Degree Name

Doctor of Philosophy (Clinical Psychology)


School of Psychology


Background: When someone with lived experience of mental health difficulties provides help to others with similar difficulties, it is generally called peer support. Peer support may be one way to enhance interpersonal relationships, a factor known to improve recovery from borderline personality disorder (BPD). There is little known about peer support in BPD.

Method: Four qualitative studies evaluated peer support for BPD. First, theory was built through an exploration to determine perceptions and possible models of peer support for BPD (Study One). Next, the application of peer support for consumers with BPD and their carers was examined from multiple perspectives (Study Two and Three). Finally, a new peer and clinician co-facilitated group for consumers with BPD was piloted (Study Four).

Results: Consumers with BPD reported experiencing increased hope and connectedness through peer support. Consumer peer workers, however can experience stigma and mistreatment in the workplace (Study One). Participants expressed how a unique contribution of consumer peer workers is their ability to provide skills based on lived experience. Consumer peer workers reported experiencing negative emotions when exposed to consumer distress (Study Two). Carers described helpful aspects of carer peer support, including feeling understood. Carer peer workers can be distinguished from clinicians due to their reciprocal approach (Study Three). Participants reported how a peer and clinician co-facilitated group helped consumers by providing skills to enhance recovery. The peer worker’s personal understanding of BPD enabled consumers to share openly, whilst the clinician delivered skills based on professional training (Study Four).

Discussion: These studies provide evidence for how peer support may be uniquely helpful for consumers and carers with lived experience of BPD. Challenges in peer support for BPD may also be experienced, including managing boundaries and the impact on the worker’s mental health. Two models of peer support were developed: an integrated model where peer workers are within a treatment team and a complementary model where peer workers are separate from a team. Limitations of the research included possible biases due to purposive sampling strategies. Future research is required to determine how both peer support and clinical interventions can best be delivered to consumers.


Thesis by publication



Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.