Peer-paracounseling-to-foster-resilience-and-reduce-the-burden-on-community MHS

Volume 4, Number. 3
March 2023
“PEER PARACOUNSELING” TO FOSTER RESILIENCE AND
REDUCE THE BURDEN ON COMMUNITY MENTAL HEALTH
SERVICES
George S. Everly, Jr., PhD, ABPP, FAPA, FACLP
The Johns Hopkins School of Medicine, and
The Johns Hopkins Bloomberg School of Public Health
Abstract: Despite gallant efforts, we have failed to provide adequate access to mental health
services in the best of times. We have clearly failed to provide adequate mental health surge
capacity during most disasters. And in many ways, we have failed to remove the stigma associated
with seeking mental health services. Perhaps it’s time for a tectonic shift in training and practice.
In this paper, I propose the creation of a new role in the functional continuum of community mental
health care. The term I shall use to describe this new role is “peer paracounseling.” Peer
paracounseling is not the practice of professional counseling, rather it is the psychological
analogue of paramedicine. Peer paracounseling may be envisioned as the functional integration
of psychological first aid with micro-counseling techniques designed to foster human resilience.
As paramedicine has been expanded to include some primary care functions, so too may
psychological first aid interventions be expanded beyond the acute into subacute applications, as
well. Adopting the well accepted function of peer support, peer paracounseling is expressly
designed to be utilized by those outside of the mental health professions. As the training, skills,
and scope of practice of the paramedic surpass those of the entry-level emergency medical
technician, but are short of those of the physician, so too should there be a level of training that
surpasses that of the crisis interventionist but falls short of the psychologist or social worker.
Key Words: Peer support, Psychological First Aid (PFA), community mental health, psychological
crisis intervention, resilience, peer paracounseling.
INTRODUCTION
diverse amalgam of professionals was at
these meetings, not because of their training
in emergency and disaster response per se,
but rather they were there because these
emergency responders and others made up
much of the volunteer outreach and mobile
crisis intervention capacity in this
community. They were a formal and integral
part of this community’s overall mental
health fabric. They were ideally suited to
provide psychological crisis intervention
services in that not only were they trained in
emergency response by virtue of their
professional roles, but they also knew the
In the early 1990s, I was invited to give a
presentation to Red Cross disaster response
volunteers in a small city in Iowa. Prior to the
presentation, I was invited to the monthly
meeting of the community mental health
consortium.
Naturally,
there
were
representatives from traditional mental health
agencies and professions, as expected. I was
surprised,
however,
to
also
see
representatives from various disaster
response agencies, as well as the law
enforcement, fire service, education, clergy,
and emergency medicine professions. This
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ISSN 2836-1709
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community very well, and most importantly
they had all received specialized training in
psychological first aid (PFA) and strategic
Critical Incident Stress Management (CISM).
These professionals represented a core
element in the overall fabric of their
community’s mental health services. In some
instances, the psychological support they
provided was restricted to their own
professional constituencies. In other cases it
was not. As such, they greatly expanded the
overall mental health capacity of their
community for day-to-day small scale
incidents and could play an especially useful
role in enhancing surge capacity should a
disaster occur. In this paper, I propose the
creation of a new role in the functional
continuum of community mental health
services which would significantly expand
the availability of community psychological
support. The term I shall use to describe this
new role is “peer paracounseling.”
holding steady. A 2016 report
released by the Health Resources and
Services Administration projected the
supply of workers in selected
behavioral health professions to be
approximately 250,000 workers short
of the projected demand in 2025
(Health Resources and Services
Administration, 2016). As of March
2021, there were over 3,400 areas in
the United States designated as
“underserved” (Health Resources and
Services Administration, 2021) with
roughly one-third of Americans
residing in areas that are underserved
for psychological health services.
• Third, the lingering psychological
effects of the COVID-19 pandemic
are noteworthy. In early 2020, the
United Nations warned of an
impending mental health crisis
resulting from COVID-19.
