Community Program Participation Experience of Peer Recovery Coaches for Substance Use Disorders Based on a Caring Perspective: A Qualitative Study

ABSTRACT

Aim

To identify peer recovery coaches' activities from a care perspective to help determine the essential care elements for substance use disorders in Korea.

Design

Descriptive qualitative study.

Methods

Using purposive sampling, data were collected through one‐on‐one interviews conducted from November 2023 to May 2024. The transcripts were analysed using deductive content analysis, with the findings structured according to the middle‐range theory of caring framework.

Results

Peer recovery coaches' program participation experiences were categorized as follows: ‘being a helper with objective insight’, ‘being a companion to move forward together’, ‘being a navigator based on experience’, ‘being a facilitator of recovery who promotes growth’, and ‘being a caregiver with positive values and attitude’.

Conclusion

Peer recovery coaches facilitate recovery and foster mutual growth within the caring process. For substance use disorder programmes to succeed, nurses must play a pivotal role in designing and implementing these interventions in collaboration with peer recovery coaches.

Implications for Nursing Practice

The findings lay a foundation for developing nurse‐led interventions that integrate peer recovery coaches into substance use disorder programmes. Specifically, the study offers insights into how nursing professionals can support peer recovery coaches in maintaining personal recovery, accessing institutional support and enhancing their clinical competencies.

Impact

This study examines the emerging role of peer recovery coaches within South Korean's substance use disorder recovery landscape through the lens of caring theory. The findings offer significant clinical insights for nursing—a field where patient‐centred and team‐based practice is essential—by demonstrating how the lived experiences of peer recovery coaches can integrate with nursing expertise to deliver highly personalized care.

Reporting Method

The COREQ guidelines were followed.

Patient or Public Contribution

No patient or public contribution.

1. Introduction

Care refers to a nurturing way of relating to a valued other, toward whom one feels a personal sense of passion and responsibility (Swanson 1991). Swanson described care as not only an act but also a relational process that promotes growth and health. This process is personal and intimate, based on passion and responsibility (Swanson 1993). Care represents the essence of nursing and remains central to nursing practice. Nursing addresses the physical, emotional, social and spiritual needs of patients who cannot care for themselves (Watson 1997).

Substance use disorders (SUDs) affect physical and mental health, social relationships and the meaning of life. Therefore, care that extends beyond simple treatment is essential (Kitt‐Lewis and Adam 2025). Individuals with SUDs experience difficulties in building therapeutic relationships and sustaining recovery because of stigma, alienation and low self‐efficacy. Nurses and caregivers can support the recovery of motivation, self‐efficacy and self‐esteem in individuals with SUDs by practicing essential elements of care, such as non‐judgmental attitudes, empathic communication, emotional support and enhancing self‐determination (Kitt‐Lewis and Adam 2025).

Peer recovery coaches (PRCs) can draw on their own experience of recovery from SUDs to provide emotional support, information, practical advice, hope and motivation to individuals experiencing similar difficulties (Hyun et al. 2022). Unlike other professionals, PRCs can build trust with clients because of the ‘power of experience’; this relationship involves non‐judgmental empathy, practical feedback, mutual responsibility, positive expectations and belief (Scannell 2021). In community‐based programmes, PRCs play important roles as companions, facilitators and navigators and can collaborate with nurses (Hyun et al. 2022; Kang and Kang 2022; Scannell 2021).

2. Background

Studies report that emotional support, empathy, positive feedback and delegation of responsibility from PRCs contribute to improving self‐efficacy, self‐esteem, recovery motivation and the social support network in individuals with SUDs (Hyun et al. 2022; Scannell 2021). PRCs' participation in SUD programmes is effective in reducing substance use, improving treatment participation, self‐efficacy, and quality of life and controlling stress (Kang and Kang 2022). Other studies emphasize that PRCs play a leading role in the growth and recovery of self‐esteem in people with SUDs because they serve as companions in recovery and facilitators of healing (Hyun et al. 2022; Williams 2021).

PRCs are widely recognized for their roles in the recovery of individuals with SUDs through participation in SUD services or programmes. However, the activities of PRCs within South Korea remain limited, and there are very few in‐depth analyses of the care they provide. Therefore, examining the care experiences of PRCs can help achieve a deeper understanding of the processes involved and can identify the elements of care essential to individuals with SUDs.

