Peer Recovery Ethics: Learning the Basics

In the Catalyst blog post Peer Recovery Support Workers: The Research Says “Yes!” from May 29, 2019, this space shared information about the origins, purposes, and latest research about Peer Recovery Workers. The fact that peer recovery workers share a unique understanding about the recovery process makes them an important piece of recovery capital), or total resources needed to initiate and sustain recovery from substance use disorders (SUDs) (SlideDecks4U, 2020). The blog post covers the many roles of peer recovery workers and the twelve Core Competency categories with detailed lists of the knowledge, skills, and attitudes that peer recovery support workers must develop for each category. The post also contained frequently asked questions and links for Nevada residents who want to be certified as a Certified Peer Recovery (PR) and Support Specialist. Peer Recovery Support Workers: The Research Says “Yes!” is a great read for learning the basics. This post will focus on the Peer Recovery Support Specialist (NCPRSS) code of ethics.

What Is a Code of Ethics and Why Do We Need One?

In a document for the purpose of identifying and offering guidance on ethical issues that might arise for peer recovery support specialists (PRSSs), William White offered a description of ethical and unethical for PRSSs. He used four terms to describe the types of harm or injury that can be the result of actions by PRSSs (White, 2007):

• Iatrogenic – meaning treatment that causes harm or injury that is unintentional. One example that White used was past treatments for addiction which included mandatory sterilizations, electroconvulsive shock therapies, and psychosurgery, or lobotomy;
• Fiduciary – a relationship where one person assumes a duty and obligation to care for another that is based on an unequal power differential rather than friendship;
• Boundary Management – exercising control over a relationship through decisions about interactions that either increase or decrease intimacy. White states that traditional helping professions maintain detachment through hierarchical boundaries, as do PRSSs, but that boundaries may be drawn quite differently because the relationships are on differing points of an intimacy continuum. This results in the same exact behaviors possibly being always or sometimes acceptable for recovery coaches when they are never acceptable for addiction professionals. Examples that White provided included giving gifts, giving a hug, or invitation to a holiday dinner.
• Multi-party Vulnerability – meaning that multiple parties might be injured by actions or lack of action by a recovery coach, such as the person in recovery, their family and friends, or the recovery coach’s employer.

In laying out the foundation for establishing formal ethical guidelines for PRSSs, White cautioned that care should be taken about assumptions about formal ethical guidelines as it is not safe to assume that a separate code of ethics for recovery coaches is not needed if they have common sense (they do not), if existing laws and regulations are followed (what is legal is not always ethical), or ethical standards for clinical roles can be used for recovery coaches (they don’t always apply uniformly to both populations). White called for establishing and using ethical guidelines based on the values and group conscience of PRSSs across religious, spiritual, and secular traditions (White, 2007).

NAADAC National Certified Peer Recovery Support Specialist (NCPRSS) Code of Ethics

NAADAC, the Association for Addiction Professionals, is an organization that represents the professional interests of over 100,000 addiction counselors, educators and other addiction-focused health care professionals in the United States, Canada and abroad. NAADAC advocates for high quality, current, and evidence-based services and provides education, clinical training, and certification for a variety of professionals in the field of addiction, including PRSSs. The NAADAC/NCC AP Peer Recovery Support Specialist Code of Ethics outlines basic values and principles of peer recovery support practice. The code of ethics governs PRSSs conduct, conflict of Interest, and Support Specialist/Client Relationships. The NAADAC/NCC AP Code Preamble states that “Peer Recovery Support Specialists have a responsibility to help persons in recovery achieve their personal recovery goals by promoting self-determination, personal responsibility, and the empowerment inherent in self-directed recovery. Peer Recovery Support Specialists shall maintain high standards of personal conduct, and conduct themselves in a manner that supports their own recovery. Peer Recovery Support Specialists shall serve as advocates for the people they serve. Peer Recovery Support Specialists shall not perform services outside of the boundaries and scope of their expertise, shall be aware of the limits of their training and capabilities, and shall collaborate with other professionals and Recovery Support Specialists to best meet the needs of the person(s) served. Peer Recovery Support Specialists shall preserve an objective and ethical relationship at all times. This credential does not endorse, suggest or intent that a Peer Recovery Support Specialist will serve independently. The Peer Recovery Support Specialist shall only work under supervision”(NCPRSS code of ethics 2021)

What a Code of Ethics Does for Peer Recovery Support Workers

Codes of ethics help to legitimize a field of practice. Practice standards consist of guidelines to use as the basis for making decisions about what are acceptable as work performance and practice. Standards are established using values, ethics, principles, and competencies and usually consist of practice guidelines, core competencies, and ethical guidelines.  Codes of ethics also help to protect both practitioners and the clients they serve and provide a means for accountability, reporting, and self-regulation.

Resources

SAMHSA’s Peers page and the Recovery Support Tools and Resources site contain numerous resources and support tools for those who want to learn more about the field of peer recovery support.

Additional resources can be found in the Catalyst blog post Peer Recovery Support Workers: The Research Says “Yes!” from May 29, 2019, on the CASAT OnDemand Resources & Downloads page. For professional development opportunities, check out CASAT Learning.

For resources about becoming certified in Nevada, check out the Catalyst blog archives under Peer Recovery Support Specialist.

References

NCPRSS code of ethics. (n.d.). Retrieved February 11, 2021, from https://www.naadac.org/ncprss-code-of-ethics

SlideDecks4U. Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Treatment (CSAT) (Grant Number TI-080200). Building Recovery Capital. All material, except that taken directly from copyrighted sources, is in the public domain and may be used and reprinted for training purposes without special permission. However, any content used should be attributed to the Mountain Plains Addiction Technology Transfer Center.

White, W., the PRO-ACT Ethics Workgroup, with legal discussion by Popovits R. & Donohue, B. (2007). Ethical Guidelines for the Delivery of Peer-based Recovery Support Services. Philadelphia: Philadelphia Department of Behavioral Health and Mental Retardation Services.

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