873934
research-article2019
WHSXXX10.1177/2165079919873934Workplace Health & SafetyWorkplace Health & Safety
vol. 68  ■  no. 2
The Role of Peer Support in Managing Occupational
Stress
A Qualitative Study of the Sustaining Resilience at Work Intervention
Bhavya Agarwal, MSc1, Samantha K. Brooks, PhD1
Abstract: Background: Peer support at work may
support psychological resilience by enhancing coping
skills and providing social support. The current study
aimed to examine how a workplace peer support
program, “Sustaining Resilience at Work” (StRaW), may
support employee mental health from the perspective
of the trained peer supporter. Method: Nine individuals
from various public and private organizations who had
completed StRaW peer supporter training participated
in semi-structured interviews to explore their views on
the StRaW program. Data were analyzed using inductive
thematic analysis. Findings: Three main themes emerged:
the impact of workplace stressors on employee mental
health, the impact of StRaW, and feedback on StRaW.
The results suggested positive effects of StRaW training
on practitioners’ ability to support colleagues and
maintain their own psychological well-being. Discussion/
Application to Practice: Our results indicated that
peer support programs in the workplace may improve
employees’ well-being and relationships between
employees. As such, occupational health professionals
should recommend that their organizations invest in these
types of programs to improve organizational resilience.
They should encourage employees they consider to be
capable of supporting their colleagues to undergo this
training as evidence suggests this is beneficial to the
trained employees’ own well-being, rather than making
them feel burdened or under pressure. Occupational
health professionals should also view such programs as
useful ways of improving attitudes toward mental health
within their organizations.
Keywords: occupational health, occupational stress, peer
support, resilience training, workplace support
DOI: 10.1177/2165079919873934. From 1King’s College London. Address correspondence to: Neil Greenberg, MD, Department of Psychological Medicine, King’s College London, Weston
https://doi.org/
Education Centre, Denmark Hill, London SE5 9RJ, UK; email: neil.greenberg@kcl.ac.uk
For reprints and permissions queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.
Copyright © 2019 The Author(s)
Workplace Health & Safety
Professional Pr actice
, and Neil Greenberg, MD1
Introduction
Research suggests that the average person spends a third of
their life at work (Fotinatos-Ventouratos & Cooper, 2015). Work
is an important aspect of an individual’s identity, and positive
work experience is associated with increased organizational
commitment, enhanced job performance, and job satisfaction
(Butts, Vandenberg, DeJoy, Schaffer, & Wilson, 2009). However,
occupational stress can lower organizational commitment,
increase turnover intentions, and may lead to absenteeism
(Bowling, Alarcon, Bragg, & Hartman, 2015), which can
consequently lead to considerable physical and psychological
problems for employees (Nixon, Mazzola, Bauer, Krueger, &
Spector, 2011). Depression and anxiety at work account for 44%
of occupational ill health and 57% of loss in productivity and
absenteeism (Health and Safety Executive, 2018).
The main support for workers within their organizations
often comes from colleagues and managers (Hancock & Page,
2013); and social support from immediate supervisors and
colleagues can help decrease feelings of perceived work
overload and occupational stress (Bowling et al., 2015).
Consequently, peer support programs have increasingly been of
interest to organizations as a way of facilitating employees’
abilities to support each other and decreasing perceived
workplace stress.
According to Mead, Hilton, and Curtis (2001), peer support
can be defined as “a system of giving and receiving help
founded on key principles of respect, shared responsibility, and
mutual agreement of what is helpful” (p. 137). Systemic social
reciprocity is an essential component of providing support
because individuals who share similar life experiences may
understand a peer’s situation better (Mead et al., 2001). Peer
support programs aim to increase social support and develop
resilience—often defined as “the process of effectively
negotiating, adapting to, or managing significant sources of
stress or trauma” (Windle, 2011, p. 12). The development of
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Workplace Health & Safety
Applying Research to Practice
Occupational stress can lead to physical and
psychological health problems, lowered productivity,
absenteeism, and poor organizational commitment.