3. Research Aims and Objectives

We conducted an in‐depth examination of SUD programme participation by PRCs based on the research question, ‘How is PRCs' SUD program participation experience from a care perspective?’ Swanson's (1993) middle‐range theory of caring, which outlines five processes of caring, was used as the framework for organizing the findings. We aimed to re‐examine the experience of PRCs from a care perspective. The findings can serve as important foundational data for the development of SUD programmes in which PRCs can participate and for training programmes to enhance the care competencies of PRCs alongside nurses, as well as to achieve mutual recovery and growth between PRCs and individuals with SUDs.

4. Methods

4.1. Design

This qualitative study involved one‐on‐one, in‐depth interviews with PRCs participating in SUD programmes at community centres. This study was conducted and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (Tong et al. 2007).

4.2. Theoretical Framework

Swanson's (1993) middle‐range theory of caring was used to analyse PRCs' experiences.

4.3. Sampling and Recruitment

We visited community facilities related to SUDs and made recruitment announcements. The inclusion criteria were: (1) PRCs currently engaged in SUD services at community organizations and (2) those with at least 1 year of active experience. The exclusion criterion was individuals with any communication difficulty that precluded in‐depth interviewing. Individuals who saw the announcement and volunteered to participate in the study were interviewed by the first author, who has published over 10 qualitative studies. The authors informed the candidates about the specific purpose, processes and procedures of the study using a research participant information sheet.

4.4. Population and Sample

The population of interest was PRCs with experience in operating SUD programmes, such as peer counselling, recovery support groups and daily living support for recovery. Korean PRCs are individuals with lived experience of recovery from SUD who have completed the prescribed training programme certified by a government agency. Although specific service delivery methods vary depending on the affiliated organizations, PRCs are formally integrated into the community mental health system, where they commonly provide emotional support, share experiential knowledge and serve as a bridge between service users and professional SUD care. Participants worked in public‐sector organizations—including community mental health welfare centres, community addiction management centres and regional addiction rehabilitation centres—located in both metropolitan and mid‐sized cities in South Korea. Nine individuals, including six men and three women, consented to participate in the study. Their mean age was 54.8 years, and the mean duration of employment in SUD centres was 48.2 months (4.0 years) (Table 1). There was no prior relationship between the researchers and any of the study participants.

TABLE 1.

Characteristics of the participants.

Participants	Gender	Age (years)	PRC experience (years)	Type of affiliated organization
1	M	50s	3–4	Addiction rehabilitation facility
2	M	70s	≥ 5	Community‐based public centre
3	M	50s	1–2	Addiction rehabilitation facility
4	M	50s	1–2	Community‐based public centre
5	F	50s	≥ 5	Addiction rehabilitation facility
6	F	50s	3–4	Community‐based public centre
7	M	50s	3–4	Community‐based public centre
8	F	40s	3–4	Community‐based public centre
9	M	50s	1–2	Community‐based public centre

Note: To reduce the risk of deductive disclosure in this small, specialized workforce, age and PRC work experience are reported as ranges rather than exact values, and affiliated organizations are collapsed into two broad categories: community‐based public centres (community addiction management centres and community mental health welfare centres) and addiction rehabilitation facilities. Additional contextual characteristics—including each participant's own recovery duration, substance use history, the specific programmes they delivered, employment status, and the name and location of the affiliated institution—are not reported. Because the number of PRCs working in these settings in South Korea is small, presenting these characteristics alongside the information in this table, even in aggregated form, could allow individual participants to be identified; they were therefore withheld in accordance with the approved institutional review board protocol.

Abbreviations: F, female; M, male; PRC, peer recovery coach.

