Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.


Health Promotion and Behavioral Sciences

Degree Program

Public Health Sciences with a specialization in Health Promotion, PhD

Committee Chair

LaJoie, A. Scott

Committee Member

Combs, Ryan M.

Committee Member

Hall, Martin T.

Committee Member

Harris, Lesley M.

Author's Keywords

behavioral health workforce; peer support; professional development; Medicaid; policy; qualitative research


Over the last twenty years, the peer support segment of the behavioral health workforce has grown rapidly. However, few researchers have studied the effects on individuals from transitioning into the role. Likewise, there is limited research examining the professional development process of early career peer support specialists. To begin to fill these gaps in the literature, I conducted a qualitative research study examining workforce development experiences of peer support specialists in Kentucky. This dissertation reports on its findings and includes a policy paper with recommendations for improving policy and practice. Chapter one offers an introduction to the peer support workforce literature and summarizes the dissertation. Chapter two provides a literature review on training and supervision within the behavioral health workforce. Chapter three reports on a qualitative study which explored the social process of transitioning from being a patient in care to becoming a peer support working in the treatment field. Constructivist grounded theory informed the study design, with its methods applied in conducting and analyzing in-depth interviews with the sample of 23 certified peer support specialists entering the field within the last three years. Study findings showed during the patient to peer support transition, individuals experienced a significant period of adjustment before accepting their new identity. Soon after joining the behavioral health workforce, participants became consumed by their work to the point their personal recovery was at risk. They saw training and supervision as insufficient in preparing them for the day-to-day realities of the peer support role. After time in the field, they successfully transitioned into their peer support identity. In doing so, they created role boundaries and sought support from outside the workplace to reduce their risk of relapse. Chapter four reports on the 23 peer support workers’ early career training and supervision experiences. It describes how their professional development was affected by these workplace experiences, with findings showing there was a wide range of training and supervision experiences among participants. Organizations lacked standards for best practices in their training and supervision. The content, methods, and time allocated for these activities varied from agency to agency. Most individuals in the study believed their training and supervision was insufficient, that still had knowledge and skills deficits in one or more areas relevant to their position. Participants employed various strategies in filling these perceived gaps, including consulting with their 12-step sponsor, applying an approach learned in their own treatment, and researching the issue on the internet. They were least likely to bring up needing more training on a topic during supervision. Chapter five is a policy paper providing the rationale and recommendations for amending existing Kentucky regulations governing its certified peer support workforce. Chapter six contains a summary of research findings and recommendations for future work.