Well good afternoon everybody and welcome to Recovery LIVE! This event is
brought to you by the Substance Abuse and Mental Health Services
Administration's Bringing Recovery Supports to Scale Technical Assistance
Center Strategy, otherwise known as BRSS TACS. Our TA center is dedicated to
increasing the access to recovery supports and we achieve this work
through a variety of mechanisms including a lot of TA focused on systems
transformation and developing the capacity of peer-run recovery community
and youth led organizations. Now we're very fortunate to have three
amazing presenters with us today and they're going to be talking about using
the core competencies to support peer workers and improve service delivery. I'm
very pleased to introduce today's presenters.
Cheryl Gagne, she's a senior associate with the Center for Social Innovation,
Ricardo Bowden, executive director of the Peer 360 Recovery Alliance, and Dan
O'Brien-Mazza, national director of Peer Support
Services Office of Mental Health and Suicide Prevention the US Department of
Veterans Affairs.
Today's Recovery LIVE event has a slightly different format in that I'm
going to immediately begin posing some questions to the presenters to lay out
the framework for the discussion, and our hope is that you'll be able to benefit
right away from a more robust and inclusive discussion as a result. Now as
soon as we've completed the introductory questions to our presenters,
we'll then dive into questions directly from the audience and we'll get all
started on all of that in about two minutes, but I've got a couple of
housekeeping items that I just want to go over with everybody
participating today. So Recovery LIVE! events are different than usual webinars.
We'd like to engage directly with the presenters and each other through the
live chat box. You'll see that that's already pretty active, and you will be
answering several audience poll questions. The presenters are going to
share some of their initial thoughts and then we're going to
answer some questions that are raised by all of you during this event. So you're
gonna see a lot of movement in the room, and it can get kind of dizzy, but we
do hope you find it both energizing and exciting, and you can also share your
questions and comments throughout this event. Audience members are always in a
listen-only mode, but you can submit questions by typing them into the
comments and questions here box or there is a questions from the audience box. So
if you just use the comments and questions here
that's going to be fine and Melissa, our competent technical staff, is going to
move them into the appropriate box so that I can pose them to the presenters.
If you experience any technical difficulties at all today, please request
assistance in that same box. Tech support monitors the box, they're
standing by, they look at the comments, and they will respond really quickly to
your needs. We also have a lot of resources that are available on this
topic and you can download them right out of the resource box. Basically you
highlight the name of the document, download button is going to
light up in that box, click the button, and that document will automatically be
sent to your computer. Now as folks were arriving today, we posted a poll question
for everybody to answer. Let's take a quick look at what those responses were.
So as I'm looking at, this is really a demographics question, and it's about
what is your role. We've got a number of individuals in recovery.
Really nice to see a smattering of recovery coaches. We've
got a lot of peer support specialists here. Really nice to see supervisors of
peer staff. Same thing with program supervisors. We've even got a couple of
executive directors, thank you for coming. We've got a few policymakers, that's
fantastic. Some educators on the call. A couple of researchers, really
nice to see. Great to see some students here as well. And then we've got some
folks that are just listed as other and are here to join in our discussion today.
You're going to see a couple more polls come up in the room today as we
move forward. We hope you'll participate and join in.
The polls really are helpful both to you all, to understand
who's here, and for the presenters to get a sense of
who's actually in the room participating with them. Today's session is being
recorded, it's going to last approximately 1 hour, and if as you
are listening you feel your organization may need or would like some technical
assistance around this particular topic or basically any other topic, please copy
the link for our online TA request form from the instructions box,
paste it into your browser, and you should have everything you need to
access TA from BRSS TACS. Last thing before we get into the good
stuff, when we close this room today, a satisfaction survey is automatically
going to open in your internet browser. We appreciate you taking just a couple
minutes to complete that survey. Your answers help us better serve you and
make Recovery LIVE events better and better as we move forward. And with that,
I'd like to get us started. So without further ado, presenters, here come those
first questions. And the first question is going to go to Cheryl. Cheryl, could
you start us off by explaining the core competencies for peer workers put forth
by SAMHSA and BRSS TACS? Sure. Absolutely. So this will be just a
little review of how we came to compile and describe these competencies.
