Sharing Their Story Of Hope and Recovery. Office of Recovery Services Department of Behavioral Health and Developmental Services

Transcription

1 Sharing Their Story Of Hope and Recovery Office of Recovery Services Department of Behavioral Health and Developmental Services

2 is a specifically trained professional who has practice guidelines, abides by a code of ethics and utilizes core skills just as every professional does.

3 A trained peer practitioner is described as a natural ally, and someone who has walked in the same shoes as the individual seeking help.

4 Peer perspectives can provide momentum to an individual toward his/her self-management and health activation.

5 Sharing lived experiences and a strengths-based approach can foster support and motivate an individual towards health, wellness, and resiliency.

6 Peer Recovery Specialists focus on increasing an individual s resiliency and coping mechanisms while enhancing communication with providers so that care can be customized to meet an individuals' needs. Workforce Development Committee of the Access Task Force Supreme Court Commission on Mental Health Law Reform January 13, 2010

7 A PRS will encourage and coach those they support to help them decide what they want in life and how to achieve it. The PRS does this without judgement. PRS help others find and use their own voice.

8 Peer supporters demonstrate that recovery is REAL! By authentically living recovery, peer supporters inspire real hope that recovery is possible for others!

9 The following guidelines were created and are practiced by Peer Recovery Specialists

10 People choose freely to give or receive support; being pressured or forced is against the nature of genuine peer support.

11 Peer Recovery Specialists: Respect the rights of those they support Have the right to choose not to work with individuals if they know they cannot provide effective support for that person Do not force Advocate for choice when they observe coercion

12 A Peer Recovery Specialist is a living example of recovery in action. Hope in recovery is inspired by knowing that another person, the Peer Recovery Specialist, is having a regular and satisfying life.

13 Peer Recovery Specialists: Tell strategic stories of their own personal recovery Model recovery behaviors at work Help others reframe life challenges as opportunities for personal growth

14 Being judged can be emotionally distressing and harmful. Peer supporters are nonjudgmental and hold individuals in unconditional positive regard, with an open mind, a compassionate heart and full acceptance of each person as a unique individual.

15 Peer Recovery Specialists: Embrace differences Respect individual s right to choose Connect with others where they are Do not evaluate or assess

16 Peer Supporters do not assume that they know exactly what the other person is feeling even if they have experienced similar challenges.

17 Peer Recovery Specialists: Ask thoughtful questions and listen with sensitivity Respond to what the other person is feeling Openly and personally relate that recovery is a day to day involvement with life Demonstrate that recovery affects decisions but does not limit goals or needs

18 Each person is valued and seen as having something important and unique to contribute to the world.

19 Peer Recovery Specialists: Treat people with warmth, kindness and dignity Accept and are open to differences Encourage people to share strengths and gifts

20 Peer Recovery Specialists: Honor everyone s ideas and opinions and truly believe every person is equally capable of contributing to the whole. Talk openly about themselves and their recovery. Their interactions are guided by respect and what is comfortable to talk about.

21 Peer supporters treat people as human beings and remain alert to any practice that is dehumanizing, demoralizing or degrading. PRS will use their personal story and/or advocacy to be an agent for positive change.

22 Peer Recovery Specialists: Recognize injustices peers face in all contexts and act as advocates and facilitate change where appropriate. Help those they support explore areas in need of change for themselves and others. Encourage, coach and inspire those they support to challenge and overcome injustice.

23 Clear and thoughtful communication is fundamental to effective peer support. Difficult issues are addressed with those who are directly involved. Privacy and confidentiality are the cornerstones of trust.

24 Peer Recovery Specialists: Engage in candid, honest discussions about stigma, abuse, oppression, crisis or safety when desired by those they serve. Do not make false promises, misrepresent themselves, others or circumstances. Strive to build peer relationships based on integrity, honesty, respect and trust.

25 Peer support is a system of giving and receiving help founded on key principles of respect, shared responsibility, and mutual agreement of what is helpful. Center of Excellence in Peer Support All parties give and share equally.

26 Peer Recovery Specialists: Learn from those they support and those supported learn from the PRS Encourage peers to fulfill a fundamental human need to be able to give as well as receive Facilitate respect and honor a relationship with peers that evokes power-sharing and mutuality wherever possible

27 PRS speak as an equal to all about the experience of living in the community with a serious disability.

28 Peer Recovery Specialists: Use language that reflects a mutual relationship with those they support Behave in ways that reflect respect and mutuality with those they support Do not exercise power over those they support

29 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 positive things they have gained through adversity.

