It’s a long road back from addiction. The drug of choice can be alcohol, street or prescription drugs, or addictive gambling, spending, sex or eating. Although the faces of addiction are many, one outcome remains the same: all persons in recovery need the support of others. And these others need to be intimately familiar with what it means to be an addict. Consider the following situations:
- Amy, 26, and the mother of two small children, has been in recovery for nearly a year. An alcoholic, she still feels the trigger of Friday night drinking at the bar with her friends. She’s looking for an alternative way to socialize with others that doesn’t involve drinking or drugs.
- John, 56, just completed his treatment program and is now in recovery. He’s scared he won’t be able to last a few weeks, since his drug cravings are now raging again and the fact that his live-in girlfriend still uses. He’s desperate for help.
- Bonnie, now in her mid-30s and a former meth abuser, who was also addicted to prescription drugs, doesn’t believe in 12-step meetings. She has a lot of friends who are still using, some of whom have relapsed, and others who attended meetings and they didn’t work. Although she goes to work at her job every day, she’s exhausted all the time from the stress of trying to stay off drugs. She doesn’t know that to do.
- Warren, late 60s, just got out of jail (a 30-day incarceration). All that time he was clean, and he hopes to be able to stay sober from now on. But he’s worried because he doesn’t have a safe place to stay, someplace where he’s not exposed to drugs and alcohol. He also needs to find a job.
- Carlos has a mild form of schizophrenia, along with an addiction to heroin. He’s had difficulty in recovery because he’s afraid to discuss things going on with him. He feels that if he does, he’ll be locked up again. He’s very tempted to go back to drugs, even though he wants to stay clean.
- Janice, a well-put-together 40-something mother of three teenagers, is also a compulsive gambler. Her finances are in ruins because of her addiction and she’s slowly trying to get back on her feet. She suffers incredible guilt because she’s gambled away her children’s college fund and feels the pressure to recoup it quick.
- Only 18, Kris has completed Wilderness training and treatment for relapse for his addiction to drugs and alcohol. He wants to return home and go to community college, promising to stay away from his drug-using friends. His parents are skeptical and want him to go to school out of state. Kris says he’ll find new friends that are clean and sober and needs help to stick to his plan.
- Sonya, 32, married for 12 years but no children, loves her husband but still feels drawn to her pattern of having sex with strangers while she’s on the road (she’s a pharmaceutical rep). She attends Sexaholics Anonymous meetings when she can, but the lure of the encounters is too strong. Her husband will divorce her if he finds out she’s cheating again.
All of these individuals are experiencing the agonizing doubt, fear, cravings and rocky instability that frequently tag along in recovery. This is especially true in early recovery, the first six months or so, but the insecurity, sense of loss and being drawn back into the addiction can also drag on for much longer – even years. Each of them is at a different point in their recovery, and each has unique needs and circumstances. All of them need help. Ironically, each of them can also serve as lifeline support to others. What will benefit these addicts? The answer is peer recovery support services.
What are Peer Recovery Support Services
Peer recovery support services are services that are designed and delivered by people who, themselves, have experienced both substance abuse disorder and recovery. They know what it’s like to be an addict, to struggle with the daily pressures and stress, to overcome the guilt, sadness, confusion, to try to find a job, rebuild careers, relationships, and self-esteem. Funded by grants from the Substance Abuse and Mental Health Services Administration/Center for Substance Abuse Treatment (SAMHSA/CSAT), the Recovery Community Services Program (RCSP) develops and delivers peer recovery support services across the United States. The purpose of peer recovery support services is to provide hope to those in recovery and to help them stay in recovery, thus reducing the likelihood of relapse. With their powerful message of hope, combined with the experience of the peers who have been successful in their recovery efforts, these services extend the clinical reach of treatment and go directly into the lives of people who most need them.
Types of Social Support and Peer Recovery Support Services
Backed by considerable research that recovery is enhanced with social support, four types of social support have been identified: emotional, informational, instrumental, and affiliational support. RCSP projects have found these types of support useful in organizing community-based peer recovery support services. Individuals in recovery don’t have a single need. They have many needs. They may need assistance in finding a job, thus requiring a job referral service (informational support). But their confidence level may be at all-time lows, so they also need emotional support, perhaps in some type of coaching on interviewing skills, how to dress appropriately, follow-up tips.
Emotional support, which may include peer mentoring or support groups led by peers, encourages the individual through empathy, concern or caring, helping to bolster confidence and self-esteem.
Examples of informational support may include a wellness seminar, child parenting class, or training for a new job. The purpose of the informational support is to provide training in various life or vocational skills and to share knowledge and information.
People in recovery often need assistance in order to complete certain tasks. Such instrumental support may include transportation or child care or help to access various community health and social services.