The New York Times referred to the
mental health challenges as a “parallel
pandemic” (Jacobs, 2021). In support of this
notion, a national survey conducted during
the COVID-19 pandemic that included 1,441
respondents revealed the prevalence of
depression symptoms was more than
threefold higher during the COVID-19
pandemic than before (Ettman et al., 2020).
More recently, data confirm the lingering
human distress associated with the pandemic
(Bourmistrova et al., 2022) and its crippling
effect on service providers (Jacobs, 2021).
In the influential 2021 report The State of
Mental Health in America, (Reinert et al.,
2021) published by the nonprofit foundation
Mental Health America, the following trends
were revealed even prior to COVID-19:
THE NEED TO EXPAND COMMUNITY
PSYCHOLOGICAL SUPPORT SERVICES
Three disturbing trend lines are currently
intersecting in the area of mental health care.
• First, the general demand for mental
health care is rapidly rising.
Loneliness and depression are
recognized to be at epidemic
proportions. In the US, nearly 1 in 5
people has some sort of mental health
condition according to the Journal of
the American Medical Association.
The disease burden—the impact of a
health problem as measured by
financial cost, death rates, disability,
and other measures of mental health
and substance use disorders was
higher than for any other condition in
2015, JAMA reported.
• Second, the number of mental health
care providers in practice is barely
1) The prevalence of mental illness
among adults was increasing with
19% of adults in the United States
experiencing a mental disorder;
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2) The number of people screening with
moderate to severe symptoms of
depression and anxiety increased
during the pandemic surge and was at
least 30% higher than rates prior to
COVID-19;
3) Since March 2020, more than
178,000 people have reported
frequent suicidal ideation;
4) Almost 10% of youth surveyed
expressed signs of depression;
loneliness or isolation are conditions
fueling depression; and
5) Finally, the US Census Bureau (2021)
reported data wherein 41% of adults
reported symptoms of anxiety or
depression after the second winter of
the pandemic.
health services has failed to achieve the goal
of adequate availability of mental healthrelated services. Stigma remains, wait times
to access professional service providers are
long—sometimes prohibitive, and sole
reliance upon such services in the wake of
community adversity or large-scale human
suffering reveals stark insufficiencies.
Access to trained mental health providers is
limited in the wake of adversity and disaster,
and even more so in geographically isolated
areas or developing nations.
To assist with remedying this problem,
recommendations from the Johns Hopkins
Center for Public Health Preparedness have
included the training of local human
resources (community members) to provide
peer psychological support to enhance
community resilience (Everly & Parker,
2005; Everly, 2020a, 2020b; McCabe et al.,
2014). A peer is someone who shares some
relevant lived experience with another
person. In this case, peers would possess
geographical and cultural familiarities that
those from outside the community would not.
Crisis
intervention
and
related
psychological support services have long
been shown to be effective in reducing
human distress and in reducing hospital
admissions and their associated costs
(Boscarino et al., 2011, Langsley et al., 1971;
Davidison, 2012; Parad & Parad,
1968a,1968b; SAMHSA, 2015). Educators,
faith-based leaders, community peers, and
emergency services personnel have been
successfully trained to deliver brief
counseling
and
psychological
crisis
intervention services since the 1960s (Brown,
1974; COPS, 2019; Davidson, 2012; Defense
Centers of Excellence, 2011; Eisdorpher &
Golann, 1969; Everly & Kennedy, 2019;
Everly et al., 2014; Greenstone, 2005; Hattie
et al., 1984; Ivey et al., 1968; Jain, 2010;
Levenson, 2003; Noullet et al., 2018 ). In an
early compelling review, Durlak (1979)
THE USE OF PEERS TO EXPAND
COMMUNITY PSYCHOLOGICAL SUPPORT CAPACITY
In their monograph Health Care at the
Crossroads, the Joint Commission on
Accreditation of Healthcare Organizations
(2003) defined surge capacity as “the ability
to expand care capabilities in response to
sudden or more prolonged demand” (p. 19).