Research suggests that feelings of pressure and stress at
work can be decreased if employees feel supported by
immediate colleagues and supervisors; therefore, many
organizations are becoming increasingly interested in
peer support programs. We evaluated the “StRaW”
program by interviewing employees who had received
StRaW training. Overall, they reported increased
understanding of mental health, the ability to recognize
distress and support colleagues, and improved
confidence and self-esteem. While more research is
required to fully understand the impact of peer support
programs such as StRaW, the results of this study and
evidence from other studies of peer support programs
suggest that occupational health professionals can use
peer support as mechanism both to improve the mental
health of the workforce and to help identify individuals
who require professional interview early on. In this
sense, StRaW may well help managers foster employee
resilience in the workplace while also allowing
occupational health staff to have earlier access to
individuals who may benefit from formal health care
interventions.
resilience is a mechanism which can mitigate negative effects of
stress-related psychological outcomes for an individual and
increase well-being. Individual resilience is related to increased
job satisfaction and organizational commitment (Sood et al.,
2011); more resilient staff are also likely to perform better at
work in a positive work environment (Shatté, Perlman, Smith, &
Lynch, 2017). Peer support programs can prevent organizational
mental ill health–related behaviors such as disengagement,
absenteeism, and intentions to leave the organization
(Whybrow, Jones, & Greenberg, 2015).
Studies suggest that peer supporters can have a positive
effect on the individuals they provide support to, and the
organizations where they work (Meehan, Bergen, Coveney, &
Thornton, 2002; Salzer et al., 2013). Salzer et al.’s (2013)
exploration of the benefits of being a certified peer specialist
found statistically significant reductions in case management,
crisis services, and inpatient hospitalizations in previously
hospitalized individuals working as “case management aides”;
certified peer specialists also reported experiencing benefits to
their own well-being and felt that they had a positive impact on
their agencies. Meehan et al.’s (2002) evaluation of an Australian
program for mental health consumer peer support trainees
found that participants’ levels of anxiety, perceived stress, locus
of control, and self-esteem all improved over the course of the
training (though not to a statistically significant level). In a focus
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February 2020
group, the same participants suggested that they felt they had
gained a lot from the training, which they perceived as
benefiting both themselves and the patients they supported.
Evidence further suggests that peer support can improve
individuals’ attitudes toward work as well as their personal
well-being (Gould, Greenberg, & Hetherton, 2007; Small et al.,
2013) and is associated with more positive attitudes toward
mental and physical health, increased positive coping strategies
(e.g., exercise), and decreased negative coping strategies (e.g.,
using alcohol to cope with distress) (Hersey et al., 2008). Peer
support programs can also decrease presenteeism and help
lower sick leave rates (Odeen et al., 2013; Werner, Laerum,
Wormgoor, Lindh, & Indahl, 2007). Salzer and Shear (2002)
suggest that peer support training also increases the self-esteem
of the practitioners.
Although there appears to be some evidence of the
effectiveness of such interventions, the impact of peer support
training programs has not been fully explored and further
research is needed to recognize which elements of such
programs are most important. There is also a lack of research—
particularly qualitative research—on the practitioners’ own
perceptions of the training programs and the impact it has had
on their lives.
This study examined one such intervention called Sustaining
Resilience at Work (StRaW). StRaW is a peer support system
which was developed by a company called March on Stress
Ltd., subsequent to a review of the literature on workplace
stress (Brooks & Greenberg, 2018). (Readers can learn more
about StRaW via March on Stress; http://www.marchonstress.
com/page/p/ort_straw.) StRaW aims to help detect, prevent,
and/or minimize the effect of everyday stressors at work or
home and on employees’ well-being (March on Stress, n.d.),
and essentially, StRaW is a peer support system which teaches
and enables individuals to support colleagues and encourage
resilience. StRaW practitioner training involves a 2-day course in
which participants receive education about how stress and
mental health problems can affect people at work; training in
the use of a structured interview schedule to ascertain whether
colleagues might be experiencing significant levels of distress,
information about how to practically manage stressed
individuals, and training about how to mentor them to take
positive, resilience enhancing actions such as positive coping,
speaking to people who can positively influence their lives such
as managers, colleagues, and family members. The training
course also provides guidance on how to recognize more
complex symptoms requiring professional intervention and
provides trainees with the skills, based on the principle of
motivational interviewing (Prochaska et al., 1994) to encourage
these employees to speak with a health care professional. The
training includes a mixture of educational sessions and
facilitated role-plays.