A sense of belonging, of community, and being with other people to promote learning social and recreational skills is important to those in recovery. Affiliational support may include opportunities for socializing that are drug- and alcohol-free, encouraging participation in sports leagues, or making recovery centers available.
How It Works
Peer recovery support groups have a peer leader, who provides support to peers (those seeking help to establish or maintain their recovery). In the interaction, both the peer leader and peers receive mutual support and their recovery gains strength in the process. The peer leader may have different titles, such as recovery guide, coach or mentor, peer resource specialist, or peer services interventionist. The role of the peer leader, however, is very clearly distinguished from that of a 12-step sponsor, treatment counselor or other professional. This is because the intent of the peer recovery support services is to enhance the recovery process by not duplicating other services in the community. Sometimes questions come up that are not the purview of the peer leader. It’s important to note that peer leaders do not diagnose, give advice or provide therapy. For example, a peer may be worried about completing the 12-steps and ask the peer leader for help. The peer leader will respond that this is an issue they need to work out with their sponsor, not the peer leader. Similarly, in the instance where a peer has questions about recurring symptoms or whether or not a medication needs to be changed. The peer leader will tell the peer that this is something they need to take up with their doctor or nurse. In early recovery especially, the peer leader, acting as mentor or coach, spends a great deal of time with the peer – typically more than a 12-step sponsor. That’s because the peer leader often has a more extensive knowledge about what’s available in the community in terms of employment, housing, educational and social services and community health services. The peer leader is involved in helping peers make appropriate choices about which recovery path will work best for them – not encouraging the peer to choose the path that worked for the peer leader. Similarly, the peer leader will typically not urge the peer to follow any particular path or recovery. Again, the intent is to encourage the peer to find the recovery path that will be in the peer’s best interest – and one he or she can follow.
How Individuals Benefit from Peer Recovery Support Services
The benefits of peer recovery support services are both tangible and intangible. They vary from individual to individual. Some people in early recovery attest to the fact that these services helped them remain in recovery, whereas a simple reliance on 12-step meetings or sessions with a counselor did not. To that end, peer recovery support services fulfill their mission: to help people strengthen and remain in recovery. Here are some other benefits:
- Safe place to socialize – Participants in peer recovery support services know they have a safe place to socialize with others who are also in recovery. This gives them a sense of belonging, of community, and a pressure-free opportunity to interact with others.
- Sharing personal stories and problem solving – Group support activities often have an educational component as well. During such group interaction, peers have the opportunity to share personal stories as well as solve problems. The group may consist of individuals with a shared substance abuse disorder, or HIV/AIDS, or those re-entering society following incarceration, or those who with the same cultural or religious background.
- Enriching spiritual values – Some, but not all, peer group activities that are led by a peer leader have a spiritual component – in addition to educational and group support. This provides participants with an opportunity to enrich their own spiritual values – whatever they may be.
- Learn new skills – Outside experts are often brought in to demonstrate and teach new skill sets to group members. The range of skills may include credit counseling, how to budget and manage finances, job skills training, how to prevent relapse, and effective conflict resolution.
- Place to practice new social skills – Peer recovery groups offer participants a nonthreatening environment in which to practice some of the new social skills they have learned.
- Providing service to others – It’s common for participants in peer recovery groups to want to give back to the community, to help others as they have been helped. After all, the peer group leader is someone who has also been in recovery – and chose to help others. This example inspires many group participants to do likewise. Most often they work as volunteers in providing peer recovery support services, but some receive a small stipend.
- Services available at different stages of recovery – The adaptability of peer recovery support services is that they are available at different stages of the recovery process. Such services may precede a person’s entering into treatment, and may facilitate or motivate the individual’s desire to change. Peer recovery support services may accompany treatment, thus providing a connection to the community during treatment. Services may follow treatment, offering a better relapse prevention. Many people who do not enter treatment because they cannot afford it or do not wish to can avail themselves of peer recovery support services.
- Leadership development – During participation in peer recovery support groups, members are also building upon their leadership ability. This gives them a foundation to be able to help others by either directing the service program or by providing support to their peers.
- Promotion of shared values – Self-direction, empowerment, choice, giving back to others, keeping recovery first, being a leader, participating, being authentic, and including all cultures are shared values that are promoted during peer recovery support services.
- Always available – Peer recovery support services are one means of providing an invaluable, continuously available support following treatment. This safety net for individuals who have completed treatment helps them in their goal to remain in recovery and begin the necessary steps to achieve their dreams.
For further information, see the Center for Substance Abuse Treatment, What Are Peer Recovery Support Services? HHS Publication No. (SMA) 09-4454. Rockville, MD: Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 2009. The document may be accessed electronically through www.samhsa.gov/shin or call the SAMHSA Health Information Network at 1-877-726-4727.