November 4 NYS BRSS training-Peer Supervision Organizational Change ETHICS Boundaries mod 1.pptx

Peer work as a discipline/profession. Is there a scope of practice/career ladder?

Differences in peer supervision vs. clinical supervision, e.g. counselors and social workers

Overview of SUD Peer Supervision Core Competencies

1. Supervision of PEERS (Recovery Coach/CRPA/CARC) within the Recovery Oriented Services of Care & Behavioral Health Field

2. Lets FOCUS our discussion on: Peer work as a discipline/profession. Is there a scope of practice/career ladder? Differences in peer supervision vs. clinical supervision, e.g. counselors and social workers Overview of SUD Peer Supervision Core Competencies

3. Organizational concerns with peers that have a reoccurrence of an SUD Importance of wellness and self care with peers-(SAMHSA Wellness Chart) Recovery Coach/CRPA/CARC Professional development/certification process

4. Is your Agency ready to Supervise Peers? KSA = Knowledge, Skills, Abilities Ask your team these questions: 1. Describe the role of a PEER in your agency. 2. Define the role of the SUPERVISOR in your agency 3. Describe the characteristics of a PEER . Either from what you know personally from lived experience or from what you know vicariously regarding the lived experience of someone else who identifies as a peer. 4. Describe the characteristics of a SUPERVISOR . Either what you know from experience of being supervised, being a supervisor yourself, or how you would define quality supervision.

5. Recovery Community and Outreach Centers Outpatient Clinics Emergency Rooms Hospital based programs Drug Treatment Courts Housing programs Prevention Programs Independent Living Centers Senior Living Homes Recovery Community Organizations Counseling Centers Community Health Centers In the Community Not-for-profits Family Programs Rescue Missions Faith-Based Programs Drug Courts College Programs : Recovery Coach/CRPA/CARC Working in many types of settings

6. No matter the modality in which peers are engaged, they must be supervised through a process of empowerment--with incremental steps leading to professional growth and development.

7. Peer supervision vs. Clinical/other disciplines Clinical Supervision (QHPS)- is a qualified health professional that utilizes both experiential and evidence based processes. This process can be done through many models. Peer Supervisors follow the Recovery-Oriented Philosophy. REMEMBER-Supervision is Not always within the clinical framework of a treatment program. Types of Peer supervision: Individual Mentoring/Peer (Supervision) Groups/Clinical Setting.

8. Unlocking The Art and Heart of Supervision and Staff Retention Equally important to recruitment, hiring and training practices for Recovery Peer Professionals (Recovery Coach/CRPA/CARC) in integrated healthcare settings are the practices that support the retention of these staff. Factors that increase retention include: • Supervisors who have specific training in the peer role/values and ethics (if they are not peers themselves) and how they can best support integration • Ongoing support, training and consultation for Recovery Peer Professionals • Career ladder opportunities

9. Unlocking The Art and Heart of Supervision and Staff Retention The Peer Support (Professional) community is filled with anecdotal evidence of failed and traumatic employment experiences in behavioral healthcare settings. Much of this is caused by poor integration of a new type of employee with a unique role on the team, combined with a lack of understanding of the distinct set of values and ethics of Recovery Peer Professionals. The supervisor is key to mitigating these issues and responsible for the change management that has to occur over time.

10. Unlocking The Art and Heart of Supervision and Staff Retention The role of the supervisor is integral to the successful integration of Recovery Peer Professionals in integrated or collaborative care settings. Like any other worker, the Certified Peer Specialist must demonstrate the capacity to: • Do what is expected: meet the requirements of the job • Go where needed: work within the environments required • Be able to work: attend to personal wellness beyond the job environment

11. Unlocking The Art and Heart of Supervision and Staff Retention FAQs I’m going to be supervising the new Recovery Peer Professionals on the team. How do I get up to speed on what these new employees can and should be doing? If you as a new supervisor for Recovery Peer Professionals are not a peer yourself, it’s important that you receive a thorough training in the peer role, values and ethics.