4.5. Data Collection

A questionnaire survey and one‐on‐one interviews were conducted to collect data regarding the participants' general characteristics. The interviews were conducted between November 2023 and May 2024, either online or offline in the conference room of community centres or in the researchers' offices. We created a safe and comfortable environment for the participants during the interviews and recorded the interview content with their consent. During the interviews, the researcher summarized and repeated the participants' statements to ensure the accuracy of the content. Each interview lasted approximately 1 h. Afterward, the recorded content was transcribed, resulting in a transcript of 123 A4 pages. We also collected field notes taken during the interviews. To address the research questions, the interview guide was validated for content appropriateness by experts in SUD, including community‐based practitioners and psychiatric mental health nursing professors. The key questions used during the interviews are as follows:

1. Please tell us about the SUD programme you are currently operating (or participating in).

2. As a PRC, what aspects are important for programme operation or participation?

3. As a PRC, what impressed you during programme operation or participation?

4. As a PRC, what were some of the difficulties regarding programme operation or participation?

5. As a PRC, do you want to add anything else about the programme?

4.6. Data Analysis

All interviews, transcriptions and qualitative data analyses were conducted in Korean to capture the authentic nuances of the participants' narrative data. The selected quotations were first translated from Korean into English by the research team. To ensure conceptual equivalence and preserve original meaning, a professional translator thoroughly reviewed and verified the translated English quotations against the original Korean transcripts for fidelity and accuracy.

The collected data were analysed using the deductive content analysis method proposed by Elo and Kyngäs (2008). To ensure methodological rigour, a structured deductive coding framework based on the five caring processes of Kristen Swanson's (1991) Middle‐Range Theory of Caring was developed prior to data analysis.

First, with the research question ‘How is PRCs' SUD programme participation experience from a care perspective’ in mind, the transcribed data were repeatedly read and reviewed to identify the overall content. Second, to extract the major codes, we identified and organized keywords, phrases and sentences related to programme operations that participants used, grouping them by similar content. Third, following the deductive content analysis approach proposed by Elo and Kyngäs (2008), the five core processes of Kristen Swanson's (1991) theory—knowing, being with, doing for, enabling and maintaining belief—were established as predetermined, overarching main categories serving as the analytical matrix. During initial coding, a small number of codes fell into an ‘unclassified’ category as they did not align with the theoretical framework. Through research team discussions, these unclassified codes were determined to be isolated participant remarks lacking recurring patterns and relevancy to the research questions; thus, they were excluded from further synthesis. Fourth, the lower level subcategories under each main process were inductively generated directly from the participants' narrative data, capturing the conceptual relationships and empirical depth within Swanson's five processes.

To ensure objectivity, the transcripts were coded independently by two researchers using the predefined framework. Following the initial coding, consensus meetings were held to compare and review the findings. Any disagreements or discrepancies during the coding process were resolved by comparing the codes, discussing differences and refining the operational definitions until consensus was achieved. In addition, to prevent theoretical bias from Swanson's Theory of Caring, the researchers actively sought data that deviated from or did not fit the predefined framework. These divergent findings were initially categorized under ‘open’ or ‘unclassified’ codes. During our consensus meetings, we thoroughly discussed these discrepancies, allowing new themes to emerge rather than forcing the data into predefined categories. This collaborative, iterative process helped minimize deductive bias and enhanced the overall trustworthiness of our findings.

Data saturation was assessed continuously throughout the data collection and analysis process. Two researchers evaluated saturation based on informational redundancy, defined as the point at which no new codes, sub‐themes or dimensions of Swanson's caring processes emerged from the interviews. Preliminary analysis was conducted concurrently with ongoing interviews. By the seventh and eighth interviews, the participants' descriptions of their experiences began to repeat, and no novel insights were identified. The ninth interview was conducted to confirm that complete informational redundancy had indeed been achieved, and data collection was concluded as further interviews were deemed unlikely to provide additional conceptual depth.

4.7. Researcher Preparation and Rigour

The researchers have conducted research and education in the fields of mental health and SUD for over 10 years, possessing clinical and practical competence as SUD specialists in client treatment and community rehabilitation. Additionally, with extensive experience conducting and publishing numerous qualitative studies, the researchers hold professional expertise in qualitative interviewing and data analysis.

To establish the reliability and validity of this study, we applied the four criteria of rigour in qualitative research proposed by Guba and Lincoln (1989): truth‐value, consistency, applicability and neutrality. To assure truth‐value, we personally interviewed workers and recovery activists who actively participated in various community‐based programmes for individuals with SUDs. During the interviews, we continuously took notes and checked with participants to confirm that we understood the content correctly. We transcribed the recorded interviews verbatim and verified that the transcripts accurately reflected the participants' statements. For consistency, we analysed the data according to content analysis procedures and maintained detailed records of each step. We also provided detailed descriptions of the research process and appropriately cited participants' statements related to the major findings for interpretation and analysis. For applicability, we described the specific characteristics of the participants based on the general characteristics reported in the survey. For neutrality, we engaged in ongoing discussions and reached consensus throughout the study to minimize potential researcher bias.

