Peer Support 101
The Basics of Peer Support
A CPSS is a trained professional providing individualized recovery focused services. In this role, the CPSS offers hope, support, and advocacy to others through sharing his or her own experiences of living in recovery with mental illness and/or substance use disorder.
Shared experiences are the foundation for peer support; they foster the initial trust and credibility necessary for developing relationships in which individuals are willing to openly discuss difficulties despite concerns about stigma. Community based peer-to-peer programs facilitate opportunities for individuals to talk with trained peer specialists who not only share common experiences, but often share ethnicity, language, and socioeconomic status. This secondary layer of interconnectedness accommodates the diverse nature of those needing services and further enhances the unique bond shared between the PSS and the peer receiving services.
Within the behavioral healthcare setting, the belief that recovery is possible for all who experience a psychiatric, traumatic, or substance use challenge is fundamental to the practice of peer support (SAMHSA, 2019). Thus, the core principles for peer support are strongly founded upon the Recovery Model, a mental health service philosophy whose focus is on consumer empowerment, resiliency, hope and optimism.
The Peer Support Specialist
In behavioral healthcare settings, Peer Support Specialists are self-identified peers who are advanced in their recovery and use their lived experience to assist other peers through providing emotional support, sharing knowledge, teaching skills, offering practical advice, role modeling, connecting those they serve with community resources, and helping to enhance peers’ support network (Mead, Hilton, & Curtis, 2001). Peer Support Specialists are guided by the principle of self-determination and the understanding that there are many pathways to recovery and each has value.
Core Competencies and Principles
Core competencies create an essential foundation for preparing and further developing a workforce to deliver integrated care. Core competencies for certified peer support specialists reflect certain foundational principles identified, developed, and promoted by members of the mental health and substance use disorder recovery communities such as the reputable organization SAMHSA. These core competencies and principles are:
Recovery-Oriented - Peer support specialists hold out hope to those they serve, partnering with them to envision and achieve a meaningful and purposeful life.
Many Pathways - Peer support specialists help those they serve identify and build on strengths and empower them to choose for themselves, recognizing that there are multiple pathways to recovery.
Person-Centered - Peer recovery support services are always directed by the person participating in services. Peer recovery support is personalized to align with the specific hopes, goals, and preferences of the individual served and to respond to specific needs the individuals have identified to the peer support specialist.
Voluntary - Peer support specialists are partners or consultants to those they serve. They do not dictate the types of services provided or the elements of recovery plans that will guide their work with peers. Participation in peer recovery support services is always contingent on peer choice.
Relationship-Focused - The relationship between the peer support specialist and the peer is the foundation on which peer recovery support services and support are provided. The relationship between the peer support specialist and peer is respectful, trusting, empathetic, collaborative, and mutual.
Trauma-Informed - Peer recovery support utilizes a strengths-based framework that emphasizes physical, psychological, and emotional safety and creates opportunities for peers to rebuild a sense of control and empowerment.
Peer Support Services Provided
Lived experience differentiates peer support specialists from other professionals as their lived experience is the foundation of both their expertise and services they provide. The primary responsibility of a PSS is to help service recipients understand recovery and achieve their own recovery needs, wants, and goals using a person-centered approach (Jacob, 2015). Peer support may be provided individually, on a one-to-one basis, or in group settings.
The Center for Medicare And Medicaid Services (CMS) requires all PSS complete specialized training and certification as defined by the state as a qualification prerequisite to bill Medicaid for PSS services rendered (Chinman et al., 2013). Services provided by peer support specialists are varied, but typically fall within six service categories...
Planning - Assists the individual in developing and monitoring a recovery plan
Resources - Teaches, role models, and coaches how to use resources and navigate the mental health and/or substance use system
Advocacy - Promotes and sustains the workforce and advances the recovery, community integration, and tenure of those they serve
Illness Management - Teaches, supports, and coaches the acquisition and use of skills needed for symptom management
Employment & Housing - Teaches, coaches, and models the skills and attributes needed to attain and maintain long-term, stable employment and housing
Education - Teaches recovery education based on the core principles of recovery and resiliency to increase knowledge and skills needed to live well per their definition of recovery
Programs in which peer support specialists can work include but are not limited to include: peer support centers, crisis stabilization units, alcohol and drug use recovery centers, psychosocial rehabilitation programs, hospital settings, homeless outreach programs, housing projects, detention centers, non-profit organizations, community mental health agencies, and veterans hospitals.
Although SC SHARE focuses on peer support in behavioral healthcare settings, one should note the vast domains a PSS may specialize in including: cancer survivor support, diabetes support, weight management support, pre/post-natal support, and long-term comorbidity support.