They further indicate surge capacity is
perhaps the most fundamental component of
public health preparedness programming. In
recognition of increasing violence in many
cities, a continuing trend of disasters,
community emergencies, and the lingering
mental health effects of the pandemic, the
need to increase psychological services
capacity becomes self-evident. Certainly,
there is no debate on the need to enhance
mental health capacity for the over 3,400
areas in the United States that are considered
underserved. Furthermore, the need to
expand on-going access to psychological
support throughout all communities seems
obvious, as well. The challenge is how to best
do so. Reliance upon traditional mental
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analyzed all published studies that had
compared the clinical outcomes of mental
health professionals (such as psychologists,
psychiatrists, and social workers) with those
of peer/paraprofessionals. The results of his
analysis of 42 research studies revealed the
effectiveness of volunteer peer/paraprofessionals was overall comparable to trained
mental health professionals and, in some
studies, superior to the professionals. Durlak
concluded, “Professional mental health
education training and experience are not
necessary prerequisites for an effective
helping person” (p. 6).
recognized by SAMHSA (2015) and
throughout the field of recovery. Peer-based
psychological support is already a virtual
standard of acute care in the healthcare (Wu
et al., 2021), and the law enforcement
professions (Sheehan et al., 2004), and as a
community intervention to potentially reduce
community violence (McCabe, Semon,
Thompson, et al., 2014; McCabe, Semon,
Lating, et al., 2014; McCabe, Everly, Brown,
et al., 2014).
Peer paracounseling consists of the
functional integration of the stabilizing and
mitigating properties of psychological first
aid (Everly, 1996, 2002; Everly et al., 2016;
Noullet et al., 2018) with techniques such as
Castellano’s reciprocal peer support and
Ivey’s five micro-counseling micro-skills
(Ivey, 1970; Ivey et al., 1968), in
combination with interventions to foster
resilience and self-efficacy (Bandura, 1997;
Ellis & Harper, 1975) for both acute and
subacute applications as applied by those
outside of the mental health professions
(peers). Analyses have documented the
effectiveness of these components (Evans et
al., 2020; Everly, et al., 2016; Ivey, 1970;
Ivey et al., 1968; Bandura, 1997).
“PEER PARACOUNSELING” AS A
SUBACUTE INTERVENTION
Peer paracounseling (PPC) may be
envisioned as the functional integration of
psychological first aid and micro-counseling
for acute and subacute applications utilized
by those outside of the mental health
professions (peers). Peer paracounseling is
not the practice of professional counseling.
As the skills and training of the paramedic
surpass those of the entry-level emergency
medical technician, but are short of those of
the physician, so too should there be a level
of training that surpasses that of the crisis
interventionist, but stops short of the
professional counselor, psychologist, or
social worker. The goal of peer
paracounseling is to reduce both acute and
subacute distress and foster human resilience.
As PFA is an acute intervention typically
consisting of only one to three contacts, peer
paracounseling could extend sub-acutely to
10 to 12 contacts, spanning three to four
months, or so.
Peer support in general and peer
paracounseling is based upon modeling
theory which states individuals are likely to
learn best from those with whom they most
closely identify. Peer support is a readily
accepted
intervention
having
been
EIGHT COMPETENCIES OF PEER
PARACOUNSELING (Adapted from
SAMHSA, 2015)
Gerald Jacobs (2016), a pioneer in
disaster mental health, also advocates for the
creation of the capacity to provide PFA at the
community level. He emphasizes one does
not need to be a mental health clinician to
provide effective psychological support. In
his book Community-Based Psychological
First Aid he suggests active listening,
problem-solving, stress management, and
knowing when to seek higher levels of care
as fundamental skills in community PFA.
Building on the recommendations of
Jacobs (2016) and those of SAMHSA (2015),
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in this section, I propose eight core
competencies of the peer para-counselor. As
such they may serve as the foundation for any
curriculum that would purport to train peer
para-counselors. These eight competencies
have been adapted from peer support
guidelines as offered by the SAMHSA
consensus committee. These are skills that
can be acquired without attaining licensure in
a mental health profession.
