Peer support role & skills

Key facts

• Check the program site for the current training list, hours, fees, and renewal rules, since they change.

Step by step

1. Have lived experience of mental illness and/or substance use, and be in recovery.
2. Have a high school diploma or equivalent.
3. Finish the approved peer support training (NC-approved curriculum) plus required extra courses.
4. Apply for certification and agree to the Code of Ethics.
5. Renew on schedule with the required continuing education hours.

Official sources

• NC Certified Peer Support Specialist Program
• NC DHHS: Peer support

Last checked October 2026. Amounts and rules change, so confirm with the official source before sharing.

Key facts

• Active listening: reflect back, summarize, and stay curious.
• Open questions: "What would make this week better?" instead of "Are you OK?"
• Motivational interviewing basics (OARS): Open questions, Affirmations, Reflections, Summaries.
• Share your story with purpose: brief, hopeful, and about them, not you.
• WRAP (Wellness Recovery Action Plan): daily maintenance, triggers, early warning signs, crisis plan.
• Strengths-based goals: in their words, small and specific.
• Shared decision-making: they're the expert on their own life.

Official sources

• SAMHSA: Peer support
• SAMHSA: Core competencies for peer workers

Last checked October 2026. Amounts and rules change, so confirm with the official source before sharing.

Key facts

• Follow your agency's policies on texting, social media, gifts, rides, and money.
• HIPAA: share only what's needed, with consent, through approved channels.
• Substance use records have extra protection (42 CFR Part 2).
• Mandated reporting in NC: anyone who suspects child abuse or neglect must report to county DSS. Suspected abuse of a disabled adult must also be reported to DSS.
• Duty to warn situations: talk with your supervisor right away.
• Know when to refer: medical emergencies, legal advice, and clinical treatment are outside the peer role.

Official sources

• HHS: HIPAA
• NC DHHS: Report child abuse
• NC DHHS: Adult Protective Services

Last checked October 2026. Amounts and rules change, so confirm with the official source before sharing.

Key facts

• Say "person with a substance use disorder," not "addict."
• Say "person living with schizophrenia," not "schizophrenic."
• Say "in recovery" or "returned to use," not "clean/dirty" or "relapsed."
• Say "medication for opioid use disorder," not "replacement."
• Say "died by suicide," not "committed suicide."

Official sources

• NIDA: Words matter

Last checked October 2026. Amounts and rules change, so confirm with the official source before sharing.

Key facts

• Ask about and respect names, pronouns, faith, and family roles.
• Use free interpreters. Don't rely on family or children to interpret.
• Be aware of the history of mistreatment in health care for many communities.
• See the Special groups section for young adults 18+, older adults, LGBTQ+ adults, and caregivers.

Official sources

• HHS: National CLAS standards

Last checked October 2026. Amounts and rules change, so confirm with the official source before sharing.

Key facts

• Watch for burnout and secondary trauma: dreading work, numbness, irritability, sleep problems.
• Use supervision regularly. Peer supervision is part of good practice.
• Keep your own WRAP or wellness plan.
• Use your agency’s supervision, employee assistance, and local clinician support; call or text 988 during a crisis.

Official sources

• SAMHSA: Self-care for peer workers

Last checked October 2026. Amounts and rules change, so confirm with the official source before sharing.