4.8. Ethical Considerations

The principal investigator personally met each participant to provide a detailed explanation of the study's purpose and procedures. Participants were informed about the measures taken to ensure anonymity throughout the study, including the methods for recording the interview content and taking notes. The principal investigator also explained that participation was voluntary and that PRCs could withdraw from the study at any stage without negative consequences. Participants were informed that a serial number, rather than their name, would be used when transcribing interview contents to ensure anonymity. The principal investigator clarified that transcribed data would be used only for research purposes and that both recorded and transcribed data would be destroyed after a legally defined period. This study was conducted with the approval of the Institutional Review Board of the university affiliated with the first author (IRB No. GIRB‐G23‐NY‐0041). Written informed consent was obtained from those who agreed to participate.

5. Findings

The categories and sub‐categories correspond to Swanson's (1993) care processes, as shown in Figure 1.

FIGURE 1.

Peer recovery coaches' experience of participating in community programmes based on Swanson's theoretical structure of caring processes.

5.1. Knowing: Being a Helper With Objective Insight

5.1.1. Making Various Attempts at Integrated Understanding

Participants sought a multidimensional understanding of individuals with SUDs by listening empathetically and employing diverse questioning techniques. They further developed integrated insights by closely observing environmental factors and subtle, non‐verbal behavioural changes.

Whenever I meet these individuals with SUDs, I tend to listen to what troubles them first. I try to comprehensively listen to how they feel inside and what environment they are currently dealing with. (P006)

I start the conversation or ask a question by using my case as an example, saying, “I did this before; perhaps, are you doing this because of the same thing?” (P001)

I often engage in conversations by saying hello. I think it is important to show that you are interested, such as asking “how was your week?” or “is something wrong because you don't look well.” (P005)

5.1.2. Recognizing the Objective Characteristics of Individuals With SUDs

The participants attempted to closely observe individuals with SUDs to objectively identify their problem with SUDs. In addition, the participants tried to identify the motivation for recovery and strengths that the individuals themselves did not recognize.

Because SUDs are linked to many legal issues in Korea, objective and close observation is very important for individuals with SUDs (ones who do not express themselves very well)—spending time with them, checking things that they could not talk about, or difficulties they have, one by one. (P007)

I try to see what the person is good at. Most individuals with SUDs yearn for praise and recognition without knowing what they like or are good at. (P006)

First, it is important to check how much the individual wants recovery. There seems to be a big difference (in the level of recovery) depending on the motive. (P005)

5.2. Being With: Being a Companion to Move Forward Together

5.2.1. Being a Peer

While operating the programme, the PRCs emphasized that they are present with individuals with SUDs as peers or friends who are in recovery from the same problem.

Individuals with SUDs are lonely. Thinking about that, I try to be a peer with the mindset that I want to be their “friend.” Not in the sense of being a close friend, but as a person suffering from the same disease… (P004)

I emphasize that I am on the same journey, “I am a companion and someone just like you,” and I am with them. (P003).

5.2.2. Going at the Same Pace and in the Same Direction

In supporting individuals with SUDs, PRCs aligned themselves with the recovery pace and direction of their peers. Drawing on personal and observational experience regarding the difficulty of behavioural change, they maintained patience, allowing individuals the time they needed to initiate their own recovery.

I think it is very important to go at a pace that the individuals with SUDs can follow. (P002)

You have to move in the same direction as the individual to achieve recovery. I place importance on how to align the passion of the recovery counselor and the direction the individual is moving toward. (P001)

I try not to lose patience. Because I experienced it myself, I know that individuals with SUDs do not change easily. I try not to forget “I am a person who must wait on the side.” (P008)

5.3. Doing for: Being a Navigator Based on Experience

5.3.1. Providing Information and Connecting to Recovery Resources Based on Experience

PRCs utilized their own recovery resources and personal narratives to support individuals with SUDs. Drawing on their lived experience, they identified specific needs and provided tailored information. When faced with service limitations, PRCs collaborated with mental health professionals or facilitated connections to essential community resources.

