Fully comprehends the substance use disorder (SUD) peer recovery role and duties through core peer training, their lived recovery experience, and behavioral health occupational experience.

1. Has recovery experience as an individual who identifies as a person being in recovery from a substance use disorder.
2. Has occupational experience as a peer, and/or other substance use disorder behavioral healthcare experience.
3. Has completed the core substance use disorder peer training.

Emphasized peer workers’ ability to initiate and develop on-going relationships with people who have behavioral health condition and/or family members. These competencies include interpersonal skills, knowledge about recovery from behavioral health conditions and attitudes consistent with a recovery orientation.

1. Initiates contact with peers
2. Listens to peers with careful attention to the content and emotion being communicated
3. Reaches out to engage peers across the whole continuum of the recovery process
4. Demonstrates genuine acceptance and respect
5. Demonstrates understanding of peers’ experiences and feelings

Provide the mutual support people living with behavioral health conditions may want.

1. Validates peers’ experiences and feelings
2. Encourages the exploration and pursuit of community roles
3. Conveys hope to peers about their own recovery
4. Celebrates peers’ efforts and accomplishments
5. Provides concrete assistance to help peers accomplish tasks and goals

As most roles in behavioral health services do not emphasize or even prohibit the sharing of lived experiences. Peer workers need to be skillful in telling their recovery stories and using their lived experiences as a way of inspiring and supporting a person living with behavioral health conditions. Family peer support worker likewise share their personal experiences of self-care and supporting a family-member who is living with behavioral health conditions.

1. Relates their own recovery stories, and with permission, the recovery stories of others’ to inspire hope
2. Discusses ongoing personal efforts to enhance health, wellness, and recovery
3. Recognizes when to share experiences and when to listen
4. Describes personal recovery practices and helps peers discover recovery practices that work for them

These competencies help peer workers to tailor or individualize the support services provided to and with a peer. By personalizing peer support, the peer worker operationalizes the notion that there are multiple pathways to recovery.

1. Understands his/her own personal values and culture and how these may contribute to biases, judgments and beliefs
2. Appreciates and respects the cultural and spiritual beliefs and practices of peers and their families
3. Recognizes and responds to the complexities and uniqueness of each peer’s process of recovery
4. Tailors services and support to meet the preferences and unique needs of peers and their families

These competencies enable peer workers to support other peers to take charge of their lives. Recovery often leads people to want to make changes in their lives. Recovery planning assists people to set and accomplish goals related to home, work, community and health.

1. Assists and supports peers to set goals and to dream of future possibilities
2. Proposes strategies to help a peer accomplish tasks or goals
3. Supports peers to use decision-making strategies when choosing services and supports
4. Helps peers to function as a member of their treatment/recovery support team
5. Researches and identifies credible information and options from various resources

These competencies assist peer workers to help other peers acquire the resources, services, and supports they need to enhance their recovery. Peer workers apply these competencies to assist other peers to link to resources or services both within behavioral health settings and in the community. It is critical that peer workers have knowledge of resources within their communities as well as on-line resources.

1. Develops and maintains up-to-date information about community resources and services
2. Assists peers to investigate, select, and use needed and desired resources and services
3. Helps peers to find and use health services and supports
4. Accompanies peers to community activities and appointments when requested
5. Participates in community activities with peers when requested

These competencies describe how peer workers coach, model or provide information about skills that enhance recovery. These competencies recognize that peer workers have knowledge, skills and experiences to offer others in recovery and that the recovery process often involves learning and growth.

1. Educates peers about health, wellness, recovery and recovery supports
2. Participates with peers in discovery or co-learning to enhance recovery experiences
3. Coaches peers about how to access treatment and services and navigate systems of care
4. Coaches peers in desired skills and strategies
5. Educates family members and other supportive individuals about recovery and recovery supports
6. Uses approaches that match the preferences and needs of peers

These competencies assist peer workers to identify potential risks and to use procedures that reduce risks to peers and others. Peer workers may have to manage situations, in which there is intense distress and work to ensure the safety and well-being of themselves and other peers.