Back, several years ago, 2015, SAMHSA engaged BRSS TACS to undertake this
process, and it was a lengthy, kind of multiphasic process, that involved 30
experts across the country to begin to first compile through a vast literature
search, list of competencies, job description, skills, knowledge, everything
required for peer workers, and we cast our net far and wide and collected
thousands of documents that listed what peer workers were doing currently across
the country, and we assembled those, eliminated redundancy, we polished the
language, we put a lot of emphasis on making these competencies
action-oriented, and so you'll see that most begin with an active
verb of what peer workers actually do in their daily work. After we assembled these
and have them vetted by a group of 25 experts, and by vetted, we did this in a
process called a Delphi Process, which allows for reviewing a body of work
getting people's feedback, but yet preventing any one person or perspective
from dominating the discussion. So it seems to be a more level playing field
that you know we can do with large groups of people.
This final list of competencies had 61 competencies across 12 categories and
then we vetted those with real-life peer workers across the country, 50 peer
workers participated in surveys and interviews to really give us their
feedback on these. The motivation for these competencies were pretty clear. At
that time, and then continuing to today, the number and variety of peer
workers in behavioral health care services is growing. There was a real
lack of clarity about what is their role, what does a peer worker do, what is peer
support versus case management versus community support, where
do they, where is there an overlap in their work? So these
competencies describe in detail what those actions are. Our hope is
that these are used primarily by peer workers themselves to
be able to look at "well, if these are the competencies, where are my
strengths, what are my limitations, what do I want to focus on, what do I want to
improve?" It also helps certainly supervisors, and I noticed many
supervisors in the room to again, get clarity to be able to describe
what are the expectations to fix job description, to fix
performance evaluations so that they align with the actual role of a peer
worker. You're being evaluated on the job that you're doing. So these were the
motivations really to get clarification and to create some tools that will
support peer workers to perform at their highest level. Now these
are called core competencies and I just want to take a step back and point out
that by core here, we mean kind of the foundational, fundamental, mental
competencies. We understand that they're not totally comprehensive. That there are
peer specialists or peer recovery coaches that have more specialized
competencies. Perhaps they've gained expertise in supported employment or
medication assisted treatment, gained additional expertise, specialty expertise,
and there's also some advanced competencies that peer workers may
develop and those would be some of the group process skills that many
peers are called to do, supervision, some of the organizational pieces of work
that peers may be called to do that are more advanced. Those aren't included
in this list of competencies. As with any profession, peer workers, you know, it's a
living, breathing entity, and we anticipate that there will be changes
over time, that these core competencies aren't necessarily engraved
in stone, but they will be shaped by the field as we move forward. I do think it
marks an opportunity, again, for peer workers to take a very
objective look at their work, being able to identify their strengths and areas
they want to develop, and also helps programs that employ peer workers, and
we're going to hear from a couple of those supervisors and administrators
today of some of the potential uses of these competencies. That's all for me.
Cheryl thank you. That was fantastic. Appreciate that the overview and
the historical context around the creation. Before we
jump into the next question, Melissa could you pull up our second poll for
today? I think it's relevant as we move into the discussion both with Dan
and Ricardo, and before folks jump in, what you're looking at on those polls is
just your familiarity with the competencies, but notice that they are
split up into "yes, I am a peer worker, yes, I am a supervisor, administrator, or "yes, I
am a policy or other and are familiar, or, all of the above
but I'm not familiar," and I just wanted to make sure that I specified
that so that folks don't make a an error in their selection, and we'll give
everybody a minute to kind of chime in, but it looks like we've got a pretty
good lead on the "yes" column with peer workers, looks like about 36 to 40
percent. The supervisor administrators on the yes, another big
big chunk, about 22 percent. The policy makers, it looks like for "yes' that's
around seven folks that are here. And then it's also really
interesting to see who isn't familiar, and really thrilled that you folks
are here today as part of this discussion as well, because I think once
this is complete, the familiarity with the core competencies
will be complete, but what we have here is about 10% of the, excuse me about
9% of the peers workers aren't familiar, about 21% of the supervisors
aren't, and that's I think really common, and same thing for policymakers
and others, and the reason I even share that and say that that's common, is
because it's the peer worker itself that it typically would be most I think
focused around the core competencies and want to
have an understanding and a bit of knowledge with that. So fantastic
folks. Thank you for responding. Appreciate it.
