What Peer Counseling Is and Why Cancer Patients Need It
After receiving an oncology diagnosis, many – in fact, all – patients require emotional support. They need to learn to cope with stress, adapt to a new reality, and fight for their lives. In other countries, the institution of peer counselors exists for this purpose. These are individuals who have overcome the disease themselves and are willing to help others with their experience, free of charge. Ekaterina Bashta, director of the «Alexandra» charitable foundation, which provides peer counseling for cancer patients, spoke to Kommersant correspondent Olga Allenova about what it is and why this type of assistance needs to be developed in Russia.
In 2023, just over 674,000 new cases of malignant neoplasms were detected in Russia. By the end of 2023, over 4.1 million people were under medical surveillance in the country (compared to just over 3.9 million in 2021).
The Importance of Peer Counseling
Peer counseling first emerged in the 19th century in psychiatric clinics, where former patients supported new ones. Later, peer counseling became standard practice in the US and Europe across various fields – among people with HIV and oncology patients, in psychiatry, and in communities dealing with different addictions. In oncology, we were the first in Russia. We learned from HIV communities, who started their work in the country nearly 40 years ago and remain leaders in this practice.
It does not replace a doctor or a psychologist, but this format creates a level of trust that is often lacking in the medical system.
The patient sees before them a person with the same diagnosis who managed to return to a normal life, and they believe that they too will recover and help others. This provides a significant positive energy boost.
Evolution of the Alexandra Foundation`s Approach
Our foundation is the successor to a support program for women with breast cancer that began in 2009 as part of the «Joint» fund. The fund primarily worked with the Jewish community but always had one charitable program outside religious or national focus. It was supported by an American foundation specializing in helping women with breast cancer. Initially, these were simply mutual support groups: women who had completed treatment assisted those who were just beginning. The program operated not in Moscow but in smaller towns. We sought individuals willing to openly discuss their illness, which was very difficult at the time. When «Joint» decided to conclude the project, our team agreed to take it over and transitioned under the wing of Oleg Deripaska`s «Volnoe Delo» fund, where we worked for a long time thanks to the support of Polina Deripaska (Yumasheva). In 2018, she created a separate fund for us – «Alexandra». Initially, we only helped women with breast cancer, then women with oncogynecological issues, and subsequently, all adult oncology patients.
Gradually, we moved from group support to individual counseling. We began training people who had completed treatment so they could help other patients. Peer counseling is not just «talking about life» but work with established rules and clear ethical boundaries.
How Peer Counseling Works
We have three key areas of focus. The first is «Peer School»: these are training courses for volunteer counselors. We have a strict selection process: individuals who completed treatment less than a year ago are not accepted. The second area is the peer counseling service itself. Not everyone who attends the «Peer School» joins this service, only those who are certain they want to dedicate themselves to it. Volunteer counselors undergo internships after training and then receive regular supervision. Currently, about 100 people work in the peer counseling service; we have a telephone hotline, a chatbot, and an application process via our website, so anyone can contact us.
And the third vector of our work is training teams from other organizations that wish to develop this area of support.
What a Peer Counselor Can Help With
A peer counselor provides two types of assistance. The first is emotional: «I understand, I have been through this too.» Such participation is very important because even someone with good support might feel isolated.
Recently, a patient – a top manager, a person with significant resources – shared her experience: «I simply replayed the consultant`s voice several times. It was living proof that my illness was not the end.»
The second type of assistance is informational. Counselors help navigate the treatment path, introduce reliable sources of information, explain how to get opinions from specialists at federal medical centers without leaving one`s home region, and share links to communities of patients with oncological diseases. We do not give medical advice or recommend specific doctors, but we have an up-to-date knowledge base: clinical guidelines for treating various types of oncology, a list of clinics, and mechanisms for accessing these institutions.
Complementing Psychological Support
No, peer counseling cannot replace full psychological support. These are different spheres of assistance. However, in conditions of limited access to psychological help, peer counseling can fulfill an important social task – reducing a person`s anxiety, saving them from isolation, and increasing their activity. Moreover, the cost of a peer consultation for the foundation is 800 RUB, while a psychologist`s consultation costs 3-5 thousand RUB.
Reach and Growth
Last year, we conducted over 5,000 consultations, providing support to about 3,300 people – many of whom contacted us repeatedly. The number of requests grows every year.
People learn about us through word-of-mouth, various communities, and personal recommendations.
The demand for peer counseling is still forming – the general public is not yet fully aware of what it is and how it differs from psychological help.
However, within the active patient community, it is already a well-understood and sought-after format.
Duration of Support
It varies. Sometimes, one conversation is enough; sometimes, several months are needed. But a counselor should not become a permanent «crutch.» Their task is to help the person rely on themselves, provide understanding of the path, and build confidence. We emphasize this in counselor training.
Funding the Foundation
Our annual budget is around 14-15 million RUB. We are not growing, but we are maintaining our level. After our main donor could no longer financially support the foundation, we had to build our funding system from scratch.
Until 2022, Polina (Yumasheva) supported us – she was both a founder and the main donor. After ceasing to be our donor, she joined the foundation`s board of trustees, which is important to us.
We receive small grants, donations from business partners – primarily pharmaceutical companies. It`s important for them that patients are active, understand their treatment, and know their rights. This also protects their interests. We are developing donations from individuals, but it`s not easy: we don`t provide targeted assistance; all donations go towards specialists` salaries and organizing the work. We have only two full-time employees and seven others on civil contracts: coordinators, trainers, supervisors.
We also participate in competitions – for example, we recently applied for a presidential grant.
Prospects for Peer Counseling in Russia
I am confident that the prospects are immense. Last year, we conducted a survey among oncology patients – involving about 1,000 people – and 85% reported needing positive experiences and information from other patients, 50% stated they lacked sufficient information about their disease and treatment at the time of diagnosis, and 36% admitted they did not have the necessary information throughout the entire treatment process. Meanwhile, 82% of patients received the information they needed about treatment from other patients or their relatives. This indicates that the need for peer counseling is very high.
We strongly hope that peer counseling will be recognized at the state level.
Yes, we hope it becomes part of social protection. It is cheaper than psychological help and addresses many people`s needs. At the invitation of the «Starost v Radost» charitable foundation, we have already participated in training social protection specialists from 40 regions.
Together with the E.V.A. association and the «Dusha Mamy» center, we have created a large professional community called «Ravnye Zdes» (Peers Here). We have developed an ethical code and are discussing a unified standard for training peer counselors. 71 organizations have already registered on our website as participants.
We want to prove that peer counseling is a professional practice, albeit a volunteer one. On October 31st, we and our partners will host the «Ravny Fest» for the third time – a conference for everyone involved in peer support in Russia. Today, the «Ravnye Zdes» community unites over 600 people from 71 Russian NGOs developing peer counseling in various fields – oncology, HIV, rheumatology, psychiatry, as well as in adoptive parenting and motherhood. I hope that together we will be able to ensure that peer counseling becomes part of the state support system for people in difficult life situations.