Competency 7: Resilience and recovery
planning. The peer will assist the individual
in formulating and activating acute and
subacute plans for empowerment, selfefficacy, and personal growth.
Competency 8: Liaison for resources
other services and resources. The peer will
serve as an effective liaison and advocate for
others in obtaining additional resources.
CONSTITUENT MECHANISMS
Competency 1: Relationship building.
The peer engages and cultivates collaborative
and caring relationships with people who
have behavioral health challenges and/or
their family members.
There exist four bodies of practice which
can inform the attainment of the eight core
competencies of peer paracounseling:
1) psychological first aid (Everly &
Lating, 2022),
2) reciprocal peer support (Castellano,
2012, 2018),
3) micro-counseling skills (Ivey, et al.
1968), and
4) heuristics for fostering resilience and
self-empowerment (Bandura, 1997;
Ellis & Harper, 1975; Everly &
Lating, 2019).
Competency 2: Active communications.
The peer will exhibit effective communication skills while assisting those in
distress and/or family members.
Competency 3: Acute crisis and stress
management. The peer will possess skill in
teaching crisis and stress management to
others.
Competency 4: Coaching. The person
will effectively provide accurate information
for developing skills for fostering health,
wellness, resilience, and recovery, including
coaching others towards self-empowerment
and self-efficacy.
Psychological First Aid
In The Johns Hopkins Guide to
Psychological First Aid (Everly & Lating,
2022), psychological first aid is presented in
a theoretically grounded, empirically derived
and validated model. The model has been
taught to over 450,000 individuals by way of
the online learning platform Coursera.org
making it one of the most viewed online
courses of all time. The online class takes
four to five hours to complete and can be
retrieved at:
https://www.coursera.org/learn/psychologica
l-first-aid . Scientific American has asserted
“everyone” should take the class.
Competency 5: The competent use of
lived experiences to facilitate recovery. Peer
workers will be capable of sharing personal
stories using their own lived experiences as a
way of inspiring and supporting others so as
to foster resilience, as appropriate. The peer
will consistently monitor countertransference
so as to keep the other person as the focus of
their attention and efforts.
Competency 6: Personalizing peer
support. The peer will tailor interventions to
the specific needs of the person.
Reciprocal Peer support
Cherie Castellano at Rutgers University
received the 2018 Silver Medal from the
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American Psychiatric Association in
recognition of her success in implementing
peer-based crisis intervention programs
based upon a model she refers to as
“reciprocal peer support” (Castellano, 2012,
2018; Evans et al., 2020). The
interventionists who staffed her programs
were community-based civilians and
uniformed emergency services personnel
(police, firefighters, etc.) specifically trained
in the provision of psychological crisis
intervention using highly structured
intervention protocols.
guides. First, Albert Bandura (1997) has
shown self-efficacy to be perhaps the most
important psychological mechanism for
fostering resilience, empowerment, and
personal growth. He has virtually
formularized the process of building selfefficacy into a four-step process which can be
easily and effectively employed by peer paracounselors. Second, the now classic work of
Albert Ellis (Ellis & Harper, 1975) on
improving the quality of one’s life through
what he then called “rational living” is
detailed in his easy to use New Guide to
Rational Living. Helping a person in distress
develop increased cognitive flexibility and
challenge “irrational” or otherwise unfounded assumptions can be useful tools to
mitigate acute distress. Philosophical
assertion (Guerin, 2022), sociological
anecdote (Everly, 2019), as well as research
(Everly & Lating, 2019), have consistently
shown
cognitive-based
psychological
support such as reinterpretation / reframing to
be easy to employ, yet highly effective at
reducing acute distress, fostering resilience,
and even personal growth.
Micro-counseling
Micro-counseling as used here may be
seen as a functional extension of crisisoriented psychological first aid. Microcounseling, as originally formulated by Allen
Ivey, was a method for teaching introductory
counseling skills (Ivey, et al, 1968). It
consisted of five core micro-skills:
1)
2)
3)
4)
5)
attending behavior
questioning,
confrontation
focusing, and
reflection of meaning.
