Teenagers today face a litany of pressures and problems that can have a direct effect on their health and safety. In 1993, for example, persons age 13-24 were the fastest-growing population with AIDS (O'Hara et al. 1996). Between the mid-1960s and 1988, the suicide rate among 15- to 19-year-olds nearly tripled (Lewis and Lewis 1996).
One method high schools have used to help combat these grim statistics is peer-led counseling groups, an approach that first became popular in the 1960s and '70s. The rationale was that students tend to seek out peers more than adults in discussing personal concerns and that both the peer counselors and their clients might benefit from such interactions (Morey et al. 1993). More recently, peer counseling has gained support for a practical reason: The demand for guidance and counseling services now far exceeds the supply of professional school counselors (Robinson et al. 1991).
Fatal Flaws
Despite the widespread popularity of peer-support programs, a dearth of research exists to substantiate the method's effectiveness. Lewis and Lewis, in particular, warn that poorly designed and supervised programs can have harmful—even fatal—results.
One of Lewis and Lewis's concerns is that students serving as peer counselors are increasingly being asked to shoulder a burden that should be overseen only by trained, seasoned professionals. In a sobering study, the two researchers compared suicide rates among schools with no peer-led suicide-prevention program; schools with peer-led prevention programs overseen by a noncounselor (for example, a teacher or building administrator); and schools with peer-led prevention programs overseen by a certified counselor, psychologist, or social worker. Shockingly, the 38 schools with the noncounselor-led peer programs had the highest ratio of student suicides: Between 1991 and 1993, 11 of those 38 schools (29 percent) reported at least one suicide, as opposed to 7 of 55 schools (13 percent) with no prevention program at all, and just 5 of 65 schools (8 percent) with a counselor-led peer program.
Lewis and Lewis note that educators should interpret these findings with caution, given several limitations of their study, including the self-selection of school counselors who completed the questionnaires, possible inaccurate reporting by counselors, and the fact that a catastrophic event in one school could throw the statistics off.
Still, these statistics are striking. Lewis and Lewis hypothesize that well-intentioned programs may actually increase the risk of suicide by normalizing it as a reaction to stress instead of a mental illness, thereby stimulating "behavioral contagion" of suicides. They note, too, that especially in cases where no trained counselor is available for consultation, student counselors may be given excessive responsibility in helping their peers cope with serious issues.
Finally, the researchers note that 32 of the 263 counselors who responded to their survey expressed concern that dysfunctional adolescents are particularly attracted to the helping role, and that without careful screening, the peer helpers chosen may be particularly ill-equipped to handle the demands of the role. In fact, of the 11 suicides in schools with noncounselor-led peer programs, two were committed by peer counselors themselves.
Although Lewis and Lewis focus on suicide-prevention programs, we can extend this argument to other health and safety issues teens face, such as AIDS and drug and alcohol abuse. As teens confront the problems of the 1990s, they want concrete advice, not just an empathetic listener. Morey and colleagues (1993) confirmed this fact when they used a stepwise regression to identify factors that contribute to students' satisfaction with peer counseling. Two such factors were "empathy and problem identification" and "empathy and problem solving," indicating that students want help from peers who are willing to listen and understand their problems, and who can suggest ways to address those problems.
Professional Support Is Critical
These studies point to the need for students to receive extensive training and professional support both before and throughout their work with their peers. If such support is given, peer programs have tremendous potential.
A case in point: O'Hara and colleagues (1996) studied the effects of a student-led AIDS prevention program in an alternative school for at-risk youth. Following an initial interview, the peer counselors were trained over the course of eight weeks, including five classroom sessions, two retreats, and a trip to a local clinic for sexually transmitted diseases. Peer counselors with attendance problems were dropped from the program. Those who successfully completed the program then conducted two carefully structured large-group sessions with their peers, followed by two small-group sessions and various schoolwide activities. The results were impressive: pre- and post-intervention student surveys revealed that the number of students who intended to use condoms each time they had sex rose from 55 to 65 percent, while those reporting they had never used a condom dropped from 15 to 4 percent.
The lesson from these examples is that peer-led programs must be adopted carefully, particularly when dealing with the high-stakes problems that many teenagers face today. In fact, professional intervention may be preferable to peer support for potentially lethal issues, such as teen suicide.
Robinson and colleagues (1991) recommend that school counseling staff run peer counseling programs, that programs be provided a large enough budget for adequate training and continuity, and that peer counselors receive ongoing support and training. This type of support is critical: Even the most mature and responsible high school peer counselor is still a teenager, facing the same formidable challenges as his or her peers.