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Peer Support is Evidence Based
In 2007, the Center for Medicare & Medicaid Services issued a letter to State Medicaid Directors recognizing peer support services as an Evidence-Based Practice (EBP) that could be Medicaid billable through various funding options. Evidence-Based Practices, sometimes called Evidence-Based Treatments or Evidence-Based Interventions, are practices established as effective through scientific research according to a set of explicit criteria, when consistently applied, produce improved client outcomes (Drake et al., 2001; NASW, n.d.). Research suggests evidence-based practices delivered by peers can improve health outcomes (for example, dietary habits, smoking, communication with doctors) among people with serious mental illness (Clossey et al., 2018).
Peer Support Works!
Major state agencies and nationally known entities that validate and promote the importance and effectiveness of peer support include the Department of Veteran’s Affairs, National Alliance on Mental Illness (NAMI), National Coalition for Mental Health Recovery, Department of Corrections, Mental Health America, National Council of Behavioral Health, U.S. Department of Health and Human Services, and Substance Abuse and Mental Health Services Administration (SAMHSA).
Peer Support Specialist Certification
Achieving a peer support certification demonstrates a strong understanding of mental illness, substance use disorders, co-occurring disorders and dedication to personal and professional growth. Time spent in the classroom, completing homework, and sitting for the exam requires commitment and we believe the return on investment is extremely worthwhile for preparing for employment in the behavioral health industry. Individuals obtaining a CPSS designation will have the satisfaction of completing an intensive certification program and gain an added competitive edge in the industry as a paraprofessional. We see this training as just as much of a personal training as a professional training. We focus on co-occurring disorders throughout the training blending mental illness and substance use information to support integrated care knowledge. This is a “do no harm” training with a job readiness concentration.
The Peer Specialist Certification curriculum is designed to expose participants to a variety of topics to include the following thirteen domains: Recovery Principles, Peer Support Practices, Cultural Competence, Communication, Recovery & Personal Wellness Goals, Whole Health Approach to Services, Managing Crisis and Emergency Situations, Group Facilitation, Advocacy, Use of Recovery Tools, Workplace Skills, and Professional Development. SC SHARE hosts multiple trainings per year throughout the state. The class size is capped at 20. The class is kept to a manageable size so that students can grapple at a deeply personal level with the material during the discussion sessions. Class consists of 40 hours of intensive classroom training with 12 hours dedicated to a homework and final presentation. An exam is scheduled after classroom training commences. Certificates are issued by mail two weeks following the exam..
In addition to attending the Peer Specialist Certification training, potential Peer Support Specialist candidates must meet the minimum requirements as outlined below. Upon program completion, candidates must successfully pass an oral evaluation and posttest before obtaining certification.
(Please note: prior peer support certifications obtained through other agencies and states are not transferable)
The following criteria must be met to apply for the certification program:
Be at least 18 years of age.
Self-identify as a person diagnosed with mental illness or co-occurring disorder
Meet minimum education requirement of high school diploma, equivalency, or in final year of high school.
Have demonstrated three years of self-directed recovery as documented by three professional references.
Have completed a minimum of 100 hours of supervised paid or volunteer work providing peer support services for individuals who have mental illness, substance use, or co-occurring disorders
A minimum of four hours of professional supervision is required (one hour of supervision per every 25 volunteer hours)
Job shadowing of another peer support specialist is strongly recommended prior to employment within hiring agency
Complete the Peer Support Specialist Certification training application packet
Submit required documents and $250 registration fee to program administrators by applicable due date
The following documentation must be submitted with application:
Copy of high school diploma, GED, or current transcript. (College Degrees may be substituted)
Signed acknowledgement of the Certified Peer Support Specialist Scope of Activities.
Signed acknowledgement of the Certified Peer Support Specialist Code of Conduct.
Three completed professional reference forms in individually sealed envelopes.
(The following are not considered professional references and will not be accepted: family members, therapists, friends, or psychiatrists)
Peer Support Specialist certification does not imply that Certified Peer Support Specialists are qualified to diagnose an illness, prescribe medication, or offer clinical services. Certified Peer Support Specialists are not authorized to provide treatment of any kind, outside of the authorized scope of their employing agency. Attending the Peer Support Specialist Certification Program is not an offer of employment or job placement, and in no way guarantees employment. Each person certified as a peer support specialist should apply for positions available in their community. Every Certified Peer Support Specialist may only operate under the supervision of a professional as defined by the Department of Health and Human Services.
"We work on ourselves in order to help others. And we help others as a vehicle for working on ourselves."
(Ram Daas & Paul Gorman, How Can I Help?)
An excellent organization dedicated to helping others. Professional trainers with high standards. Their commitment to the high ideals of this organization shines bright.
Peer Support Specialists at SCSHARE are trained and equipped to handle the specific needs of the peer and help redirect when life gets off track.
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