StRaW training focuses on the recommendations of an expert
group that explored the rationale for organizational-focused
peer support training which concluded that peer supporters
vol. 68  ■  no. 2
should (a) provide an empathetic, listening ear; (b) provide
low-level psychological intervention; (c) identify colleagues who
may be at risk to themselves or others; and (d) facilitate
pathways to professional help (Creamer et al., 2012).
Importantly, the StRaW interview process includes telling the
individual that the only reason that a StRaW practitioner would
break confidentiality without the express permission of the
interviewee is whether they considered there was a significant
risk of serious harm (to self or others) occurring. Such an
approach is important to facilitate the open discussion of mental
health issues between a distressed employee and a StRaW
practitioner.
This study explored the views of employees who had
become peer supporters by completing StRaW training to
identify what difficulties StRaW may help with, how StRaW
might affect their colleagues’ or their own mental health, and
suggestions for improvement to the StRaW program.
Method
Design and Study Participants
The study used qualitative analysis of nine interviews carried
out by one researcher (B.A.) in May through June 2017. Seven
interviews were carried out via telephone, and two face-to-face
interviews were conducted in individuals’ workplaces. All
participants were employees who had completed a 2-day StRaW
peer support training package. These peer supporters, known
as StRaW practitioners, were not specialists in occupational
health and safety or counselors but were employee volunteers
who performed their StRaW practitioner role in addition to their
usual job.
The study received full ethical approval from the King’s
College London Ethics Committee (Reference No. LRU-16/17-
4175) before commencement of the study. All participants read
detailed information sheets regarding the study before providing
informed consent. Participants were assured that their
confidentiality would be respected by removing any identifying
details from transcripts and were informed they could stop the
interview or request withdrawal of their data at any time.
Procedures
Three organizations trained in StRaW were identified by the
company who trained them, March on Stress Ltd, and
approached via email to ascertain if they would be willing to
participate in the research. The StRaW leads of two
organizations agreed to participate in the study after approval
from their respective StRaW teams and their organizational
management. Eligible participants were over the age of 18 and
had attended StRaW training at least 2 months previously to
ensure they had the opportunity to gain a degree of experience
of supporting colleagues and thus consolidate training. Eligible
practitioners (i.e., those employees who have been trained as
StRaW practitioners) who were interested in taking part were
further contacted individually via email, provided by the StRaW
leaders. Before the commencement of interviews, participants
Workplace Health & Safety
were provided with study information sheets and consent
forms. Interviews began after formal informed consent was
received.
Interviews
Semi-structured interviews were conducted to explore
StRaW practitioners’ experiences of supporting colleagues and
identify whether they had experienced any positive or
negative impacts from using StRaW themselves. For example, a
negative impact could possibly occur if they did not find the
training helpful and could lead them to feeling unable to assist
their colleagues. Questions about suggestions for improvement
were also asked.
As interviews were semi-structured, participants had the
freedom to guide the direction of their interviews; however, a
general topic guide was developed by the researchers to ensure
some level of consistency throughout the interviews. The
interview schedule was developed through a combination of
discussion with the StRaW leads within the organizations,
reviews of other papers investigating peer support training (e.g.,
Gould et al., 2007), and discussions with other professionals in
the field. The final schedule consisted of 13 broad questions
which covered the relationship of the participant with their
colleagues and immediate supervisor, whether the StRaW
training had any impact on their relationship with their
colleagues and supervisors, and whether the StRaW training had
been useful to them both personally and professionally.
Examples of questions included “looking back, what were the
most useful parts of the course for you?”; “what else might the
course have included which you would have found helpful?”;
and “how have you found using the principles of StRaW at your
place of work; what has worked well; what has not worked so
well?” Interviews lasted for an average of 30 minutes. The first
two interviews were conducted as pilot interviews; however, as
no changes to the interview schedule needed to be made after
these pilots, all interviews were included in the analysis.
