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SickKids

Peer Support & Trauma Response Program

As the first hospital-wide program in Canada, the SickKids’ Peer Support & Trauma Response Program was launched in 2018 to promote greater psychological health and safety amongst staff, aligning itself closely with the National Standard, established by the Mental Health Commission of Canada, and the SickKids’ principles of Caring Safely.

Events such as poor patient outcomes, prolonged recovery efforts, medical error, conflict and moral distress are part of the professional landscape and can have a significant impact on mental health and day-to-day functioning of healthcare professionals. The cumulative effect can hold consequences not only for the individual, but also for their family, healthcare team and for public health.

Our program operates 24/7 and is available to anyone who wears a SickKids badge. We provide consultation, training and facilitation of program development in the areas of mental health, trauma response and peer support programming to organizations outside SickKids. We are further engaged in research to understand occupational stress and inform more responsive organizational processes.

Why peer support?

Peer support can be influential to colleagues in reducing distress and encouraging resiliency. Peers occupy a critical role in providing responsive psychological and emotional support through their shared experiences and are instrumental in directing affected colleagues to needed resources. Cornerstones of the program include:

  • capacity-building
  • post-traumatic growth
  • reducing stigmatization of mental health issues
  • increased awareness

Peers provide confidential individual support and outreach to colleagues, and through delivery of trauma response, they are able to provide opportunity for teams to engage in psychological decompression and debriefing following a critical incident. This responsive level of intervention facilitates re-stabilization of the affected team and creates a focused environment of cohesion and support for its members. Peers can make a permanent impact on a colleague’s mental health journey and contribute to the prevention of additional challenges or issues.

Trained peers

The SickKids network of peers consists of over 100 clinical, non-clinical, physician and research staff from across disciplines. A rigorous recruitment and training process has been embedded in the Peer Support and Trauma Response Program to ensure capacity-building and sustainability.  

A SickKids branded training curriculum has been developed with a trauma-informed lens to prepare and introduce staff to their peer role. This includes advanced development of communication skills, education in the dimensions of mental health and psychological first aid, and an individual crisis intervention and support model that guides the one-to-one peer conversation dynamic.  Additional training is provided in Group Crisis Intervention with certification provided in conjunction with the International Critical Incident Stress Foundation (ICISF).

What we do

Since the launch of the program in 2018, peers have provided individual and group support to staff in thousands of interactions and are considered a trusted and reliable mental health resource at SickKids. The success and growth of the program has drawn recognition from our peer organizations in a variety of sectors, both locally and internationallyOur program supports organizations moving to establish peer response by offering consultation regarding:   

  • Peer models of delivery  
  • Budget   
  • Program management models 
  • Policy development  
  • Impact assessment 
  • Program planning 
  • Operationalization 
  • Resourcing and allocating peers 
  • Triaging and coordination 
  • Metrics and program evaluation 
  • Program sustainability 
  • Leadership engagement 
  • Promotion 
  • Recruitment and screening processes 
  • Training 

Kelly McNaughton

MSW, RSW, CTS, PhD Student, Program Manager, Peer Support & Trauma Response and Organizational Lead, Mental Health, Occupational Health and Safety

Kate Paulino

MA, RP, Program Specialist, Peer Support & Trauma Response Program, Occupational Health and Safety

Headshot of Brandon Zhu

Brandon Zhu

MSW, RSW, Program Coordinator, Peer Support & Trauma Response Program, Occupational Health and Safety

Peer program development and consultation

Consultation is available to health-care organizations who may be contemplating or are in the process of developing a peer support team.

SickKids has tailored program development and team operations towards the health-care sector, however, programming is informed by experience and knowledge with first responder populations. Mentoring is offered to any organization with a desire to improve the mental health and psychological safety of its employees.

Consultation provides the opportunity to guide organizations in a best practice approach to peer program and team development. Our team assumes a tailored approach from concept and needs assessment through phases of program and mental health awareness promotion, nomination, recruitment, screening, program evaluation and sustainability. Consultation may support the program development process, or inform a phase of team development such as coaching organizations on interviews and psychological screening.  

  • Development of policy and best practice protocols
  • Recommended tools and best practices including over 40 documents developed to support the program and operations
  • Considerations in the nomination and recruitment process
  • Promotion of mental health and the peer program
  • Development of operational and communication infrastructures
  • Screening and interview protocols
  • Peer training
  • Onboarding and implementation
  • Sustaining the peer network
  • Development of operational and communication infrastructures
  • Program evaluation and ongoing training

Peer support training and program development for your organization

Preparation and the training of peers for their critical role is founded on mental health education and advanced communication skill development in an interactive, psychoeducational workshop aimed at preparing staff for the practical and psychological challenges of supporting their colleagues. A trauma-informed approach with a lens to allyship, equity, diversity and inclusion, are pillars in the SickKids brand of training. 

