An exploratory study of working alliance in traumatic brain injury peer support
Bibliographic record
Abstract
BACKGROUND: Peer support is recognised as a promising intervention for people with traumatic brain injury (TBI). Peer support increases belonging, mood and self-acceptance after TBI. In peer support, working alliance is associated with rehabilitation engagement and better health-related outcomes. A better understanding of the working alliance formed between those providing and receiving TBI peer support will inform design considerations for creating peer support networks, including specific considerations for matching peer support workers with peer support receivers. OBJECTIVE: The objectives of this study were to characterise how working alliance is developed through brain injury peer support, and to identify barriers and facilitators of creating peer support networks. METHODS: This study used a qualitative interpretive description methodology. Semi-structured interviews were conducted with peer support receivers and peer support workers who were involved in a co-designed TBI peer support program, as well as community partners who were involved in the development or implementation of the program. Responses were analysed using reflexive thematic analysis (Objective 1) and inductive content analysis (Objective 2). RESULTS: Nine participants participated in the interviews: three peer support receivers, two peer support workers and four community partners. Three themes describe how working alliance is developed. First, 'feeling understood' explored the importance of validating experiences after TBI. Second, 'expanding conversations beyond injury' highlighted participants' desire to connect on similar life experiences and personal topics other than TBI, such as navigating milestones and life events. Last, 'reciprocal growth' identified how learning occurs between both the peer support receiver and worker. There were four main facilitators of forming a peer support network: characteristics of peer support workers, flexibility in content of sessions, collaboration between researchers and peer support organisations, and formatting of sessions. There were three main barriers to forming a peer support network: irregularity of sessions due to scheduling conflicts, lack of an established peer support program within acute care settings, and lack of resources including space, volunteers and funding. CONCLUSIONS: Findings reveal how working alliances between peer support workers and peer support receivers in TBI peer support are facilitated through validation of individual TBI recovery experiences, and mutual growth in the areas of self-acceptance and hope. Successful peer support networks appear to benefit from flexibility and individualisation of format and content of sessions, as well as the creation of collaborations between acute care and community support networks.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".