1. Recognizes signs of distress and threats to safety among peers and in their environments
2. Provides reassurance to peers in distress
3. Strives to create safe spaces when meeting with peers
4. Takes action to address distress or a crisis by using knowledge of local resources, treatment, services and support preferences of peers
5. Assists peers in developing advance directives and other crisis prevention tools

These competencies provide guidance on how peer workers interact verbally and in writing with colleagues and others. These competencies suggest language and processes used to communicate and reflect the value of respect.

1. Uses respectful, person-centered, recovery-oriented language in written and verbal interactions with peers, family members, community members, and others
2. Uses active listening skills
3. Clarifies their understanding of information when in doubt of the meaning
4. Conveys their point of view when working with colleagues
5. Documents information as required by program policies and procedures
6. Follows laws and rules concerning confidentiality and respects others’ rights for privacy

These competencies provide direction on how peer workers can develop and maintain effective relationships with colleagues and others to enhance the peer support provided. These competencies involve not only interpersonal skills but also organizational skills.

1. Works together with other colleagues to enhance the provision of services and supports
2. Assertively engages providers from mental health services, addiction services, and physical medicine to meet the needs of peers
3. Coordinates efforts with health care providers to enhance the health and wellness of peers
4. Coordinates efforts with peers’ family members and other natural supports
5. Partners with community members and organizations to strengthen opportunities for peers
6. Strives to resolve conflicts in relationships with peers and others in their support network

These competencies describe actions that peer workers use to provide leadership within behavioral health programs to advance a recovery-oriented mission of the services. They also guide peer workers on how to advocate for the legal and human rights of other peers.

1. Uses knowledge of relevant rights and laws (ADA, HIPAA, Olmstead, etc.) to ensure that peer’s rights are respected
2. Advocates for the needs and desires of peers in treatment team meetings, community services, living situations, and with family
3. Uses knowledge of legal resources and advocacy organization to build an advocacy plan
4. Participates in efforts to eliminate prejudice and discrimination of people who have behavioral health conditions and their families
5. Educates colleagues about the process of recovery and the use of recovery support services
6. Actively participates in efforts to improve the organization
7. Maintains a positive reputation in peer/professional communities

These competencies describe how peer workers become more reflective and competent in their practice. The competencies recommend specific actions that may serve to increase peer workers’ success and satisfaction in their current roles and contribute to career advancement.

1. Recognizes the limits of their knowledge and seeks assistance from others when needed
2. Uses supervision (mentoring, reflection) effectively by monitoring self and relationships, preparing for meetings and engaging in problem-solving strategies with the supervisor (mentor, peer)
3. Reflects and examines own personal motivations, judgments, and feelings that may be activated by the peer work, recognizing signs of distress, and knowing when to seek support
4. Seeks opportunities to increase knowledge and skills of peer support

Understands and supports the philosophy of recovery management and recovery oriented systems of care (ROSC), including, but not limited to: hope, self‐disclosure, mutuality, person‐first language, self‐determination, empowerment, many pathways and styles of recovery, fostering independence, utilizes strength‐based approach, addressing stigma & oppression, providing stage of change appropriate support, client choice, and advocacy.

1. Understands the importance of instilling hope, often facilitated through appropriate self‐disclosure, and mutuality. Supervisor defines appropriate self‐disclosure.
2. Uses person‐first language while simultaneously acknowledging the value of the substance use disorder recovery identity (“addict” and “alcoholic”) for those who choose their own terms of self‐identification.
3. Promotes self‐determination avoiding the culture of diagnosis and labeling.
4. Supports concepts of self‐efficacy and empowerment.
5. Honors client choice, many pathways to recovery, self‐direction, and person‐centered recovery planning.
6. Supports fostering independence versus dependence, including employment assistance and overcoming barriers to independent living.
7. Recognizes recovery capital/assets, natural supports, inclusion of family, friends and allies, and a strengths‐based approach to supporting recovery.
8. Recognizes the imperative of addressing discrimination, oppression, and stigma, and its transformative power in recovery.
9. Acknowledges the importance of client advocacy and that peer staff are “in” but not “of” the system.
10. Supports informed consent and client choice regarding the use of behavioral health medications. Supervisor assists peer staff in maintaining neutrality regarding prescribed behavioral health medications and the importance of operating within scope of practice.
11. Understands that recovery support services are non‐linear services, occurring pre‐treatment, during treatment, and post‐treatment. For some, Peer Delivered Services could also be an alternative to professional treatment, particularly those with low to moderate problem severity and moderate to high recovery capital.
12. Recognizes that individuals receiving peer services are active agents of change in their lives and not passive recipients of services.

