IC&RC Peer Recovery cheat sheet

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.

SAMHSA's four major dimensions of recovery are Health, Home, Purpose, and Community; a wellness plan that ignores any one dimension is incomplete.

The ten guiding principles of recovery are hope, person-driven, many pathways, holistic, peer support, relational, culturally based, trauma-informed, strengths/responsibility, and respect.

Stages of change (Prochaska & DiClemente): precontemplation, contemplation, preparation, action, maintenance; recurrence re-enters the cycle, so support is matched to the current stage rather than to an assumed endpoint.

The eight dimensions of wellness are emotional, physical, occupational, intellectual, spiritual, environmental, financial, and social.

Recovery capital has four categories: social (relationships and community), physical (housing, money, transportation), human (health, education, skills), and cultural (values, beliefs, belonging).

Trauma-informed care uses the 4 R's - Realize, Recognize, Respond, Resist re-traumatization - and six principles: safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice and choice; cultural, historical and gender issues.

Harm reduction meets people where they are and reduces negative consequences without requiring abstinence as a precondition for services.

Recovery is nonlinear: a return to symptoms or substance use is an expected part of the process, not proof of failure, and does not by itself terminate a person's eligibility for support.

Peer support is a non-clinical, mutual relationship in which a person with lived experience of recovery offers hope, companionship, and practical guidance; it is not therapy, counseling, or case management.

The 'doing with, not for' rule: the peer supports the person's own decisions and actions rather than completing tasks for them, which preserves autonomy and builds self-efficacy.

Motivational interviewing microskills are summarized as OARS - Open questions, Affirmations, Reflections, Summaries - and are used to evoke the person's own change talk rather than to advise or confront.

WRAP (Wellness Recovery Action Plan, Mary Ellen Copeland) sections: wellness toolbox, daily maintenance plan, triggers, early warning signs, signs things are breaking down, crisis plan, and post-crisis plan.

Intentional self-disclosure is purposeful, brief, and offered for the peer's benefit; it is not a vehicle for the worker to process unresolved personal material.

Role boundaries: peers may mentor, model recovery, and link to resources, but do not diagnose, treat, or assume case-management functions outside their defined role.

Empathy conveys understanding of the person's experience and keeps the relationship equal; sympathy expresses pity from a distance and reinforces a helper–helped power imbalance.

Strengths-based practice inventories a person's abilities, interests, relationships, and resources before organizing support around deficits or diagnoses.

In small communities, dual roles are common; the decision rule is to disclose the overlap to a supervisor and agree in advance how the second role will be managed.

Case advocacy addresses one person's unmet need; cause advocacy targets the policies, systems, or laws that produce the problem for a whole group.

A written, time-limited, revocable release of information naming the information, the recipient, and the purpose is required before disclosing health information to any outside party.

42 CFR Part 2 governs substance use disorder treatment records and is stricter than HIPAA: re-disclosure generally requires specific written consent identifying the recipient.

A warm handoff is a direct, real-time connection to another provider - introduction made, next step confirmed - not a phone number written on a slip of paper.

Core U.S. linkage resources: 988 (Suicide & Crisis Lifeline), 211 (health and social services navigation), 1-800-662-4357 (SAMHSA National Helpline), naloxone distribution, and syringe services programs.

Housing First provides housing without sobriety or treatment preconditions and offers supports voluntarily alongside the housing.

Referral decisions must be based on the person's needs and preferences; accepting gifts, fees, or incentives from a referral destination is a conflict of interest.

Self-advocacy coaching prepares the person to speak for themselves; the peer advocates alongside the person rather than in place of them.

Frequent linkage barriers to screen for: transportation, insurance and cost, waitlists, documentation requirements, stigma, and limited English proficiency or interpreter access.

Scope of practice: peer workers do not diagnose, prescribe, provide psychotherapy, or give legal advice; needs beyond that scope are referred out with a warm handoff.

Decision rule for boundaries: a boundary crossing is minor, sometimes unavoidable, and must be disclosed and discussed in supervision; a boundary violation harms or exploits the client and is never acceptable.

Limits of confidentiality are explained at first contact and include mandated reporting of suspected child abuse or elder/dependent adult abuse, imminent danger, and valid court orders.

Duty to warn/protect: in many jurisdictions, a credible threat against an identifiable third party creates an obligation to notify the intended victim, authorities, or both.

Sexual or romantic relationships with current clients and financial exploitation or significant gift-taking are prohibited without exception.

Dual relationships with clients (friend, relative, employer, fellow community member) must be avoided where possible or actively managed through disclosure and supervision.

Documentation must be timely, accurate, objective, and written in neutral language; entries are never falsified, back-dated, or altered, and clients may access records as permitted by law.

Credential maintenance requires continuing education units, supervision hours, and renewal before the expiration date set by IC&RC and the state or tribal board.

Impaired practice: when burnout, substance use, or an untreated personal crisis threatens competence, the ethical response is to seek support and step back from duties rather than to continue serving.