International Association of Peer Supporters (INAPS) www.inaops.org Page 1 of 24

National Practice Guidelines for Peer Specialists and Supervisors Recovery is a process of change through which

individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.

~~SAMHSA’s Working Definition of Recovery

The belief that recovery is possible for all who experience a psychiatric, traumatic, or substance use challenges is fundamental to the practice of peer support. The likelihood of long-term recovery is increased with effective support. Peer support has been demonstrated through research and practice to be highly effective. In addition to SAMHSA’s Working Definition and Guiding Principles of Recovery, the following core values have been ratified by peer supporters across the U.S.

1

as the core ethical values for peer support practice: 1. Peer support is voluntary

2. Peer supporters are hopeful

3. Peer supporters are open minded

4. Peer supporters are empathetic

5. Peer supporters are respectful

6. Peer supporters facilitate change

7. Peer supporters are honest and direct

8. Peer support is mutual and reciprocal

9. Peer support is equally shared power

10. Peer support is strengths-focused

11. Peer support is transparent

12. Peer support is person-driven

1 See the Appendix for the development of the U.S. National Practice Guidelines for Peer Supporters. International Association of Peer Supporters (INAPS) www.inaops.org Page 2 of 24 Background

rules about what peer workers can’t do, these guidelines focused on strengths and what peer workers can do in alignment with these 12 core values. Reviewed by a peer leadership panel at SAMHSA and endorsed with a 98.5% approval by over 1,000 peer supporters in the U.S., the National Practice Guidelines for Peer Supporters were issued by the International Association of Peer Supporters (iNAPS) in 2013 and have been recognized in all 50 states and the World Health Organization (WHO) for training and guiding peer workers on respecting and protecting the rights of people with mental disabilities worldwide. GUIDELINES FOR SUPERVISORS

With the continued growth of the peer workforce since 2013, increased attention has turned to supervision of peer support workers (also known as peer support specialists).

Many states funded peer support worker positions through Medicaid reimbursement, which required supervision by a licensed (qualified) mental health professional as defined by each state. While this led to substantial growth in the peer support specialist workforce, it also resulted in peer support worker supervisors with no direct knowledge of peer support values; their ethical codes often prevented practice of essential aspects of peer support such as self-disclosure (sharing relevant elements of one’s own personal story to connect with someone else). International Association of Peer Supporters (INAPS) www.inaops.org Page 3 of 24 Recognizing concerns about supervision, in 2018 iNAPS convened a National Supervision Workgroup to review issues, existing research reports, curricula, and webinars related to the supervision of peer support specialists. A Supervision Resource page was created on the iNAPS website. iNAPS continues to offer a monthly online discussion open to all peer support specialists and an additional monthly online discussion for supervisors. The Supervision Workgroup drafted National Practice Guidelines for Supervisors of Peer Support Specialists, identifying supervisors’ roles in helping peer staff uphold the core values of the 2013 National Practice Guidelines for Peer Supporters. The Workgroup sought national input through surveys and focus groups from both peer support specialists and supervisors. The National Practice Guidelines for Supervisors of Peer Support Specialists received an approval rating of 91.8% from 232 responses to a national survey. PURPOSE AND SCOPE

The purpose of the Guidelines for Supervisors (The Guidelines) is to educate supervisors about the core peer support values as applied in supervisory relationships. The Guidelines describe the supervisor’s role and offer practical promotion of these values in practice. These Guidelines do not address general topics in supervision beyond the values of peer support. While some tips in the Guidelines apply to all staff, their purpose is to educate (or remind) supervisors and peer support specialists of peer support values.