12. Unlocking The Art and Heart of Supervision and Staff Retention What kind of orientation does the Peer Support Specialist need when beginning the job?   Ensure that the Peer Support Specialist gets a thorough orientation. With the fast-paced culture of behavioral health and primary care work environments, a thorough orientation is easy to skip over without understanding how important it is for the newest member of the team. Before jumping right in, the supervisor needs to organize an orientation that includes:

13. Unlocking The Art and Heart of Supervision and Staff Retention Orientation Should include: • Introductions to all members of the team and key collaborators • Overview of the program and agency mission, values and philosophy • Organizational chart, lines of communication, key personnel • Operation of the phone, voicemail, email and computer • Process for accessing work supplies • Review of the policies and procedures • The time spent in providing this grounding and fundamental information will pay off in reduced stress and greater ease in integrating onto the team.

14. Unlocking The Art and Heart of Supervision and Staff Retention The Recovery Peer Professionals do not seem to understand the workplace culture. What can I do to help? Assist Recovery Peer Professionals in navigating the culture of the workplace. Recovery Peer Professionals can find that the fundamental values and ethics that define their work and that create the type of relationship experience essential to healing are in conflict with the status quo operation of most behavioral health/primary care work settings.

15. Unlocking The Art and Heart of Supervision and Staff Retention Supervisors help to mitigate the clash in cultural values and can even promote more adoption of peer values into traditional behavioral health/primary care settings. Encourage the Peer Professional to provide feedback to and from colleagues as well as to and from the supervisor.

16. Unlocking The Art and Heart of Supervision and Staff Retention FYI---Where to go for more guidance? The Substance Abuse and Mental Health Administration (SAMHSA) has two excellent resources on supervision of Recovery Peer Professionals in integrated settings on their website. These resources provide information on orientation to peer-provided services in whole health, an overview of competencies, scope of practice, job descriptions, peer code of ethics, supervision issues, quality improvement and outcomes models. The Supervisor Guide: Peer Whole Health and Wellness Wellness Coaching: Supervisor Manual

17. Unlocking The Art and Heart of Supervision and Staff Retention Many agencies prefer that the supervisor for Recovery Peer Professionals is someone who also has lived experience and understands the role and functions of peer provided services from having come up the ranks themselves. In many instances, there has just not been the length of experience in hiring peer providers to create a large enough pool of peer supervisors from which to draw. In this case, the supervisor must be specifically trained in the role of Recovery Peer Professionals as well as the values and ethics of peer-provided services.

18. Peer Supervision Effective supervision is critical for successful employment of persons in recovery, as it is for any worker. Supervising people with who are in recovery is, in most ways, exactly like supervising people who are not. After recruiting, hiring, and orienting a new employee, any ongoing issues can be readily addressed in supervision, such as job and role clarification, expectations, and performance; confidentiality; disclosure; dual roles; and working as a team member.

19. Peer Supervision Supervision is a dynamic process by which a worker who has direct responsibility for carrying out a program in an agency is helped by a designated responsible staff person to make the best use of knowledge and skills so as to perform the requirements of the position effectively. In this context, the purpose of supervision is to help the Recovery Peer Professional to be resourceful and effective in performing his/her work duties and effectively fulfilling the requirements and duties of the position.

20. Peer Supervision Supervision works well as a reflective process in which The supervisor helps the Recovery Peer Professional to examine his/her performance and continue to develop and refine his or her abilities to perform all required duties as effectively as possible. In order to accomplish this, both the supervisor and the Recovery Peer Professional need clear expectations. Therefore, a position description or job description should be provided, and clear performance evaluation reviews should be performed at pre-determined intervals.

