Review of research about the buddy system

08 Jan 2015 20:59
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Do you have any written resources about the buddy system? Perhaps any studies done on effectiveness or other background material? I am putting together a proposal for assisted living/nursing home facilities to work with the direct care staff on mindfulness and self-care and I think the buddy system could be a useful tool to consider. —a reader

These notes are based on the seven most useful papers I found in a quick literature search. One paper attends to preventative stress management in a corporate environment, one help-seeking during suicidality by college-age youth, one stress in the military, two veteran mental health, one disaster mental health, and one child welfare worker safety.

People use buddies

The literature suggests that a person is more likely to seek help for a buddy than for himself, and more likely to seek help from a peer than from a professional.

Curtis [1] found that while youth suicide is common, youths seeking help for themselves is uncommon. Students were more willing to seek help for others than for themselves. Furthermore, "Participants expressed greater willingness to seek help for another if they were not a close friend" [p. 699]. Rings et al. [6] discussed the everpresence of the buddy system in the military ("the main benefit often is safety or survival; buddies work together to provide monitoring, assistance, or even rescue during a crisis" [p. 103]).

"In a study surveying U.K. peacekeepers, 98% of personnel felt able to talk to military friends or peers in the same deployment and only 8% had used formal support networks (such as the use of medical or welfare services). Furthermore, only 15% had spoken to the chain of command about their experiences" [3, p. 932]. I wouldn't be surprised to see similar numbers for civilians.

Some roles of buddies

The basic role of the buddy system is to promote safety and prevent physical and psychic injury. As such, it is a primary prevention method [2]. Hargrove et al. [2], in their literature review of preventative stress management in professional environments, list roles buddies play and outcomes they promote: "[buddies] may provide direct aid in dealing with a stressor, or may help individuals reframe their stressful experience. Social support may reduce the intensity and duration of stressors by buffering or protecting individuals from sources of stress… developing interdependent workers with healthy attachments to each other leads to more sound psychological contracts and a pipeline of individuals who can sustain themselves in stressful environments without becoming distressed" [p. 188].

Training to establish buddy systems

Buddies can be trained, their training should teach them to provide practical support, and workers who enter dangerous scenes or who have faced an on-job assault should be entitled to a buddy.

Pfeiffer et al. [5] focus on treatment resistance among veterans, and the role of peer networks in promoting help-seeking. They find that "formal peer-based programs may assist soldiers not sufficiently benefitting from natural peer networks" [p. 1471]. Hargrove et al. [2] summarize literature which finds training that improves peoples' coping resources "enhances satisfaction and well-being," but caution that support should be practical, not just emotional: "Informational and emotional support should be coupled with instrumental support that helps individuals meet job demands, and appraisal support that facilitates role clarity and provides concrete performance feedback" [p. 188].

Scalera [7] documented the 9-point plan he instituted for child welfare worker health and safety as director of New Jersey's DYFS. Point one was mandated "teamed response" (buddy system) for a variety of potentially dangerous circumstances. Among these circumstances, "workers who were previously assaulted are entitled to a buddy until such time as the worker and his or her supervisor jointly decide that one is no longer routinely needed" [p. 342].

Who makes a good buddy

Military, police, and emergency medical buddies are field partners within a squad. In human service professions, it might be harder to figure out who makes a good buddy. Scalera writes, "Buddies might be other DYFS staff members or supervisors, or other helpers, such as a mental health/crisis team worker, a family preservation services worker, a pediatric nurse consultant, or other professionals involved in the case" [7, pp. 342-3].

More applications

Other papers I looked at (not cited; find them yourself if you're interested) discussed:

  • how suicide occurs in clusters in Australian indigenous communities, and an intervention in which a pre-planned buddy system becomes active with at-risk people after a suicide to decrease their likelihood of following suit;
  • a randomized controlled trial of a buddy system involving people with psychiatric or cognitive disabilities buddied with nondisabled adults in which the disabled adults showed improved social functioning and self-esteem;
  • emergency responders promoting the standard practice of a buddy system among the "walking wounded" in mass-casualty incidents in Iraq;
  • a buddy system used as part of a secondary trauma healing intervention for professionals who assisted Hasidic settlers injured by rockets in the Al-Aqsa Intifada;

MSF (Doctors Without Borders) used buddy systems and family groups as a first-stage intervention after cyclone Nargis in Burma, followed by more formal training of community health workers: "…they designed a 'buddy system', through which MSF teams could provide support and counselling to staff and help them cope with working in arduous conditions. Staff members were divided into 'work families'—teams working together in the delta region, each with a 'father' and 'mother' who help the team solve its problems on its own…" [4, p. 16].

Other papers discussed buddy systems for HIV and TB medication compliance / lifestyle modification, obesity interventions, suicide prevention in a deployed military unit, preparation and support of transplant patients, emotion-focused therapy for incarcerated offenders of intimate partner violence, and rural home care nurses' cold-weather self-monitoring for frostbite and hypothermia.

A note

"The objective of primary intervention is not to eliminate all stress, because the elimination of stress in organizations would lower individual and organizational performance. Managers should attempt to eliminate only those extreme stressors, which have no possibility of producing positive responses, e.g. violence, hazardous conditions, etc. Because eradication of stress is not the principal goal, primary intervention should seek to reduce stressors to levels that promote positive stress responses and create conditions of eustress. Primary interventions, in addition to reducing stressors, may also be effective at developing psychological capital among employees and improving employee well-being" [2, p. 188].

Limitations

This was just the result of a brief literature review on EBSCOhost, looking at the first 80 hits for one search string. These papers are by no means the most influential or important on the topic: they're just a taste of the literature available.


Bibliography
1. Curtis, C. (2010). Youth perceptions of suicide and help-seeking: 'They'd think I was weak or 'mental''. Journal Of Youth Studies 13(6), 699-715.
2. Hargrove, M., Quick, J., Nelson, D. L., & Quick, J. D. (2011). The theory of preventive stress management: a 33-year review and evaluation. Stress & Health: Journal Of The International Society For The Investigation Of Stress 27(3), 182-193.
3. Langston, V. et al. (2007). Culture: What Is Its Effect on Stress in the Military? Military Medicine 172(9), 931-935.
4. Steffens, M. (2008). After the deadly storm. Mental Health Practice 12(2), 14-17.
5. Pfeiffer, P. N., Blow, A. J., Miller, E., Forman, J., Dalack, G. W., & Valenstein, M. (2012). Peers and Peer-Based Interventions in Supporting Reintegration and Mental Health Among National Guard Soldiers: A Qualitative Study. Military Medicine 177(12), 1471-1476.
6. Rings, J. A., Alexander, P. A., Silvers, V. N., & Gutierrez, P. M. (2012). Adapting the Safety Planning Intervention for Use in a Veterans Psychiatric' Inpatient Group Setting. Journal Of Mental Health Counseling 34(2), 95-109.
7. Scalera, N. R. (1995). The Critical Need for Specialized Health and Safety Measures for Child Welfare Workers. Child Welfare 74(2), 337-350.

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