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Currently submitted to: Journal of Medical Internet Research

Date Submitted: Nov 27, 2019
Open Peer Review Period: Nov 27, 2019 - Jan 16, 2020
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Non-professional peer support to improve mental health: Randomized trial of a scalable web-based peer counseling course

  • Samantha L. Bernecker; 
  • Joseph Jay Williams; 
  • Norian A. Caporale-Berkowitz; 
  • Akash R. Wasil; 
  • Michael J. Constantino; 



Millions are underserved by the mental health care system. Most mental health problems go untreated because people lack access or are not interested in professional help. Innovative and scalable treatment delivery methods are needed to supplement traditional treatments in order to make mental health support more accessible and more appealing.


This study investigated whether a self-guided web-based course can teach pairs of non-professional peers to deliver psychological support to each other.


Thirty dyads (60 participants; mostly friends), many of whom presented with mild to moderate psychological distress, were randomized to immediate or delayed access to a web-based counseling skills course. Dyads were recorded taking turns discussing stressors before and after training. Participants’ skills in the helper role were assessed before and after taking the course by coding recordings for the presence of specific counseling skills and overall competence. When in the client role, participants rated how helpful they found the session.


The course had large effects on most helper-role speech behaviors: helpers decreased total speaking time, used more restatements, made fewer efforts to influence the speaker, and decreased self-focused and off-topic utterances (ds = 0.8-1.6). On average, helpers met 5 out of 6 competence criteria after completing the course. As clients, participants perceived more progress in addressing their stressors during post-training counseling sessions than during pre-training sessions (d = 1.1).


Results provide proof-of-concept that non-professionals can learn basic counseling skills from a scalable web-based course. The course serves as a promising model for the development of highly scalable, web-based counseling skills training. Such scalable, web-based courses could potentially be used for professional training purposes as well as for reciprocal peer counseling programs that can provide accessible mental health support to those underserved by traditional psychotherapy.


Please cite as:

Bernecker SL, Williams JJ, Caporale-Berkowitz NA, Wasil AR, Constantino MJ

Non-professional peer support to improve mental health: Randomized trial of a scalable web-based peer counseling course

JMIR Preprints. 27/11/2019:17164

DOI: 10.2196/preprints.17164


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