21. Peer Supervisor Competencies #1: Understands Peer Role #2: Recovery Orientation #3: Models Principles of Recovery #4: Supports Meaningful Roles #5: Recognizes the importance of addressing Trauma, Social Inequity & Health Care Disparity #6: Ongoing Training #7: Professional System Navigation #8: Applicable Laws & Regulations #9: Community Resources #10: Role Clarity

22. Peer Supervisor Competencies #11: Strength-based Person-Centered #12: Identify & Evaluate Peer Competencies #13: Confidentiality #14: Ethics & Boundaries #15: Quality Supervision #16: Accessibility #17: Occupational Equity & Staff Development #18: Staff Safety #19: Peer Delivered Services Advocacy # 20: Employment Practices

23. SUD Peer Supervision Core Competencies--Recovery-Oriented Philosophy (Martin, Jordan, Razavi, Nurnham, Linfoot, Knudson, DeVet, Hudson, & Dumas,(2017) The Regional Facilitation Center, Portland, Oregon. Competency One: Understands Peer Role Supervisor fully Comprehends the substance use disorder (SUD) peer recovery role and duties through core peer training, their lived recovery experience, and behavioral health occupational experience. Types of training a supervisor should have?

24. Competency Two: Recovery Orientation Supervisor understands and supports the philosophy of recovery management and recovery oriented systems of care (ROSC), including, but not limited to: hope, self‐disclosure, mutuality, person‐first language, self‐determination, empowerment, many pathways and styles of recovery, fostering independence, utilizes strength‐based approach, addressing stigma & oppression, providing stage of change appropriate support, client choice, and advocacy.

25. Competency Four: Supports Meaningful Roles Supervisor supports meaningful peer roles, including: outreach and engagement, empathetic support, instilling hope, enhancing motivation, client advocacy, and system navigation. Supervisor advocates to maintain those meaningful roles and discourages the use of peers in other roles that diminish the value of their work or create ambiguity in their occupational roles, or are beyond the boundaries of one’s education, training, and experience. Supervisor embraces the value of lived‐experience and appropriately utilizes peers based on their lived‐experience (e.g., addiction peers, forensic peers, mental health peers, and family peers).

26. SUD Peer Supervision Core Competencies—Training and Education Competency Six: Ongoing Training Supervisor acknowledges that requisite entry level education is modest and that their role includes ongoing training & education, including coaching /mentoring peers regarding: competencies, skills development, documentation, data collection systems, ethical standards, professional boundaries, community resources, applicable laws, and client rights.

27. Competency Seven: Professional System Navigation Supervisor assists peer staff in understanding the greater behavioral health system and its relationship to health care, allied providers, courts, child welfare, and entitlement programs. Supervisor assists peer staff in understanding the etiquette, procedures, and legal obligations of working with community partners (Courts, Child Welfare, TANF, WIC, SNAP, Probation/Parole, Addiction Treatment, and Psychiatric Institutions.)

28. SUD Peer Supervision Core Competencies—Facilitating Quality Supervision Competency Ten: Role Clarity Supervisor provides role clarity for peers through accurate job descriptions and the written articulation of duties , utilizing supervision time to identify, discuss, and process situations where there is role ambiguity or role confusion.

29. Competency Eleven: Strength-based Person-Centered Supervision Supervisor exercises strength‐based person‐centered approach to supervision. Supervisor has capacity to give and receive feedback, engendering mutuality and trust. Supervisor creates a safe atmosphere for all staff to give and receive feedback, facilitate self‐reflection, and the experience of professional growth. Supervisor utilizes a strength‐based approach and can consistently give recognition and praise for competency development and successful outputs/outcomes with clients.

30. Competency Twelve: Identify & Evaluate Peer Competencies Supervisor can identify SUD peer competencies (knowledge, skills and attitudes) specific to the peer role (active listening, motivational interviewing, and other skills). Supervisor monitors the fidelity of those competencies and can give feedback to individual peers regarding their efficacy, and creating work plans as indicated.