With that, I'd like to go to Ricardo, and Ricardo, as a direct staff supervisor
at a recovery community organization, how do you use the core competencies?
People who work with me recognizing that from activity to
activity, from the work that we do is dynamic, there are situations that don't
always look the same, and in those circumstances, typically folks don't think in
terms of what core competencies I need to reach for. They're looking for trying
to figure out how to be the best they can be
in that circumstance. So I try to first of all role model these competencies. I
think that's really really critical as a director so that I can continue to
be teaching and keeping people's awareness. Things like just
straightforward things like, "are you asking open-ended questions,"
and when I interact with people and with them when I want to explore a challenge
that maybe we haven't, I begin with open-ended question, I began by asking
them how they thought about them, how you
think we should go to let them drive the discussion and
and share what strengths they may have and acknowledged and support the efficacy. So
I try to role model that as I teach folks to continue to do that in work
that they do, and I also try to offer them shortcuts, ways that when
you in the middle of a situation where you don't quite know what to do,
we have been in this territory before, is to have some shortcuts, like where
you do entry level coaching they do a WRAP with a person, ask yourself
who's doing the talking and about hearing my voice a lot, then it's not
like this is a person-centered experience. You know, am I
fostering hope is circumstance. I had young woman for instance the
other day who called me and she received a call from a lady who was wanted to get
was making a choice to withdraw for methadone without through the
temptation process, and so she was scrambling around potential clinic,
didn't know what to do, decided she would go to the emergency room, she reached out
to the person who worked with for me by telephone and so she supported
important people in the emergency room, all of that, but she called me there to say
Ricardo, I don't know what to do next, because there were no structures where
she's able to actually go to the emergency and be with this person, and so we have to
answer excellent questions first of all, and get her think about it some more, and
what we wind up talking about is try remember from your own experience what
it would be like to be in an emergency room right now if you were her and to fix
about how important it would be just to have somebody out there you know cares,
and so being able to sift through all of the teachings and the learning the new
skill set we tell people people about when they do this work to
reach down to the core of being genuine in your relationships, and so I
try to provide those kinds of insights for people, and also as I develop
evaluations around core competencies, I don't call them that
in terms of the words that I use, but I evaluate from that context
and from that conceptual framework, and then the other piece, the other thing is
that I encourage all of my people, all my folks, to always be mindful of
walking the talk that they do, and in doing so, it keeps you,
keeps them, keeps me, because I have to do the same, keeps me focused on whether or not I'm
doing the work in a way and I'm representing the work in a way
that's going to be most effective and come across in a genuine fashion. Ricardo,
that was fantastic and thank you for some real-world examples and diving
into a little bit of the detail around how you, you and your staff
both use them. Fantastic. Thank you. Dan, this next question is directed at you,
and on a systems level, how did the Veterans Administration
use core competencies when the VA really decided to establish a large workforce
of peer support specialists? Hi Steven, everybody out there. A little
background first, if I may. Other careers in mental health have well-established
territories already in terms of their knowledge, skills, competencies, and the
acceptable practices. They've been around for years, we think of
physicians and psychologists and nursing, they all have pretty well established
career fields. There's even a theory out there that mental health treatment is
built upon some kind of science, that is based on emperical
data and an established evidence base, but I think many of us will say the
truth is that there isn't any consistent measurement system which looks at either
organizational or private practice mental health providers to determine if
they are adhering with any fidelity to any evidence-based practice or
scientific model that's effective. Now in peer support, we have to remember that in
this occupation, which it is now, it was only formalized in the last 15 to 20
years, before that it was primarily an informal reciprocal self-help process
that has been around for eons. We can go back to classical scriptures
and find verses about one person helping another through various
difficulties, military, certainly in the VA there's always been peer support. So
the challenge with implementing a new career field using peer support, is you
have to know what it is and what it does. Where do the people who do it get
their knowledge skills and abilities? For peer support, the expertise rests on very
individualized experiences of recovery that are rather unique, existential, and
idiosyncratic. There are some common themes no doubt shared by many and the
impact of those experiences have been spoken and written about by many
talented and intelligent individuals. As an aside here, some commonly shared
experiences of many of those that were treated for mental illness was abuse,
especially in inpatient settings, social isolation and stigmatization, this
resulted in some early iterations of peer support driven to become a social
movement that sought to rectify and challenge not only the current
established system of care, but the portrayal of individuals who have mental
illnesses as being dangerous and not capable of fully participating in their
communities as full members. So for some in the peer support movement,
actually joining those systems as participating staff and becoming
professionalized may seem contradictory to the role of some peer supporters.