30 Peer Recovery Specialists: Realize and help show those they support that individual talents, cultivated skills and relationships are strengths Encourage others to identify their strengths and use them to improve their lives Focus on the strengths of those they support Openly share the story of their experiences as a tool of recovery that helps people discover their unique strengths and goals

31 Peer supporters are experientially qualified to assist others in this self-help process of recovery. They set expectations with each person about what can and cannot be offered in a peer support relationship and communicate with everyone in plain language so that everyone can understand. There is no hidden agenda.

32 Peer Recovery Specialists: Provide support in a professional yet humanistic manner Have roles that are distinct from the roles of other behavioral health service professionals Make only promises they can keep and use accurate statements

33 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 and inclusion in the community of their choice.

34 Peer Recovery Specialists: Do not offer solutions but encourage the development of unique strengths and goals that help a person shape an individual path of recovery Do not tell others what to do Encourage resilience and personal growth Help others learn from their mistakes Encourage and coach those they support to decide what they want in life and how they will achieve it

35 Peer Support is widely recognized as effective treatment for many disabilities and is an Evidence-Based Practice

36 For Information about Certification, Supervision and Training please contact: Mary McQuown, MA, CPRS Peer Recovery Specialist Liaison

37 An Introduction to Supervising Certified Peer Recovery Specialists Office of Recovery Services DBHDS DBHDS Vision: A life of possibilities for all Virginians

38 Supervising CPRS s What do we mean by the word: Supervision? Slide 2

39 Managerial Supervision to watch over so as to maintain order, etc.; to superintend; have the oversight and direction of; to oversee a process, work, and workers during the execution or performance of their job; Tasks include such things as performance reviews, workload planning and management, and general problem solving and decision making. Slide 3

40 Clinical Supervision Clinical supervision is a formal and disciplined working alliance that is generally, but not necessarily, between a more experienced and a less experienced worker, in which the supervisee's clinical work is reviewed and reflected upon, with the aims of: improving the supervisee's work with clients; ensuring client welfare; supporting the supervisee in relation to their work, and supporting the supervisee's professional development. Slide 4

41 SAMHSA defines Clinical Supervision as follows: Quality clinical supervision is founded on a positive supervisor supervisee relationship that promotes client welfare and the professional development of the supervisee. You are a teacher, coach, consultant, mentor, evaluator, and administrator; You provide support, encouragement, and education to staff while addressing an array of psychological, interpersonal, physical, and spiritual issues of clients; Ultimately, effective clinical supervision ensures that clients are competently served; Supervision ensures that counselors continue to increase their skills, which in turn increases treatment effectiveness, client retention, and staff satisfaction; The clinical supervisor also serves as liaison between administrative and clinical staff. Treatment Improvement Protocol (TIP) Series, No. 52. Center for Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); Slide 5

42 But CPRS don't do clinical work... The term 'clinical' is infused with many meanings, including a strong association with the medical model of health; The practice of CPRS focuses on the idea that recovery is based on the presence of wellness not the absence of disease. Based on what is strong, not what is wrong. The term Professional Supervision is a more precise descriptor. Slide 6

43 Borrowing the SAMHSA definition... Quality Professional Supervision is founded on a positive supervisor supervisee relationship that promotes the welfare of individuals being served while supporting the professional development of the CPRS. The Professional Supervisor is a teacher, coach, consultant, mentor, evaluator, and administrator; A Professional Supervisor offers support, encouragement, and education to staff while addressing an array of psychological, interpersonal, physical, and spiritual issues of individuals being served; Ultimately, effective Professional Supervision ensures that individuals are competently served; Professional Supervision ensures that CPRS continue to increase their skills, which in turn increases positive recovery outcomes and staff satisfaction; The Professional Supervisor also serves as liaison between peer recovery staff, and clinical or administrative staff. Slide 7

44 Supervisors: Assist in planning for how the Certified Peer Recovery Specialist (CPRS) will use their skills; Provide regular opportunities for the CPRS to reflect on their work with peers; Give feedback on why things turned out the way they did; Slide 8

45 Supervisors: (Cont.) Ensure quality and fidelity to the provision of peer support; Give feedback regarding how the CPRS uses their wellness/recovery in the Peer to Peer interaction; Encourage professional development; Inform of company Policy and Procedures. Slide 9