31. Competency Fifteen: Quality Supervision Supervisor maintains the integrity of Peer Delivered Services supervision. Too often in traditional behavioral health, supervisors are promoted to leadership roles due to their administrative competencies as opposed to their supervision competencies. Supervisor can balance administrative/clerical supervision versus quality peer services supervision, and continuously provides peer supervision, and resisting “administrative compliance” being the primary function of peer‐delivered services supervision.

32. Something to think about: Too often in traditional behavioral health care, supervisors become absorbed into the “administrative meeting” culture, forgoing their duties of quality supervision in favor of administrative meetings with city, county, state officials, funders, auditors, and other “important” people. They eventually become “absentee supervisors.”

33. Competency Seventeen: Occupational Equity & Staff Development Supervisor affords opportunities for participation, and training to all staff equally, including peer staff. Supervisor promotes professional development and advancement through a career ladder. Supervisor develops written professional development plans with peer staff.

34. Competency Eighteen: Staff Safety Supervisor understands safety issues inherent in community‐based work, outreach, and in‐home care. Supervisor considers reasonable precautions for staff safety when working outside of the confines of an institution or community recovery center. Supervisor and peers recognize stigma and misconceptions regarding safety as it applies to race, ethnicity, infectious disease, and mental health challenges.

35. Ensure policy and procedures are written and given and signed for by peer. Develop job descriptions that are focused on specifics tasks that are results-focused and can be achieved. Note: It is important not to include in job “And other tasks as assigned”. Why?

36. Importance of wellness and self-care

37. Integra ti ng Peers in your Workforce: An Overview of Organiza ti onal Change

38. Five Core Tenants /Pillars of Peer Support Educa ti on Cer tification Employment Professionalism Organizational Advocacy From: Daniels, A., Bergeson, S., Ashenden, P., Fricks, L., Powell, I.,L Pillars of Peer Support: Advancing the Role of Peer Support Specialists in PromoOng Recovery , The Journal of Mental Health Training, Educa6on and Prac6ce ( 2012).

39. Pillars of Peer Support--SUPERVISION Peer Supervisors are Trained in Quality (Peer Recovery specific) Supervisory Skills. Peer Supervisors Understand and Support the Role of the Peer. Peer Supervisors Understand and Promote Recovery in their Supervisory Roles. Peer Supervisors Advocate for the Peer and Peer Services across the Organizaton and in the Community. Peer Supervisors Promote both the Professional and Personal Growth of the Peer within Established Human Resource Standards.

40. In teg r a t in g P ee r s i n the W o r k f o r c e: S t r e n gthe nin g Or g aniza t iona l Cul t ur e

41. Organizational Culture: Values and Expectations ! Integration of Clinical SUD Services, Peer Recovery Support Services and other program services ! Recovery Oriented Systems of Care (ROSC) ! Shared vision of peer (value continuum ) role across the organization

42. ARE YOU READY? ! Suggestion: Conduct readiness survey —Use as a guide/tool to promote Continuous Quality Improvement ! Expectation : to employ a sufficient workforce of individuals with lived experience throughout all levels of the agency who are paid fair and competitive wages

43. Assessing Organizational Readiness You must first determine if your organization is prepared to hire peers. Staff at different organizational levels should fill out the below readiness assessment by marking the box that reflects how much they agree with each statement. This can help your organization identify what to address before recruiting peers. Assessing Non-Peer Staff Engagement Next, encourage non-peer members of the care team to complete the self-assessment below by marking the box that reflects their level of concern with each statement. The purpose of this assessment is not to judge staff, but to help identify any concerns or questions before peers join the team. You may choose to have staff complete the assessment anonymously and hold a meeting to discuss the results afterwards.

44. !