International Association of Peer Supporters (INAPS) www.inaops.org Page 4 of 24 integrated care, and related non-peer-run workplace settings, the number of experienced and interested peer support practitioners credentialed for funder-required supervisor eligibility is limited. Both lived experience and role-specific training are required to practice as a peer support specialist. Traditional academic education is not a substitute for the training and life experience of a peer support specialist who practices from the perspective of having lived experience. Whether or not a supervisor has lived experience as a peer supporter, the Guidelines for Supervisors offer important information to assist in delivering services in alignment with the fundamental values of peer support. MUTUAL RESPECT IN SUPERVISION

The INAPS National Supervision Workgroup recognizes the importance of mutual respect in supervision. The Guidelines recognize that circumstances arise in traditionally-structured agencies in which liability may influence decisions including supervisors’ use of authority. In these challenging situations, supervisors and supervisees can continue a mutually respectful relationship and open communication.

The focus of this document is the role of the supervisor in helping peer specialists practice the values in the INAPS National Practice Guidelines. Other recognized models for supervision of peer specialists may also be considered. International Association of Peer Supporters (INAPS) www.inaops.org Page 5 of 24 Contents

NATIONAL PRACTICE GUIDELINES FOR PEER SPECIALISTS AND SUPERVISORS 6 1) Peer support is voluntary 6 2) Peer supporters are hopeful 7 3) Peer supporters are open minded 8 4) Peer supporters are empathetic 8 5) Peer supporters are respectful 9 6) Peer supporters facilitate change 10 7) Peer supporters are honest and direct 12 8) Peer support is mutual and reciprocal 12 9) Peer support is equally shared power 13 10) Peer support is strengths-focused 14 11) Peer support is transparent 15 12) Peer support is person-driven 16 GLOSSARY 17 APPENDIX: 22 International Association of Peer Supporters (INAPS) www.inaops.org Page 6 of 24 National Practice Guidelines for Peer Specialists and Supervisors With 98% agreement among nearly 1,000 peer supporters responding to surveys and participating in focus groups, the following 12 core values were identified and validated as a basis for this work. CORE VALUE PEER SUPPORTER GUIDELINES

What this core value looks like in practice

SUPERVISOR GUIDELINES

How supervisors promote this practice

1) PEER SUPPORT IS VOLUNTARY PRACTICE: SUPPORT CHOICE THE SUPERVISOR ROLE IS TO: Recovery is a personal choice.

The most basic value of peer

support is that people freely choose

to give or receive support. Being

coerced, forced or pressured is

against the nature of genuine peer

support.

The voluntary nature of peer

support makes it easier to build

trust and connections with another.

• Peer supporters do not force or coerce

others to participate in peer support

services or any other service.

• Peer supporters respect the rights of

those they support to choose or cease

support services or use the peer

support services from a different peer

supporter.

• Peer supporters also have the right to

choose not to work with individuals with

a particular background if the peer

supporter’s personal issues or lack of

expertise could interfere with the ability

to provide effective support to these

individuals.

In these situations, the peer supporter

would refer the individuals to other peer

supporters or other service providers to

provide assistance with

• Encourage peer support specialists

in promoting individuals’ choices

includingore

knowledgeable about trauma-

informed approaches that reduce or

eliminate force and coercion to

create a safer environment for all.

• Explore peer support specialists’

choices about how they might or

might not choose to work with

certain individuals, especially if there

are issues related to dual

relationships or trauma.

International Association of Peer Supporters (INAPS) www.inaops.org Page 7 of 24 CORE VALUE PEER SUPPORTER GUIDELINES

What this core value looks like in practice

SUPERVISOR GUIDELINES

How supervisors promote this practice

• Peer supporters advocate for choice

when they observe coercion in any

mental health or substance abuse

service setting.

• Provide guidance to peer support

specialists when they are advocating

for choice or speaking up when

coercion occurs, especially when it

is subtle or systemic.

2) PEER SUPPORTERS ARE

HOPEFUL

PRACTICE: SHARE HOPE

THE SUPERVISOR ROLE IS TO:

The belief that recovery is possible

brings hope to those feeling

hopeless. Hope is the cataly

recovery

Peer supporters demonstrate that

recovery is real—they are the

evidence that people can and do

overcome the internal and external

challenges that confront people

with mental health, traumatic or

substance use challenges. As role

models, most peer supporters

make a commitment to continue to

grow and thrive as they “walk the

walk” in their own pathway of

recovery. By authentically living

recovery, peer supporters inspire

real hope that recovery is possible

for others.