Data Analysis
Interviews were audio recorded, then transcribed verbatim.
Following multiple re-readings of the transcripts to allow
familiarization, one researcher (B.A.) used thematic analysis
(Braun & Clarke, 2006) to code the data using NVivo Software
(2012). The type of thematic analysis used was inductive, in that
the data itself was used to generate codes without
predetermined ideas about what might be found, and similar to
phenomenology, in that its goal was to understand and describe
how participants thought and felt in relation to the research
topic. Data were coded by allocating excerpts of text to
thematic codes representing meanings in the data. Related
codes were combined to create “themes,” which were reviewed
and organized until we had a master list of thematic codes. This
approach was utilized to best understand the experience of the
participants and develop any emerging themes from the data.
Our working definition of resilience, used to aid analysis, was
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Workplace Health & Safety
that it is the sum of the dynamic processes that help individuals
cope with adversity (MacManus et al., 2014).
Results
Nine individuals took part in the study; four male and five
female. Participants were from one public and one private
organization; they worked in Human Resources (HR), Commercial,
Advertising, or Administrative roles. Time in their current role
ranged from 2 to 20 years. All participants were StRaW
practitioners at the time of the interviews and had been trained for
at least 1 year.
Thematic analysis yielded three main themes: workplace
stressors and their impact on employee mental health, the
impact of StRaW, and feedback on StRaW. References to specific
individuals, organizations, or places have been changed to
“(name)” to retain participants’ anonymity. Text in square
brackets within an extract indicates text that has been added by
the authors to clarify what the participants were referring to if
this was not clear from the extracts. “(. . .)” within an extract
indicates some text has been omitted.
Workplace Stressors
Discussion of workplace stressors was prevalent throughout
the discussions, and such stressors appeared to be a contributing
factor to how participants perceived their own and their
colleagues’ work before the StRaW program, their experience
with StRaW, and StRaW’s role in mitigating workplace stress.
Work characteristics (such as heavy workload, a high level of
workplace demands, and inadequate resources) and specific
workplace responsibilities were highlighted as the main
workplace stressors experienced by employees in the workplace.
Participants described experiences of employees feeling
stressed due to hectic work schedules, needing to keep up to
date with new trends, meeting deadlines, competitive working
environments, and a multitude of tasks which affected how they
managed their work and maintained a work–life balance.
It is a hard-paced environment and organizations like
ours have always been. I think people still have their
moments of stress of the work environment and
achieving targets. (Participant 8)
Satisfaction (or lack of) with the immediate supervisor was
important in how participants felt about their jobs. Participants
had varied views of their supervisors, with some being positive:
I have always had a very good relationship with my
supervisor. He has always been very supportive, I can
confide him in any work issues or even personal things
and I know he would have some good advice. He’s a
very good listener. (Participant 7)
Relationships with supervisors tended to be perceived as
positive if participants felt able to talk to them and felt both
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February 2020
respected and supported. Others described more negative
relationships:
I think he [supervisor] is very driven and has a very
opinionated view about things like where we should be,
and I have always admired that about him but in terms of
his team management, I don’t find his ways effective at
all. (Participant 5)
Negative relationships with supervisors tended to be
characterized by inefficient management, poor communication,
or feeling unable to approach them regarding problems.
Another workplace stressor was organizational change in the
form of relocation, role adjustment, and administrative changes,
which were all cited as factors which could lead to role
ambiguity and feelings of disengagement and stress. StRaW was
viewed as a possibly useful way of mitigating the stress
experienced as a result of organizational change as helped
generate feelings of a supportive network and structure. StRaW
practitioners reported commonly supporting new staff or staff in
new roles to help them adjust to the change.
We have had a lot of structural change here, there have
been lots of new people coming who are not aware of
the history. So that’s one thing we talk about more in our
StRaW group, of how we can help. (Participant 3)
Impact of StRaW
No participant reported any negative effects of having
attended StRaW training or taking on the role of StRaW
practitioner. Participants felt that StRaW had a positive impact
on both themselves and those they supported in their
organizations.
First, StRaW-trained staff reported feeling more aware of
their own mental health needs and the needs of others in
terms of situational, personal, and environmental
circumstances. They noted that they were more likely to
recognize problems in others and more able to self-reflect
than pre-StRaW training.