45. Policy Section: Recovery Policies, procedures, and a process in place that support s and encourage s the opportunity to participate in multiple aspects of care coordination. Agency -wide explicit policies and procedures that support individual choice, person centered, culturally competent, trauma informed practice that will incorporate SUD PEER RECOVERY SUPPORT into the service delivery system

46. T raining and Co ntinuing Education Power, conflict, and integrity in the workplace Ethics Medicaid Provider description for Certified Recovery Peer Advocates (CRPA) billable services Continuing p eer and supervisor training --

47. ! Evidence shows that… Recovery happens in communities and neighborhoods where people live so they can access natural support systems and live a life of independence. Peer Recovery Professionals are an integral part of enabling individual/clients to have access to additional support within their communities.

48. Organizational Vision : Peer recovery professionals as a respected evidence-based practice will support individuals in leading self-determined lives with a focus on health and wellness to increase quality of life and life expectancy for individuals in their pathway of recovery.

49. Crea ti ng a welcoming environment

50. Listening to peers about how they want to support recovery Conduc ting peer recovery focused training within the organization Promo ting/supporting local, peer oriented recovery community organiza ti ons Promo ti ng programs and services peer staff has deemed necessary Keeping a feedback loop open to keep working together! Creating a Culture support for Peer Recovery Professionals : What successful organizations are doing…

51. Creating a Culture that Supports Peer Recovery Services : O ne Suggested Approach… Something is working here What you focus on you will find more of… Redefine /Allocate Resources Build Trust Model Recovery – WHAT’S RIGHT WITH YOU?!? Share Success Stories Promote the VALUE of Lived Experience

52. Hiring Program Graduates as Peers Organizations may choose to hire program graduates, but are not obligated to. Staff should weigh the pros and cons while making this decision. Graduates know the program and the organization’s views on treatment and recovery very well. However, staff may have trouble accepting a graduate as a member of the care team. Before hiring peers, it is helpful to determine whether or not organizational stakeholders and non-peer staff feel comfortable working with treatment program graduates. Organizations can also identify policies or protocols to ease some of the concerns staff may have about hiring program graduates. For example: Organizations with multiple treatment programs can only assign peers to treatment programs from which the peer did not graduate. Others can impose waiting periods for graduates returning to work as a peer.

53. Care Team Proceedings Peers are an important part of care teams and should be included in all team meetings, case conferencing, and care planning sessions. After an orientation, peers should know any confidentiality policies and team data collection procedures so they can fully participate in case conferences and other team-wide activities. Peers can offer insight into participant progress, which is not observed in clinical encounters and would otherwise not be included in case conferences. Working in the Community Recent changes in Medicaid have given programs new opportunities to provide reimbursable services in the community. Peers, as well as other staff, can now work off-site to bridge the gap between treatment settings and the larger community.

54. Working in the Community Organizations must establish clear policies and procedures to help peers work safely and professionally off-site. For suggestions, see the protocols established in fields with substantial home-visit components, such as intensive case management and child welfare. Sustaining and Developing New Services Peers can help develop and sustain organization-wide services, like community outreach and education efforts. They can also help improve the peer support program by giving feedback and identifying areas for growth. Organizations can demonstrate their commitment to peer support by actively incorporating peers into various service modalities and incorporating the peer perspective into program development.

55. Integration Strategies To help non-peer staff understand the role and value of peers, organizations can develop a presentation explaining the peer program. This can include an overview of the services peers provide and details about their background and experience. Upper level staff should answer questions and address any concerns staff have about the peer program before establishing a peer program LETS FIGURE THIS OUT TOGETHER!? Peers can be involved in staff training sessions.

56. Creating a Culture that Supports Peer Recovery Services: What some peers have said about their new job … “Not being able to speak to upper management in any kind of meaningful way , nor clearly understanding what they think or feel my role there is . Sometimes I feel I’m only there to sa ti sfy their quota for having a C RPA on staff.” “Not being respected by clinicians at first until they got to know me and see the work that I do.” “Some challenges I have faced are when advoca ti ng for a peer I tend to get nega ti ve feed b ack from other professionals.”

