January 23, 2020

Peer Support Core Competencies

The TTA Center has used three key sources to compile a comprehensive list of peer support competencies.

Peer Support Core Competencies

SAMHSA​ ​has led​ ​the​ ​effort​ ​to​ ​identify​ ​the ​​ ​core competencies​ ​needed​ ​by​ ​anyone​ ​who​ ​provides​ ​peer​ ​support​ ​services​ ​to​ ​people​ ​with​ ​or​ ​in recovery​ ​from​ ​a​ ​mental​ ​health​ ​or​ ​substance​ ​use​ ​condition​ (​​SAMHSA,​ ​2015)​, which built upon earlier work by local and national peer-run and peer-led organizations that defined peer practice, its philosophies, and guidelines.  Additionally, the International Certification & Reciprocity Consortium (IC&RC) has identified four domains that underpin the peer specialist certification exams in 28 States and territories.  Lastly, the Regional Facilitation Center (Portland, OR) developed a best practices curriculum that focuses on practices associated with forensic peers who are in recovery from addiction, adjudication, and criminogenic thinking/lifestyles. The ten practices identified have concomitant competencies that were founded on a review of the existing literature, supporting research, and the experience of subject matter experts.

The BJA COAP PRSS TTA Center has used the sources above to compile a comprehensive list of peer support competencies. The list uses the SAMHSA categories and ​core competencies​ as its base; items from the other sources were added under the corresponding SAMHSA categories.

Category 1.  Engages​ ​peers​ ​in​ ​collaborative​ ​and​ ​caring​ ​relationships
This​ ​category​ ​of​ ​competencies​ ​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
  6. Establishes and maintains a peer relationship rather than a hierarchical relationship. (ICRC Domain 3: Mentoring and Education)
  7. Establishes a respectful, trusting relationship with the individual (ICRC Domain 3: Mentoring and Education)
  8. Recognizes and use person-centered language (ICRC Domain 1: Advocacy)
  9. Inspires hope and change (Regional Facilitation Center, Best Practice)
    ..1.Fulfills the role of a trusted and supportive guide

Category 2. Provides​ ​support
The​ ​competencies​ ​in​ ​this​ ​category​ ​are​ ​critical​ ​for​ ​the​ ​peer​ ​worker​ ​to​ ​be​ ​able​ ​to​ ​provide​ ​the mutual​ ​support​ ​people​ ​living​ ​with​ ​behavioral​ ​health​ ​conditions​ ​may​ ​want.

The competencies in this category are critical for the peer worker to be able to 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
  6. Assists the individual in identifying and establishing positive relationships (ICRC Domain 3: Mentoring and Education)
  7. Assists the individual in identifying support systems (ICRC Domain 4: Recovery/Wellness Support)
  8. Practices a strengths‐based approach to recovery/wellness (ICRC Domain 4: Recovery/Wellness Support)

Category 3. Shares​ ​lived​ ​experiences​ ​of​ ​recovery
These​ ​competencies​ ​are​ ​unique​ ​to​ ​peer​ ​support,​ ​as​ ​most​ ​roles​ ​in​ ​behavioral​ ​health​ ​services do​ ​not​ ​emphasize​ ​or​ ​even​ ​prohibit​ ​the​ ​sharing​ ​of​ ​lived​ ​experiences.​ ​Peer​ ​workers​ ​must​ ​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
  5. Serves as a role model for an individual (ICRC Domain 3: Mentoring and Education)
  6. Educates through shared experiences (ICRC Domain 3: Mentoring and Education)
  7. Inspires hope and change (Regional Facilitation Center, Best Practice 6)
    ..1.Understands the meaning of the statement, “I am the evidence that..."
    ..2.Understands the fears associated with re-integration and help resolve those fears through shared lived experience
    ..3.Acts as role models, and as a testament to changes in thinking
    ..4.Exercises discernment when deciding which stories to share

