National Standards — Informational Meeting
Friday, October 12, 2012

National Association of Peer Specialists (NAPS) held an informational / listening session at Alternatives 2012 in Portland, Oregon about National Standards for Peer Specialists.

Thanks to OptumHealth for their generous contribution of a toll-free phone line for people across the country to call in and listen to the meeting. Comments offered during the meeting are provided in the notes submitted by attendees and also listed in the Comment fields below.


Steve Harrington’s Call for Collaboration to establish National Standards for Peer Specialists (for all peer support providers) is an opportunity for the entire c/s/x peer and substance use communities to unite in the common purpose of defining the value of lived experience and the strength of strategic sharing in supporting others.

At the Pillars of Peer Support, the National Association of Peer Specialists (NAPS) was charged with bringing together representatives from many different peer groups to discuss and build consensus toward a core set of standards to guide the practice and supervision of the peer support provider professions.


The purpose of the meeting at the Alternatives Conference in Portland, Oregon was to plan for the development of a core set of national standards.

Common themes included: standards protect those who receive services, standards help to ensure quality services, standards are a tool to help advocate for recovery, standards help prevent co-optation, important to integrate substance use peer support, nothing about us without us, need a united voice to be heard.

Now is the time to define the peer specialist profession — before others do it for us.

Click the following link to download a one-page summary and example of a practice standard by Steve Harrington, Executive Director of the National Association of Peer Specialists.


With some initial answers. Important: The following terms, definitions, and requirements are subject to change based on input from the advisory groups and work groups that are soon to be established.

(1) Why are we talking about National Standards for Peer Specialists?

— Well defined standards lend credibility and accountability to the profession. 

(2) What are Practice Standards?

— Practice standards are guidelines that define acceptable (and unacceptable) practices. They include values, ethics, and standards of good practice. For a DRAFT example of a potential practice standard, review the following document: 


Note: This was a first attempt — created for people to give thoughts and reactions.

Please feel free to leave comments about this draft below (on this web page) or send email to

(3) What’s the difference between National Certification and National Standards?

— Certification refers to the amount and type of training (including on-the-job, supervised training) that qualifies someone for a particular job. Currently, for peer specialists, these qualifications vary widely from state to state, and in many cases from setting to setting within a particular state. Add to the complexity the variety of titles and services offered by peer support providers. There are a wide variety of training requirements to perform these more specific jobs, which may not apply to a more generic peer specialist training. 

— Practice standards are statements that describe the values and ethics and provide guidelines for the core (essential) practices for a profession.

— Practice standards may recommend a specific amount or type of training. However, the actual training requirements would depend on the more specific job title, core competencies necessary to perform the job, and the needs of those who are receiving services in the organization that is hiring for the position.

(4) Is the goal to develop a National Peer Specialist credential?

— The current goal is to establish National Standards that offer a “minimum set” of guidelines for practice and inform the supervision of that practice. The intent is to develop a clear set of statements that reflect agreed upon values of peer support providers, which in turn lead to better job descriptions/more appropriate tasks that make best use of the lived experience of the peers who are providing services and provide more consistent services for the people who are receiving services.

(5) What is the value of establishing National Practice Standards?

— More credibility as a profession, better recognition of the value and validity of peer support as a healing art, increased quality assurance, tools that help peers advocate for recovery focused practices and supervisors to evaluate job performance.

(6) What will happen if we don’t establish National Practice Standards?

— Continued lack of recognition of peer support as a valid profession (lacking equal status and pay to other practitioners of healing arts) and continued confusion over the role of peers in mental and behavioral health care.


Post them below or submit them to:

Notes from the meeting (taken by participants):



For additional comments captured during the meeting, view the comments below.


We are striving to establish a collaborative and inclusive coalition to determine
National Standards for Peer Specialists. Toward that goal, we are now working on: 

  1. An intentional and inclusive process for inviting members to join the proposed work groups
  2. Inviting the national technical assistance centers and national organizations to share the invitation to join this effort with their members
  3. Consensus building throughout the process
  4. Inclusion of all c/s/x peers (not just peer specialists) in the review
  5. Inclusion of substance use / dual recovery communities for comment

To learn more about the Call for Collaboration and recent discussion, visit the National Standards page on the NAPS website:

Like us on Facebook and give informal feedback at

If you know others who would like to be involved in this effort – ask them to send email with JOIN LIST in the subject to

To Sign Up for a specific work group complete this survey (which gives us more information about your specific skills and interests and availability): 

59 thoughts on “Meeting at ALTERNATIVES

  1. Managed care needs peer specialists to have a credible credential – like other professions – and managed care organizations will create one if peers don’t – because the managed care company needs it to bill for services. It comes from both the top and bottom.

  2. Why are we turning peer support into a “profession?” Doesn’t that defeat the value of being peer to peer? Let’s not turn into what we’re trying to get away from.

  3. Practice Standards are made up of Values | Competencies | Ethics
    Example: Medical profession – “First – Do no harm”
    The professional context occurs in three areas / practice / education / research –

  4. Any standard must NOT have any of the bio-medical language. Our history teaches us that we were intended to be change agents NOT medication monitors, not mini- case managers. Hence no use of the bio-medical language nor any of their standards. ~ Lester E. D. Cook
    New York State

  5. A lot of peer specialists are currently doing work that is counter to our values –
    Doing everything except what came out of the ethics of our profession –
    Abuse happens inside of Medicaid agencies. Standards will protect the people who we’re trying to work with. We do things in a different way and that’s what makes us peers.

  6. We’re not (at this point) trying to create an additional training program or credential —-
    Perhaps the greatest value is to start forming into working groups.
    We need to harness this energy and start getting people into groups now.