SUMMARY
In the extant context, we use the term
micro-counseling in a somewhat expanded
capacity, which transcends original applications. In this context, we used the term
to denote not only constituent micro-skills,
but the establishment of a helping
relationship that may extend beyond several
sessions to several months.
The wisdom of expanding surge capacity
and overall ongoing community mental
health capacity using persons outside of the
mental health professions should not be a
stretch. It is prudent to remember Rapoport’s
(1965) assertion, “A little help, rationally
directed and purposely focused at a strategic
time, is more effective than extensive help
given at a period of less emotional
accessibility” (p. 30). A similar assertion
regarding the effectiveness of compassionate
and practical psychological support was
made after September 11 (Bisson et al.,
2007).
In many states, counseling is a protected
term and psychotherapeutic process. Peer
paracounseling is not counseling, per se. It is
Intervention Heuristics for Resilience and
Self-empowerment
Expanding the scope of micro-counseling
with two formidable heuristics for selfempowerment serves to significantly
increase the impact of peer paracounseling.
Fortunately, there exist two step-by-step
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not a substitute for professional therapeutic
counseling. It does not include diagnosis nor
treatment. Peer paracounseling may be
considered a psychological intervention
designed to mitigate distress and foster
human resilience that does not require a
terminal degree in mental health to
competently affect. As such, it fits nicely into
the
overall
fabric
of
community
psychological services. In the final analysis,
consonant with World Health Organization
(2018) goals and recommendations, the
extant model of peer paracounseling may be
considered as an intervention as we strive to
approximate universal mental health support
delivered not only in nonspecialized health
settings but via nontraditional communitybased mechanisms as well.
It is important to view the proposed peer
paracounseling initiative in the context of
“advanced” paraprofessional services designed to assist in the mitigation of human
suffering. It should not be seen as
encroaching upon protected practices which
require graduate training, licensure, or the
like. As the training, skills, and scope of
practice of the paramedic surpass those of the
entry-level emergency medical technician,
but are short of those of the physician, so too
should there be a level of training that
surpasses that of the crisis interventionist but
falls short of the mental health clinician.
the world trade center disaster:
Utilization trends and comparative
effectiveness. Journal of Nervous and
Mental Disease, 199(2), 91-99.
https://doi.org/10.1097/nmd.0b013e3182043
b39
Bourmistrova, N. W, Solomon, T., Braude,
P., Strawbridge, R., & Carter, B. Longterm effects of COVID-19 on mental
health: A systematic review. J Affect
Disord. 2022 Feb 15; 299, 118-125.
DOI: 10.1016/j.jad.2021.11.031
Epub 2021 Nov 16. PMID: 34798148;
PMCID: PMC8758130 .
Brown, W. F. (1974). Effectiveness of
paraprofessionals:
The
evidence.
Personnel and Guidance Journal, 53,
257-264.
http://dx.doi.org/10.1002/j.2164<H>491
8.1974.tb03779.x
Castellano, C. (2012). Reciprocal Peer
Support (RPS): A decade of not so
random acts of kindness. International
Journal of Emergency Mental Health, 14,
137-142.
Castellano. C. (2018). Silver award:
Reciprocal peer support for addressing
mental health crises among police,
veterans, mothers of special needs
children, and others. APA Psychiatric
Services
Achievement
Awards.
Psychiatric Services, 69, e7-8.
http://dx.doi/10.1176/appi.ps.691006
COPS (Community Oriented Policing
Services). (2019). Law enforcement
mental health and wellness act: Report to
Congress. US Department of Justice.
Davidson, L. (2012). Peer support: Coming
of age of and/or miles to go before we
sleep? an introduction. J Behav Health
Serv Res 42, 96–99 (2015).
https://doi.org/10.1007/s11414-0139379-2
REFERENCES
Bandura, A. (1997). Self-efficacy: The
exercise of control. W. H. Freeman.