Category 4.  Personalizes​ ​peer​ ​support
These​ ​competencies​ ​help​ ​peer​ ​workers​ ​to​ ​tailor​ ​or​ ​individualize​ ​the​ ​support​ ​services​ ​provided to​ ​and​ ​with​ ​a​ ​peer.​  ​By​ ​personalizing​ ​peer​ ​support,​ ​the​ ​peer​ ​practitioner​ ​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
  5. Applies the principles of individual choice and self‐determination (ICRC Domain 1: Advocacy)
  6. Recognizes that there are multiple pathways to recovery/wellness. (ICRC Domain 4: Recovery/Wellness Support)
  7. Assists the individual to identify and build on their strengths and resiliencies (ICRC Domain 4: Recovery/Wellness Support)
  8. Elicits individual needs and goals (Regional Facilitation Center, Best Practice 5)
    ..1.Creates an environment where individuals feel safe acknowledging areas where they need improvement
    ..2.Assists individuals to identify their experience personal characteristics strengths, and skills necessary to develop success
    ..3.Helps individuals clarify goals and develop desistance strategies

Category 5. Supports​ ​recovery​ ​planning
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
  6. Assists the individual with setting goals (ICRC Domain 4: Recovery/Wellness Support)
  7. Applies effective coaching techniques such as Motivational Interviewing (ICRC Domain 4: Recovery/Wellness Support)
  8. Recognizes the stages of change (ICRC Domain 4: Recovery/Wellness Support)
  9. Recognizes the stages of recovery/wellness (ICRC Domain 4: Recovery/Wellness Support)
  10. Assists the individual in identifying basic needs (ICRC Domain 4: Recovery/Wellness Support)
  11. Elicits individual needs and goals (Regional Facilitation Center, Best Practice 5)
    ..1.Encourages broad and ambitious thinking about future goals and achievements

Category 6. Links​ ​to​ ​resources,​ ​services,​ ​and​ ​supports
These​ ​competencies​ ​assist​ ​peer​ ​workers​ ​to​ ​help​ ​other​ ​peers​ ​acquire​ ​the​ ​resources,​ ​services, and​ ​supports​ ​they​ ​need​ ​to​ ​enhance​ ​their​ ​recovery.​ ​peer​ ​practitioners​ ​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​ ​practitioners​ ​have​ ​knowledge​ ​of resources​ ​within​ ​their​ ​communities​ ​as​ ​well​ ​as​ ​online​ ​resources.

  1. Develops and maintains up-to-date information about community resources and services
  2. Assists peers to identify (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
  6. Provides resource linkage to community supports and professional services (ICRC Domain 3: Mentoring and Education)
  7. Develops tools for effective outreach and continued support (ICRC Domain 4: Recovery/Wellness Support)
  8. Collaborates with individual to identify, link, and coordinate choices with resources (RC Domain 1: Advocacy)
  9. Addresses barriers to housing (Regional Facilitation Center, Best Practice 3)
    ..1.Aware of barriers individual face, such as homelessness
    ..2.Understands that housing weighs heavily on individuals re-entering society
    ..3.Stays up-to-date on housing availability, programs that assist with deposits and move-in fees, re-entry program that provide transitional housing
    ..4.Knows civil rights, fair housing laws, and legal protections for persons with criminal histories
    ..5.Collects information and makes appropriate referrals
    ..6.Assist individuals with self-advocacy
  10. Addresses barriers to employment (Regional Facilitation Center, Best Practice 4)
    ..1.Understands the importance of employment for those re-entering society
    ..2.Addresses employment challenges that include the development of job readiness skills and access to professional attire
    ..3.Facilitate job application process: gathering supportive documents, filling out applications, writing resumes
  11. Elicits individual needs and goals (Regional Facilitation Center, Best Practice 5)
    ..1.Assists individuals in acquiring medical insurance, dental insurance, or care
    ..2.Uses needs assessment tools or basic needs questionnaires to discover an individual’s area of need and direct individuals to the appropriate services and community resources

Category 7. Provides​ ​information​ ​about​ ​skills​ ​related​ ​to​ ​health,​ ​wellness,​ ​and​ ​recovery
These​ ​competencies​ ​describe​ ​how​ ​peer​ ​workers​ ​coach,​ ​model​ ​or​ ​provide​ ​information​ ​about skills​ ​that​ ​enhance​ ​recovery.​ ​These​ ​competencies​ ​recognize​ ​that​ ​peer​ ​practitioners​ ​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
  7. Support the development of healthy behavior that is based on choice (ICRC Domain 3: Mentoring and Education)
  8. Apply basic supportive group facilitation techniques (ICRC Domain 4: Recovery/Wellness Support)
  9. Recognize the importance of a holistic (e.g., mind, body, spirit, environment) approach to recovery/wellness (ICRC Domain 1: Advocacy)
  10. Assists individuals in discovery of healthy lifestyle choices across SAMHSA’s 8 dimensions of wellness (Regional Facilitation Center, Best Practice 9)
    ..1.Addresses the importance of self-care
    ..1.Facilitates self-assessment of medical, dental, hygienic, social, and emotional needs
    ..1.Facilitates the creation of a wellness plan
    ..1.Models wellness
    ..1.Introduces pro-social events and outings