57. … Ethical Considerations for Recovery Coaches Non-Clinical Model

58. Many thanks to extensive work of: -- William White who, through his much publicized work, assisted heavily in bringing the Recovery Movement to the forefront. -- CCAR and, the McShinn Foundation and Recovery Coach International (RCI) for making their work available for public sharing.

59. Learning Objectives Learn what Ethics are Understand why Ethics are so important when functioning as a Recovery Coach Know how to STAY IN YOUR LANE as a Recovery Coach Understand the ETHICAL decision making process Develop guidelines for making ethical decisions Apply the new learning to your everyday work as a Recovery Coach

60. Ethics Please take a few minutes to review your personal definition of Ethics What is ETHICS ?

61. Ethics According to Merriam Webster… Ethics are rules of behavior based on ideas about what is morally good and bad. For Recovery Coaches, ETHICS are: A set of developed and accepted standards or principles of behavior and actions for BOTH individuals and organizations within a profession. A standard code of behavior that is created to enhance service provision and create a climate of dignity and respect. An agreed upon set of morals, values and conduct standards accepted by the group.

62. Ethical Terms Definitions Principles – Fundamental truths, laws, doctrine and motivating forces upon which others are based; a rule of conduct (e.g. Above all, DO NO HARM!!!). Morals – Principles with respect to right or wrong in conduct Values – Social principles, goals, or standards held by an individual, group or society.

63. ETHICS: A BRIEF PRIMER (Adapted from William White) The topic of ethics may be a relatively new one for recovery coaches who have never worked within or received services from an addiction-related service agency. Before proceeding to a discussion of how best to make decisions in the face of ethical dilemmas, we must further enhance our understanding of what we mean when we say that an action of a recovery coach is ethical or unethical. At its most primitive level, aspiring to be ethical involves sustained vigilance in preventing harm and injury to those to whom we have pledged our loyalty. This meaning is revealed through four terms: Latrogenic (Iatrogenic), Fiduciary, Boundary Management, and Multi-party Vulnerability

64. I-at- ro - genic means unintended, treatment-caused harm or injury. It means that an action taken to help someone, possibly with the best of intentions, actually resulted in injury or death. Can you think of an example of such an action? There is a long history of such problems in the history of healthcare, e.g., mandatory sterilizations, withdrawal using chemo- and electroconvulsive shock therapies, psychosurgery (e.g., lobotomies), and all manner of drug misuse (e.g., treating morphine addiction with cocaine). It is easy today to look back on such “treatments” and wonder “What were they thinking?!” And yet history tells us that it is hard to see such potential injuries close-up. Given the new frontier of recovery coaching, we must be vigilant to quickly weed out well intended actions that harm one or more parties. This potential for harm also underscores the importance of seeking guidance from other recovery coaches and from supervisors.

65. Fiduciary — a word whose roots are linked to those of the word “faith”—describes relationships in which one person has assumed a special duty and obligation for the care of another. This word is a reminder that the relationship between the recovery coach and those to whom he or she provides services is not a relationship of equal power: It is not solely a supportive friendship. “Fiduciary” implies that one person in this relationship enters with increased vulnerability requiring the objectivity, support, and protection of the other—like a relationship we would have with our own physician or attorney. While the power differential between the recovery coach and those whom he or she coaches is less than that between a surgeon and his or her patient, the recovery coach can still do injury through what he or she does or fails to do---SO these relationships are held to a higher level of obligation and duty than would be friendships that are reciprocal in nature

66. Boundary Management… Encompasses the decisions that increase or decrease intimacy within a relationship. This is an area of potentially considerable conflict between recovery support specialists and traditional service professionals. Where traditional helping professions (physicians, nurses, psychologists, social workers, addiction counselors) emphasize hierarchical boundaries and maintaining detachment and distance in the service relationship, peer-based services rely on reciprocity ( mutual exchange) and minimizing social distance between the helper and those being helped (Mowbray, 1997). While addiction professionals and peer-based recovery support specialists both affirm boundaries of inappropriateness, they may differ considerably in where such boundaries should be drawn.

