FAQ

Becoming a Peer Specialist


Maintaining Certification and Continuing Education


Working as a Peer Specialist


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Becoming a Peer Specialist


Does an individual need to be trained and certified in order to provide peer support?

Peer support has been occurring naturally for a very long time in many unique ways. Whether it is in the form of several friends gathering to play dominoes and commiserate about aches and pains, a grieving widow being comforted by another who has also lost a spouse, or a person attending a 12-step meeting, there are endless examples of the healing power of sharing lived experiences with one another. Mental health and substance use programs have further developed such powerful exchanges of support, leading to the peer workforce. Due to the evolution and growth of the peer workforce, many options now exist to learn how to use one’s recovery story and experience, as well as other tools, in a more systematic fashion in order to offer hope and support to others. This generally involves attending a training and then taking and passing an exam that measures mastery of specific competencies. With this evolution, many states now include peer support as a Medicaid billable service. For those states, training and certification process are now a requirement. Ideally, training also ensures that peer specialists have the complementary skills to work well as partners with other team members, including clinicians.


Who is eligible to become a certified peer specialist?

Generally, a peer specialist is required to identify as an individual with personal lived experience in recovery from a mental health or substance use condition who is willing to share their recovery story as appropriate. Some states offer their training and certification only to people who have received or are currently receiving publicly funded services, whereas other states only require that you have at some time been a user of services, regardless of whether public or private. Some states have requirements about the length of time a person identifies as having been living in recovery.


How does an individual find out about the training requirements and opportunities where they live?

Each state has unique requirements for peer specialist certification. There are still some states, although not many, that do not yet have a certification process. It is important to start the process by learning about your state’s requirements. You can begin by reviewing this document. It is important to note that this field is consistently evolving, so while all of the resources in this document may not always be up to date, it is still a good place to start to begin researching your state’s process and resources.

Once you know the requirements in your state, you can begin to research training opportunities. Your state requirements can guide you in understanding if you must attend training through your state (which the state website can provide details for) or if you should begin researching non-profit organizations that provide training. You can find a calendar of future trainings here.


Are there online trainings for peer specialists?

At this time, most training for initial peer specialist certification is conducted in person, rather than online. As the field continues to evolve, this may change. There are many online training opportunities for continuing education once an individual is certified as a peer specialist. The DBSA Peer Leadership Center includes many online continuing education opportunities, as well as listings of other organizations’ trainings.


How can an individual find funding to pay for training?

While some state trainings have no cost, many trainings require an investment in this important educational experience. Once you research your state requirements and identify which training is right for you, the next step is to begin the process of planning for payment. While some people are able to cover the costs of training themselves, many people could benefit from financial support. Many trainings include the opportunity to apply for a full or partial scholarship. Asking the organization you’re applying to about scholarships is a great first step. These scholarships can often be quite competitive, so it is important to continue planning and researching funding options while you wait for scholarship announcements. Other funding ideas and sources include:

  • Your state’s Office of Consumer Affairs
  • Local resources for individuals living with disabilities
  • Local mental health agencies, drop-in centers, or mental health departments
  • Your local church community
  • Vocational rehabilitation counselor or benefits office
  • Consumer-run organizations and other mental health organizations in your area
  • Online personal fundraisers through sites such as Indiegogo, Crowdfunder, or Gofundme. There are many options for online fundraising, so research which site will provide the most benefit to you.
  • Your workplace or an organization you volunteer for may benefit from you learning peer support competencies, so you may decide to request to discuss financial support options with your supervisor.
  • Family and friends may be able to provide some financial support, or can assist in brainstorming additional fundraising ideas.

When fundraising, be sure to consider the total amount needed, including not only the cost of the training course itself, but also any additional costs that you might incur for travel, lodging, etc. While it is rare that one supporter would cover the entire cost, don’t let that discourage you. Many smaller donations can add up quickly! When presenting your request for support, be sure to share your reasons for wanting to attend the training and what you plan to do once you receive certification. If a person or organization is not able to support at the time, they could be a great resource for additional ideas on fundraising.


What is the difference between clinical services and peer specialist services?

Clinical services include diagnosis, different types of therapy, or possible prescription of medication. These services are provided by clinically trained and licensed individuals. Historically the clinical perspective has been more focused on stabilization and maintenance, but with the current transformation of the mental health system, their perspective is largely changing to focus on wellness and recovery. Clinical professionals therefore may increasingly seek to support people in achieving goals, using treatments to overcome barriers to those goals.

