Klodnick Vanessa Vorhies, LaPelusa Brianne, Reznik Samantha J, Johnson Rebecca P, Myers Neely L, Lucksted Alicia, Cohen Deborah A, Lopez Molly
Steve Hicks School of Social Work, Texas Institute for Excellence in Mental Health, University of Texas at Austin.
Dedman College of Arts and Sciences, Southern Methodist University.
Psychiatr Rehabil J. 2025 Sep;48(3):182-190. doi: 10.1037/prj0000612. Epub 2024 Jul 25.
Substance use (SU) is common among adolescents and young adults, including those experiencing early psychosis. Coordinated Specialty Care (CSC), a community-based multidisciplinary team-based service model, is increasingly used to support people experiencing first-episode psychosis. In addition to prescribers, clinicians, and vocational specialists, CSC includes peer support specialists who use their own living/lived experience with mental health and treatment to engage and support young people with their recovery goals. Peer support is also foundational in SU recovery. However, little is known about how peer support specialists navigate client SU in CSC. The purpose of this article is to detail CSC peer support SU practice.
Informed by community-based participatory research methods, a PhD-level qualitative researcher and a former peer support specialist conducted virtual interviews with 20 CSC peer support specialists. A multidisciplinary team including researchers with lived mental health experiences thematically coded interview transcripts.
A spectrum of CSC peer support specialist SU responses emerged: (a) leverages lived SU experiences; (b) does not explore SU with clients; (c) shares client SU information with the CSC team; (d) educates, mentors, and advocates; (e) shares SU consequences and/or challenges substance use; (f) nonjudgmental, nondirective SU exploration; and (g) promotes harm reduction.
CSC peer specialist SU practice is influenced by several contextual tensions that must be better understood and addressed in future research to improve peer SU practice. Study findings speak to practice nuances that are helpful for CSC peer support training and supervision. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
物质使用（SU）在青少年和青年中很常见，包括那些患有早期精神病的人。协调专科护理（CSC）是一种基于社区的多学科团队服务模式，越来越多地用于支持首次发作精神病患者。除了开处方者、临床医生和职业专家外，CSC还包括同伴支持专家，他们利用自己在心理健康和治疗方面的生活/经历来参与并支持年轻人实现康复目标。同伴支持在物质使用康复中也是基础。然而，对于同伴支持专家如何在CSC中应对客户的物质使用情况知之甚少。本文的目的是详细介绍CSC同伴支持物质使用实践。
在基于社区的参与性研究方法的指导下，一位拥有博士学位的定性研究人员和一位前同伴支持专家对20名CSC同伴支持专家进行了虚拟访谈。一个包括有心理健康生活经历的研究人员的多学科团队对访谈记录进行了主题编码。
出现了一系列CSC同伴支持专家对物质使用的反应：（a）利用自身物质使用经历；（b）不与客户探讨物质使用情况；（c）与CSC团队分享客户的物质使用信息；（d）进行教育、指导和倡导；（e）分享物质使用的后果和/或挑战物质使用行为；（f）进行非评判性、非指导性的物质使用探索；以及（g）促进减少伤害。
CSC同伴专家的物质使用实践受到多种背景因素的影响，未来研究必须更好地理解和解决这些因素，以改善同伴物质使用实践。研究结果揭示了一些实践细节，有助于CSC同伴支持培训和监督。（PsycInfo数据库记录（c）2025美国心理学会，保留所有权利）
