Employment Trajectories of Recently Certified Peer Support Specialists: A Longitudinal Qualitative Analysis

Background: Recent work has highlighted the challenges and benefits that certified peer specialists (CPSs) experience in the workforce. While their work can lead to personal fulfillment and financial independence for CPSs, and improved mental health and substance use recovery outcomes for their clients, little is known about CPS employment trajectories or the circumstances that impact their early-career workforce involvement over time.Methods: This study used within- and across-case analyses of longitudinal data from qualitative interviews with 13 CPS that participated in a multistate, 3 year observational prospective cohort study of CPS graduates to explore employment changes and circumstances that led to these transitions. Qualitative results were organized according to whether cases were "employed as a CPS at follow-up" (N = 5) or "not employed as CPS at follow-up" (N = 8).Results: Participants "employed as a CPS" at follow-up held various positions following certification, and they shared a sense of optimism about their future work. At the second interview, most remained in the same positions they held at baseline and described personal fulfillment and a supportive work environment as reasons for remaining. Participants who were "not employed as a CPS" at follow-up were also not employed as a CPS at their baseline interview but aspired to pursue future CPS work. At their second interview, many remained unemployed due to poor health and disability, or described past traumatic experiences, stress, and burnout related to being a CPS as reasons for leaving the CPS work force. All participants were challenged to find work as a CPS at various moments in their trajectories.Conclusion: Results indicate that securing employment as a CPS was challenging for participants. Findings are discussed with implications for supporting CPS job seeking, well-being, and workforce retention.