Peer specialist services are provided by trained and certified individuals who identify as having personal lived experience with a mental health or substance use condition. Peer specialists use their own recovery stories to provide hope, to support people in finding their own inner wisdom, and to set personal goals for recovery. Peer specialists assist individuals in developing skills and finding resources to overcome barriers to the self-identified goals.

The services of peer specialists complement, but do not replace, clinical services. 


What is the difference between Certified Peer Specialist and Peer Supporter?

The difference between peer supporters and peer specialists is that peer specialists are required to attend peer specialist specific training and certification, where specific skills and competencies are learned for the role. While peer supporters may attend many various trainings, and may receive certificates for different educational experiences, unless peer specialist training and certification has been completed, they are not a peer specialist. Peer specialists, on the other hand, are also peer supporters. Some individuals may train and certify as a peer specialist, and then make the decision they prefer the role of peer supporter. If you are interested in learning more about becoming a peer specialist, the peer specialist section provides an overview.

Many of the roles and activities of peer supporters are the same as peer specialists. For instance, both peer supporters and peer specialists may choose to…

  • Facilitate support groups
  • Sponsor a peer in a 12 step community
  • Deliver community educational programs
  • Share resources about wellness with peers
  • Offer hope and inspiration
  • Talk one on one with an individual who has had a similar experience to provide support and hope
  • Volunteer at a warm line or hotline
  • Work at a community center
  • Volunteer throughout the community

However, unlike peer specialists, no specific training is required to identify as a peer supporter. While education is not required to be a peer supporter, many peers choose to expand upon their knowledge and skills.

While the evidence is rapidly growing in support of the peer support movement, hearing real people share their thoughts about their own experiences as peer supporters truly shows the impact of the role.


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Maintaining Certification and Continuing Education


Once a peer specialist is certified, how long before the certificate expires?

This depends on your original training, certification, and your state. The best first step is to contact your state’s certifying body to confirm requirements. If you attended training through a non-profit training organization, rather than a state training, contact the organization to inquire if your certificate expires. If you attended training through a non-profit organization and then certified through your state, ensure that you check in with both the training organization and the state about requirements. It is important not only to inquire about certificate expiration, but also to find out if there are any continuing education requirements from your state, the non-profit organization that you attended training through, or your employer.


If a peer specialist trained and certified in one state, will that be recognized and accepted in other states?

At this point, there is no single nationally recognized peer specialist certification. Each state has unique requirements, and some states only accept their own training and certification. Some states accept training and certification from other states and/or from approved training organizations, but still may require that an individual takes the state specific exam. Additional training hours or competencies related to state-specific issues may also be required in certain states. The system in which the peer specialist works or volunteers may also have requirements on this. For example, the United States Department of Veteran Affairs accepts certification for Veteran Peer Support Specialist employment from either an approved not-for-profit training body or the state training and certification from the state where the Veteran is working.


How does a peer specialist find Continuing Education (CEU) training?

The DBSA Peer Leadership Center has a number of continuing education opportunities available, as well as listings for many other organizations that can provide continuing education. You can learn about upcoming training opportunities here. Your state office, mental health organizations, or local agencies may also provide listings of accepted continuing education opportunities on their website or newsletter.


Are there online continuing education trainings for peer specialists?

While most training for initial peer specialist certification is conducted in person, there are many online training opportunities for continuing education once a person is certified as a peer specialist. The DBSA Peer Leadership Center includes many online continuing education opportunities, as well as listings of other organizations’ continuing education training.


How can an individual find funding to pay for continuing education training?

Some continuing education opportunities are available at no cost, some include a small fee, and others have higher price tags. If you are working as a peer specialist, discuss what options might exist to support your continuing education. If support is not available from your place of employment, or you are not yet employed as a peer specialist, there are many options to fundraise for training. Many trainings include the opportunity to apply for a full or partial scholarship. Asking the organization you’re applying to about scholarships is a great first step. These scholarships can often be quite competitive, so it is important to continue planning and researching funding options while you wait for scholarship announcements. Other funding ideas and sources include:

  • Your state’s Office of Consumer Affairs
  • Local resources for individuals living with disabilities
  • Local mental health agencies, drop-in centers, or mental health departments
  • Your local church community
  • Vocational rehabilitation counselor or benefits office
  • Consumer-run organizations and other mental health organizations in your area
  • Online personal fundraisers through sites such as Indiegogo, Crowdfunder, or Gofundme. There are many options for online fundraising, so research which site will provide the most benefit to you.
  • Your workplace or an organization you volunteer for may benefit from you learning peer support competencies, so you may decide to request to discuss financial support options with your supervisor.
  • Family and friends may be able to provide some financial support, or can assist in brainstorming additional fundraising ideas.

