Peer Counseling in hospitals: Empowering amputees

"Peers are partners at eye level," says Dagmar Marth. "They share your unique experience and are intimately familiar with the resulting fears and challenges." These qualities make them beacons of hope who provide encouragement and serve as role models for those who are new to this journey.

Dagmar Marth knows what she is talking about. She has worked as a peer counselor at the Unfallkrankenhaus Berlin (ukb) for many years. A million questions went through her mind when an accident 34 years ago led to amputation. "Back then, I had no idea where my life was headed and how I could possibly move on. My wounds were healing but my mental anguish was mounting." During this difficult time for Marth, there was no other amputee who could have encouraged her or offered advice. This is what led Marth to become a peer counselor.

Peer counseling is one of many support measures and coping strategies in the rehabilitation and recovery process. And there is a growing demand as about 60 to 70 percent of patients at the ukb hospital take advantage of this service. Currently, there are twelve peers at the ukb who counsel amputees. If the hospital needs more helpers, it has access to counselors from a collaborating self-help support group. "Unfortunately, there is currently no nationwide list or register of active peers for amputees," says Dr. Melissa Beirau from ukb. "However, the so-called peer maps from the Federal Amputee's Association of Germany (BMAB), the BMAB website with its contacts or the peer map provided by the German Social Accident Insurance (DGUV) are very helpful tools."

Something that was still in the works back in 2015 when we first sat down with Dagmar Marth for a We asked Interview has now become reality: Beirau is happy to report that nationwide expansion of peer counseling for amputees has now been achieved – thanks to the extensive efforts of ukb, BMAB and countless self-help support groups. The DGUV's peer map also shows that peer counseling has made its way into the (chronic) disease realm – where counseling services are now a fixture for conditions such as multiple sclerosis, spinal cord injuries, burn injuries, cancer and mental illnesses. Beirau says, "The number of contacts and collaboration between peer support agencies is increasing. The Hospital Peers (PiK) are in close contact with the German Paraplegic Association (FGQ e.V.)." Nevertheless, peer providers still have to improve their networking and teamwork. Beirau also points out that the general public needs to be made more aware of peer counseling services. "Affected patients need easier and faster access to explicit contacts and respective resources," Beirau adds. "Another challenge is to establish a contact in hospitals and clinics to ensure prompt access to support services."

There are many real-world examples that illustrate the importance of finding and talking with someone who is in the same boat – and preferably do so immediately after the amputation. Theresa T. wasn’t able to get this type of support until she changed prosthetic providers because her prosthetic limb caused her tremendous pain. She wanted to get a second opinion but was very cautious when she first came to ukb and Dagmar Marth. "Back then, I had to stop going to college, which was a devastating setback for me," says Theresa T. She was anxious about the new fitting process and wondered if and how soon this would improve her situation. When she talked with Dagmar Marth, Theresa T. felt like she could ask her anything. "One year after my amputation, this marked the first time I met another female amputee who also had a very short residual stump. What a blessing it was to find someone to talk to about the pain, the problems, my fears and hopes and knowing we shared a similar experience. I felt so understood. She encouraged me and I lost my fear of new things and changes. It boosted my energy and allowed me to collaborate in achieving the best fit for my prosthetic limb."

Based on their own experience, peers like Dagmar Marth have an understanding and empathy that allows them to show ways and solutions that those who are not affected could not possibly think of in situations like this. Marth points out that she and her colleagues can primarily provide authentic emotional support to both the affected person and their family members. Theresa T. brought her mother along twice to join her conversations with Dagmar Marth and immediately realized how much she needed and enjoyed the exchange and compassion. After numerous counseling sessions, the student noticed how this prompted some changes in her life. "I feel much calmer now. I know that I am on the right path and learned to accept that amputation and prosthetic fitting are a lifelong continuous learning process." She credits the conversations with her peer counselor for her new perspective on life.

Stories and progress like this are why Dagmar Marth loves her job. It allows her to support others during tough times in their lives and offer positive encouragement. Yet at the end of the day, her message is always the same: "You can live a happy and fulfilling life after amputation."