• Peer supporters tell strategic stories of

their personal recovery in relation to

current struggles faced by those who

are being supported.

.

Being nonjudgmental means

holding others in unconditional

positive regard, with an open mind,

a compassionate heart and full

acceptance of each person as a

unique individual.

• Peer supporters embrace differences of

those they support as potential learning

opportunities.

• Peer supporters respect an individual’s

right to choose the pathways to

recovery individuals believe will work

best for them.

• Peer supporters connect with others

where and as they are.

• Peer supporters do not evaluate or

assess others.

• View differences as an opportunity

for learning. Refrain from seeing

differences as pathology

(symptoms); consider “what

happened?” rather than “what’s

wrong?”

• Learn with and from peer support

specialists about different pathways

to recovery and alternate

perspectives about individuals.

• Respect peer support specialists’

individual recovery journeys and

knowledge of recovery approaches.

4) PEER SUPPORTERS ARE

EMPATHETIC

PRACTICE: LISTEN WITH EMOTIONAL

SENSITIVITY

THE SUPERVISOR ROLE IS TO:

Empathy is an emotional

connection that is created by

“putting yourself in the other

person’s shoes.”

• Peer supporters practice effective

listening skills that are non-judgmental.

• Practice effective listening that is

non-judgmental and empathic while

balancing the need to hold peer

support specialists accountable for

their job duties.

International Association of Peer Supporters (INAPS) www.inaops.org Page 9 of 24 CORE VALUE PEER SUPPORTER GUIDELINES

What this core value looks like in practice

SUPERVISOR GUIDELINES

How supervisors promote this practice

Peer supporters do not assume

they know exactly what the other

person is feeling even if they have

experienced similar challenges.

They ask thoughtful questions and

listen with sensitivity to be able to

respond emotionally or spiritually to

what the other person is feeling.

• Peer supporters understand that even

though others may share similar life

experiences, the range of responses

may vary considerably.

• Provide adequate time and space,

with coaching and feedback, for peer

specialists to become proficient in

this critical skill.

5) PEER SUPPORTERS ARE

RESPECTFUL

PRACTICE: BE CURIOUS AND EMBRACE

DIVERSITY

THE SUPERVISOR ROLE IS TO:

Each person is valued and seen as

having something important and

unique to contribute to the world.

Peer supporters treat people with

kindness, warmth, and dignity.

Peer supporters accept and are

open to differences, encouraging

people to share the gifts and

strengths that come from human

diversity.

• Peer supporters embrace the diversity

of culture and thought as a means of

personal growth for those they support

and themselves.

• Peer supporters encourage others to

explore how differences can contribute

to their lives and the lives of those

around them.

• Peer supporters practice patience,

kindness, warmth, and dignity with the

people they support.

• See peer support as different from

traditional service, one that does not

start with the assumption that there

is a problem. Instead, peer support

is a way of relating to many different

world views.

• Gain awareness of one’s own world

view including personal stigmas,

stereotypes and bias that can

interfere with the ability to treat all

employees, including peer support

specialists, with respect and

fairness.

International Association of Peer Supporters (INAPS) www.inaops.org Page 10 of 24 CORE VALUE PEER SUPPORTER GUIDELINES

What this core value looks like in practice

SUPERVISOR GUIDELINES

How supervisors promote this practice

Peer supporters honor and make

room for everyone’s ideas and

opinions and believe every person

is equally capable of contributing to

the whole.

• Peer supporters treat each person they

encounter with dignity and see them as

worthy of all basic human rights.

• Peer supporters embrace the full range

of cultural experiences, strengths, and

approaches to recovery for those they

support and themselves.