Bisson, J. I., Brayne, M., Ochberg, F. &
Everly, G. S., Jr. (2007). Early
psychosocial intervention following
traumatic events. American Journal of
Psychiatry, 164, 1016-1019.
http://dx.doi.org/10.1176/ajp.2007.164.7
.1016
Boscarino, J., Adams, R., & Figley, C.
(2011). Mental health service use after
CSHR  Volume 4, Number 3  March 2023
157
“PEER PARACOUNSELING” TO FOSTER RESILIENCE AND
REDUCE THE BURDEN ON COMMUNITY MENTAL HEALTH
SERVICES
Defense Centers of Excellence (2011). Best
practices identified in peer support.
Defense Centers of Excellence.
Durlak, J. (1979). Comparative effectiveness
of paraprofessional and professional
helpers. Psychological Bulletin, 86, 8092.
http://doi.org/10.1037/0033<H>2909.86.
1.80
Ellis, A. & Harper, R. (1975). A New Guide
to Rational Living. Prentice-Hall.
Eisdorpher, C., & Golann, S. (1969).
Principles of the training of “new
professionals”
in
mental
health.
Community Mental Health Journal, 5,
349-357.
http://dx.doi.org/10.1007/BF01438980
Ettman, C. K., Abdalla S. M., Cohen, G. H.,
Sampson, L., Vivier, P. M., & Galea, S.
(2020). Prevalence of depression
symptoms in US adults before and during
the COVID-19 pandemic. JAMA Network
Open, 3, e2019686.
http://dx.doi.org/10.1001/jamanetworko
pen.2020.19686
Evans, M., Tang, P. Y., Bhushan, N., Fisher,
E. B., Dreyer, D., & Castellano, C.
(2020). Standardization and evaluation
for dissemination of telephone peer
support
for
high-risk
groups.
Translational Behavioral Medicine, 10,
506-515.
http://dx.doi.org/10.1093/tbm/baa047
Everly, A. N. (2019). Fairytales: A Novel
Way of Educating Children About
Psychological Health. Crisis, Stress, and
Human Resilience, 1(3), 183-186.
Everly, G. S., Jr. (1996). A rapid crisis
intervention
technique
for
law
enforcement. In Reese, J. T. & Soloman,
R. (eds) Organizational Issues in Law
Enforcement
(pp.
183-192).
US
Government Printing Office.
Everly, G. S., Jr. (2002). Thoughts on peer
(paraprofessional) support in the
provision of mental health services.
International Journal of Emergency
Mental Health, 4, 89-90.
Everly, G. S., Jr. (2020a). Psychological first
aid (PFA) to expand mental health
support and foster resiliency in
underserved and access-compromised
areas. Crisis, Stress, and Human
Resilience, 1, 227-232.
Everly, G. S., Jr. (2020b). Psychological first
aid to support healthcare professionals.
Journal of Patient Safety and Risk
Management, 25, 159–162.
http://dx.doi.org/10.1177/251604352094
4637
Everly, G. S., Jr., Davey, J., Smith, K.,
Lating, J. & Nucifora, F. (2011). A
defining aspect of human resilience in the
workplace: A structural modeling
analysis. Disaster Medicine and Public
Health Preparedness, 5(2), 98-105.
https://doi.org/10.1001/dmp.2011.38
Everly, G. S., Jr., & Kennedy, C. (2019).
Content validation of the Johns Hopkins
model of psychological first aid (RAPIDPFA) expanded curriculum. Crisis,
Stress, and Human Resilience, 1, 6-14.
Everly, G. S., Jr., Lating, J. M., Sherman, M.,
& Goncher, I. (2016). The potential
efficacy of psychological first aid on selfreported anxiety and mood: A pilot study.
Journal of Nervous and Mental Disease,
204, 233-235.
http://dx.doi.org/10.1097/NMD.0000000
000000429
Everly G. S., Jr., & Lating, J. M. (2019)
Clinical guide to the treatment of the
human stress response. 4th Ed. Springer.
