Demonstration of consistent outcomes and data is a key requirement for providers to obtain the reimbursement they expect from payers. Understanding the distinction and benefits between the various professional and volunteer roles in the recovery space has become vital for providers to succeed going forward. It is also important that they know how they can complement each other within a recovery network.
Utilizing the strengths of these various roles is especially true when it comes to the collaboration of Peer Specialists (PRSS), Alumni Coordinators, and Sponsors in substance use disorder (SUD) recovery. It is crucial to highlight that these roles are not in competition with each other. Rather they complement one another. Working together, they help to increase the support network of persons in recovery (PIRs) and improve outcomes across the care continuum.
Different Lanes in Recovery Create Better Outcomes
Payers and providers are recognizing the growing importance of Peer Specialists as an extension of recovery support. However, there are fears among some members of the treatment industry that Peer Specialists will usurp or replace the need for Alumni coordinators.
Related content: Why Alumni Support is Vital to Addiction Recovery
In addition, though it’s not a professional position, many members of the recovery community who are specific to a twelve step fellowship model and an abstinence-based model have presented the concern that Peer Specialists are not much different than a Sponsor.
These roles might have some technical overlaps. But each of these positions has their own lane to run in and their own specific ways they improve on conditions and outcomes within the treatment spectrum.
As a therapist working in recovery, I have a unique perspective on the strengths of each of these positions given my own experience working around professionals and individuals in the recovery field. Additionally, therapists also have a specific lane in SUD recovery. So, recognizing how different lanes can coexist and work together to create better outcomes for PIRs is a part of my work.
After all, creating opportunities for better outcomes for those who suffer from the chronic disease of addiction should be the primary purpose of anyone working in the recovery industry.
PRSS and Alumni Coordinators
Between Peer Specialists, Alumni Coordinators, and Sponsors, the first two seem to have the most overlap in the recovery field. As I mentioned above, some Alumni Coordinators even fear that this overlap by Peer Specialists will eventually make their positions obsolete. I firmly believe that nothing is farther from the truth, but I can understand the concern.
Payers have started to reimburse providers for utilizing Peer Recovery Support Services. However, they are not generally reimbursing them for the costs of employing Alumni Coordinators.
Reducing business expenses is not the primary goal here though. Our primary purpose has to be creating demonstrable positive outcomes in the recovery space. In that light, treatment providers must recognize that both positions have important contributions to make for persons in recovery (PIRs) themselves and the larger care continuum.
I have talked previously about the differences between Peer Recovery Support Specialists and Alumni Coordinators. However, I think a more in-depth analysis of these two positions and how they stand apart is necessary.
Peer Specialists work most effectively in the lane of individualized post-treatment telehealth support for PIRs. Alumni Coordinators work most effectively in the lane of maintaining contact with treatment facility Alumni. They also organize social events, groups, networks, and opportunities for PIRs to engage with each other in a post-treatment recovery environment.
Training and certification
One of the key differences between Peer Specialists and Alumni Coordinators is the amount of peer support training and certification Peer Specialists obtain. Alumni Coordinators do not necessarily have to obtain formal training and certifications in order to work for a treatment facility. Nor is there a consistent specific sobriety requirement.
Peer Specialists can be certified at the national or state level. At either level, individuals must meet certain criteria and complete training programs in order to obtain peer specialist certification.
A full list of qualifications can be found on NAADAC’s website, some of those include:
- Being in recovery for at least 2 years
- Multiple hours of experience supporting others under supervision
- Trainings on topics such as peer recovery, co-occurring disorders, ethics, and HIV (NAADAC)
Additionally, Peer Specialists have to undergo supervised training with industry professionals and have continuing education requirements to maintain their certifications.
This extensive training and certification process suggests that Peer Specialists have a more informed ability to provide individualized post-treatment support at the peer to peer level than Alumni Coordinators might.
Another difference that highlights the unique contributions these two positions make to the care continuum is location. Alumni Coordinators are typically very familiar with the region surrounding the treatment centers where they work.
In many cases, they are involved in the recovery community in that area. Alumni Coordinators use this familiarity to be a vital source of guiding information for PIRs who are getting ready to discharge or have just completed treatment.
Alumni Coordinators can direct PIRs toward groups, resources, and employment or housing options in the area that are a good fit for that individual’s particular needs.
On the other hand, Peer Specialists can work remotely by using telehealth. This enables specialists to provide their services to a variety of individuals over a broad geographic area.
So, Peer Specialists will generally not be as familiar with any one particular regional area like Alumni Coordinators. However, they will be very familiar with resources they can point a PIR to, as well as different strategies to face challenges on their recovery journey. However, if a PIR is no longer living in the area where they attended treatment, the support a Peer Specialist can provide for their transition to the new area can be indispensable.
Related Content: The Multidisciplinary Specialist Team: A New Model of Care
Separation of these two professional lanes
The separation of these two professional lanes in the recovery space is pretty well summed up by their names:
- Peer Recovery Support Specialists are just that, they specialize in Peer Recovery Support. They have been on the recovery journey for long enough to be able to relate to another peer who is just beginning or is not as far along on their path.