Development and training opportunities:

  1. Peer Support Intervention & Skills Development (1 day) 
  2. Critical Incident Stress Management (CISM) Group Crisis Intervention** (2 days) 
  3. Assisting Individuals in Crisis** (1 day) 
  4. Combined Peer Support Intervention & Skill Development and Group Crisis Intervention** 
  5. SickKids’ Peer Program Development Toolkit (40 documents) 
  6. Standardized Psychological Inventory (administered in conjunction with interview component of recruitment process) 

** Denotes CISM Certification through the International Critical Incident Stress Foundation 

Training provides essential preparation for peer learners in delivering individual support as well as group intervention to teams following a traumatic event. Simulation exercises with standardized patients enable learners to practice and integrate newly acquired skills in a safe learning environment and provides further opportunity for reflection, guided discussion and real time coaching. Learners develop an essential suite of tools and resources that align with a best practice approach in peer support.

  • Understand how to cultivate a therapeutic and trusting connection with colleagues   
  • Recognize indicators of common mental health issues and how to assess risk   
  • Advanced development of communication skills  
  • Knowledge in dimensions of mental health and psychological first aid   
  • Training in an individual crisis intervention model   
  • Engagement of standardized patient (SPs) for interactive learning and practical skill development   
  • Learning through blended modalities: video, simulation, observation, large and small group discussion and lecture  

Core courses

Peer Support Intervention and Skill Development

This training is intended specifically for organizations in the process of developing peer support teams or interested in advancing critical communication and intervention skills for learners. Emphasis is on the delivery of both crisis intervention as well as general individual support informed by principles of psychological first aid. 

  • Understand how to cultivate a therapeutic and trusting connection with colleagues  
  • Recognize indicators of common mental health issues and how to assess risk  
  • Apply enhanced knowledge of essential communication skills in practice  
  • Engage as an ally with increased awareness in issues of equity, diversity, and inclusion  
  • Identify strategies in individual crisis intervention and apply them in practice 

Critical Incident Stress Management (CISM) Certification

Critical Incident Stress Management (CISM) courses are designed for anyone in the fields of health care, business, crisis intervention, disaster response, education, emergency services, employee assistance, mental health, military, spiritual care, and trauma. These courses are approved by the International Critical Incident Stress Foundation (ICISF), and delivered by Kelly McNaughton, ICISF certified instructor.

A. Group Crisis Intervention

Designed to present the core elements of a comprehensive, systematic and multi-component crisis intervention curriculum, the Group Crisis Intervention course will prepare participants to understand the impact of trauma and the traumatic stress reaction as well as crisis intervention and the critical dimensions of mental healthLearners are introduced to a range of crisis intervention approaches and evidence-based techniques. Fundamentals of Critical Incident Stress Management (CISM) are outlined and learners acquire essential knowledge and tools that will enable facilitation of different levels of group crisis intervention, specifically demobilizations, defusing and the Critical Incident Stress Debriefing (CISD)  

  • Understand and explain Critical Incident Stress Management (CISM)  
  • Define key terms and concepts in CISM  
  • Discuss psychological and behavioural reactions to stress and trauma  
  • Understand Resistance, Resilience and Recovery  
  • List the elements that must be considered in the strategic planning of crisis interventions  
  • Learn to assess which type of intervention should be activated following an incident  
  • Engage in mock Defusing and Debriefing group exercises   
  • Stages of Crisis  
  • Principles of Crisis Intervention  
  • Critical Incident Stress  
  • Traumatic Stress  
  • PTSD   
  • 6 Elements of CISM  
  • Assessment  
  • Tactical Components  
  • Informational Group Interventions  
  • Defusing  
  • Critical Incident Stress Debriefing  

B. Individual Crisis Intervention

This program is designed to teach participants the fundamentals of, and a specific protocol, and model for, individual crisis intervention. This course offers core knowledge for anyone involved in Peer Support and crisis intervention. 

  • Understand the need for psychological crisis intervention (PFA). 
  • Understand and differentiate the key terms and concepts relevant to the study of psychological crisis intervention/PFA. 
  • Be able to assess the “psychological toxicity” of a critical incident/disaster. 
  • Understand the nature and definition of Critical Incident Stress Management (CISM) and its role as a continuum of care. 
  • Understand the risks of iatrogenic “harm” associated with psychological crisis intervention and will further understand how to reduce those risks. 
  • Review research relevant to the practice of psychological crisis intervention. 
  • Be better able to recognize common psychological and behavioral crisis reactions. 
  • List the putative and empirically-derived mechanisms of action in psychological crisis intervention. 
  • Understand the steps in the SAFER-R model of individual psychological crisis intervention/ PFA. 
  • Understand how the SAFER-R model may be altered for suicide intervention. 