I would say that I have learned how to reflect upon
myself, become more self-aware and I feel more aware of
the people around me in general. And on a conscious
level, I try to be more aware of things and I know it’s a
big difference since last year. (Participant 5)
Some participants felt that they could cope better personally,
even when workplace stressors persisted, indicating an overall
increase in their personal resilience.
I was quite distraught and could not get my thoughts in
order . . . I am still dealing with the problem (with
supervisor). But now I feel more resilient and know how
to pull myself together and calm down. (Participant 4)
vol. 68  ■  no. 2
Most participants felt more confident because the skills they
had learned in the StRaW course had increased their ability to
deal with stressors and challenges.
I would say that it (StRaW training) has made me more
confident. It has helped me on an organizational level but
I could see how it can help me personally as well.
(Participant 8)
The StRaW practitioners also felt that they had become more
approachable after the training and reported that colleagues
more often wanted to speak to them for advice or to gain an
understanding of what might help them by going through the
formal StRaW process. Some felt that StRaW had added more
credibility to their role.
I am someone who has been through a major problem,
has done a (StRaW) training and hence people feel that
they can always talk to me. It has made me more
approachable. (Participant 7)
In addition to increased confidence and perceived
approachability, participants also suggested they perceived
improvements in their own emotional intelligence and social
intelligence. Often, these were skills participants felt they
already possessed, but StRaW had enhanced them: “I already
had most of those skills but StRaW enhanced them . . . I think I
was quite emotionally intelligent anyways but perhaps it just
added to it” (Participant 8).
Feedback on StRaW
Overall, participants found the concept of peer support
beneficial and suggested such programs were essential because
they allowed employees to approach a familiar, trusted figure
with their problems. Many felt that people were more likely to
approach a StRaW-trained colleague than HR, for example, and
felt that StRaW created a safe space for people to talk about
problems without judgment.
I think people don’t always want to go and talk to HR.
So, having a peer in the department that people trust is a
good thing, moreover they do not want things on record
officially and want to talk to someone who can keep it
confidential and would not use it against them.
(Participant 3)
Most participants reported that the StRaW techniques were
easy and practical to implement; “I find it easy, very
straightforward and simple to follow” (Participant 7). They felt
empowered by using the techniques they had learned, such as
the decision-making matrix, a tool taken from a psychotherapy
technique called motivational interviewing, and having a
structured approach to problem solving had helped them make
Workplace Health & Safety
decisions and take actions to improve their own and their
colleague’s mental health.
The decision-making matrix (. . .) has fit in with a lot of
reasons why someone has come to talk to me. I use it to
make decisions myself as well. (Participant 4)
Participants appreciated the concept of peer support in an
organization which they felt had encouraged the development
of resilience, provided a structure for providing social support
and created a safe space for staff to talk about their mental
health problems. Overall, the program was perceived to be
empowering and fostered resilience in both the practitioners
and those they supported: “it has given the ability and
empowerment to people to come back to work next day [after a
stressful event]” (Participant 7).
As well as providing positive feedback, participants made
suggestions for how StRaW could be improved. Six
participants suggested that StRaW training should be longer
than 2 days to have more time to learn and reflect on the
training. Three participants suggested follow-up training to
learn more, discuss the training, and enhance their skills.
The majority felt the materials provided were sufficient, but
three suggested more materials (such as videos, online
material) should be provided for future reference.
Participants also suggested that StRaW should be developed
for organizations with smaller group dynamics, although
participants did not suggest how this might effectively be
done.
Three participants said that potential StRaW beneficiaries
might find it difficult to differentiate between the role of StRaW
practitioners and HR, which led to a recommendation that
StRaW practitioners as being confidential and wholly
independent of HR are important:
The most difficult part of my StRaW experience has been
trying to reassure people that it is not HR. The questions
are similar to HR and people are very sceptical about the
motivations as they are scared of it in any large
organisation. (Participant 8)
Discussion
This study aimed to examine the possible benefits of peer
support within an organization using qualitative interviews with
personnel trained in the StRaW peer-led support program. Our
results showed that StRaW practitioners felt that peer support
would be helpful for mitigating the impact of a wide range of
stressors and had helped them become more aware of their
own psychological health and better understand the
psychological health needs of others. StRaW training was also
viewed as equipping trainees with skills to support distressed
colleagues who might be contending with significant
occupational and personal stressors. Furthermore, the skills
learned on the course were also viewed as helping to maintain
their personal resilience.