- Alumni Coordinators help to coordinate the alumni of a treatment facility in order to enhance their experience of living in recovery.
There are some Alumni Coordinators who are also trained and certified Peer Specialists. They perform some of the services that Peer Specialists provide, but this is not the norm.
Moreover, treatment providers should recognize that creating an expectation that Alumni Coordinators play both roles is not scalable from a treatment or business perspective. Alumni Coordinators have a whole roster of PIRs that they are working to assist.
In many ways, the emergence of peer recovery support specialists was made possible by the work that Alumni Coordinators have been doing. Peer Specialists are just the next logical step in that continuum of care. That doesn’t mean Alumni Coordinators are not needed. It means that there is a gap in the services they can realistically provide and what is needed by the SUD population.
Expecting an individual to perform the jobs of both Alumni Coordinator and Peer Specialist impairs that person’s ability to do their job effectively. It also can decrease positive outcomes for the PIRs that are at the center of all the work we do in the recovery space.
A sponsor is contained within a certain kind of recovery pathway. Twelve-step fellowships like AA, NA, CA, and others utilize individuals, with a varying amount of experience in that fellowship’s recovery pathway who volunteer to be “sponsors” to others, called “sponsees”, who generally have less experience in recovery than they do.
Most Sponsors limit their role to helping their sponsees work through the specific fellowship’s 12 steps. They also act as a level of accountability when it comes to whatever fellowship or tradition of fellowship that person is choosing to walk.
Sponsors have a very important but narrow lane to run in when taking into account the entire recovery care continuum. After all, Sponsors only exist in one modality of post-treatment recovery: the twelve-step abstinence-based model of recovery.
Peer Specialists are generally trained in multiple modalities of recovery. Therefore, they can help a wider range of PIRs depending on the mode of post-treatment recovery they follow. Peer Specialists, many times, are actually involved in the process of helping the PIR decide which modality of post-treatment recovery seems most suited to their individual needs.
There are a loose set of parameters for sponsors to follow outlined in the literature of any 12 step fellowship. However, one person’s version of ideal sponsorship can look very different from someone else’s.
Generally speaking, a sponsor utilizes their own version of the method and approach they learned from their sponsor and the particular literature of that 12 step fellowship. This approach tends to work for a specific set of the recovery population. But it can create a barrier to delivering consistent outcomes.
This is mostly because the outcome almost entirely depends on the PIRs willingness to follow their sponsor’s suggestions. A PIR or Sponsor can end the Sponsor/Sponsee relationship at any point if it is not the right fit.
The training and certification process that all Peer Specialists go through creates a fairly consistent approach to how they provide support to PIRs. This type of training and certification process creates a more uniform protocol for Peer Specialists to provide individualized support for different PIRs and track outcomes and recovery related data.
Key difference: the primary functions
This is not to say that a Sponsor is less important or less reliable than a Peer Specialist for PIRs following a twelve-step model of recovery. The key difference between these two is in their primary functions.
Sponsors exist to help PIRs work through the twelve-step model of abstinence-based recovery and hold them accountable to the traditions of their particular 12-step fellowship.
Peer Specialists do not tread on this territory, they exist to provide individualized support to PIRs. Both of these positions working in tandem for PIRs on a twelve-step model of abstinence-based recovery can create a far better set of predictable positive outcomes than either can do alone.
Expanding the Care Continuum for Positive Outcomes
From a historical perspective, many of the pre-professional and professional positions that now exist in the recovery space were made possible by the work of volunteer positions that existed before them, such as Sponsors.
All of these positions contribute to the same primary purpose, which is to create positive outcomes for the SUD population. The urge to cut costs or demand double the work from single individuals working in the recovery space will only hurt providers in the long run.
Payers and patients will continue to hold providers accountable to provide better outcomes. Those who do not utilize as many resources as possible to do this will end up failing.
The bottom line
Providers should recognize that there is strength in numbers when it comes to creating a network of recovery for PIRs and positive outcomes for the addiction epidemic in our country.
Thomas G. Kimball, PhD
Thomas G. Kimball, Ph.D., LMFT, is the George C. Miller Family Regents Professor at Texas Tech University and the Director of the Center for Collegiate Recovery Communities. Dr. Kimball has been part of the MAP team since 2012 and serves as Clinical Director, where he oversees and consults on the implementation of extended recovery modalities, techniques, and practices on individuals who undergo treatment for Substance Use Disorder (SUD).
He has received numerous teaching awards for his courses on families, addiction, & recovery. He is the author of several peer-reviewed articles on addiction and recovery in respected medical journals, a frequent contributor to leading addiction and recovery publications online, and co-authored the book,
Six Essentials to Achieve Lasting Recovery, by Hazelden Press.
In addition to consulting and presenting on recovery-related issues across the U.S. and internationally, he frequently writes articles pertaining to emerging addiction recovery data, recovery techniques and modalities, the science behind addiction, the addiction crisis, and long term treatment for the chronic disease of addiction.
Dr. Kimball has made the focus of his career studying collegiate and long term addiction recovery by focusing on factors that enhance long term recovery and improve the treatment industry at a local, national, and international level. Follow him @drtomkimball
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