Q&A: How Shared Experience Can Be Essential Medicine for People in Recovery

Peer support – the concept of offering and receiving help, based on shared understanding, respect and mutual empowerment between people with similar experiences – can help reimagine healthcare.

Clarence Jordan provides strategic direction and leadership for Carelon Behavioral Health wellness and recovery initiatives, including peer support, in his role as director of clinical programs. He ensures recovery-based principles or best practices are applied in all of the organization's behavioral health offerings.

Jordan joined the Substance Abuse and Mental Health Services Administration (SAMHSA) technical expert panel in 2023. The subject matter experts on the panel helped draft a national set of standards for the certification of peer support specialists. Here, Jordan reviews the current state of peer support and what makes it so effective. 
 

What’s the current state of peer support in behavioral health services?

The peer support community has made a great deal of progress in recent years and is helping reduce the stigma associated with seeking treatment for mental health conditions and substance use disorder. I think peer support was treated for years as something that was nice to have but not essential and, for that matter, not beneficial. But the evidence has shown peer support to be a valuable service. So we’ve seen increased backing for peer support, at both the state and national levels.

The Centers for Medicare and Medicaid Services has provided guidance and direction to states to formulate their own peer support programs and establish certification criteria. SAMHSA’s National Model Standards for Peer Support Certification have helped create additional awareness. And the White House has pledged to accelerate the adoption of peer-support techniques across all elements of healthcare.

Healthy relationships throughout recovery are important, and the therapeutic value of peers continues to be proven. This is a unique intervention that helps people in long term recovery through a powerful bond.
 

How is peer support defined for people in recovery?

The U.S. Department of Health and Human Services defines a peer worker as someone who, through their own lived experience of navigating a substance use or mental health condition, works to help others in recovery. It’s often likened to the Alcoholics Anonymous (AA) 12-step program and the concept of having a sponsor.

But there are important differences. An AA sponsor is a volunteer, someone who has personal experience with substance use disorder and is now using that lived experience to coach others. A peer support specialist also has that lived experience, but we are trained, vetted, and supervised as we provide personal support to others with similar lived experiences. The medical community has found success using this approach to help people with a range of conditions, from mental illness to substance use disorders to other chronic illnesses like diabetes and Crohn’s disease.
 

Why is peer support effective?

The greatest strength of any peer support specialist is the ability to share their story. By that I mean identify with the situation or set of circumstances that relates to another person’s position along a continuum of steps or phases associated with recovery and wellness (meeting them where they are). A peer specialist can empathize with others in a situation they have also experienced. It gives you credibility and helps the person in recovery know they can trust in the process and see firsthand others who have successfully recovered.
 

Why is community an important aspect of peer support and SUD recovery?

SAMHSA has identified eight major dimensions that support life in recovery, and community – or environment – is one of them. Relationships and social networks provide support, friendship, love, and hope. That’s a crucial part of SUD recovery because few of us can do it alone.

A peer knows where to get assistance, in the form of clothing, food, or household items. You, as the peer, can also know the best support group meetings to attend, and the places to avoid. A peer will know the great spots to eat, where other people in recovery go for fun and relaxation, and how to get the goods and services you need to sustain recovery and wellness.

It helps to be a person in the community who is known in the community. That person is welcomed and can help to model recovery.
 

What are some important recent changes in the peer support approach?

SAMHSA published national standards for Substance Use, Mental Health, and Family Peer Worker Certifications in June 2023.

These new standards will encourage organizations and providers to create a career path for peer-support specialists. Increasingly, peer specialists are in demand because of an increase in the number of people seeking mental health treatment. We can help address the need by reimagining whole-health care and designing care management that includes peer support specialists.
 

What do people not know that they should know about peer support?

Peer specialists are difficult to find, because only a small percentage of individuals are trained to do the work. It takes a lot of effort to build and maintain a successful peer network.

Carelon Behavioral Health routinely convenes our own panel of experts -- peers, supervisors, and program managers -- to examine current peer programs and identify strategies for continuous improvement. Focus areas include everything from hiring and onboarding, to measuring outcomes, to cataloging tools and techniques.

We have ongoing education and training programs, and our research has contributed to the body of knowledge and advanced this area of expertise.

There is a saying in wellness and recovery that I think summarizes the success of peer support: “We are the evidence.”