• Take training themselves and

support offering all agency

employees, including supervisees,

training on cultural humility, which is

a process of openness and self-

awareness that incorporates self-

reflection and self-critique while

willingly interacting with individuals

from diverse cultures, ethnicities and

gender orientations.

• Invite ongoing feedback on personal

and staff practice of cultural humility.

6) PEER SUPPORTERS FACILITATE

CHANGE

PRACTICE: EDUCATE AND ADVOCATE THE SUPERVISOR ROLE IS TO: Some of the worst human rights

violations are experienced by

people with psychiatric, trauma or

substance use challenges.

They are frequently seen as

“objects of treatment” rather than

human beings with the same

fundamental rights to life, liberty

and the pursuit of happiness as

everyone else.

• Peer supporters recognize and find

appropriate ways to call attention to

injustices.

• Peer supporters strive to understand

how injustices may affect people.

• Peer supporters encourage, coach and

inspire those they support to challenge

and overcome injustices.

• Define and model advocacy for peer

support specialists, including

advocating for organizational

changes.

• Coach peer support specialists on

how to respect the rights of

individuals while helping individuals

challenge and overcome injustice.

• Build on lived experience, model

recovery and advocate for peer

support workers.

International Association of Peer Supporters (INAPS) www.inaops.org Page 11 of 24 CORE VALUE PEER SUPPORTER GUIDELINES

What this core value looks like in practice

SUPERVISOR GUIDELINES

How supervisors promote this practice

People may be survivors of

violence (including physical,

emotional, spiritual and mental

abuse or neglect). Those with

certain behaviors that make others

uncomfortable may find themselves

stereotyped, stigmatized and

outcast by society.

Internalized oppression is common

among people who have been

rejected by society. Peer

supporters treat people as human

beings and remain alert to any

practice (including the way people

treat themselves) that is

dehumanizing, demoralizing or

degrading and will use their

personal story and/or advocacy to

be an agent for positive change.

• Peer supporters use language that is

supportive, encouraging, inspiring,

motivating and respectful.

• Peer supporters help those they

support explore areas in need of

change for themselves and others.

• Peer supporters recognize injustices

peers face in all contexts and act as

advocates and facilitate change where

appropriate.

• Assist colleagues to understand the

peer specialist role and the

perspective and experience of peer

support specialists.

• Identify situations in which the

supervisor has responsibility to

address agency liability and maintain

respectful communication with peer

support specialists when differences

of opinion occur.

• Provide time and support for peer

support specialists to connect and

participate in the greater peer

movement and the peer workforce

profession.

International Association of Peer Supporters (INAPS) www.inaops.org Page 12 of 24 CORE VALUE PEER SUPPORTER GUIDELINES

What this core value looks like in practice

SUPERVISOR GUIDELINES

How supervisors promote this practice

7) PEER SUPPORTERS ARE HONEST

AND DIRECT

PRACTICE: ADDRESS DIFFICULT ISSUES

WITH CARING AND COMPASSION

THE SUPERVISOR ROLE IS TO:

Clear and thoughtful

communication is fundamental to

effective peer support.

Difficult issues are addressed with

those who are directly involved.

Privacy and confidentiality build

trust.

Honest communication moves

beyond the fear of conflict or

hurting other people to the ability to

respectfully work together to

resolve challenging issues with

caring and compassion, including

issues related to stigma, abuse,

oppression, crisis or safety.

• Peer supporters respect privacy and

confidentiality.

• Peer supporters engage when desired

by those they support, in candid,

honest discussions about stigma,

abuse, oppression, crisis or safety.

• Peer supporters exercise compassion

and caring in peer support

relationships.

• Peer supporters respect privacy and

confidentiality.

• Peer supporters strive to build peer

relationships based on integrity,

honesty, respect, and trust.

• Establish clear boundaries, set

reasonable and mutually agreed-

on expectations

• Promote responsibility and

accountability.

• Build trust and develop the

integrity of the supervisory

relationship with peer support

specialists through honest and

respectful communication about

strengths and areas that need

improvement.