I think I provide a lot of data. Data from the internet or education I've received up to now, and if someone is worried about something, I often identify, prepare, and provide the information that person needs. (P005)

I provide all of the knowledge and data I possess. Whatever I can share, I tend to share it all. For those who want to attend self‐help meetings, I provide a meeting schedule or detailed map of the meeting venue that I personally drew. (P008)

As some things are difficult to discuss with me or their family, I try to connect or introduce them to fully utilize what they can for recovery, including hospitals and community centers. (P009)

I didn't receive specialized education like professionals (nurses, doctors). I don't know a lot about mental health. So, I seek consultation or help from professionals to help the individuals with SUDs when necessary. (P002)

5.3.2. Providing Actual and Direct Help

During SUD programme delivery, participants facilitated recovery by co‐creating structured daily routines and providing customized interventions based on individual profiles. They actively collaborated with service users to identify and implement practical, immediate solutions for their specific needs.

In the early stage of the program, I help them move (their bodies) no matter what. I try to minimize their personal time and help them go to centers or self‐help meetings. So, I try to make a daily life schedule together with them. We try to check regular activities on a daily and weekly basis. (P006)

I go to different local centers as a PRC, so I talk a lot so that the individuals with SUDs can try programs that were effective in other places. Because each individual (characteristics) is different, when they experience “this is right for me” even once, they can challenge themselves to try something new. I try to draw out such experience. (P005)

There are many people who seek actual help. We try to help as much as possible but cannot provide them with everything, so we try together to find specific methods for those. (P008)

5.3.3. Being a Supportive and Competent Role Model

PRCs continued their efforts to serve as good role models by actively supporting individuals with SUDs and demonstrating professionalism to provide more effective recovery support. They promoted growth for individuals with SUDs and for themselves by continuing to study, learn and practice various methods that they could recommend to individuals with SUDs.

What I can do well for individuals with SUDs is providing endless support. (P003)

My role is to be like a role model, so I can't let myself slip. I have to be humble. If I'm not taking care of myself—like managing stress or maintaining healthy relationships—then I have nothing to say to them. (P005)

It is necessary to personally try various methods that can fulfil me and be prepared to hand over something when someone reaches out to me. (P008)

As I was working as a PRC, I realized that I need to make my work more specialized and objective, so I am now attending graduate school. (P006)

5.4. Enabling: Being a Facilitator of Recovery Who Promotes Growth

5.4.1. Encouraging Practice

During programme operation, participants facilitated behavioural practice by recommending accessible and achievable activities for individuals with SUDs. They further encouraged engagement in tasks designed to foster positive life transitions and sustainable change.

We say “let's try to resolve this in this manner and try to do the easiest first” among what the individuals with SUDs can do. (P003)

Practice starting from small things. We encourage them by saying that doing so can open the door to new happiness and that they can start a new life. (P004)

We recommend that individuals with SUDs keep a diary of things they are thankful for. It always takes reflection to be “thankful.” Even if it's short, they can look back at the day and be thankful for that, which can revive many emotions. It was like that for me too. (P006)

5.4.2. Empowering and Motivating

PRCs continuously motivated individuals with SUDs to maintain their recovery efforts and helped them restore self‐esteem by enabling them to experience small achievements.

PRCs can continuously provide new motivation to individuals with SUDs based on what they personally experienced. (P001)

When individuals with SUDs are given a small responsibility and they work hard to achieve the goal, that can give positive feedback. (P006)

Sometimes, individuals with SUDs took a leading role and resolved their own problems according to the situation and rules as I had recommended before. (P007)

5.5. Maintaining Belief: Being a Caregiver With Positive Values and Attitude

5.5.1. Having Faith and Desire for Recovery

During meetings with participants, PRCs aimed to maintain their sincere desire for recovery from SUDs and their belief in the recovery of individuals with SUDs. Having themselves experienced the process, PRCs believed that although SUDs have a high relapse rate, continued effort after relapse can enable recovery.

I continue to try to deliver the message with the faith that recovery can be achieved if you follow those who have gone before with only earnest desire. Saying, just with earnest desire, “go humbly today too.” (P002)

I believe that “effort does not betray” and I talk to the individual about that. If you practice and put in the effort for however many hours in a day, that will never go to waste. I also got here after many failures. (P006)

5.5.2. Opening New Possibilities

While faithfully carrying out their roles as PRCs, the participants explored new possibilities for recovery. They discovered new aspects of SUDs, which they had previously viewed negatively, and expressed hope for changes in individuals with SUDs.