When fundraising, be sure to consider the total amount needed, including not only the cost of the training course itself, but also any additional costs that you might incur for travel, lodging, etc. While it is rare that one supporter would cover the entire cost, don’t let that discourage you. Many smaller donations can add up quickly! When presenting your request for support, be sure to share your reasons for wanting to attend the training and what you plan to do once you receive certification. If a person or organization is not able to support at the time, they could be a great resource for additional ideas on fundraising.

 


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Working as a Peer Specialist


What are some of the different settings/programs in which peer specialists currently work?

Peer specialists are found in many different settings throughout the country. These settings can include providing outreach to many unique individual experiences, including among people who are homeless, within transitional or long-term housing programs, acute and longer-term hospital settings, employment programs, Clubhouses, jails and prisons, diversion programs, outpatient treatment programs, recreation programs, Assertive Community Treatment teams, warm lines and hotlines, and even in Primary Care settings. The United States Department of Veterans Affairs employs Veteran peer specialists at every facility throughout the country. These are just some of the many different settings in which a peer specialist can be found, and this list is expanding steadily as the workforce grows. Most frequently, peer specialists work as paid employees, although some choose to offer their services as volunteers.


What do peer specialists do?

Peer Specialists support their peers, other individuals who identify as having personal experience living with a mental health or substance use condition, both individually and in small groups.
Peer Specialists:

  • Help peers create individual service plans based on recovery goals and steps to achieve those goals
  • Use recovery-oriented tools to help their peers address challenges
  • Assist others to build their own self-directed wellness plans
  • Support peers in their decision making
  • Set up and sustain peer self-help and educational groups
  • Offer a sounding board and a shoulder to lean on…and more!

How much do peer specialists earn?

Wages can vary greatly, beginning with a local minimum hourly rate, to a salary with benefits, depending on where a person is employed and the experience they bring to the position. Recently, a national study was conducted of over 1,600 peer specialists about earnings.


Where can peer specialists find job openings?

Many states, counties, agencies, and health centers post employment opportunities in newsletters and on websites. Searching online with the name of your city and state, along with specific titles such as “peer support” and “peer specialist,” can also provide listings of positions. Networking with other peer specialists, mental health professionals, and the program contacts where you participated in training can provide connections and open the lines of communication about job opportunities. The DBSA Peer Leadership Center also has a job board where organizations interested in hiring peer specialist post opportunities.


If an individual is trained both as a clinician and as a peer specialist, how can those two roles be integrated?

This is both wonderful and challenging!  An individual with personal lived experiences can be an especially empathetic clinician with strong rapport and credibility with consumers. “Professional boundary” issues for clinicians might limit the extent to which those with personal lived experience can relate their own recovery stories, or perhaps not be allowed to mention them at all. Some clinicians who identify as peers might reference their experience briefly, using phrases such as “I, too, am in recovery from….” or “There was a time in my life when….”  Even without sharing details of one’s own recovery, a clinician who is also a peer will know from their own personal experience that recovery is possible and that therapeutic efforts should focus on ways to overcome any barriers to a person achieving self-selected goals.

When working as a peer specialist, an individual with clinical training can further understand some of the diagnosis and treatment issues and will help work in a partnership with clinicians while still supporting peers in achieving their goals. For individuals who have been trained as both a peer specialist and a clinician, it can be difficult to avoid slipping into a clinical role while in the peer specialist role. Separating the peer specialist and clinical roles can require extensive self-awareness, especially for someone who works or has worked in both roles at different times.


How much of a peer specialist’s recovery story should be shared and with whom? How much of a peer specialists mental health history should be disclosed to an employer?

What should a peer specialist do if an employer states that sharing recovery stories are not allowed? 