Understands Trauma‐Informed Care, social and health care equity, and incorporates that understanding into their supervision practices, peer programming, and administration. Supervisor acknowledges trauma experienced by historically oppressed and/or underserved populations (ethnic & cultural minorities, those with mental health challenges, those with addiction, sexual minorities, those in poverty, those experiencing homelessness, those who are disabled, including disabled veterans).

1. Recognizes the consequences of trauma on individuals, families and communities, including, but not limited to: physical health, psychological health and well‐being, occupational performance, and parenting. Supervisor recognizes the consequences of institutional and societal trauma and its impacts on social determinants of health.
2. Understands models of trauma‐informed care and best practices for varied populations. Supervisor assist peers in developing skills to express empathic understanding and validate traumatic experiences, oppression, institutional, and judicial bias experienced by vulnerable populations that have been historically stigmatized and marginalized.
3. Recognizes the traumatic challenges faced by vulnerable populations (poverty, ethnic/cultural minorities, sexual minorities, disabilities, homelessness, military experience, or other vulnerabilities).
4. Aware of specific health care disparity data of vulnerable populations in the local community and local systems of care. Supervisor promotes health equity in multiple ways, including overcoming barriers to diversity within organizations and eliminating health disparities among behavioral health populations.
5. Cognizant of his or her own biases and the institutional biases within organizations in which they work.
6. Promotes trauma awareness among peer staff, peer‐delivered services programming, and the greater behavioral health system in which they work.
7. Addresses discrimination, stigma, and shame experienced by vulnerable populations, creating and promoting a culture of safety within the agency and peer‐delivered services environment.

Acknowledges that requisite entry-level education is modest and that their role includes ongoing training & education, including coaching/mentoring peers regarding: competencies, skills development, documentation, data collection systems, ethical standards, professional boundaries, community resources, applicable laws, and client rights.

1. Has the capacity to provide education and ongoing coaching on a variety of topics, and understands basic principles of adult learning strategies.
2. Designs and implements ongoing education in staff meeting formats, agency in‐services, and individual instruction/coaching as indicated.
3. Provides ongoing education/training/coaching regarding: documentation standards and data entry systems, motivational enhancement techniques/micro‐skills, outreach, engagement, rapport‐ building, peer competencies (SAMHSA, IC&RC, etc.), regulations, legal compliance, ethics, professional boundaries, cultural awareness, self‐care, and community resources.
4. Supports peer staff in obtaining ongoing training to advance their personal efficacy and competencies in delivering peer support services through participation in classes, conferences, webinars, and other forms of education and training.

Assists peer staff in understanding the greater behavioral health system and its relationship to health care, allied providers, courts, child welfare, and entitlement programs. Supervisor assists peer staff in understanding the etiquette, procedures, and legal obligations of working with community partners (Courts, Child Welfare, TANF, WIC, SNAP, Probation/Parole, Addiction Treatment, and Psychiatric Institutions.)