Individuals with SUDs are full of energy. SUDs have negative aspects, but I think they also have some positive aspects. What is important is how to set the direction and using it. (P001)

I always believed that I must have hope that the person I meet will definitely change, whether on his or her own or because of me. (P003)

5.5.3. Maintaining a Respectful Attitude

PRCs maintained an egalitarian perspective, viewing themselves as peers rather than authoritative experts. They refrained from projecting their own recovery strategies onto others, remaining mindful of the diverse needs and unique differences among individuals with SUDs.

That person and I are equal. I think very seriously and deeply about that. I have the belief that if I am not able to uphold that, then perhaps I cannot act properly as a PRC. As a PRC, I believe if that is broken, then my qualifications are lost as well. (P005)

People have their own way of recovery and a method that suits them. I try to deal with each individual based on the principle that everyone is different. (P009)

6. Discussion

We examined the experiences of PRCs participating in SUD recovery services or programmes from a care perspective, in order to provide useful information that can be applied to training future PRCs and planning PRC participation programmes in the nursing field.

PRCs' SUD program participation experiences, identified from a care perspective based on Swanson's (1993) middle‐range theory of caring, were divided into five categories. First, PRCs attempted to understand individuals with SUDs comprehensively by listening, asking questions, using non‐verbal expressions and demonstrating interest as helpers with objective insight. They also objectively understood both the individuals with SUDs and the problems associated with SUDs through close observation. Understanding individuals with SUDs who require care is the first step in care and serves as the basis of the process for recognizing the unique characteristics and needs of these individuals (Swanson 1993). In this process, listening, asking questions, using non‐verbal expressions and showing interest increase trust and understanding with clients during the early stage of counselling (Fitriana and Rosyidi 2021). Notably, observing and listening are essential for recognizing clients' non‐verbal cues and are key elements in forming a professional relationship (Park and Oh 2018). The findings of this study are consistent with previous research showing that peer supporters go beyond merely sharing their own recovery experiences and strive to understand individuals multidimensionally by remaining open, demonstrating genuine interest, accompanying them like friends, and empathizing with them (Hyun et al. 2022). While previous studies have primarily emphasized the empathic attitudes and experience‐based support provided by peer supporters, this study further identified that peer supporters actively sought to recognize individuals' hidden motivations for recovery and personal strengths through questioning and careful observation. These findings suggest that peer support extends beyond simple emotional support, functioning as a relational caring process that explores individuals' potential for change and identifies recovery resources. Simultaneously, such close relational involvement may create challenges related to emotional burden and professional boundaries, as peer supporters continuously engage with the complex recovery experiences of individuals with SUDs (Hyun et al. 2022; Scannell 2021). Therefore, future peer supporter training programmes should include systematic instruction in active listening, nonverbal communication, reflective practice and boundary‐setting skills.

Second, PRCs acted as companions who progressed together with individuals with SUDs. To serve as companions, PRCs emphasized being present with individuals with SUDs throughout the recovery process as peers who face similar problems. They demonstrated patience with the pace of each individual's recovery and provided continuous support. These findings align with research reporting that PRCs, in the role of recovery companions, help reduce social isolation and strengthen the sense of belonging among individuals with SUDs (Sulaiman et al. 2024). Accompanying and supporting individuals as companions during the recovery journey represents a unique approach that PRCs can offer (Hyun et al. 2022). This approach can contribute to increased self‐efficacy and motivation for recovery among individuals with SUDs (Norton et al. 2025). However, PRCs may sometimes experience confusion about their role and identity because they are neither therapists nor patients (Hyun et al. 2022). These findings highlight the importance of organizational support for role clarification, psychological well‐being and self‐care among PRCs.

