Grounded In Self: A Grounded Theory Study of Factors Affecting Peer Recovery Coach Productivity and Well-Being – Preliminary Findings

Background and Purpose

The behavioral health workforce shortage is a pressing issue. Hiring Peer Recovery Coaches (PRC) is one response to this shortage. While Peer-Recovery Coaching (PRC) has been utilized by many different organizations looking to serve people with substance-use disorders (SUD), research points to systematic concerns that need to be addressed by agencies who adopt these practices. Concerns include issues of stigma, confusion of job roles, and sustainability of these programs. There is a gap in the literature on how these are issues are overcome, or how to overcome them to provide services. The study examines what factors affect a PRC’s job productivity and personal well-being?

Method

This ongoing study employs a grounded theory design to examine factors affecting job productivity and personal well-being among PRCs. Data collection is ongoing via semi-structured interviews with PRCs; six interviews have been completed to date, with data collection anticipated to conclude by October 30, 2026. Preliminary data have been analyzed using Dedoose (Version 10.0.59), a web-based qualitative data analysis platform. Two raters independently applied open coding procedures consistent with grounded theory methodology, generating initial codes inductively from the data. Categories have been refined through constant comparative analysis across transcripts, with inter-rater reliability established via consensus meetings in which discrepancies are resolved through discussion. As data collection continues, coding will progress through axial and selective phases, with constant comparative analysis and consensus procedures maintained throughout. Theoretical saturation is anticipated by October 2026.

Results

Preliminary results yielded four themes: grounded in self, stigma, caseloads, and opportunities and job security. Grounded in self refers to the importance of establishing personal boundaries and protecting one's own recovery to prevent compassion fatigue. Stigma emerged in two forms: Being perceived negatively by others due to their PRC identity, and experiencing vicarious stigma. Caseload structures varied considerably across employment settings, with each PRC developing individualized approaches to managing workload and prioritizing client needs. Finally, regarding opportunities and job security, PRCs described uncertainty about the stability of their positions; some responded by pursuing further education to transition into other roles within behavioral health.

Implications

Findings carry implications across multiple levels of the behavioral health workforce. PRCs would benefit from targeted training in rapport-building, peer communication, and compassion fatigue management. At the interprofessional level, clinicians, physicians, nurses, and harm reductionists need education on PRC scope of practice and strategies for supporting peer professionals to reduce burnout and turnover. At the organizational level, agency leadership should align PRC compensation with the scope of their contributions to operations and client care, while establishing structured pathways for advancement and continuing education that cultivate the next generation of peer support professionals. At the community level, enhanced public education is needed to raise awareness of the role PRCs play in harm reduction, treatment, and recovery. Despite the significant contributions peer support workers make to the behavioral health workforce and to the lives of individuals pursuing recovery, their impact remains largely unrecognized by the general public.