Reflections on Teaching the Recovery Peer Services Model

Corresponding to the ten-year rise of a powerful grassroots recovery advocacy lobby, we’re also seeing a growing nationwide network of recovery community centers providing practical and vocational services in an environment characterized by activist Tom Hill as “recovery nurturing.” Meeting identified service gaps, these centers are responding with increased efficacy and sophistication to the acknowledged inadequacy of “treating a chronic disease as if a crisis intervention would be enough.”

Recovery community centers are also pioneering the concept that recovering people ourselves are well placed to provide ongoing support as recovery peer advocates and coaches. Peer service providers, in the language of the centers, work to help remove personal and external obstacles to recovery by making recovery community linkages and serving as personal guide and mentors in the management of individual and family recovery (Connecticut Community for Addiction Recovery). In offering peer-staffed support, the centers provide both continuity of care before and after treatment, and a companion service to twelve-step programs.

In promulgating this non-clinical recovery oriented systems of care model (ROSC), the recovery community centers return us to the experiential roots of successful recovery support at the same time as they add value through the expertise of trained peer service providers. These providers, in turn, are building an emerging and evolving credentialed profession bound by formal Codes of Conduct and disciplinary procedures.

As early as the 1990s, George Mason University’s Thomasina Borkman developed a definition of qualifications appropriate to the special responsibiities of this non-clinical model. She writes that people serving as recovery peers “rather than being legitimized through traditionally acquired education credentials, draw their legitimacy from experiential knowledge and experiential expertise.” Experiential knowledge is defined as information acquired about addiction recovery through the process of one’s own recovery or being with others through the recovery process; experiential expertise requires the additional ability to transform this knowledge into the skill of helping others achieve and sustain recovery.

Specialized trainings and certifications offered nationwide prepare peers for voluntary or entry-level employment as recovery peer support providers in their communities. Formal credentialing, requiring further education and supervised work experience, creates additional opportunity for peer vocational development.

As an experienced trainer of the CCAR Recovery Coach Academy, I can attest to the depth and value of the training curricula, not only for the aspiring professional but for anyone seeking to deepen an understanding of the peer services model. Much of the material common to most recovery coach training is based on the work of Harvard emeritus, William L. White, an intellectual leader of the recovery movement, whom we – affectionately! – remember in class as “white guy, white hair, white goatee.”

For the student versed in the clinical treatment role, ROSC presents the very specific challenge of managing role clarity. “Stay in your lane,” we advise: if you’ve begun a working relationship in your clinical capacity (counselor or therapist), do not switch lanes by behaving as a non-clinical coach or advocate. (If a recoveree could benefit from referral to a compatible service provider with different professional protocols, by all means, let’s make the introduction.) Similarly, netiher coaches or advocates, no more than counselors, perform the work of 12-step sponsorship, notwithstanding that individual providers may also be personally experienced in that role. Protecting role boundary integrity is a key service value in the field.

In my teaching experience, I’ve found the video-vignette, The Birth of a New Movement, to be particularly effective in illustrating the recovery oriented systems of care model. This short piece looks at the emergence and mission of the recovery community centers and the support services they provide. Comments by activists such as Andre Johnson and Michael Askew, together with footage showing community programs as far afield as Detroit and Philadelphia, confirm the adage that “a picture is worth a thousand words” – or any number of power-point slides! And, at a tight six minutes, the video-vignette holds the attention.

“All the video-vignettes in the ManyFaces1Voice library are great for teaching,” says Faces & Voices Executive Director, Patty McCarthy Metcalf. I don’t doubt her. They are a terrific resource and available via Vimeo for use in a wide variety of recovery education settings.

Meanwhile, thanks to the advocacy efforts of the grassroots recovery movement, participation in approved training may be state-funded as a pathway not only to meaningful personal recovery but to professional opportunity. The formal credentialing available at state level –for example, the New York Certification Board’s Peer Recovery Advocate certificate (CPRA) – may also lead to medicaid-funded employment under the ROSC model. As the treatment field evolves, additional peer opportunities may be created under both public funding and expanded private health insurance.

As we see in “The Birth of a New Movement,” the success of the non clinical peer services model is valued beyond the recovery community by public officials such as Arthur Evans Jr. of Philadelphia’s Department of Behavioral Health. Evans goes so far as to support taxpayer funding of services – such as peer advocates and coaches – that can be shown to result in lives which are personally meaningful and socially productive.

It works when we work it, and it’s a particularly exciting and innovative time for the field. Come join us!

This blog post was provided by Ruth Riddick, a woman in long-term recovery since 2003, she is the Founding Director of Sobriety Together™ – Peer Education & Recovery Coaching Services.