Third, PRCs acted as navigators by applying their personal experiences to support individuals with SUDs in their recovery practice. They shared useful data and information based on their experiences and personal stories, and introduced and connected individuals to recovery resources. In this process, they sought plans and solutions that addressed the specific characteristics of individuals with SUDs. Their efforts also included promoting their own growth and serving as role models. For example, they learned and practised methods that they could recommend to individuals with SUDs. This approach is similar to the experience of PRCs who support individuals with gambling addiction (Jang and Chun 2021). In Jang and Chun's (2021) study, PRCs acted as role models in self‐help meetings or group counselling sessions and taught peers self‐care methods applicable in daily life, such as recognizing relapse triggers, stress management and relapse prevention strategies tailored to each individual. Such experiences allowed PRCs to find broader meaning in recovery for themselves, including joy from helping others, personal growth and living a richer life with a deeper realization of the meaning of life.

The practical experience and empathy provided by PRCs play an important role in strengthening motivation for recovery among individuals with SUDs (Bassuk et al. 2016). Peer support can also lead to positive outcomes for individuals with SUDs, including reduced relapse rates, increased treatment retention rates and improved social support (Bassuk et al. 2016), as well as increased treatment participation (Reif et al. 2014) and improved quality of life (Reif et al. 2014). One‐to‐one involvement by a PRC has been shown to reduce the use of illicit drugs such as cocaine and heroin, and to increase the rate of abstinence from these substances (Reif et al. 2014). Various studies show that PRCs refer individuals with SUDs to specialized centres or seek professional help when the need arises or when the problem exceeds their own capabilities. To do this, PRCs must accurately understand their own care competencies and have information about various referral centres. These findings suggest the importance of clearly defined scopes of practice, appropriate training and accessible referral pathways to support PRCs when individuals require services beyond their competencies.

Fourth, PRCs served as facilitators of recovery. Swanson (1993) described ‘enabling’ as the process of facilitating a person's passage through life transitions and unfamiliar events, and enhancing the capacity for healing, growth and self‐care. In a similar context, by encouraging them to perform small tasks, assigning them minor responsibilities and providing positive feedback when they achieved goals, PRCs observed restoration of self‐confidence and growth among individuals with SUDs. This facilitator role contributes to the patient's dignity, empowerment and psychological stability (Al Yasin 2023). Providing continuous encouragement and positive feedback during the recovery process for individuals with SUDs increases self‐confidence and self‐efficacy and prevents relapse (Tracy and Wallace 2016). The findings of this study are consistent with previous research reporting the recovery‐promoting effects of peer support (Bassuk et al. 2016; Reif et al. 2014). However, this study differs by highlighting the importance of a relational caring process that continuously supports and reinforces individuals' small changes and daily practices, moving beyond the functional role of simply improving recovery outcomes. Specifically, previous studies have often explained the effects of peer support using outcome‐oriented indicators, such as treatment retention and relapse reduction (Reif et al. 2014). In contrast, this study found that the process through which peer supporters recognized and repeatedly reinforced individuals' everyday efforts and potential for change itself functioned as an important mechanism of recovery. These findings suggest that addiction recovery is not merely a short‐term behavioural change, but rather a process that develops through continuous support and interaction. However, such ongoing relational engagement may also contribute to role ambiguity, as peer supporters navigate between being supportive peers and quasi‐professional helpers. Previous studies have reported that peer supporters may experience emotional burden and role burnout as they become deeply involved in individuals' recovery processes (Williams 2021). Therefore, to enable peer supporters to consistently fulfil their role as recovery facilitators, support systems for peer supporters themselves—including self‐care, role clarification and regular supervision—should also be provided, alongside support for individuals with SUDs.

Fifth, PRCs aimed to maintain positive attitudes toward individuals with SUDs. These findings are consistent with previous studies reporting that peer supporters' provision of hope and positive attitudes plays an important role in the recovery process (Scannell 2021; Eddie et al. 2019). Concurrently, some previous studies have suggested that peer supporters may experience emotional exhaustion or relational tension when they hold excessive expectations regarding recovery and encounter relapse among individuals (Williams 2021). However, in this study, participants attempted to maintain belief in individuals' potential for recovery and continued to support them, rather than blaming or giving up on them, even in situations involving relapse or delayed change. Additionally, they demonstrated attitudes that respected individuals' choices and recovery pace rather than insisting on their own approaches. Such attitudes may help peer supporters understand and accept relapse as part of the recovery process rather than as a failure, thereby reducing emotional exhaustion and relational tension. Therefore, future peer supporter training programmes should include education that strengthens recovery‐oriented attitudes that value and respect individuals' recovery potential, while helping peer supporters understand relapse as part of the recovery process rather than as a failure.