8) PEER SUPPORT IS MUTUAL AND

RECIPROCAL

PRACTICE: ENCOURAGE PEERS TO GIVE

AND RECEIVE

THE SUPERVISOR ROLE IS TO:

In a peer support relationship, each

person gives and receives in a

fluid, constantly changing manner.

• Peer supporters learn from those they

support and those supported learn from

peer supporters.

• Ask peer support specialists how

they best receive feedback and

direction.

International Association of Peer Supporters (INAPS) www.inaops.org Page 13 of 24 CORE VALUE PEER SUPPORTER GUIDELINES

What this core value looks like in practice

SUPERVISOR GUIDELINES

How supervisors promote this practice

This is very different from what

most people experience in

treatment programs, where people

are seen as needing help and staff

is seen as providing that help.

In peer support relationships, each

person has things to teach and

learn. This is true whether you are

a paid or volunteer peer supporter.

• Peer supporters encourage peers to

fulfill a fundamental human need -- to

be able to give as well as receive.

• Peer supporters respect and honor a

relationship with peers that evokes

power-sharing and mutuality, wherever

possible.

• Encourage co-learning (collaborative

learning) and welcome peer support

specialists’ input in decision-making

wherever possible.

• Welcome feedback from peer

support specialists during

supervision sessions to develop

supervisory relationships based on

mutuality.

9) PEER SUPPORT IS EQUALLY

SHARED POWER

PRACTICE: EMBODY EQUALITY THE SUPERVISOR ROLE IS TO: By definition, peers are equal.

Sharing power in a peer support

relationship means equal

opportunity for each person to

express ideas and opinions, offer

choices and contribute. Each

person speaks and listens to what

is said.

Abuse of power is avoided when

peer support is a true collaboration.

• Peer supporters use language that

reflects a mutual relationship with those

they support.

• Peer supporters behave in ways that

reflect respect and mutuality with those

they support.

• Peer supporters do not express or

exercise power over those they

support.

• Peer supporters do not diagnose or

offer medical services but do offer a

complimentary service.

• Educate peer support specialists on

the concept of power and the

potential for inadvertently reinforcing

power differentials in the peer

support relationship.

• Reinforce the non-clinical nature of

the peer support role with peer

support specialists and other

organizational colleagues to avoid

‘peer drift’ or co-optation, and role

ambiguity.

International Association of Peer Supporters (INAPS) www.inaops.org Page 14 of 24 CORE VALUE PEER SUPPORTER GUIDELINES

What this core value looks like in practice

SUPERVISOR GUIDELINES

How supervisors promote this practice

• Consider how power in relationships,

including the relationship between

the supervisor and peer support

specialist, affects those with

histories of trauma, to create a safe

work environment.

• Support peer support specialist

values and scope of non-clinical

practice, especially in situations in

which the peer support specialist is

called upon to endorse or enforce a

form of treatment or clinical practice.

10) PEER SUPPORT IS

STRENGTHS-FOCUSED

PRACTICE: SEE WHAT’S STRONG NOT

WHAT’S WRONG

THE SUPERVISOR ROLE IS TO:

Each person has skills, gifts and

talents they can use to better their

own life. Peer support focuses on

what's strong, not what's wrong in

another’s life. Peer supporters

share their own experiences to

encourage people to see the “silver

lining” or the positive things they

have gained through adversity.

• Peer supporters encourage others to

identify their strengths and use them to

improve their lives.

• Peer supporters focus on the strengths

of those they support.

• Peer supporters use their own

experiences to demonstrate the use of

one’s strengths and to encourage and

inspire those they support.

• Model a focus on strengths rather

than deficits with all employees.

• Encourage peer support specialists

to develop meaningful personal,

career, and leadership development

goals and suggest they use a similar

process with those they support.