​Category 8. Helps​ ​peers​ ​to​ ​manage​ ​crises
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
    ..1.Recognizes signs of distress (ICRC Domain 4: Recovery/Wellness Support)
  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

Category 9. Values​ ​communication
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. Practices effective communication skills (ICRC Domain 1: Advocacy)
  2. Uses respectful, person-centered, recovery-oriented language in written and verbal interactions with peers, family members, community members, and others
  3. Uses active listening skills
  4. Clarifies their understanding of information when in doubt of the meaning
  5. Conveys their point of view when working with colleagues
  6. Documents information as required by program policies and procedures
  7. Follows laws and rules concerning confidentiality and respects others’ rights for privacy

​Category 10. Supports​ ​collaboration​ ​and​ ​teamwork
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. Contributes to the individual’s recovery/wellness team(s) (ICRC Domain 4: Recovery/Wellness Support)
  2. Works together with other colleagues to enhance the provision of services and supports
  3. Assertively engages providers from mental health services, addiction services, and physical medicine to meet the needs of peers
  4. Coordinates efforts with health care providers to enhance the health and wellness of peers
  5. Coordinates efforts with peers’ family members and other natural supports
  6. Partners with community members and organizations to strengthen opportunities for peers
  7. Strives to resolve conflicts in relationships with peers and others in their support network
  8. Recognizes the importance of self-care (ICRC Domain 3: Mentoring and Education)

Category 11. Promotes​ ​leadership​ ​and​ ​advocacy
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​ ​practitioners​ ​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
  8. Relate to the individual as an advocate. (ICRC Domain 1: Advocacy)
  9. Advocate within systems to promote person-centered recovery/wellness support services. (ICRC Domain 1: Advocacy)
  10. Explain importance of self-advocacy as a component of recovery/wellness. (ICRC Domain 1: Advocacy)
  11. Differentiate between the types and levels of advocacy. (ICRC Domain 1: Advocacy)
  12. Advocate for multiple pathways to recovery/wellness.
  13. Describe the skills needed to self-advocate. (ICRC Domain 3: Mentoring and Education)
  14. Advocate for Individuals while Supporting Compliance (Regional Facilitation Center, Best Practice 2)
    ..1.Advocate for peer support and treatment interventions in the entire continuum of criminal justice involvement and educate the system, society, and communities regarding the cost‐benefits of these interventions over traditional criminal justice models
    ..1.Advocate for individuals in a variety of settings including detention, court, parole/probation, specialty courts, child welfare proceedings, and other justice related programs
    ..1.Understand that advocacy efforts are dynamic in nature and are determined on an individual basis by client need
    ..1.Understand that they can be advocates regardless of level of engagement or compliance, and should not abandon any individual due to noncompliance or perceived low motivation for change understand that they can be advocates regardless of level of engagement or compliance, and should not abandon any individual due to noncompliance or perceived low motivation for change.

Category 12. Promotes​ ​growth​ ​and​ ​development
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 practitioners’​ ​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 the signs of distress, and knowing when to seek support
  4. Seeks opportunities to increase knowledge and skills of peer support

References

IC&RC. (2017).  Candidate Guide for the IC&RC Peer Recovery Examination. Retrieved from https://internationalcredentialing.org/resources/Candidate%20Guides/PR_Candidate_Guide.pdf

Razavi, M, Ayala, J, Burnham, V, Carson, E, Dumas, L, Fitzpatrick, K, Martin, E, Bichsel,  R, Sanden, S, & Syrek, S. (2017). Substance Use Disorder Forensic Peer Best Practices Curriculum. Regional Facilitation Center, Portland, OR.

Substance Abuse and Mental Health Service Administration. (2015). Core Competencies for Peer Workers in Behavioral Health Services. Retrieved from https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/core-competencies_508_12_13_18.pdf

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