I believe that corrections in the mental health systems are necessary and the
recovery orientation is transforming many, and peer support where it is in
place is becoming part of the solution to that end. We could go on and on about
that issue, but I digress a little bit. So in 2007, the VA had about a hundred and
thirty peer support staff that were mistakenly classified as health
technicians and very few were being utilized as agents of recovery to do the
work what most of us today would agree constitutes peer support. Instead, it was
assumed that they would be doing the activities that other health technicians
did based on the competencies of that occupation, which was more along the
lines of medical techniques and behaviors, like taking vital signs, doing
drug testing, alcohol sensors. Well, we assembled a group of individuals at that
time, what as Cheryl was talking about, gathering experts to look at
competencies for SAMHSA, and we took people who were in recovery, some mental
health providers, some researchers whose specialty area was peer support, and we
reviewed existing literature, certification, curriculum to see what it
was that those who said someone was certified to perform peer support
provided training on. You see, we couldn't go to a college catalog then and look at
what peer supporters were being taught. That didn't exist then, or at least if it
did nobody, knew about it in our group. So we determined at that time that there
were about 35 competencies that were being taught and tested. These
competencies were basically skills that allowed individuals in recovery to share
their own recovery experiences or their personal recovery stories with others in
ways that were respectful, helpful, effective, and did no harm. We adapted
these and put some VA spin on a few, especially those having
to do with culture to ensure that there was inclusion of military and veteran
diversity issues. We then developed our own training manual for these
competencies and used it for a few years before a federal law was passed
requiring VA peer specialists to be certified by not-for-profit entities
approved by the VA or a state mental health authority. So back in 2012, we
wrote our own specifications for certification training based on our
competencies and solicited not-for-profits to bid on providing the
training and testing. At the same time, in 2012, we wrote new position descriptions
that were based on these competencies to change the job classification that the
peer supporters had been working in for five years. The new one allowed us to
include the competencies that enabled veterans who were in recovery to learn
how to translate those individualized lived experiences into active support
that was respectful, helpful, and effective for others who were still
early in their recoveries. We awarded our first certification training contract to
DBSA, the Depression Bipolar Support Alliance in 2013, and in 2015, we reviewed
the SAMHSA recommended core competencies and adopted a version of them that we
used in our next contract that was awarded later that year to Recovery
International. So then, our whole system was impacted by utilizing competencies
to define a new career field, develop certification training requirements,
write position descriptions, and inform ongoing training as well as being the
criteria for performance reviews and evaluations. Let me stop there, thank you.
Dan, fantastic, thank you for a great overview. I'm gonna jump into the next
question. This one, Cheryl, I think has probably likely to take the first stab
at. Cheryl, how does lived experience with mental illness or substance use disorder
or both is part of being a peer, but not the only qualification
to be a peer worker? How's that the competencies help professionalize the
career path of peer workers? Great, thank you. We do know lived
experience is kind of a foundational experience of people who
are peers that actually contribute to their peerness. That they have lived
experience of a behavioral health condition, but we also know that while
that's necessary, it's probably not sufficient to make sure, you know that
they do a good job in offering peer support services. So I think the competencies
point out specifically what are those other actions that peer workers do in
addition to kind of sharing our story. The other thing I wanted to say that in
addition, you'll see this in the document when you, the documents in the download
box, you can download it after, but this document that's up now in the room. We
also list the kind of the principles and values, and that is the spirit in which
these competencies are delivered. So there are many ways to share our
experience, but when we do it with mutuality with the person's best
interest at heart, when we do that, when we're truly listening, then we're doing
it in the spirit of peer support. So it's not just the competencies what we do,
it's the principles and values that describe how we do it, that
really gives it the kind of the spirit of peer support, and so together
these behaviors or these tasks activities in addition to kind of the
spirit in which they're delivered form the core role of peer support workers.
Fabulous. Cheryl. Thank you.