46 The Supervisor of CPRS Assists the CPRS to stay within the Practice Guidelines of Peer Support; Maintains confidentiality of things disclosed during both formal and informal supervision; Understands and supports the core values of purposeful Peer to Peer support; Conducts the supervisory relationship based on mutual respect and recovery principles; Slide 10

47 The Supervisor of CPRS (Cont.) Helps the CPRS identify additional resources and how to use those resources; Provides a different perspective, while supporting the maintenance of the unique CPRS perspective; Advocates on behalf of Peer Support as an emerging, evidence-based modality; Supports the non-linear nature of Recovery. Slide 11

48 It s About the Job Everyone else has stuff, too. Keep the conversation about whether the job is done well, not if the PRS is stable. Use the Code of Ethics, Practice Guidelines and Core Competencies as guides for supervision. Use your HR Department for understanding ADA accommodations. Slide 12

49 PRS are Team Members Sometimes PRS are supposed to be agitators Reminding others of strong not wrong Nudging about recovery language Advocating for system change Helping to show the other side of the picture A washing machine agitator transforms the clothes without harming the clothes Slide 13

50 Agenda for Supervision Meeting Performance: how are things going, what is working well, time management, peer relationships Education & Growth: skill development resources, review of progress toward professional goals Relationships with co-workers Management Issues: general agency policies and procedures Personal Recovery as a Tool: any challenges getting in the way of performing duties or factors that can improve performance of the job. Slide 14

51 Stay current RECOVERY BLAST RECOVERY BLAST is an list that the Office of Recovery Services uses to keep people posted on Certification and other Recovery topics. Send a request to opt in to A.Anderson@DBHDS.Virginia.Gov Subject Line: Please place me on the RECOVERY BLAST Slide 15

52 Thank You Becky Sterling, QMHP, CPRS Director Office of Recovery Services DBHDS.Virginia.Gov

53 A Story of Mice and Elephants Created by Becky Sterling QMHP, CPRS Office of Recovery Services DBHDS Do not reproduce without attribution to DBHDS Office of Recovery Services

54 Once there was a herd of elephants.

55 There were also some mice who were the elephant's relatives. They were like-minded and wished only health and well being for all mice and elephants. Elephant Shrew or Elephantulus

56 The elephants thought they should take care of the mice since sometimes the smallest amongst them needed help.

57 The mice were pretty sure they knew more about being a mouse than the elephants. They wanted to join the herd and help the elephants as they helped other mice. You know, mouse to mouse support.

58 So the mice talked to the elephant herd. They said nothing about us without us.

59 Elephants thought helper mice would be really nice to have around. They saw that mice could make the world a healthier place for everyone. They were pretty wise elephants.

60 Now, the elephants were pretty sure that you had to look like one of the herd to join the herd. That was the way it had always been. New herd member

61 So they spent time and money developing a new type of helping elephant.

62 But the wisest among them realized that a mousephant just could not make a difference. Trying to make the mice look like elephants was a failure. The other mice did not recognize them. And the other elephants did not recognize them either. A mousephant was a drain on the resources they all shared.

63 So the wise elephants and the mice met once again to see if there was a way to capture the valuable and unique services of the mice.

64 They determined that the mice must be in the herd, and yet remain mice. They would have all the respect, privileges and responsibilities of the herd but they would not have to become elephants. Elephants would be elephants and mice would be mice. The mice would be in but not of the herd.

65 In but not of the system There is a foundational concept of peer work commonly referred to as being 'in but not of' the system. This can be a somewhat confusing conceptto understand at first, but makes a lot of sense after closer examination. The idea is that the person in a peer role is working IN the system, but does not use the standard language or approach OF the system. Similarly, although the person in a peer role is working IN the system, they are operating under a different framework than that OFthe system. Specifically, they have a primary responsibility to support the voice of the individual without having major functions of the system become barriers to that responsibility.