Testimonials

"Working with the SickKids team was a supportive and pleasant experience. Kelly and Kate provided a very detailed explanation of the expectations related to the program, as well as the key elements for both the CISM and PEER support training modules. From a participant perspective, the feedback was very positive: staff shared that the interaction and the simulations that were incorporated into the learning were a key element in solidifying the content that was being shared. Kelly also provided feedback after the training, which was very much appreciated, as it allowed our team to receive acknowledgment and recognition for the dedication and engagement they had demonstrated. This program has been embraced by the group and is vital in building our support structure for our teams throughout the Women’s and Children’s program. June will mark our one-year anniversary since implementing the PEER Support program, and we have seen amazing results, with staff feeling supported in a timely way, and a decrease in burnout overall. Thank you to Kelly and Kate for your support and guidance throughout the implementation process, it was greatly appreciated."

– Lisa Killen, Clinical Manager L&D and NICU, Peterborough Regional Health Centre


"I want to express my heartfelt gratitude for the invaluable peer support training your team provided. Your insights have deeply enriched my understanding, allowing me to cultivate a more empathetic and effective therapeutic presence. Your guidance has enhanced my skills and boosted my confidence in providing support that fosters resilience and empowerment. Thank you for your dedication and wisdom." 

– Social Worker, UHN, Toronto General Hospital


"The CISM training offered by the Hospital for Sick Children was invaluable, providing engaging content with relevant case scenarios. Following the training, our Peer Supporters felt an increase sense of confidence in their ability to respond to a colleague in distress or a team who had experienced a traumatic event. Kelly and Kate (or you could say 'the instructors') were warm, approachable and clearly passionate about their work in crisis intervention training. We hope to partner again with the Hospital for Sick Children to scale this training throughout our organization."

– Heidi Clay, Manager for Team Member Health and Well-being, Grand River Hospital


"The peer program on our unit has been a success and very often utilized! We didn’t know we needed this so much until it was in place!"

– RN, Peterborough Regional Health Centre


"Thank you so much for coming to our hospital and spending the time with us to help us help each other. It was very evident that this course and the knowledge and skills in our 'toolbox' you provided us with will help in so many ways, starting with one of our favourite paediatricians suddenly passing away. Our peers (all effected based on the nature of the 6th floor) came together; some standing back needing peer support (myself included) but as a whole were able to set up a room, get food delivered, set up a schedule for someone to be available for reach out to our colleagues. The hospital set up a tribute day, and it was so beautiful to watch unfold because the core of it all was from this peer training! This is going to be much more valuable than I ever imagined and wanted to thank you and Kate for giving us this opportunity!"

– Rachel Whiteside, RN, Peterborough Regional Hospital


"Thank you so much for a fantastic session yesterday. Our participants had nothing but great feedback to share after you left and are very engaged and excited for next steps."

– Tania Williams, Workplace Wellness Manager, Toronto General Hospital

  • "I found it really encouraging to hear the other nurses' stories that things will get better with time and experience."
  • "Speakers were open about sharing mental health experiences/validating the feelings of new grads."
  • "I enjoyed hearing about other nurses' stories to help normalize my feelings I have at this time."
  • "I loved the aspect that nurses working with SickKids shared their real life stories with us. It made it feel like we aren't alone, and everyone is in the same boat at one point."
  • "This was one of the most beneficial parts of orientation in my opinion."

“Thank you for validating that I did everything I could, and that you were impressed how I handled it. It really means a lot...... especially after feeling so discouraged with what happened last week.” 

– RN


“I can only say wonderful things about the peer support and trauma team at SickKids - specifically Kelly McNaughton. Kelly reached out to me during a very tumultuous time where I felt alone, confused, and unsure of where to go and what to do for help. After working many years as both a paediatric oncology and ICU nurse, the idea that I was likely suffering from burnout and mental exhaustion was both foreign and frightening. Kelly gave countless hours of her own time making sure I felt safe, supported, and on the right path. Not only did she help guide me through the process of going on medical leave, but she also ensured I got connected to some amazing professionals that were able to help me overcome my PTSD. I am forever grateful to Kelly for the care and support she provided to me, and she - and the Peer Support and Trauma Team - are a valuable asset to any healthcare institution and their staff.”

– Aleisha Marchant, RN


“Thank you for all your help, kind words, active listening and helping me with resources. It was a very positive experience, and I learned a lot about my responsibilities in conflict. I learned how I can conduct myself in a different fashion by focusing on shifting from a victim mentality through self-questioning to something more effective, like in this case empowerment. This also helped with the overall burnout I was feeling - and generally what burnout is for me and how to understand and manage it by applying the same type of self-questioning. I will use peer support in the future if I need to. And I have recommended it to others.”