Ricardo, building on your last statement, can you talk about
the guidance you might have for our audience to help your workers reflect on
whether they are really adhering to core competencies, particularly when they're
busy working a large caseload.
I am a huge proponent and encourager of people going to trainings after
trainings after trainings. The more folks do that, the more it keeps that slop
deepen. My experiences is that a lot of people will come to trainings, buy into
the notion of recovery coaching and all that entails, the different mindset that
that brings to the service delivery as opposed to personal thoughts
for people's own personal journeys, and then go back to wherever they're working
and not be and those messages are not reinforced in the workplace. So they
begin to move very quickly oftentimes, kind of move back to what they knew best
before they came through training in the first place, and more guided by the
traditional treatment service provision setting if they go back to, because they
don't go back to a place that supports but has conversations or talks about the
principles of recovery coaching. So the more often people are exposed to
trainings to get that reinforcement, the better. The other
thing I've been proponent of, I think it really really helps, is encouraging
people to in trainings around all the issues around
recovery coaching professionalism, ethical
considerations, those kind of things, we do booster trainings on a regular basis
or active listening skills and looking that ethics from a practical way
that was really going on in your world and how you respond to that much
ethically perspective to make it very real that way to the skills building, but
importantly though to, for a good self check, is to be will get as good as you
can at using motivational interviewing skills. That there's something that
that approach to interacting with people is almost always forces you to be back
in that mindset of really trying to understand what the person is coming
from, hearing what motivates them, check in your own self on when you do
conversations and you fall back into I know where this
conversations gonna go, I do what they should do, and if you step back and just
ask one more open ended questions, you may find it was what people have a whole
different agenda in mind and where you thought they were going, and you can keep
yourself from erring in those kind of ways. So I encourage people and
that I mentioned before to ask yourself some questions.
Am I fostering hope and
check themselves around are they interacting with people based
on their diagnosis or are they interacting with people based on their humanity,
because we can people get so caught up and are you using, are you about to use,
are you going to relapse, when recovery coaching embraces the whole person,
and so the more folks can check themselves around that. Then the other piece to is
how important that you look at it from a lens in my
interaction with people. Am I helping that
individual to feel good about themselves, and supporting their dignity
and their self-worth and perhaps even helping them to increases their
self-esteem. Ricardo, that was fabulous, and I just want to point out
there's a number of people in the chat right now who are saying
absolutely, great information, so I think what you were saying
really resonated and thank you for that. Dan, I'm gonna turn to you, and I want to
just check in with you around this. Most states have created paths to become
certified as a peer worker. Those certification requirements vary from
state to state. Now how has the VA, which basically hires
peers in every state, use the core competencies to help standardize the
peer work requirement? You're correct Steven that state certification
requirements affect us all and perhaps not all of us equally. For example, some
states require only a minimum of 40 hours of formal training to become
certified and others demand rigorous, on-the-job supervised experience as well
as formal training to ensure a qualified workforce. Since the VA, by law, has to
accept any state certification for peer support to make a veteran eligible for
VA employment, we thought we needed a way to ensure that regardless of the
individual's adherence to their state's requirements, there was a national
standard that was the same for all veterans who received care, whether in
New York, Alabama, or Alaska, for example. So we require our peer supporters to get
15 hours of continuing education annually in peer support competencies
that are approved by their supervisors and match our core competencies, which I
said earlier, pretty much match the competencies developed and approved by
SAMHSA and had the input of iNAPS, the the major organization of peer
supporters internationally. So indeed, we have an internalized process
for ensuring a high quality of care throughout our system using core
competencies as topics for the continuing education, and by the way, we
provide similar continuing education based on the same competencies to
supervisors of our peer specialists so that they will be able to supervise the
process and effective methods of peer support that these competencies are
meant to ensure. That was great, Dan, thank you, and I think that kind
of leads me into another quick question, and Dan, I'm going to pose this to
you first and then I'll check in with Ricardo and Cheryl to see if they've got
a follow up, but are there any specific core competencies for veteran peer groups
or faith-based peer groups? That's a good question
Steven. When we looked at the 60 or so competencies that SAMHSA had published,
we tried to look at those through the eyes of veterans, and again, we have
veterans on our work groups, and we specifically address some of the
competencies perhaps in a veteran centric way by seeing if there are
cultural specific competencies that we could add, and indeed, what we did do is
we added some specifications to our contract training that asked the folks
who are teaching our veterans about core competencies to actually address how we
would interpret and understand all the diversity that veterans bring. Now I'm
not saying veterans don't bring this same breadth of diversity that non
veterans do, because they certainly do in a whole
well aura of areas, but when it comes to being a member of a very rigid
militarized group or organization, there are certain ways that people think and
act based upon that experience that we wanted to make sure people understood,
and even within the armed military services for example, you will find some
of our veterans who were members of the Marine Corps or specialized forces, in
the Navy or the Army, all have a sense of more specific, individualized things
that happened with them that didn't happen among the other service members.
