The following citations can serve as additional resources for this
To Whom Does this Apply?
All behavioral health providers delivering training services for certification1 of individuals as Peer/Recovery Support Specialists within the ADHS/DBHS public behavioral health system.
Did you know...?
People who have achieved and sustained recovery can be a powerful influence for individuals seeking their own path to recovery (see
Center for Mental Health Services (CMHS) Consumer Affairs E-News October 2, 2007, Vol. 07-158). By sharing personal experiences, peers help build a sense of self-worth, community connectedness, and an improved quality of life.
Peer-delivered services are supported on a statewide and national level. The Centers for Medicare and Medicaid Services (CMS) issued a letter to state Medicaid directors/agencies, recognizing the importance of peer support services as a viable component in the treatment of mental health and substance abuse issues. In the letter, CMS provides guidance to state Medicaid and public health agencies on minimum requirements for establishing criteria for peer support services, including supervision, care-coordination and training/credentialing (see SMDL
#07-011 for a full copy of the letter).
Definitions for terms are located online at
The following terms are referenced in this section:
Behavioral Health Paraprofessional
Behavioral Health Professional
Behavioral Health Technician
Covered Behavioral Health Services Guide
Individual Service Plan
Peer Support Services
Peer/Recovery Support Specialist
To ensure that behavioral health providers and peers have the necessary knowledge and skills to successfully provide quality behavioral health services in the public behavioral health system.
To ensure that Peer Support Employment Training Certification Programs offer training and education that effectively prepares individuals for delivering behavioral health services, including Peer Support Services, as a peer.
To ensure that Peer/Recovery Support Specialists are certified to provide Peer Support Services, as described in the
ADHS/DBHS Covered Behavioral Health Services Guide.
Peer/Recovery Support Specialist Qualifications
Individuals seeking certification and employment as Peer/Recovery Support Specialists must:
Self identify as a “peer”; and
- Meet the requirements to function as a behavioral health paraprofessional, behavioral health technician, or behavioral health professional.
Individuals meeting the above criteria may be certified as a Peer/Recovery Support Specialist by completing training and passing a competency test through an ADHS/DBHS approved Peer Support Employment Training Program. ADHS/DBHS will oversee the approval of all certification materials including curriculum and testing tools.
Certification through an ADHS/DBHS approved Peer Support Employment Training Program is applicable statewide.
Some agencies may wish to employ individuals prior to the completion of certification through a Peer Support Employment Training Program. However,
required trainings must be completed prior to delivering behavioral health services (see subsection 9.2.7-D.). An individual must be certified as a
Specialist/Recovery Support Specialist or currently enrolled in a ADHS/DBHS-approved
Peer Support Employment Training Program under the supervision of a
qualified individual (see subsection 3.e.) prior to billing Peer Support Services.
9.2.7-B. Peer Support Employment Training Program Approval Process
A Peer Support Employment Training Program must submit their program curriculum, competency exam, and exam scoring methodology (including an explanation of accommodations or alternative formats of program materials available to individuals who have special needs) to ADHS/DBHS, and ADHS/DBHS will issue feedback or approval of the curriculum, competency exam and exam scoring methodology in accordance with subsection 9.2.7-D.
Approval of curriculum is binding for no longer than three years. Three years after initial approval and thereafter, the program must resubmit their curriculum for review and re-approval. If a program makes substantial changes (meaning change to content, classroom time, etc.) to their curriculum or if there is an addition to required elements (see subsection 9.2.7-C.) during this three year period, the program must submit the updated
content to ADHS/DBHS for review and approval.
ADHS/DBHS will base approval of the curriculum, competency exam and exam scoring methodology only on the elements included in this policy. If a Peer Support Employment Training Program requires regional or culturally specific training exclusive to a GSA or tribal community, the specific training cannot prevent employment or transfer of Peer Support Specialist/Recovery Support Specialist certification based on the additional elements or standards
Individuals seeking certification and employment as a Peer/Recovery Support Specialist must complete and pass a competency exam with a minimum score of 80% upon completion of required training. Each Peer Support Employment Training Program has the authority to develop a unique competency exam. However, all exams must include at least one question related to each of the curriculum core elements listed in subsection 9.2.7-D.
Individuals certified in another state may obtain certification after passing
a competency exam. If an individual does not pass the competency exam, the
individual Peer Support Employment Training Program may require that the
individual repeat or complete additional training prior to taking the competency exam again.