1. Assists peer staff in understanding the etiquette, procedures, and legal obligations for cooperative working relationships with Child Welfare. Supervisor orients peer staff to their role within the child welfare system: family court, case workers, protective services, foster care, ASFA timelines, termination of parental rights, alternate plans, limitations to confidentiality, and completing appropriate documentation for child welfare agencies.
2. Assists peer staff in understanding the etiquette, procedures, and legal obligations for cooperative working relationships with Courts, Probation, and Parole. Supervisor will orient peer staff to their role and participation within courtroom proceedings, the Department of Corrections, forensic peer services, court expectations, common violations, limitations of confidentiality and completing appropriate documentation required by to probation/parole and the courts.
3. Assists peer staff in understanding the etiquette and procedures for cooperative working relationships with various entitlement programs. Supervisor orients peer staff to self‐sufficiency services (employment services, Vocational Rehabilitation, Medicaid enrollment, TANF, SNAP, WIC, Assurance Wireless, etc.) and regulatory compliance issues involved in working with these services.
4. Assists peer staff in understanding the etiquette, procedures, and legal obligations for cooperative working relationships with addiction treatment. Supervisor orients peer staff regarding the nature of addiction treatment services, expectations, legal compliance, treatment completion status, abstinence requirements/court orders, DUI, DMV completion certificates, addiction treatment client rights, urine drug testing, other drug screening, and consequences of non‐attendance/substance use.
5. Assists peer staff in understanding the etiquette, procedures and legal obligations for cooperative working relationships with traditional mental health institutions. Supervisor orients peer staff to the nature of traditional mental health services, involuntary commitment, social security disability, payee services/representative payees, mental health client rights, the use of psychiatric medications, and abusable medications (anxiolytics, ADHD medications), and client choice regarding medications.
6. Assists peer staff in understanding the etiquette, procedures, and legal obligations for cooperative working relationships with Medication Assisted Treatment services. Supervisor orients peer staff to the nature of Medication Assisted Treatment, Methadone, Suboxone, Vivitrol, addiction treatment client rights, anticipated effects from changes in medication dosage, ADA protections, and outcome research supporting the use of MAT.
7. Assists peer staff in understanding the etiquette, procedures and legal obligations for cooperative working relationships with primary care providers. Supervisor orients peer staff regarding the nature of primary care services, scope of practice regarding medicine and medical advice, pretreatment peer support, and HIPAA.
8. Audits peer staff documentation to allied health care and governmental agencies and coach peers with writing skills and documentation practices appropriate to circumstances and congruent with client rights and protections.

Awareness of all relevant laws and can advise peers regarding the application of those laws in their peer work (CFR 42 p.II, HIPAA, Mandatory Reporting, ADA, Civil Rights, Fair Housing, Medicaid Fraud).

1. Advises peer staff regarding the applicability of confidentiality regulations HIPAA and Code of Federal Regulation 42, Part II in their cases. Supervisor is available to discuss disclosures, releases of information, items to be discussed, responding to subpoenas and permissible disclosures within the exceptions to confidentiality (medical emergency, QSOA, crime on premises or against Peer Delivered Services program personnel, duty to warn, child/elder abuse, research, audit, court order, medical emergency), restrictions, and notice of prohibitions on re‐disclosure.
2. Advises peer staff regarding the applicability of Mandatory Reporting Guidelines and their obligations to report suspected child abuse.
3. Advises peer staff regarding the applicability of the Americans with Disabilities Act, reasonable accommodations, and those participating in Medication Assisted Treatment as a protected class under the ADA.
4. Advises peer staff regarding the applicability of the Civil Rights Act of 1964 and the principles of non‐discrimination.
5. Advises peer staff regarding the applicability of Medicaid Fraud reporting, investigations, and legal consequences.
6. Advises peer staff regarding the applicability of the Fair Housing Act and protections for those participating in addiction and recovery services and those participating in Medication Assisted Treatment.
7. Monitors relevant service obligations specific to the contracts/conditions provided by funders including reporting criteria and schedules, service restrictions, special requirements, and respecting their legal and regulatory obligations.
8. Supports, advises, and develops policies regarding accommodations for those with other special needs, language barriers, literacy challenges, and other impediments.

Peer Specialist facilitates finding and sharing community resource information through organizational resource libraries, binders, databases, and other research methods. Supervisor models appropriate use of community resources.

1. Assists peer staff in maintaining access to community resource directories and facilitates the sharing of community resource information within the team.
2. Assists peer staff in developing referral relationships with varied community resources, including indigenous recovery support resources that are not part of the traditional health and human services system.
3. Provides means for the development and ongoing maintenance of a resource library/directory and/or access to community resource information (e.g., computer access, notebooks/binders, and directories.)
4. Models methods for seeking and understanding community resources and models the appropriate use of community resources. For example, supervisor discourages peers from using inpatient addiction or psychiatric treatment as a “housing” program for individuals who are experiencing homelessness. Moreover, supervisor discourages the fraudulent acquisition of resources, encouraging peers to model “practicing an honest program” with their clients.

Includes but is not limited to: • CRPA work environments • In-person communication skills • Telephone skills • Electronic health records