67. Multi-party Vulnerability… Is a phrase that conveys how multiple parties can be injured by what a recovery coach does or fails to do. These parties include: The person receiving recovery support services That person’s family and intimate social network The recovery coach The organization for which the recovery coach is working The recovery support services field The larger community of recovering people The community at large.

68. Ethical Assumptions Because Recovery Coaching is a peer-to-peer service, the boundaries may not always be clear. Keep in mind the following Assumptions about Recovery Coaching. There are Seven Core Assumptions (Ethical Guidelines for the Delivery of Peer-based Recovery Support Services Great Lakes ATTC)

69. Core Assumption #1 Assumption 1: People who have a long and, by all appearances, high-quality sobriety can be counted on to act ethically as Recovery Coaches. Fact: Recovery, no matter how long and how strong, is not perfection. We are all vulnerable to isolated errors in judgment, particularly when we find ourselves isolated in situations unlike any we have faced before.

70. Core Assumption #2 Assumption 2: People hired as recovery coaches will have common sense. Fact: “Common sense” means that people share a body of historically shared experience that would allow a reasonable prediction of what they would do in a particular situation. The diversity of cultural backgrounds and life experiences of people working as recovery coaches provides no such common foundation, and behavior that is common sense in one cultural context might constitute an ethical breach in another.

71. Core Assumption #3 Assumption 3: Breaches in ethical conduct are made by bad people. If we hire good people, we should be okay. Fact: Most breaches in ethical conduct within the health and human service arena are made by good people who often didn’t even know they were in territory that required ethical decision making. Protecting recipients of recovery support services requires far more than excluding and extruding “bad people.” It requires heightening the ethical sensitivities and ethical decision making abilities of good people.

72. Core Assumption #4 Assumption 4: Adhering to existing laws and regulations will ensure a high level of ethical conduct. Fact: The problem with this assumption is that what is legal and what is ethical do not always coincide. There are many breaches of ethical conduct about which the law is silent, and there might even be extreme situations in which to do what is legally mandated would constitute a breach of ethical conduct resulting in harm or injury to the service recipient. It is important to look at issues of law, but we must avoid reducing the question, “Is it ethical?” to the question, “Is it legal?”

73. Core Assumption #5 Assumption 5: Ethical standards governing clinical roles (e.g., psychiatrists, psychologists, social workers, nurses, addiction counselors) can be indiscriminately applied to the role of recovery coach. Fact: There are considerable areas of overlap between ethical guidelines for various helping roles, but ethical standards governing clinical work do not uniformly apply to the RC role. This potential incongruence is due primarily to the nature of the RC service relationship (e.g., less hierarchical, more sustained, broader in its focus on non-clinical recovery support service needs) and to its delivery in a broader range of service delivery sites.

74. Core Assumption #6 Assumption 6: Formal ethical guidelines are needed for recovery coaches in full-time paid roles but are not needed for recovery coaches who work as volunteers for only a few hours each week. Fact: Potential breaches in ethical conduct in the Recovery Coach span both paid and voluntary roles. The questions recovery support organizations are now wrestling with is whether volunteer and paid Recovery Coaches should be covered by the same or different ethical guidelines.

75. Core Assumption #7 Assumption 7: If a recovery coach gets into vulnerable ethical territory, he or she will let us know. If the supervisor isn’t hearing anything about ethical issues, everything must be okay. Fact: Silence is not golden within the ethics arena. There are many things that might contribute to such silence, and all of them are potential problems. The two seen most frequently are the inability of recovery coaches to recognize ethical issues that are arising and their failure to bring those issues up for fear it will reflect negatively on their performance. The latter is a particular problem where supervision is minimal or of a punitive nature. The best recovery coaches regularly bring up ethical issues for consultation and guidance.

76. Recovery Coaching Definition According to CCAR (Connecticut Community for Addictions Recover) Recovery Coach is defined as: Anyone interested in promoting recovery by removing barriers and obstacles by serving as a personal guide and mentor for people seeking or in recovery.