Everly, G. S., Jr., & Lating, J. M., (2022). The
Johns Hopkins guide too psychological
first aid. 2nd Ed. Johns Hopkins Press
Everly, G. S., Jr., McCabe, O. L., Semon, N.,
Thompson, C. B., & Links, J. (2014). The
development of a model of psychological
first aid for non-mental health trained
CSHR  Volume 4, Number 3  March 2023
158
“PEER PARACOUNSELING” TO FOSTER RESILIENCE AND
REDUCE THE BURDEN ON COMMUNITY MENTAL HEALTH
SERVICES
public health personnel: The Johns
Hopkins RAPID-PFA. Journal of Public
Health Management and Practice, 20,
S24<N>S29.
http://dx.doi.org/10.1097/PHH.0000000
000000065
Everly, G. S., Jr., & Parker, C. L. (Eds.)
(2005). Mental health aspects of disaster:
Public health preparedness
and
response. Johns Hopkins Center for
Public Health Preparedness.
Guerin, L. (2022). Modern stoicism and its
usefulness in fostering resilience. Crisis,
Stress, and Human Resilience, 3(4) 130143.
Greenstone, J. (2005). Peer support for police
hostage and crisis negotiators. Journal of
Police Crisis Negotiations, 5, 45-55.
http://dx.doi.org/10.1300/j173v05n01_0
5
Hattie, J. A., Sharpley, C. F., & Rogers, H. J.
(1984). Comparative effectiveness of
professional
and
paraprofessional
helpers. Psychological Bulletin, 95, 534–
541.
http://dx.doi/10.1037/0033<H>2909.95.
3.534
Health Resources and Services Administration (2021, February). Shortage
areas.
https://data.hrsa.gov/topics/healthworkforce/shortage-areas
Health Resources and Services Administration (2016). National projections of
supply and demand for selected
behavioral health practitioners: 20132025.
https://bhw.hrsa.gov/sites/default/files/b
ureau-health-workforce/dataresearch/behavioral-health-20132025.pdf
Institute of Medicine (2003). Preparing for
the psychological consequences of
terrorism: A public health strategy.
National Academy of Sciences.
Ivey, A. E. (1970). Attending behavior: The
basis of counseling. School Psychologist,
18, 117-119.
http://www.jstor.org/stable/23896657
Ivey, A. E., Normington, C., Miller, C. D.,
Morrill, W., & Haase, R. F. (1968).
Microcounseling and attending behavior.
Journal of Counseling Psychology, 15, 112. http://dx.doi.org/10.1037/h0026129
Jacobs, A. (2021, February 5). One year in,
pandemic pushes health care workers to
the brink. New York Times, Section A, p.
6.
Jacobs, G. A. (2016). Community-based
psychological first aid. ButterworthHeineman.
Jain, S. (2010). The role of paraprofessionals
in providing treatment for posttraumatic
stress
disorder
in
low-resource
communities. JAMA, 304, 571-572.
http://dx.doi.org/10.1001/jama.2010.109
6
Joint Commission on Accreditation of
Healthcare Organizations. (2003). Health
care at the crossroads: Strategies for
creating and sustaining community-wide
emergency preparedness systems.
Langsley, D., Machotka, P., & Flomenhaft,
K. (1971). Avoiding mental health
admission: A follow-up. American
Journal of Psychiatry, 127, 1391-1394.
http://dx.doi.org/10.1176/ajp.127.10.139
1
Levenson, R. (2003). Peer support in law
enforcement. International Journal of
Emergency Mental Health, 5, 147-152.
McCabe, O. L, Everly, G. S., Jr., Brown, L.
M., Wendelboe, A. M., Hashidah Abd
Hamid, N., Tallchief, V. L., & Links, J.
M. l. (2014). Psychological First Aid: A
consensus-derived, empirically supported,
competency-based
training
model. American Journal of Public
Health, 104(4), pp. 621-628.