So there is an area of knowledge that veterans and service members have
experienced that non veterans have not. So those are things that we
changed around. I'd have to actually pull up the competencies to go through those,
but we we will make those available to folks who have an interest, and by the
way, for you peer supporters that are out there that are not VA employees, whether
you're veterans or not, the VA does have a training program for individuals who
want to know more about how to be more culturally and military friendly and
sensitive to our veterans and there's an online course which is very good that
you could enroll in and take at your leisure. It's computerized,
self-paced course, it's several hours long, but it does provide a lot of good
information that you might be interested in accessing. Great. Wow, that was great
Dan, thank you, and some some really great information. Cheryl or Ricardo, any any
thoughts about the core competencies
for veterans or faith-based groups? I think a lot of the issues that come up to in
training are around application of these issues, kind of going, I know Benjamin had
a question like "what's the difference peer support one-to-one versus in group
facilitation," and the competencies are the same, but the
application in how you roll them out may be different. Certainly any
peer who's well trained, highly competent, will also need additional training
that's specific to their role to their organization. Every
organization has a different culture, a different way of doing things around, you
know, peer workers are in hundreds of different work environments and so you
know core competencies aren't going to be able to really discuss all of the
applications, but that's where the peer worker, the supervisor, the program
administrator, can really get to what is the training that peers needs specific
to this organization, and again, they may be different applications of the core
competencies or it might be actually an additional competency or two depending
on the role in the work environment. So yeah, those are the issues with kind
of applying these competencies to work in real life.
Ricardo, can you check in before I go on to the next question?
Any final thoughts about the core competencies around veterans or
faith-based groups? I don't have anything more useful to add.
Fantastic, thank you. So then let me go through the next question. There's a
question that says "I'm curious to learn about the International Association
of Peer Specialists. Didn't they have some competencies they developed and does
Mental Health America have core competencies for their certification program?"
So iNAPS absolutely has what they call "practice
standards." They were very similar to core competencies. They articulated certainly
the core values and principles of peer work. We used all of their work,
everything they've ever written were part of the foundational first
review of documents included all of the iNAPS stuff. So those have been
somewhat included and folded in to these core competencies, they were not
lost. Mental Health America, I'm not sure where they are with their core
competencies. I do know that they're rolling out a national certification and
have core competencies, but I would direct people to the website of Mental
Health America if they want to learn more about those competencies. Fantastic
Cheryl. Thank you. Let me just check in with Dan and Ricardo. Any
follow up on that? That sounds like a Cheryl question to me.
Dan? I concur with Cheryl. I'm sure that Mental Health America
has core competencies, but you would need to address those with that
organization. Got it, got it, thank you. So here's another question. How have you
reconciled possibly duplicated work by the AA community or the 12-step
community and recovery coaches as well as work through some of the conflicts
between those groups? Steven, would you please repeat that question?
How have you reconciled possibly duplicated work by
the AA community and recovery coaches as well as work through some of the
conflicts between these groups? Steven, I can take a shot. Sure Dan,
go ahead. I don't really see that there is a conflict or or duplication between
community peer supports, through self helped groups and formalized peer
support, through mental health or consumer run organizations. I think that
we obviously, at least in our organization, we try to find as many
natural supports with an individual so that they do not have to depend on the
VA. I think the VA has had problems in the past of institutionalizing
outpatient care and a long-term commitment to being a patient. With our
work over the past 10 to 15 years in transforming our mental health system, we
really look to finding veterans and, not we finding, but the veteran finding with
our assistance places in the community where they can have natural supports and
we believe that if a veteran chooses self-help through AA/NA any of the
various 12-step programs, faith-based programs, wherever they might choose, if
they have means to hire a recovery coach, that those are great options to utilize
to help maintain their recovery. If there are any conflicts that emerge in our
discussions with our staff, we have found them to be a minor and easily
resolved with open communication. Sometimes it does
require a signed release of information because of HIPAA, but usually the veteran
and the community organization is more than happy to participate in that
process. So I really think that these should be and are complimentary
for the most part. Terrific, thank you. Ricardo or Cheryl, any follow-up? Oh go ahead
Ricardo. First of all, a couple of things in out community.