77. Why is ETHICS so Important? Ethics in Recovery Coaching A Recovery Coach is anyone interested in promoting recovery by removing barriers and obstacles to recovery by serving as a personal guide and mentor for people seeking or in recovery. A Recovery Coach is: Motivator and Cheerleader Resource Brokers Ally and Confidant Advocate Truth Tellers Community Organizers Role Models & Mentors Friends & Companions Problem Solvers Lifestyle Consultant

78. Stay In Your Lane How to stay in your LANE as a Recovery Coach According to CCAR Recovery Coach Academy a Recovery Coach is NOT a: Sponsor You are moving beyond you role of a Recovery Coach if you: Perform AA/NA or other mutual aid group service in your role. Guide someone through the steps or principles of a particular recovery program .

79. Stay In Your Lane Recovery Coach is NOT a: Counselor You are moving beyond your role of a Recovery Coach if you: Diagnose Provide counseling or refer to your support activities as “counseling: or “therapy”. Focus on problems/“issues”/trauma as opposed to recovery solutions

80. Stay In Your Lane Recovery Coach is NOT a: Nurse/Doctor You are moving beyond your role of a Recovery Coach if you: Suggest or express disagreement with medical diagnoses (including psychiatric diagnoses). Offer medical advice Make statements about prescribed drugs beyond the boundaries of your training and experience.

81. Recovery Coach is NOT a: Clergy Person You are moving beyond your role of a Recovery Coach if you: Promote a particular church or religion Interpret religion doctrine Offer absolution or forgiveness (other than forgiveness for harm done specifically to you). Provide pastoral counseling

82. Core Values for Ethical Decision Making Gratitude & Service —Carry hope to individuals, families, and communities. Recovery —All service hinges on personal recovery. Use of Self —Know thyself; Be the face of recovery; Tell your story; Know when to use your story. Capability —Improve yourself; Give your best.

83. Honesty —Tell the truth; Separate fact from opinion; When wrong, admit it. Authenticity of Voice —Accurately represent you Authenticity of Voice —Accurately represent your recovery experience and the role from which you are speaking.

84. Credibility —Walk what you talk. Fidelity —Keep your promises. Humility —Work within the limitations of your experience and role. Loyalty —Don’t give up; Offer multiple chances.

85. Hope —Offer self and others as living proof; Focus on the positive—strengths, assets, and possibilities, rather than problems and pathology. Dignity and Respect —Express compassion; Accept imperfection; Honor each person’s potential. Tolerance — “The roads to recovery are many” (Wilson, 1944); Learn about diverse pathways and styles of recovery. Autonomy & Choice —Recovery is voluntary: It must be chosen; Enhance choices and choice- making.

86. Discretion —Respect privacy; Don’t gossip. Protection —Do no harm; Do not exploit; Protect yourself; Protect others; Avoid conflicts of interest. Advocacy — Challenge injustice; Be a voice for the voiceless; Empower others to speak. Stewardship —Use resources wisely.

87. Ethical Considerations

88. A Peer-based Model of Ethical Decision Making: 3 Questions 1. Who has the potential of being harmed in this situation and how great is the risk for harm? This question is answered by assessing the vulnerability of the parties involved and the determination the potential severity of injury to each. If there are several parties at risk of moderate or significant harm, it is best not to make the decision alone, but to seek consultation with others.

89. 2. Are there any core recovery values that apply to this situation and what course of action would these values suggest be taken. 3. What laws, organizational policies or ethical standards apply to this situation and what actions would you suggest or dictate?  

90. Zone of Decision-Making for a Recovery Coach When you consider our discussion around ethics boundaries and decision making Complete the Zone of Decision Making Checklist Zone of Safety Always OK – No harm Zone vulnerability Sometimes OK – Sometimes Not Zone of Abuse Never Ok

91. THANK YOU!