CSHR  Volume 4, Number 3  March 2023
159
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REDUCE THE BURDEN ON COMMUNITY MENTAL HEALTH
SERVICES
https://doi.org/10.2105/ajph.2013.30121
9
McCabe, O. L., Semon, N., Lating, J. M.,
Everly, G. S., Jr, Perry, .C J., Straub
Moore, S., Mosley, A. M., Thompson, C.
B., & Links, J. M. (2014). Developing an
academic-government-faith partnership
to build disaster mental health
preparedness and community resilience:
Program Description and Lessons
Learned. Public Health Reports., 129, S4,
S96-106.
https://doi.org/10.1177%2F0033354914
1296S413
McCabe, O. L., Semon, N., Thompson, C. B.,
Lating, J. M., Everly, G. S., Jr., Perry, C.
J., Moore, S. S., Mosley, A. M., Links, J.
(2014). Building a National Model of
Public Mental Health Preparedness and
Community Resilience: Validation of a
Dual-Intervention,
Systems-Based
Approach. Disaster Medicine and Public
Health Preparedness
https://pubmed.ncbi.nlm.nih.gov/254835
96/ DOI:10.1017/dmp.2014.119
Noullet, C., Lating, J. M., Kirkhart, M. W.,
Dewey, R., & Everly, G. S., Jr. (2018).
Effects of pastoral crisis intervention
training on resilience and compassion
fatigue in clergy. Spirituality in Clinical
Practice, 5, 1-7.
http://dx.doi.org/10.1037/scp0000158
Parad, L. G., & Parad, H. J. (1968a). A study
of crisis-oriented planned short-term
treatment: Part I. Social Casework, 49,
346-355.
http://dx.doi.org/10.117/1044389468049
00603
Parad, L. G., & Parad, H. J. (1968b). A study
of crisis-oriented planned short-term
treatment: Part II. Social Casework, 49,
418–426.
http://dx.doi.org/10.117/1044389468049
00705
Rapoport, L. (1965) The state of crisis. In H.
Parad (Ed.), Crisis intervention: Selected
readings (pp. 22-31). Family Service
Association of America.
Reinert, M., Nguyen, T. & Fritze, D. (2021).
The state of mental health in America.
Mental Health America.
https://mhanational.org/researchreports/2021-state-mental-healthamerica
Sheehan, D., Everly, G. S., Jr., & Langlieb,
A. (2004). Current best practices coping
with major critical incidents. FBI Law
Enforcement Bulletin, 73(9), 1-13.
Stapleton, A. B., Lating, J. M., Kirkhart, M.,
& Everly, G. S., Jr. (2006). Effects of
medical crisis intervention on anxiety,
depression, and posttraumatic stress
symptoms: A meta-analysis. Psychiatric
Quarterly, 77, 231-238.
http://dx.doi.org/10.1007/s11126<H>00
6<H>9010<H>2
Substance Abuse and Mental Health
Administration (SAMHSA; 2015). Core
competencies for peer workers in
behavioral health services
https://www.samhsa.gov/sites/default/fil
es/programs_campaigns/brss_tacs/corecompetencies_508_12_13_18.pdf
United Nations (2020). Policy brief: COVID19 and the need for action on mental
health.
https://www.un.org/sites/un2.un.org/files
/un_policy_briefcovid_and_mental_health_final.pdf
US Census Bureau (2021, February). Week
24 household pulse survey: February
3<N>February 15.
https://www.census.gov/data/tables/2021
/demo/hhp/hhp24.html
World Health Organization. (2018). mhGAP
operations manual: Mental Health Gap
Action Programme (mhGAP).
https://doi.org/10.1176/appi.ajp.162.12.2
309
CSHR  Volume 4, Number 3  March 2023
160
“PEER PARACOUNSELING” TO FOSTER RESILIENCE AND
REDUCE THE BURDEN ON COMMUNITY MENTAL HEALTH
SERVICES
Wu, A. W., Connors, C. A. & Norvel, M.
(2021) Adapting RISE: meeting the needs
of healthcare workers during the COVID19 pandemic, International Review of
Psychiatry, 33(8), 711-717, DOI:
10.1080/09540261.2021.2013783
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