A peer specialist’s recovery story is their “street cred” and resume. It is important for peer specialists to remember that this work is not all about their specific stories and experiences, but rather the story must be used in relevant bits and pieces. Committing to working as a peer specialist means committing to a willingness to share one’s recovery story with colleagues and consumers, but only in relevant and succinct ways, and only with details with which the peer specialist is comfortable.

One thing for peer specialists to consider is whether they’re really telling their “recovery story,” or maybe are they actually telling their “illness story”?  An illness story describes the issues and difficulties an individual faces, and focuses mostly (or entirely) on problems. A recovery story briefly mentions such issues, but then most of the focus is instead on how the individual overcame barriers and challenges, and what skills and strengths were discovered that are now aiding the individual in achieving goals.

As a peer specialist, if your employer states that story sharing is are not allowed, try acknowledging their reasons for feeling that way while also explaining the difference between the boundaries about self-disclosure for clinicians, compared with the essential role of recovery stories in providing hope, role modeling, and mentoring. This is a foundational piece of the work that peer specialists can do, so sharing examples of situations in which a recovery story might aid in supporting an individual can be helpful. Sharing when a recovery story might make an impact, and how a story might be shared, can help a peer specialist relate the importance of the story to their supervisor, while also reassuring them that the focus is on recovery, not the peer specialist as an individual.


How can peer specialists find peer support for themselves and answers to questions?

Self-care and prioritizing one’s own wellness and recovery plan cannot be stressed enough to peer specialists. Living in recovery is a requirement of this role, so actively choosing wellness is one of the most important parts of being a peer specialist. Peer specialists might find supports beyond their local community or agency by staying connected with individuals who attended peer specialist training with them, connecting with other peer specialists who are co-workers, attending continuing education classes, and/or participating in mental health and peer support conferences. Peer specialists are also encouraged to connect with other peer specialists through the DBSA Peer Leadership Center, where peer specialists can participate in discussion boards and send messages to one another.

How do peer specialists deal with burnout?

Self-care and prioritizing one’s own wellness and recovery plan cannot be stressed enough to peer specialists. Living in recovery is a requirement of this role, so actively choosing wellness is one of the most important parts of being a peer specialist. Peer specialists might find supports beyond their local community or agency by staying connected with individuals who attended peer specialist training with them, connecting with other peer specialists who are co-workers, attending continuing education classes, and/or participating in mental health and peer support conferences. Peer specialists are also encouraged to connect with other peer specialists through the DBSA Peer Leadership Center, where peer specialists can participate in discussion boards and send messages to one another.


What happens if an individual has a relapse while working as a peer specialist?

As peers know, relapse can be a part of recovery. It’s important that peer specialists have a wellness and recovery plan, and to stay in tune with personal changes and warning signs. Having a plan in place, whether a Wellness Recovery Action Plan (WRAP), DBSA’s Wellness Tracker, or another type of wellness tool or strategy, can provide guidance on positive steps to take if symptoms or signs occur. Wellness plans and supports may also assist in preventing a debilitating relapse and/or reducing the severity and length of a relapse. Peer specialists’ wellness plans can be tailored to include the possibility of relapse, as well as how to work with an employer if it occurs, including how to communicate the situation, adjust time schedules, and determine and use additional supports. And seeing a peer specialists experience a relapse and successfully manage it can provide consumers they work the opportunity to see an example of how a wellness plan works. 


What should a peer specialist do if something a peer is saying or doing triggers issues for them?

No matter what type of wellness plan a peer specialist chooses, self-care is vital. Peer specialist wellness plans should include as many known triggers as possible, with additions if more become apparent. With each of those triggers, peer specialists can include how to respond and cope. Peer specialists may find it helpful to reconsider any known triggers and coping strategies specifically with their positions in mind. When triggered, some peer specialists find that calmly saying something such as, “That’s difficult for me. Can we take a break from that right now and I will give it further thought, and then we can come up with a plan about how to talk about it?” Another possibility might be, “This is a tough topic for me. I’d like to consult with my supervisor about how I can talk with you about this.”

Peer specialists actively focus on their own recovery and health, so communicating with one’s supervisor about triggers is very important. Supervisors and the peer specialist’s supporters can be very helpful in dealing with triggering situations. If a peer specialist finds that working with a specific peer is consistently triggering, it is best to consult their supervisor about making a change. Sometimes, a peer specialist might not be able to work with an individual who triggers them.


How does a peer specialist relate to their peers if at one time they received services together and now the peer specialist is employed and assigned to work with them?