Peer Support Employment Training Curriculum Standards
A Peer Support Employment Training Program curriculum must include the following core elements:
Professional Responsibilities of the Peer Support Employee and Self Care in the Workplace. Qualified
individuals must receive training on the following elements prior to delivering any covered behavioral health services:
Concepts of Hope and Recovery
Instilling the belief that recovery is real and possible;
The history of
the recovery movement and the varied ways that behavioral health issues have been viewed and treated over time and in the present;
Knowing and sharing one’s story of a recovery journey; how one’s story can assist others in many ways;
Mind-Body-Spirit connection and holistic approach to recovery; and
Overview of the
Individual Service Plan (ISP) and its purpose.
Advocacy and Systems Perspective
state and national behavioral health system infrastructure;
and the history of Arizona's behavioral health system;
Stigma and effective stigma reduction strategies;
countering self-stigma; role modeling recovery and valuing
the lived experience;
to organizational change- how to utilize person-first language and energize one’s agency around recovery, hope, and the value of peer support;
Creating a sense of community;
the role of culture in recovery;
Forms of advocacy and effective strategies; and
to the Americans with Disabilities Act (ADA).
Psychiatric Rehabilitation Skills
Strengths based approach; identifying one’s own strengths and helping others identify theirs;
Distinguishing between sympathy and empathy;
- Understanding learned helplessness; what it is,
how it is taught and how to assist others in overcoming its effects;
- Introduction to motivational interviewing; communication skills and active listening;
– building trust and creating mutual responsibility;
Combating negative self-talk; noticing patterns and replacing negative statements about one’s self, using
mindfulness to gain self-confidence and relieve stress;
- Introduction to Culturally & Linguistically Appropriate
Services (CLAS) Standards; creating
a safe and supportive environment.
Self-care skills and coping practices for helping professionals; the importance of ongoing supports for overcoming
stress in the workplace; resources to promote personal resilience; and, understanding burnout and using self-awareness to prevent compassion fatigue, vicarious trauma and secondary traumatic stress.
Professional boundaries & ethics- the varied roles of the helping professional; Collaborative supervision and the unique features of the Peer/Recovery Support Specialist;
Confidentiality laws and information sharing – understanding the Health Insurance Portability and Accountability Act (HIPAA);
Responsibilities of a mandatory reporter; what to report and when;
signs and experiences of mental illness, substance abuse,
addiction and trauma; orientation to commonly used medications
and potential side effects;
- Guidance on proper service documentation; billing and using recovery language throughout documentation; and
Some curriculum elements include concepts included in required training, as described in
PM Section 9.1, Training Requirements. Peer support employment training programs must not duplicate training required of
individuals for employment with a licensed agency or Community Service Agency (CSA)2. Training elements in this section must be specific to the
Peer/Recovery Support Specialist's role in the public behavioral health system and instructional for peer
For a list of references to assist in developing a curriculum that addresses the topics listed in the Curriculum Standards, see
Attachment 404.1, Suggested Curriculum Development References.
Supervision of Peer Workers Employed as Peer/Recovery Support Specialists
Agencies employing Peer/Recovery Support Specialists must provide supervision by individuals qualified as Behavioral Health Technicians or Behavioral Health Professionals. Supervision must be appropriate to the services being delivered and the Peer/Recovery Support Specialist’s qualifications as a Behavioral Health Technician, Behavioral Health Professional or Behavioral Health Paraprofessional. Supervision must be documented and inclusive of both clinical and administrative supervision.
Individuals providing supervision must receive training and guidance to ensure current knowledge of best practices in providing supervision to Peer/Recovery Support Specialists. (For more information, see
DBHS Practice Protocol, Clinical Supervision.)
The T/RBHA must develop and make available to the providers policies and procedures regarding resources available to agencies for establishing supervision requirements and any expectations for agencies regarding T/RBHA monitoring/oversight activities for this requirement.
Process for Submitting Evidence of Certification
Agencies employing Peer Support Specialists/Recovery Support Specialists who are providing peer support services are responsible for keeping records of required qualifications and certification. T/RBHAs must ensure that Peer Support Specialists/Recovery Support Specialists meet qualifications and have certification, as described in this policy.
T/RBHAs must develop and make available to providers policies and procedures that describe monitoring and auditing/oversight activities where personnel files of Peer Support Specialists/Recovery Support Specialists are reviewed.
Peer Support Services are also billed by family members who provide services in the public behavioral health system (see PM Section 4.5, Partnerships with Families and Family-Run Organizations in the Children’s Behavioral Health System for additional information). Training and certification requirements described in this policy, however, are specific to peers, as defined in this policy.
2 While peer support employment training programs must not duplicate training required of licensed agencies or CSAs, it is possible that licensed agencies and/or CSAs may consider training completed as part of the peer support employment training program as meeting the agencies’ training requirements.
Peer Support/Recovery Support
Last Revised: 2/27/2015
Effective Date: 2/27/2015