an important aspect of peer support, but little is known about its use by peers. This study aimed to qualitatively understand peer self-disclosure in the context of depression care delivery to older adults.
69 audio-recordings of peer-client meetings were coded for self-disclosure using the Roter Interaction Analysis System (RIAS). Peer self-disclosure was defined as a statement describing personal life experience with physical and/or emotional relevance for the client. A total of 3421 discrete statements were organized into 770 disclosure episodes. The episodes were qualitatively analyzed to identify themes related to the content and function of self-disclosure within the peer-counseling context.
Peer self-disclosure was used to 1) counsel through reframing perspectives, modeling positive behaviors, offering coping skills, and sharing mental health resources and health information; 2) establish rapport by emphasizing similarities unrelated to depression; and 3) show empathy and understanding of personal struggles. In addition, self-disclosure rarely only focused on the peer experience without relevance for the client.
CONCLUSIONS & PRACTICE IMPLICATIONS: Peer self-disclosure can be purposively used in depression care delivery with older adults. Training and supervision in appropriate self-disclosure should be provided to peers to ensure purposive use.
自我表露被认为是同伴支持的一个重要方面，但人们对同伴的自我表露知之甚少。本研究旨在定性了解在为老年人提供抑郁护理的背景下同伴的自我表露。
使用罗特互动分析系统（RIAS）对 69 份同伴-客户会议的音频记录进行自我表露编码。同伴自我表露被定义为描述个人生活经历的陈述，这些经历与客户的身体和/或情感相关。总共 3421 个离散语句被组织成 770 个披露事件。对这些事件进行了定性分析，以确定与同伴咨询背景下自我表露的内容和功能相关的主题。
同伴自我表露用于 1）通过重新构建视角、塑造积极行为、提供应对技巧以及分享心理健康资源和健康信息来提供咨询；2）通过强调与抑郁无关的相似之处来建立融洽关系；3）表示对个人挣扎的同理心和理解。此外，自我表露很少只关注与客户无关的同伴经历。
同伴自我表露可以在为老年人提供抑郁护理时有意使用。应向同伴提供适当的自我表露培训和监督，以确保有意使用。