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Workplace Health & Safety
Our results suggest that employees’ satisfaction with their
immediate supervisor was extremely indicative of how
supported the participants felt in their organizational
environment. Perceptions of having good support from one’s
supervisor were seen as being indicative of support from the
entire organization. Healthy working relationships and
supervisor support have been previously shown to be positively
correlated with job performance (Alessandri, Borgogni, &
Latham, 2017), job satisfaction (Alessandri et al., 2017), and role
clarity (Zheng, Thundiyil, Klinger, & Hinrichs, 2016). While most
of the participants felt they had a healthy working relationship
with their immediate supervisor, a minority described it to be
strained. However, they felt that StRaW training equipped them
to cope better with the associated stress and made them more
resilient. In these cases, they felt that their stress was also
possibly mediated by peer support and by implication potential
StRaW beneficiaries would also likely benefit from peer support
if they faced difficulties with their supervisors.
Another psychosocial effect of the StRaW training was a
perceived increase in confidence and self-esteem of the
practitioner. Practitioners felt more equipped to deal with
problems and everyday stressors and provide adequate support
to their colleagues when approached. The results can also be
understood in the context of the job demands–resources model
(Demerouti & Bakker, 2011). In this model, factors associated
with job stress can be classified as either demands (aspects of
the job which require physical or psychological effort, and are
thus associated with certain physical or psychological costs) or
resources (aspects of the job which help to achieve goals or
reduce demands and their costs). In this study, peer support
was viewed as being an important resource to deal with the
stressful demands from work or home life.
However, peer support training might well enhance
organizational and personal resilience more than simply by
mitigating the impact of one’s supervisor. Although resilience
may come from many sources (Rutter, 2006; Sarkar & Fletcher,
2014; Windle, 2011), our results suggest that peer support may
protect employees from the potentially harmful effects of a
range of stressors by bolstering an individual’s resilience and
consequently increasing personal well-being and improving
their mental health (Grant, Curtayne, & Burton, 2009; Vanhove,
Herian, Perez, Harms, & Lester, 2016). The present study also
found that the resources provided by the StRaW training could
possibly strengthen an individual’s coping mechanisms which
may lead to improved mental health, self-esteem, and ability to
access social support (Taylor & Stanton, 2007). Most participants
perceived they had become more resilient and could deal with
day-to-day stressors and by implication they felt that potential
StRaW beneficiaries would also experience improved coping
skills. From an organizational viewpoint, improved ability to
cope with adversity should also lead to increased productivity.
Employees who had volunteered to be StRaW practitioners
expressed that they had hoped that the training would help
themselves and others. This desire is in keeping with social
support theory (Salzer, 2002; Solomon, 2004) and the helper
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February 2020
therapy principle (Salzer & Shear, 2002) as practitioners felt able
to help their colleagues with whom they felt a sense of
camaraderie. Practitioners also experienced positive feelings
from being approached for help by potentially distressed
colleagues. Being better able to understand their colleague’s
situation and being able to help them seemed to not only help
the colleagues receiving StRaW support but also the
practitioners themselves. Being able to deal with distress in the
workplace is likely to improve social relatedness and bolster
employee self-determination (Ryan & Deci, 2000) and autonomy
(Cherrington et al., 2015), both of which are associated with the
development of healthy coping behaviors.
The interviews also suggested that StRaW had the potential
to help initiate an organizational culture change. Respondents
felt that the introduction of StRaW had increased mental health
awareness in their organizations and the majority of participants
perceived their organization to be more proactive in raising
mental health awareness and providing support since the
introduction of StRaW. This organizational change was viewed
positively by the practitioners and some felt it had empowered
them to be more responsible to bring about further positive
culture change.