66 CODE OF ETHICAL CONDUCT FOR CPRS Principle: Recovery First My primary obligation and responsibility is my recovery. I will immediately seek outside counsel and if applicable, notify my supervisor if alcohol, drug use, mental illness or anything else gets in the way of my recovery. Principle: Sharing Personal Recovery Story I will share my lived experiences to help others identify resources and supports that promote recovery and resilience. Principle: Service Approach I affirm the rights and dignity of each person that I serve. The services I provide will be guided by the principle of self determination to assist others in achieving their needs and goals. This includes advocating for the decisions of the peers regarding professional and other services. I will advocate for the right of peers to self select their own recovery pathways and recovery communities and will promote the individual s inherent value to those communities and pathways. Principle: Confidentiality I respect the privacy of those I serve and I will abide by confidentiality guidelines as required by the law. Principle: Non Discrimination I provide recovery support services regardless of someone s age, gender, race, ethnicity, national origin, sexual orientation, religion, marital status, political belief, language, socioeconomic status or mental or physical condition. If differences that impact the motivation for recovery occur, I seek consultation and, if necessary, make referral to another Certified Peer Recovery Specialist. Principle: Conduct I act in accordance with the law. I never use physical force, verbal or emotional abuse; intimidate, threaten, harass, or make unwarranted promises of benefits. I will fairly and accurately represent myself and my capabilities to the peer and the community. I will not accept money or items of significant value from people that I serve. I will not lend or borrow from the peers that I serve. I will not engage in sexual activities or intimate relations with peers that I serve. I will not engage in sexual activities or sexual contact with former clients within a minimum of two years after terminating services. I will not provide services to individuals with whom I have had a prior sexual or intimate relationship. Principle: Integrity I will not discontinue services to a peer without his or her knowledge and will make a referral for continued services when appropriate.

67 I will report violations of the Code of Ethics by other Certified Peer Recovery Specialists to the appropriate certifying entity. Principle: Conflict of Interest I will not use my role as a CPRS to promote any treatment, procedure, product or service, which would result in my personal gain. Principle: Scope of Practice I will not perform services outside of my area of training, expertise, competence, or scope of practice. Principle: Personal Development I will improve my recovery service knowledge and skills through ongoing education, training and supervision. My signature below affirms that I have read and promise to uphold the Certified Peer Recovery Specialist Code of Ethics in the performance of my role as a Certified Peer Recovery Specialist. Signature Date VCB CPRS Grandparenting Application April 17, 2015 July 17,

68 DBHDS Peer Recovery Specialist Practice Guidelines 1.) Provide face to face interaction that supports an individual achieving their self-identified level of recovery, wellness, independence or personal strength. a. Serve as a role model for recovery and wellness and self-advocacy. Provide feedback and insight into the value of every individual s unique recovery experience. b. Assist an individual or family receiving services with writing and communicating their personal recovery-wellness plans and to identify ways to reach those goals using a personcentered, individual recovery-wellness plan. c. Increase the individual s resiliency by assisting them in recognizing and augmenting personal strengths in skill areas related to handling problems encountered in daily life; such as self-awareness, resource discovery, and self-responsibility. Assist in gaining/regaining control of their lives through recovery and/or wellness based activities, concepts, and understandings. d. Share effective and positive strategies for developing coping skills and wellness tools related to overcoming the effects of having a trauma, a substance use disorder, or a mental health challenge. e. Clarify and enhance self-advocacy skills. Encourage peers to develop independent behavior that is based on informed choice; assisting peers in developing empowerment skills through self-advocacy. f. Establish and maintain a peer relationship based on mutuality rather than a hierarchical relationship. Partner with the other person to facilitate recovery dialogues and other evidence-based and/or best practice methods g. Assist peers in selecting behavioral health services that suit each person s individual recovery and wellness needs; Inform peers about community based and natural supports and how to utilize these in the recovery process. h. Provide education on wellness and/or recovery i. Assist in developing a psychiatric advance directive j. Assist individuals and families of children in creating crisis recovery response plans. k. Accompany people through the behavioral health service intake process and the discharge process, with person to person, face-to-face follow up after discharge of person. Help people identify and implement service exit strategies. l. Provide outreach to people who have frequent inpatient experiences. Provide outreach to people who have failed to engage with the behavioral health system. 2.) Provide trained peer-to-peer support in groups encouraging and supporting participation and self-directed participation. a. Serve as a role model for recovery and wellness and self-advocacy. Provide feedback and insight into the value of every individual s unique recovery experience. b. Assist in developing skills needed to identify a variety of groups that may be helpful and available in the community.