• Encourage peer support specialists

to use a strength-based approach to

evaluate their own progress and

performance;

International Association of Peer Supporters (INAPS) www.inaops.org Page 15 of 24 CORE VALUE PEER SUPPORTER GUIDELINES

What this core value looks like in practice

SUPERVISOR GUIDELINES

How supervisors promote this practice

Through peer support, people get

in touch with their strengths (the

things they have going for them).

They rediscover childhood dreams

and long-lost passions that can be

used to fuel recovery.

• Peer supporters operate from a

strength-based perspective and

acknowledge the strengths, informed

choices and decisions of peers as a

foundation of recovery.

• Peer supporters encourage others to

explore dreams and goals meaningful

to those they support.

• Peer supporters don’t fix or do for

others what they can do for

themselves.

invite them to provide a similar

strength-based approach when

working with others.

11) PEER SUPPORT IS

TRANSPARENT

PRACTICE: SET CLEAR EXPECTATIONS AND

USE PLAIN LANGUAGE

THE SUPERVISOR ROLE IS TO:

Peer support is the process of

giving and receiving non-clinical

assistance to achieve long-term

recovery from severe psychiatric,

traumatic or addiction challenges.

Peer supporters are experientially

credentialed to assist others in this

process.

• Peer supporters clearly explain what

can or cannot be expected of the peer

support relationship.

• Peer supporters use language that is

clear, understandable and value and

judgment-free.

• Peer supporters use language that is

supportive and respectful.

• Use the job description to orient peer

support specialists to job duties and

requirements, including the type of

documentation a peer support

specialist is expected to keep, and to

guide understanding of the

performance review process.

• Explain the supervisor’s role,

including connecting peer support

specialists to other colleagues with

additional expertise, as needed.

International Association of Peer Supporters (INAPS) www.inaops.org Page 16 of 24 CORE VALUE PEER SUPPORTER GUIDELINES

What this core value looks like in practice

SUPERVISOR GUIDELINES

How supervisors promote this practice

Transparency refers to set

expectations with each person

about what can and cannot be

offered in a peer support

relationship, including privacy and

confidentiality.

Peer supporters communicate in

plain language so people can

readily understand and they “put a

face on recovery” by sharing

personal recovery experiences to

inspire hope and the belief that

recovery is real.

• Peer supporters provide support in a

professional yet humanistic manner.

• Peer supporter roles are distinct from

the roles of other behavioral health

service professionals.

• Peer supporters make only promises

they can keep and use accurate

statements.

• Peer supporters do not diagnose nor

do they prescribe or recommend

medications or monitor their use.

• Describe the benefits and

expectations of the supervisory

relationship, including frequency and

duration of supervision meetings.

• Use plain, person-first language in

all interactions with peer support

specialists.

• Reinforce the non-clinical nature of

the peer support role with peer

support specialists and colleagues,

including documentation which is

consistent with the peer support role.

12) PEER SUPPORT IS PERSON-

DRIVEN

PRACTICE: FOCUS ON THE PERSON, NOT THE

PROBLEMS

THE SUPERVISOR ROLE IS TO:

All people have a fundamental right

to make decisions about things

related to their lives. Peer supporters

inform people about options, provide

information about choices and

respect their decisions.

Peer supporters encourage people to

move beyond their comfort zones,

learn from their mistakes and grow

from dependence on the system

toward their chosen level of freedom

• Peer supporters encourage those they

support to make their own decisions.

• Peer supporters, when appropriate, offer

options to those they serve.

• Peer supporters encourage those they

serve to try new things.

• Peer supporters help others learn from

mistakes.

• Peer supporters encourage resilience.

• Provide an environment where peer

support specialists are empowered to

move beyond comfort zones and learn

from their mistakes.

• Reframe unexpected outcomes as

opportunities for personal growth,

recovery, and resilience.

• Assist peer support specialists in

identifying areas for personal growth

International Association of Peer Supporters (INAPS) www.inaops.org Page 17 of 24 and inclusion in the community of

their choice. • Peer supporters encourage personal growth in others.

• Peer supporters encourage

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