Participants were mostly satisfied with the content and
significance of the StRaW training. The decision-making tools,
conversation structuring techniques, and role-play activities
were found to be useful and relevant. However, some
participants had difficulty with the 2-day training program and
felt they required more time to learn and reflect on the course
content. In addition, four participants felt the two full-day
training should be split into four half-day training programs to
make it less hectic. However, there is limited evidence to
suggest that programs which are longer in duration lead to
more positive outcomes (Robertson, Cooper, Sarkar, & Curran,
2015) and organizations need to balance the needs to provide
their peer supporters with effective training with the need for
them to also be effective employees.
Limitations
We acknowledge that our sample size was small; however, it
was determined that “saturation” (the point at which no new
themes were emerging from the data) had been achieved after
seven interviews. Transcripts were coded by one author (B.A.),
and although they were discussed with the other authors, it may
have been useful to have all transcripts double-coded. In
addition, the possibility of selection bias must be considered, in
that perhaps only those who were particularly satisfied with
their StRaW training decided to take part.
Implications for Occupational Health Practice
The findings of this study provide additional evidence with
respect to the effects of peer support resilience training by
providing three key insights. First, the presence of a peer
support program at work may improve employees’ resilience
and well-being. This finding should help occupational health
vol. 68  ■  no. 2
professionals recommend that the organizations they work for
should invest in increasing the bonds between employees,
through provision of a peer support program or in another
fashion, as this may help improve organizational resilience.
Second, StRaW-trained participants felt more emotionally aware
in their personal and professional lives and, having developed
more sympathy and understanding toward other people, felt
their personal resilience had improved. This suggests that StRaW
training may have a direct positive impact on those who
complete it. This finding suggests that occupational health
professionals should feel confident in encouraging employees
they consider capable of supporting their colleagues to undergo
the training and should not fear that those who become
practitioners will feel overly burdened by their work as a peer
supporter. Finally, as a consequence of participants feeling
better equipped to support their peers, StRaW practitioners also
felt they were well placed to foster positive improvements in
their organization’s culture in respect of mental health over
time. As such, occupational health professionals should view
the implementation of a peer support program as a useful
element to improving organizational attitudes toward mental
health. As there is limited research on such programs, however,
there are implications for further research as well as practice:
Future studies could adopt a mixed-methods approach to
incorporate quantitative elements to the study to evaluate and
measure variables of work stress; for example, self-administered
stress audit tools such as a shortened stress evaluation tool
(ASSET; Faragher, Cooper, & Cartwright, 2004) could be used
before and after the implementation of the StRaW intervention
to assess whether there is an improvement following StRaW
training. Resilience training evaluation studies could also use
randomized controlled trials with a StRaW-trained group and a
control group (Robertson et al., 2015), comparing scores on—
for example—measures of organizational and colleague
support, work–life balance, psychological well-being and
individual resilience, as well as rates of work satisfaction and
sickness absence. These comparative data would provide a
better understanding of the effect of StRaW training across an
organization.
Acknowledgments:
We gratefully acknowledge the Sustaining Resilience at Work
(StRaW) practitioners who participated in this study.
Conflict of Interest
The author(s) declared the following potential conflicts of
interest with respect to the research, authorship, and/or
publication of this article: Professor Neil Greenberg is one of
the developers of Sustaining Resilience at Work (StRaW)
training, which is offered by March on Stress (www.
marchonstress.com), of which he is the managing director. For
this manuscript, Professor Greenberg was involved with the
design and development of the manuscript, but was not
involved in the data collection or analysis.
Workplace Health & Safety
Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.
ORCID iD
Samantha K. Brooks https://orcid.org/0000-0003-3884-3583
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Author Biographies
Bhavya Agarwal, MSc, completed her master’s in organizational
psychiatry and psychology at King’s College London, and
currently works as a consultant in Dubai, UAE.
Samantha K. Brooks, PhD, is a post-doctoral researcher at King’s
College London, specializing in organizational response to trauma.
Neil Greenberg, MD, is an academic consultant psychiatrist
based with King’s College London. He is also the Chair of the
Royal College of Psychiatrists Special Interest Group in
Occupational Psychiatry.