  7. When it comes to competencies – Harvey Rosenthal mentioned that someone might be working as a peer bridger, which is different than a wellness coach, which is different than a crisis respite worker …. Competencies that are required may be different for different settings. We need to make a distinction between the role of a peer support worker (title), vs. the practice of peer support (profession).

    Are we talking about the title vs. the practice of peer support?

    It is like nursing – where the practice of nursing is common across the profession. But nursing is divided into specialty areas such as psychiatric nursing vs. ER nursing vs. pediatric nursing vs. hospice nursing. The practice standards for nursing are common across the specialty areas.

  8. Need to agree about the human rights framework and standards about what peer specialists should NOT be doing. They don’t have anything to fall back on (currently) to advocate for doing peer work. Code of Ethics (part of practice standards) will define what we DON’T do. (Example: Push meds. Push paper. Push brooms.)

  9. Standards are very important – they define what we do for ourselves – and they also define for the providers and supervisors what we do. (Example: I’m not a case manager, I’m a relationship specialist…) Re-emphasize the need for recovery language and individual choice.

  10. (Substance abuse / mental illness treatment) Some states have separate but parallel processes…. It’s not a forgone conclusion that the standards will reflect both because some states are segregated by funding and philosophies.

  11. Cultural competence is a key element. With Native Americans, for example, peer and family support is essential. See cooperation between peer and family support.

  12. Political process is still a part of advocacy. Where does political activity fit into peer support? How will the standards reflect the importance of advocacy in the political system?

  13. I’m confused about the role of a peer support specialist in areas such as substance abuse or forensics – how can we be trained to share ‘lived experience’ for a specific experience we don’t have?

  14. We’re not trying to recreate a *new* mental health profession. We should be growing together with the people we’re supporting. We can’t be trained to offer something we don’t have in our own life experience.

  15. The difference between us and other professionals is that we have empathy and supportive skills – that are needed for peer support. The ability to inspire hope is a critical value that is needed for peer support. We don’t help people. We inspire and support people.

  16. Important to pay attention to continuing education. Would like to see continuing (ongoing) education as an emphasis in the standards. Give us the ability to go (and grow) beyond the job title of peer specialist.

  17. Standards offer the 30,000 ft. view that includes the values and ethics and job descriptions (HR) offer details needed to accomplish specific tasks.

    Ideally National Standards will inform future job descriptions. (The ideal job descriptions people need to live up to.)

  18. Recovery job coach (trained in 2 days). Concern was expressed that somewhere / there needs to be a minimum standard requirement (number of hours) for the training to qualify someone for a position.

  19. In New York State a coalition was formed to protect the integrity of peer support — fighting to make sure peer jobs stay within peer run organizations – and for ongoing support for peer support workers to from a peer run organization. The coalition recommendation was that peer-run organizations be the ones to support peer specialists. Important to incorporate / communicate the value of peer run organizations and the need for peer support within peer run organizations.

  20. Need National Standards so we don’t just get “anyone” to do peer specialist work (unqualified).

    For example: I have a peer at my center who was studying to become an ADA coordinator – but the person who does sanitation was chosen to became the ADA coordinator. There’s no national standards – and even though the peer had been studying for the position, they were able name anyone to be the ADA coordinator.

  21. There are states that are changing their job requirements so people need to have a masters degree to become a peer specialists (without regard to the amount of lived experience).

  22. Develop a system of peer supervision so peers in the workplace have access to other peers with advanced skills in supervision (buffer between peers and non-peers).

  23. Health care reform – peers have an unprecedented opportunity – but only if we have uniformity (state buy-in) at the National level.

  24. We understand the ideal of having peer-run organizations as the sole provider of peer services, but if everything had to be done by peer–run organizations our state could not adopt the standards.

  25. We need to strategize now to be sure our voice has a central role in this process. Whether it is through NAPS or State-wide organizations or local groups that unite.

  26. State run organizations in 31 states – work together – connect – with consumer organizations.
    Unified voice.
    Determine the content of the standards.
    Need to offer everyone / inc. voices from the front line / informed choice and options.
    Don’t want to hear from the usual suspects.

  27. Impress upon people…
    CMS at the federal level are paying the peer specialist movement (dictating who gets funding). Who’s deciding there – where’s the peer specialist advisor there? Managed care psychiatrists make decisions. Peers should be on the board of Managed Care. (Tables for peers to get involved.)

  28. Many organizations are currently working on peer credentials for substance use and mental health. IC&RC International credentialing (substance abuse counselors) – certify peer coaches / peer specialists.

  29. Delaware – substance abuse community did not reflect our values (may be a good model).
    Peer supervisors – (Delaware) created our infrastructure. Delaware had an influx of money that other states have not been getting lately.

  30. Stunned that we’re listening passively to standards related to medicare reimbursable systems – where people are already co-opted. Horrified that we’re going to be involved in treatment planning. Our culture is to fight those things that are going to corrupt us.

  31. Human relationships is the work that we do and our roles within our agencies.
    We will beholden to the state – if we don’t understand the credibility of the national organization and how the states have co-opted peer support so it looks nothing like other geographies.

    We’ll be doing a lot of work for nothing unless it is done where it is going to count.
    CMS / Managed Health Organizations. Making connections where it is going to count.

  32. Let’s not forget the people who are being served. Standards protect the peers we’re working with.
    I will finally be able to say, “I WILL NOT…” for those things that are not true to our values.

  33. National disability leadership alliance. All run by people with disabilities. No professionals. No family members. This needs to be our voice. Not people working for us. Senate. CMS.

  34. Building our future requires a National Standard. State Certifications that have established core competencies can assist HHS and SAMHSA with this much called for initiative.

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