– Patient Information Clerk


“There are so many parts of nursing life that are incredibly challenging. There can be difficult moments where you find yourself in the middle of work chaos - the stress, the constant battle with time, the innate pressure to deliver the highest quality of care on your 11th hour. The journey we go through has many layers and all of those complex feelings we experience can take a toll. We are only human. Having the awareness of when work life puts insurmountable pressure on your mental health and the foresight to actively seek the support you need are two things I think we health care workers constantly battle with. This is where the Peer Support Program comes in. The day I met Kelly, she provided that one on one support for me. It was at a time when I wasn’t even aware of how much I needed it. I was emotionally and physically drained and I didn’t know where to look for support. She called me. I think vulnerability can be a scary thing but the support I got that day and over the next month was probably the largest contributor to rebuilding my strength and resilience. Kelly made herself available for face-to-face support as well as group debriefs. The encouragement I got from this program was confidential, non-judgmental, and helped to remove some of the stigma that still exists around mental health. As nurses, we need to be honest and authentic with how trying our careers can be. By doing so, we all discover how important self-care is to have a healthy work life. Peer support gave me concrete help and initiated the need to process a very difficult part of my career. This in turn made me feel strong enough to support other people as a CSN. When it comes to working with our team, confidence in a peer-based support system can be one of the most powerful ways to build each other up.”

– Tiffany, RN


"I am glad to have reached out to peer support quite early in my nursing career. It really helped having nurses to talk to about particular events and obstacles faced in my nursing career. I was able to get the support I needed, which was something I was unable to get at home from family or friends who are working in different professions. I found peer support really valuable in the sense that I was able to talk about all my problems and feelings and have people truly understand me without any further explanation. It was also really reassuring knowing that everything was confidential, and my privacy was protected."

– RN

CISM & Peer Support Intervention and Skill Development Training

Peterborough Regional Healthcare Centre (PRHC) Training

Spring 2022, Summer 2023, Summer 2024

  • "I enjoyed the way it was conversational and the facilitators ensured everyone was comfortable; it never felt rushed."
  • "Group discussion was interesting and engaging, facilitators created a safe learning environment that encouraged participation."
  • "Strategies helpful in supporting peers, appreciated the compassionate communication outline as a reminder."
  • "The interaction with the facilitator."
  • "Peer interview practice."
  • "Great workshop with great resources."

Peer Support Intervention and Skill Development Training

Grand River Hospital

Fall and Winter 2023

  • “Balance of information and pace was excellent. The presenters with deep knowledge and experience were wonderful.”  
  • “Kelly was extremely well spoken and kept my interest.” 
  • “Role play as well as strategies to ask questions in a non-challenging way to help others be able to feel safe and share.” 
  • “Organized and provided real practice.”  
  • “A wonderful space was created for discussion/dialogue with colleagues, provided tangible tips for conversation, validated that I don't need to know all answers, but rather offer a safe space/validation.” 
  • “It gave me a better understanding of approaches to coworkers and to help de-escalate.” 
  • “Very engaging, time to reflect with new and old colleagues about challenges with debriefing and past experiences.”  
  • “Kelly was very engaged and insightful.”   
  • “The discussions and sharing of knowledge between all instructors and learners.”  
  • “The facilitators were great. It was informative. Training was 8:30 a.m to 4:30 p.m but the time went by.  An excellent day!”    
  • “The model and techniques for conversations and having the ability to put them into action.”  
  • “The role playing was stressful, but a great tool to use for training purposes. Lots of great discussions topics and opportunities, but in a safe environment to ask questions or make errors.” 

University Health Network (UHN) Training

Spring and Summer, 2024

  • “Balance of information and pace was excellent. Three presenters with deep knowledge and experience was wonderful. SP was extraordinary.” 
  • “Simulated patient and role playing.” 
  • “Very hands-on.” 
  • “Role play as well as strategies to ask questions in a non-challenging way to help others be able to feel safe and share.” 
  • “It was interactive.” 
  • “The patient simulation was very helpful because even though I did not get to go up front to practice with the actor, I was imagining what I would say, so it was good practice and made me think about how I would respond to peers.” 
  • “It was outstanding and beyond expectations I had before walking in, keep doing the great work.” 

Contact us

We are all blazing a trail with peer programming to improve mental health and wellbeing of our colleagues in health care. We welcome inquiries or requests for information.

Email: peer.support@sickkids.ca 

Peer Support and Trauma Response Program  
Department of Occupational Health and Safety  
The Hospital for Sick Children 
Patient Support Center
175 Elizabeth St
20th Floor
Toronto, ON
M5G 1H3

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