The are number of us who are involved in recovery coaching in a
recovery community organization, 50 60 recovery Alliance, who certainly have
benefited from being engaged in those 12-step communities for
decades, and so we have been able to leverage some of our personal
relationships in a way to engage with people, let them know what we're
about. Secondly, as we have developed groups, we
have sought to find the gaps in our community. There are sometimes a days
where people are over the years is that wish we had a meeting around here at 5
o'clock for instance, and we don't and so we say "okay, well we have what we call our
recovery, feel freedom," we open up like that. We try to find the niches
in our communities and try fill those niches. Also,
when we do provide a lot of recovery community focused
socialization events and our outreach spans across all kinds of pathways,
mental health recovery communities, medication assisted therapy recovery
community, AA, NA, and when we do our promotions, fellowships with respect to traditions, cello chips with respective traditions
we don't take out we we have we have prostrations hip we can give flyers to, but
never in fact that we're doing a meeting. Real respectful, it would not trying to
be real with responsible about honoring how they operate. What we have
found, and then the other part is that we just continue to invite them to engage
with us, and we continue doing the programming that we do, and what we have
found is we haven't any bit like an out of state park for instance and we have
all kinds of people coming out to do tables. People from AA have information table,
people from NA have an information table, suboxone, medications assisted therapy
organization have information tables, and so bit by bit, what we found is a lot of
cooperation as we go forward, and the other part is to we also a high
operational recognition that there are some folks who would not going to be
open to what we do. They may, for whatever kind of the reason, and they have a
right to that. So we don't try to be anything but what we are, and walk what we talk. You
know be who we are and stay our integrity and so we have found a lot cooperation over time, its
taken time, but that approach has been productive for us.
That was fabulous Ricardo. I mean that was great. Thank you.
Cheryl, did you have any final thoughts on that? The only thing I was
going to say is that one of the competencies of peer recovery coaches
and peer support specialists in mental health is really accepting and
embracing multiple pathways of recovery and not being too attached to just one
way, and I think that that has created some conflict for people who
are passionate believers in their own pathway to recovery. However, that's
something that through training, supervision, support, guidance, many people
will then open up and recognize that yes
indeed, there are multiple legitimate pathways to recovery, and we teach that
very specifically in most training programs. There was a question too about
what are the differences and the delineation between what is a peer
recovery coach do versus a sponsor. In general, a sponsor, its primary role is to
help the person through the 12-step work and doing the 12 steps of
whether it's AA or NA, the sponsor is very active in that. As a peer recovery
coach, we wouldn't work on the steps together. That would be work for the
sponsor to do. However, the peer recovery coach, I might be talking about
career aspirations and possible jobs or housing and medicine
and how do I make a doctor's appointment, very daily life challenges that
in addition to sort of the the spiritual healing that AA talks about,
includes this getting my feet back underneath me and leading
a meaningful and productive life.
Fantastic. I wanted to say I know Tom Kelly had asked that question
about coaches and AA sponsors. There's a really good article by
William White that even has a table that delineates the the
actual path. So I would refer you to that. If you just google "peer recovery coach
William White," you'd probably get that article. It's a good one. Awesome.
