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May 31, 2012 Volume 3, Issue 20
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Call for Papers

RTP is calling for personal and practitioner articles that illustrate the principles and potential of recovery. Whether they describe how self-directed care has changed the nature of your practitioner–client relationship, your journey of healing and recovery, a recovery-oriented tool or strategy, or how peer involvement has influenced your workplace, your stories deeply touch our readers and continue to advance the mission and values of Recovery to Practice.

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Reciprocal Peer Support*
Lessons Learned From a Decade of Experience
by Cherie Castellano, L.P.C., and Marie Verna, B.A.
Decades ago, efforts began throughout the U.S. to garner support for people with mental illness and their families from those with lived experience—individuals who had endured behavioral health struggles and wanted to help others dealing with similar issues.

The University of Medicine and Dentistry of New Jersey's University Behavioral HealthCare (UBHC) has hired peer specialists in many of its traditional treatment settings, including Supported Housing, Intensive Outpatient Treatment Support Services, Homeless Outreach, Integrated Case Management Services, Partial Hospitalization, and the Behavioral Research and Training Institute. These specialists are paid staff members who bring unique insight and skills to the people they serve.

In the last 10 years, UBHC has also developed innovative peer support programs: Cop2Cop, Vet2Vet, Mom2Mom, Teacher2Teacher, and Vets4Warriors. They have provided peer support through these programs to specific groups of trauma survivors who want to give back.

Our experience with peer support has provided a framework for the concept we call Reciprocal Peer Support (RPS). Along the way, we have learned about truly reciprocal support—a shared experience of healing and restoring emotional and mental balance.

As part of high-risk groups and subcultures themselves, peer supporters practice their work with inherent resilience—a quality that uniquely positions them to recover from difficult situations. They possess unusually sophisticated coping skills for managing trauma and crisis. Their sense of worth is often based on selfless service to others, and their deep desire to relieve suffering is typically the most compelling factor in our recruitment and employment process.

By the time a peer joins one of our programs, he or she has overcome tremendous suffering and trauma and developed extraordinary resilience. In the process of listening to and supporting members of their subculture who are in distress, they are consistently reminded of their own strengths and courage. Because peer specialists and the people they serve experience struggles in a cyclical manner, their ongoing exchange allows both sides to learn and grow at a comfortable pace. Peer support is a mutually beneficial process grounded in shared responsibility, respect, and consensus on what is and isn't helpful.

In traditional treatment settings, peers help other professionals comprehend mental illness and addiction challenges that non-peers cannot possibly understand, simply because they have not lived through them. Whereas non-peer staff have learned through formal education, peer staff have learned "on the street." In this way, they are part of a unique group of service providers who can share personal vulnerabilities and strengths to foster recovery.

There are eight defining components of RPS:
  1. RPS requires equal partnerships between peer supporters and behavioral health care professionals.
  2. A well-designed RPS program creates volunteer opportunities for peer specialists who seek a provisional role before becoming paid employees.
  3. Any RPS program serving subcultures that are repeatedly exposed to trauma yet hesitant to reach out for help must provide a full continuum of services—from prevention, to crisis response, to outreach, to service accessibility.
  4. RPS programs thrive when leadership provides community collaboration, resilience-building activities, and recognition.
  5. Subcultures possess unique skill sets that do not necessarily translate across other subcultures. RPS training must integrate subcultural competencies to determine peers' capacity for working in RPS programs.
  6. An effective RPS program must have the resources needed to discover the full continuum of services available in a geographic area.
  7. To sustain RPS programs, peer specialists must develop strong community partnerships while advocating for legislation and policies that formally recognize the contributions of peer support.
  8. We must research the reciprocal nature of UBHC's peer support programs to fully understand how to facilitate the mutual healing of RPS teams and the people they serve.
*Reciprocal Peer Support is a copyright-protected term.

Cherie Castellano is the Program Director of Cop2Cop, NJVet2Vet, and Mom2Mom peer support helpline programs at the University of Medicine and Dentistry of New Jersey–University Behavioral HealthCare.

Marie Verna is a Program Support Coordinator at University Behavioral HealthCare, where she facilitates efforts to integrate peer specialists in all programs and promotes the consumer and family voice.

Arizona Vows to Improve Health Services
Over the past few years, Arizona has faced one of its greatest financial challenges. To cut operating expenses, state agencies have initiated hiring freezes, salary reductions, and mandatory furloughs, as programs and services throughout the state continue to struggle. Like most state agencies, Arizona's Division of Behavioral Health Services (DBHS) has restricted its programs. In addition to the budget crisis, Arnold vs. Sarn, the ongoing class action lawsuit alleging Arizona does not adequately fund a comprehensive mental health system, has been suspended until June 2012.

But DBHS is responding in a positive way, seeking community input to improve mental health services. Read more about the division's efforts to transform the system, develop new treatment modalities, and promote consumer voice, recovery principles, and innovations in clinical practice and service delivery.

Army to Review Psychiatric Evaluation Management
The U.S. Army is assembling a task force to determine how its doctors diagnose psychiatric disorders. Led by Lieutenant General David G. Perkins, Commander of the Combined Arms Center and Fort Leavenworth, Kan., the group aims to ensure that consistent and accurate diagnoses are issued by the disability evaluation system.

Independent reviews conducted by the Army Inspector General and Auditor General will explore the pressures doctors face to issue certain diagnoses and whether soldiers can appeal those decisions.

"Just as our behavioral health professionals are committed to providing the best possible care, we, too, must ensure that our processes and procedures are thorough, fair, and conducted in accordance with appropriate, consistent medical standards," said Army Secretary John McHugh in a May 16 statement.

Going through the disability evaluation system is a nerve-racking process. When soldiers are declared unfit, the Army and Department of Veterans Affairs decide if they will receive a monthly disability check and other benefits based on the severity of their injuries.

Read the article.

Black Women, Recovery, and Resilience
When it comes to mental health services, black women continue to face significant disadvantages. Research shows higher rates of admission for black women at British treatment centers and less access to community care, like women's crisis houses.

These inequalities are compounded by sociocultural and political factors. Immigration status, family circumstances, discrimination, poverty, and isolation all influence mental wellness and recovery for black women in the U.K.

England's new mental health strategy promotes recovery as a benchmark for quality of life. The Department of Health has endorsed personalized services, but a diminished focus on race equality and spending cuts for community organizations have affected mental health care for minority ethnic groups.

Read the article.

RTP Wants to Hear From
Recovery-Oriented Practitioners!
We invite practitioners to submit personal stories that describe how they became involved in recovery-
oriented work and how it has changed the way they practice.
RTP Wants to Hear From You, Too!
We invite you to submit personal stories that describe recovery experiences. To submit stories or other recovery resources, please contact us at 877.584.8535,
or email

We welcome your views, comments, suggestions, and inquiries.
For more information on this topic or any other recovery topic,
please contact RTP at
877.584.8535, or email

The views, opinions, and content of this Weekly Highlight are those of the authors, and do not necessarily reflect
the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services.