6.1. Strengths and Limitations

A strength of this study is that it applied Swanson's caring theory (Swanson 1993) as a theoretical framework to systematically understand and structure the experiences of PRCs from a caring perspective. The findings provide insight into how PRCs engage in relational caring processes, including building trusting relationships, providing emotional support, facilitating recovery and maintaining hope throughout the recovery process.

Despite these strengths, this study has several limitations. First, as the participants were recruited from selected SUD‐related centres and the study was based on their experiences within these programmes, the transferability of the findings to other settings may be limited. Second, because the experiences of PRCs were examined specifically from a caring perspective, the findings may not represent the full range of PRC experiences. Third, the theory‐driven analysis may have directed researchers' interpretations toward predefined theoretical categories. As the data were interpreted primarily through Swanson's caring processes, sociocultural contexts and organizational or institutional challenges may not have been fully captured, and experiences that did not clearly align with the theoretical categories may have been underrepresented. Finally, because PRCs were recruited from diverse organizational settings, contextual differences in institutional policies, environments and client characteristics may not have been fully reflected in the analysis.

6.2. Implications for Nursing Practice

The findings suggest potential opportunities for collaboration between PRCs and nurses in SUD services. PRCs may contribute experiential knowledge, emotional support and recovery‐oriented perspectives, while nurses may contribute clinical perspectives related to assessment, risk recognition and referral to appropriate services. Potential forms of collaboration could include PRC education, supportive supervision, regular case conferences, shared recovery planning and the development of referral pathways for situations requiring clinical intervention. Such interdisciplinary collaboration may help integrate experiential and clinical perspectives while preserving the unique role of PRCs in recovery‐oriented care.

The findings also suggest that PRCs may benefit from clear role boundaries, practice‐oriented training and organizational support related to self‐care and burnout prevention. However, as this study did not evaluate nursing interventions, collaborative models, programme effectiveness or patient outcomes, these implications should be interpreted as potential directions for nursing practice rather than evidence of effectiveness. Further research is needed to develop and evaluate PRC–nurse collaborative models in SUD services.

6.3. Recommendations for Further Research

Future research could include larger and more diverse samples across different SUD service settings. To understand PRC roles from multiple perspectives, future studies may also include healthcare and community practitioners who collaborate with PRCs. In addition, studies are needed to develop and evaluate PRC–nurse collaborative models and examine their feasibility, effectiveness and potential influence on PRC and patient outcomes.

7. Conclusion

In this qualitative study, we examined the participation experience of PRCs in SUD services and programmes conducted in several SUD centres in South Korea. Five categories of care experience based on Swanson's (1993) middle‐range theory of caring were identified. The findings suggest that PRCs in SUD programmes can promote recovery among individuals with SUDs and support mutual growth. Furthermore, the study indicates that nurses need to play a central role from the PRC training process through programme implementation to ensure the success of SUD programmes.

The results provide clinically meaningful insights in the field of nursing, where patient‐centred care and team‐based practice are emphasized. PRCs, based on their lived experiences with mental health challenges and recovery, can offer crucial help for delivering personalized care. They serve as valuable collaborators in care teams and, at the same time, as care recipients maintaining their own recovery, requiring tailored nursing approaches. The findings of this study may contribute to the development of nursing intervention and online/offline programmes involving PRCs in the field of SUDs. Furthermore, the results offer significant information on how nursing can specifically support PRCs in maintaining their recovery, receiving adequate support and enhancing their competencies.

Author Contributions

Kyung Im Kang: conceptualization, investigation, funding acquisition, writing – original draft, methodology, validation, visualization, writing – review and editing, formal analysis, project administration, data curation, resources. Chan Mi Kang: writing – original draft, writing – review and editing, conceptualization, methodology, formal analysis.

Funding

This work was supported by National Research Foundation of Korea, NRF‐ 2021R1G1A1094282.

Ethics Statement

This study was conducted with the approval of the Institutional Review Board of Gyeongsang National University (IRB No. GIRB‐G23‐NY‐0041).

Consent

All participants provided written informed consent.

Conflicts of Interest

The authors declare no conflicts of interest.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.