69 DBHDS Peer Recovery Specialist Practice Guidelines c. Facilitate peer-to -peer evidence-based practices or best practices, such as WRAP, Dual Recovery, 12-Step groups, WHAM, High Fidelity Wraparound, etc. d. Facilitate non-clinical peer to peer recovery education and wellness coaching through group activities in topics such as stress management, healthy leisure activities, wellness, alternative treatment options, recovery, focusing on individual health and wellness strengths and needs, self-affirmation, treatment management techniques, community involvement strategies, etc. e. Increase the individual s resiliency by assisting them in recognizing and augmenting personal strengths in skill areas related to handling problems encountered in daily life; such as self-awareness, resource discovery, and self-responsibility. Assist in gaining/regaining control of their lives through recovery and/or wellness based activities, concepts, and understandings. f. Share effective and positive strategies for developing coping skills and wellness tools related to overcoming the effects of having a trauma, a substance use disorder, or a mental health challenge. g. Clarify and enhance self-advocacy skills. Encourage peers to develop independent behavior that is based on informed choice; assisting peers in developing empowerment skills through self-advocacy. h. Establish and maintain a peer relationship based on mutuality rather than a hierarchical relationship. Partner with the other person to facilitate recovery dialogues and other evidence-based and/or best practice methods. i. Assist peers in selecting behavioral health services that suit each person s individual recovery and wellness needs; Inform peers about community based and natural supports and how to utilize these in the recovery process. j. Provide education on wellness and/or recovery. k. Assist in developing a psychiatric advance directive. l. Assist individuals and families of children in creating crisis recovery response plans. m. Accompany people through the behavioral health service intake process and the discharge process, with person to person face to face follow up after discharge of person. Help people identify and implement service exit strategies. n. Provide outreach to people who have frequent inpatient experiences. Provide outreach to people who have failed to engage with the behavioral health system. 3.) Mentor community integration activities (one-to-one or in groups) a. Provide community networking and linkage with social, recreational, spiritual, volunteer, educational or vocational resources. Assist the person in identifying traditional and nontraditional community based supports that sustain a healthy life style. Provide opportunities to practice socialization, interaction and engagement abilities in the community. Support, encourage, and enhance the development of natural support systems and independent choice and participation.

70 DBHDS Peer Recovery Specialist Practice Guidelines b. Assist in the development of a community integration plan that sets milestones for an increased independent community involvement, showing a decrease of dependency on the CPRS c. Support for day-to-day problem solving related to integration/reintegration into the positive community of choice. d. Enhance the person s/family s ability to navigate the systems of service delivery related to the person s written wellness-recovery plan or individual service plan. Provide, when available, time-limited transportation focusing on increasing the individual s transportation independence through access to natural or formal resources. e. Assist other behavioral healthcare service providers in identifying program and service environments that are conducive to recovery. 4.) Provide emotional support during the acquisition, exploration and sustaining of employment and/or educational services. a. Support the vocational and educational choices of peers and assist them in developing strategies for overcoming educational or job-related behavioral health challenges that lead to independence. 5.) Attend treatment team and program development meetings. a. Promote the use of self-directed recovery and wellness tools in individualized treatment planning. Facilitate the inclusion of the person being served in all meetings that relate to the delivery of services. Promote the inclusion of the individual in all treatment plans related to their healthcare. b. The CPRS will share his or her unique perspective on recovery from mental illness or substance use disorder with non-peer staff. Assist non-peer staff in identifying programs and environments that are advantageous to supporting recovery and wellness outcomes.

71 Core Competencies Background Peers are defined as a person in recovery from mental illness and/or substance use disorder or, in the case of family peer support, a family member of a person living with a behavioral health condition. Peer Recovery Specialists are individuals that use their lived experience to assist others in or seeking knowledge and experience of recovery. What are Core Competencies? The integration of knowledge, skills, and attitudes that contribute to the quality of a person s work performance. Knowledge is information and understanding learned through experience or training. Skill is the result of applying knowledge or ability to a set of circumstances and attitude is the manner in which a behavior is performed. Attitudes often align with the principles or values of a practice. Foundational and essential Required by all positions that provide peer support in behavioral health services. Common across a range of roles and environments. Peer roles in some settings or program models may require advanced or specialized competencies in addition to basic core competencies. Guide delivery and promote best practices in peer support. Inform peer training programs Provide standards for certification Inform self-evaluation and Inform job descriptions and performance evaluations Principles and Values All competencies should be performed in a manner that aligns with the principles of recovery-orientation, person-centered, non-coercive, traumainformed and relationship-focused. Recovery-oriented:

72 Peer support provides a hopeful framework for the person to envision a meaningful and purposeful life, recognizing that there are multiple pathways to recovery. Person-centered: Peer support is directed by the person participating in peer support service. Peer support is personalized to meet the specific hopes, needs and goals of an individual. Non-coercive: Peer support never involves force and participation in peer support is always voluntary. Relationship-focused: Peer support centers on the affiliation between peers. Characteristics of the relationship are: respectful, empathetic, and mutual. Trauma-informed care: Peer support utilizes a strengths-based framework that emphasizes physical, psychological, and emotional safety and creates opportunities for survivors to rebuild a sense of control and empowerment. Virginia Core Competencies Current Body of MH/SA Knowledge Knowledge of current body of knowledge of recovery from substance use disorder and/or mental health conditions (wellness, trauma) Define mental illness and substance use disorder recovery Knowledge of key language and terms Explain individual advocacy Knowledge of current research practices and trends in MH and SA Recovery Process - Promoting Services, Supports, and Strategies Knowledge of recovery plans, strengths-based recovery planning, and recovery goal setting (WRAP, Relapse Plan), Knowledge of the recovery process and recovery-promoting services, supports and strategies

73 Explain major recovery models (12 steps, Intentional Peer Support, SMART recovery, Women for Sobriety, Celebrate Recovery) Knowledge of multiple pathways to recovery Explain evidence based practices, practice based evidence, and promising practices Explain recovery plans and recovery goal setting (such as but not limited to WRAP) Assist individual with goal setting Promote self-determination and choice Crisis Intervention Knowledge of basics of crisis intervention Explain de-escalation techniques Explain basic suicide prevention concepts and techniques Knowledge of peer role and activities for peer support during crisis Identify and utilize legal and ethical policies and practices Recognize signs and symptoms of distress Recognize various crisis and emergency situations Values for Role of Recovery Support Specialist Knowledge of the role of peer recovery support coach values such as strengths-based, mutuality, unconditional high regard, shared experience, etc. Explain the concept of a strength based approach to recovery Ability to share experience using lived experience Establish and maintain a peer relationship rather than a hierarchical relationship Establish a respectful, trustful relationship Practice non-judgmental language Identify strengths and resilience in others Knowledge of peer recovery philosophy and practices Basic Principles Related to Health and Wellness Knowledge of basic principles related to health and wellness Define the concepts of health and wellness Understand the concepts of recovery and resilience Recognize the importance of holistic health

74 Understand the impact of mental illness and substance use disorders on the experience of health and wellness Stage Appropriate Pathways in Recovery Support Knowledge of stage-appropriate pathways that support recovery Knowledge of medication assisted recovery State the stages of recovery State the stages of change Knowledge and use of motivational enhancement techniques Ethics & Boundaries Knowledge of ethics, confidentiality, boundaries and self-care as practiced in non-clinical settings (ADA, HIPAA, 42CFR, Advanced Directives). Adhere to peer code of ethics Recognize and adhere to the rules of confidentiality Explain how and why individuals should establish an Advanced Directive Knowledge of and adherence to professional and personal boundaries Understand self-care principles Establish working relationships with other professionals Use organizational/departmental chain of command to address ethical issues Cultural Sensitivity and Practice Knowledge of cultural sensitivity and practice Define culture, elements of culture, and its impact Ability to communicate utilizing first person and person centered language Recognize different types of cultures Explain key recovery language and culture concepts Knowledge of the influence of cultural heritage on individuals and groups Knowledge of and sensitivity to how cultural identity can influence the dynamics in communication. Knowledge of and sensitivity to how cultural identity shapes the helping process.

75 Trauma and Impact on Recovery Knowledge of trauma and its impact on recovery from mental and substance use disorders Define trauma and its impact on recovery process Explain trauma informed care and recovery support Understand the symptoms of PTSD Skill in identifying physical and sexual abuse symptoms Knowledge and awareness of risk indicators when working with others Identify and respond to personal stressors and triggers Community Resources Identify community resources, including crisis services, community supports and professional services Ability to access and refer to community resources Ability to coach others to navigate community resources Knowledge of and ability to collaborate with community organizations and other partners Demonstrate effective networking skills Delivering Peer Services within Agencies and Organizations Knowledge of how to deliver peer recovery support coaching on an individual level and in an agency, organizational, systems, and federal setting Define systems level advocacy Knowledge of Virginia s service delivery systems Provide peer support within an organizational culture and requirements Understand documentation requirements of activities to meet organizational requirements Knowledge of when to seek out and use supervision Advocate for peers and recovery support services within the organizational culture Differentiate between the levels of advocacy