This can be awkward, especially in the beginning, as it can be something of a loss for both the peer specialist and the peer, since the relationship has changed. It can be helpful for the peer specialist to explain what the role entails and share details of the training and certification process. It is important for the peer specialist to reassure the peer that this does make anyone “better than” another, and that the lessons learned together as peers are part of what prepares peer specialists for this role.

As a peer specialist, it is very important to reflect on personal comfort and boundaries when it comes to receiving services and socializing. If the agency where you are employed is where you receive services, talk with your teams to establish boundaries, or to discuss the process of transitioning to new service providers. If you are friends with individuals who receive services at the place where you are a peer specialist, have conversations with your supervisor, team, and friend about the best practices both for ensuring everyone’s comfort and maintaining appropriate boundaries. Finding a balance between roles as peer and peer specialist can be a delicate process; communicating with all individuals involved is the best place to start.


What can a peer specialist do if they are not able to help someone?

A tough reality is that sometimes a peer specialist connects with a person who seems as if they are not at a place in their life where they are open to help. Sometimes people just want to be heard but don’t want to take any actions yet. It is important for peer specialists to try to maintain a positive, open relationship, because these individuals may well be ready for change in the future.

The peer specialist can re-examine what tools they are using in their work with the peer, consult with their own peer specialist network, and strategize with their supervisor. For some peer specialists, reflecting on the relationship, and what tools and actions have been or not been helpful, may allow them to see that they are trying to set goals for the person rather than supporting them in setting their own goals. When other people set goals for a person, they may reject those goals, and it may end up looking as if the person does not want help. Another possibility for a peer specialist to consider is that the individual might be able to connect with a different peer specialist in more productive ways. Building an open, trust-based relationship with a peer is the foundation for peer support, so it is crucial to make that connection first.


What if a peer specialist sees an individual’s rights being violated?

Some states view peer specialists as mandatory reporters, meaning that peer specialists are obliged to report certain issues to the appropriate agencies and/or people in that state. Most agencies and mental health centers have reporting policies, so it is important for peer specialists to learn and understand those policies. Some states and systems have an ombudsperson or consumer rights office, and every state has a federally mandated Protection and Advocacy System and Client Assistance Program all of which are resources that a peer specialist might find helpful in relationship to consumers’ rights.


What do peer specialists do if an individual they are working with contacts them outside of work?  

Self-care is vital to maintaining wellness and recovery, which will help ensure that a peer specialist is best able to perform at work.  Because of peer specialists’ natural empathy and personal lived experiences, there can be a high risk of burnout, which can then impact recovery. Accordingly, although it can be challenging, most agencies ask that employees limit their contact with consumers to work hours. The reasons for that vary but include liability issues, the potential for consumers to misinterpret the nature of their relationship with the peer specialists, and work-life balance.  It can be very difficult to put aside one’s thoughts, feelings, and concerns at the end of the day and may require the mutual support of other peer specialists.  It can be very helpful for peer specialists, and fair for both parties, to be very clear with consumers about when the peer specialist is going to be available to them as a support.  Making sure the peers that a peer specialist is working with have a list of emergency resources to contact outside of working hours can be helpful for everyone, and it can help begin this conversation.  Should a peer specialist be contacted outside of work, it is important for them to explain why they cannot talk with the peer at that time, to ensure the peer has emergency resource contact information if necessary, and to let the peer know when they will next be able to talk with them. If it is an emergency, a peer specialist might also contact emergency responders to report it.


How can peer specialists help supervisors understand the role and skills of peer specialists? What if an employer won't allow the peer specialist to use my peer specialist skills?

Change can be challenging! Remember that peer specialists are relatively new additions to the network of supports in a time of transformation to mental health care. Supervisors and clinicians share peer specialists’ vision of supporting people to live rich, joyous, fulfilling lives, but they might not have had much exposure to the field of peer specialists, or know how best to support their new team members.

Sometimes it can be helpful for a peer specialist to review the materials from their peer specialist training with their supervisor. Peer specialists can also share specific examples of skills learned that will add to the productivity of the team, and even provide information about peer support as an evidence-based practice. The DBSA Peer Leadership Center has a number of resources for supervisors of peer specialists, and many organizations have educational resources for supervisors. Working together to identify situations in which a peer specialist could make a positive impact is a great opportunity for peers to demonstrate the effectiveness of this role.

 

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