Great reference to a resource too, thank you. Folks
I'm just conscious of the time and I want to make the best out of the
remaining time we have. So here's a question I'm just going to pitch out to
all three of our presenters today. "It is critical for peer workers to maintain
professional boundaries when doing their work as a form of wellness
and self-care." How does the core competency help with
that?" Well I can start and then I'll let Dan and Ricardo. One of the explicit
directions in the core competencies is that peer providers follow the ethics of
peer workers, the ethical guidelines, and many states have
articulated what are our ethical guidelines, peers
must, and again, no exploitation. It's much more nuanced than that. We talk about
peers because another skill is sharing your experience, right, and when that is
done skillfully, it's done at the right time, in the right amount, with the right
person. It's not done indiscriminately everywhere all the time, right, so if
we're talking about really in on just two competencies
that speak directly to that. In addition to that, most organizations will
have behavioral standards, just, what do they
call that, codes of conduct, and person must follow
those as well. So that's occasionally, very occasionally, there may be conflicts
between the code of conduct and the peer role and then that would need to be
discussed and may be altered, but in general, peers are held
accountable for those ethics and those codes of conduct. That was awesome.
Ricardo, go ahead. Okay, as Cheryl mentioned, the code of conduct at our organization, we have an
established code of conduct that we provide and we talked about and
reinforced in our team meetings and such and in our
trainings, and we are very focused on repeating ethical consideration trainings
throughout the year. From that, one of the other, in my directing of
interaction with people and in the trainings, we talked about thinking
through situations based on the kind of the notion of the possibility of
multi-party harm, and so to stop and think not just as engagement in
make this decision or engage the person in this kind of way, how might it impact
me or this individual, but think about how that might impact our organization,
for instance. How it might impact, the outcome of this might impact the profession
of recovery coaching, and to create a lens to look through in making
those decisions. The other piece too, it's also, but the boundaries are also about
protecting the recovery coaches, and we also talked a lot about the
importance of self-care, and that because ultimately if you don't keep
what you got, you have nothing to give to anyone else. And we want that to be,
we want people to be focused on being the better person they can be because the
better person they are, the better they can help someone else. So we talk about
my self-care boundary considerations and conversations are all through all
through the notion of self-care. So those are how the core competencies or
the way in which I try to make them practical in our organization
come into play. Fantastic. Thanks again. And Dan. Yeah Steven, I mean just the nature of the
question that it is critical for peer workers to maintain
professional boundaries and it affects wellness and self-care. Around all of the
professions, there are constructs about the relationships
between individuals, between the employees of an organization
and those who receive care from them, and also between the employees that work in
that organization. That if you didn't have certain competencies, then there
wouldn't be an assurance that individuals receiving services and the
organization itself would be protected from unethical or illegal practices. So
the VA has competencies that again, I think you'll recognize came from SAMHSA
like recognizing the dynamics of stress, compassion, fatigue, burnout, seeks
appropriate strategies and demonstrates understanding that self-care is
essential to successfully manage one's duties. So not to belabor the
point, but those aren't important that we address through competencies. That was
great Dan, thank you. And again, I'm conscious of the time. It's 2:57 Eastern
time. We did not get to all of the questions that we wanted to respond to
today and I apologize for that. Certainly if you'd like responses to
your questions, you can email Melissa Witham or you can use the
Recovery LIVE! address on the screen now with your questions and we'll do our
best to respond. We are so glad that so many of you could come and participate
today, and if you haven't done this already, be sure to grab the resources in
the download pod. Before everybody runs off the back to their daily demands,
I've got two more things to do really quick. First, I want to thank Ricardo, Dan,
and Cheryl. These guys are rock stars and they do this work every day and it's
just such a great time to have them come and share and provide responses to
everybody. Thank you all for your time. I know that you're all very busy people
and we're just grateful to have you on our event today. There is going to
be a link that's going to pop up here in about a minute or so. It is the
satisfaction survey and we really want you to fill that out. It takes about two
minutes to complete and we hope that you'll give us some feedback because
those comments and the suggestions that come from
those responses actually are why we have Recovery LIVE! events today. It's because
of all of you and us responding to the requests that you've
all had about how to make these sessions more engaging and lively and more user
friendly. Please give us your feedback, good, bad, and ugly, because
that's what we learn from, and then if you've got any additional questions, feel
free to add them to the satisfaction survey, and remember folks,
there's a link to apply for BRSS TACS technical assistance. It's free, use it,
and we'll be in touch with you within about 48 hours at the latest and we'll
get your support in any way that we can. I want to thank everybody
today for joining us for this Recovery LIVE! event. Again, Ricardo, Cheryl, and Dan,
thank you guys for a great presentation. Have a great day and a fantastic weekend
everybody. Bye-bye now.
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