Peer Recovery Support Foundations and Roles
The foundations domain tests whether you can explain what peer recovery support is, what it is not, and where the role sits in the service system. Expect items on SAMHSA's working definition of recovery, the four dimensions and ten guiding principles, the concept of peerness, and the boundary between peer support and clinical or case-management functions.
Lived experience is the qualification
A peer recovery support specialist is a person in recovery from a substance use and/or mental health condition who uses that lived experience, plus formal training, to support others. Mutuality - shared power, shared story, shared responsibility - is the defining feature, not a bonus. The peer is a role model of recovery and an ally; the peer is not a clinician, sponsor, therapist, or case manager.
The recovery framework to cite by name
SAMHSA defines recovery as a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. Four dimensions: health, home, purpose, community. The ten guiding principles are hope, person-driven, many pathways, holistic, peer support, relational, culture, addresses trauma, strengths/responsibility, and respect. Exam items quote these words, so learn them verbatim and apply them to scenarios.
What peers actually do
Engage and walk alongside; model coping, help-seeking, and sustained recovery; offer "what worked for me" as one option among many; link people to community and recovery supports; advocate; co-facilitate peer-led groups; help build recovery capital (relationships, housing, employment, health, community); and support self-directed recovery planning. Peers do not diagnose, treat, prescribe, give clinical direction, or make decisions for the person.
Worked example
A supervisor tells a new specialist: "Chart this as a treatment goal: client will attend three AA meetings per week as you instructed." The correct response is to reframe. The plan belongs to the person; peer documentation records the person's own self-identified goal and the support provided. Attending AA is one pathway among many, chosen by the person, not assigned by the peer. Ask what the person wants, record their words, and raise the scope and role-clarity question in supervision rather than silently complying.
Traps that cost marks
Assuming your pathway is the pathway. Letting mutual support slide into advice-giving or therapy. Using your story to compete or to push one program. Claiming clinical authority you do not have. Neglecting your own recovery, supervision, and support network as the caseload grows.