On The Role of Peers in Addiction Recovery

peerrecoveryAs the treatment of addiction moves inexorably toward inclusion in the larger healthcare system, with its standards of evidence-based care, there is also a movement towards the use of peer counselors with “lived experience” with addiction. Are peer counselors able to connect with and help persons struggling with addiction in a unique way? Do the outcomes achieved in employing peers suggest that they should be more widely used, and supported by public funding? Melissa Killeen opens the conversation and highlights a case in which peer counseling played an integral role…Richard Juman

A peer recovery support specialist has many job titles across the United States and around the world. They may be called certified recovery support practitioners, recovery advocates, peer mentors or recovery coaches. They tend to be employed at recovery community support centers, at hospitals, behavioral health agencies or addiction treatment centers. The peer recovery support specialist may be working with substance misusers, traumatic brain injury clients, behavioral health clients or clients that identify with all of these diagnoses. Certified peer recovery support specialists are generally employed by the facilities at an hourly rate for their services; for the client, peer recovery support services are typically free. In this article, I will focus on the peer recovery support specialists working in the addiction field.

Recovery community support centers, financed with state and federal funding, some with funding from churches or individuals, are slowly taking hold and becoming more prevalent. The recovery advocacy organization Faces & Voices of Recovery, developed the Association of Recovery Community Organizations that unites and supports a growing membership of over 100 recovery community support organizations, although there are many organizations which have not yet become members of ARCO. For example, in my neck of the woods, there are currently 12 recovery community support organizations in Pennsylvania and 10 in New Jersey. Recovery community support centers can provide computer training, job interviewing skills training, resume writing, legal assistance, parenting skills training, social services linkages, 12-step meetings and even haircuts! It is important to highlight that these are non-clinical settings. Treatment is not provided—these are healthy places where people with current or past histories of addiction can go as an alternative to hanging out at a bar or on a street corner. Recent research completed by Chyrell Bellamy, MSW, PhD and Michael Rowe, PhD, both assistant professors at Yale University, concluded that working with peers in a recovery community environment may reduce alcohol use, drug use, and criminal justice chargesfor at-risk populations.

In my view, the most important service that a recovery community support center offers is the assignment of a peer recovery support specialist or recovery coach to work with each client that comes to the center. At the outset, the peer recovery support specialist meets the client and sets up a schedule upon which the client and peer will meet. The format and structure varies widely, with some relationships based on daily phone calls and others on weekly face-to-face visits. The actual length of a coaching engagement will also vary. The McShin Foundation suggests that, as at the community recovery support centers run by the Virginia-based foundation, a 90-day limit is placed on the coaching assignment. However, other organizations, like the Hartford-based Connecticut Community for Addiction Recovery, does not place an arbitrary limit on the length of coaching time. Instead, it recommends that standards of goal achievement, like drafting a recovery plan, a relapse prevention plan and/or attaining sobriety goals, be used to determine the length of engagement.

What do peer recovery support specialists actually do for their clients? Here is one example:

In 2013, I helped create the first community recovery center in southern New Jersey, one of only a handful of recovery centers in New Jersey at the time. Heather Ogden-Busch was one of the first people we hired at the Living Proof Recovery Support Center in Voorhees, NJ. At the time, because she had many years of sobriety and experience in sponsorship, she naturally fell into the role of a peer recovery support specialist, or recovery coach. On Heather’s first day at the recovery support center she received a call from a member of her 12-step group. This member relayed the story about another member from the meeting, Beth (not her real name), who had relapsed on heroin. Beth was living in a trailer with her boyfriend, who was also addicted to heroin, and she was not doing well. Beth wanted to stop using. Heather called her immediately.