The Community Health Workforce provides tremendous and often unseen value to the communities they serve. In this three-part series, CHAP introduces a peer recovery specialist, a community-based doula, and a community health worker, and shares what sets them apart from other healthcare professionals.
Things have come full circle for Angela Cicchino. Her work as a peer recovery specialist takes place in a hospital similar to where her parents took her when she was struggling with substance use. As a manager of the Peer Recovery Program at the RWJBarnabas Health Institute for Prevention and Recovery in New Jersey, she walks the halls and sees patients in all-too familiar situations. The difference is that now she is in recovery, and Angela has the skills and training to help those people at a critical time in their lives.
Angela defines the role of peer recovery specialist as someone who identifies with, supports, and guides people through recovery from substance use disorder. Peers don’t tell you what to do, what path to take, or how to structure your recovery. Instead, they guide people toward whatever path feels right for the patient. When she first heard about the peer model launching in 2016, she wished it had been available when she was struggling with recovery. “It was so valuable, in the first five years of recovery, to have someone to talk to who understood what I was going through. When I stepped foot into recovery and met other people like me, it was the first time I felt like ‘I’m not alone, I can do this.’” The early days of recovery from substances can be very difficult, and having a peer recovery specialist on your team can make all the difference.
There is no such thing as a typical day for a peer recovery specialist. In the face of unpredictability, Angela’s focus is always making sure the patient is okay. Are they hot, cold, sick, hungry? “Right away, it’s about a human connection.” Initial encounters with a peer can happen through referrals, community resources, or after an emergency department visit. When Angela first enters the room with a new patient, she explains that she’s a peer, that she’s been in their shoes before, and that she is here to support them. Unlike other healthcare professionals who juggle many priorities at once, the only item on a peer’s agenda is to help the patient with their own goals for recovery.
Angela uses the first fifteen minutes of an encounter to establish a relationship and kick off motivational interviewing. The patient may choose to enter eight weeks of intensive follow up with Angela, who helps them set goals and make progress towards achieving recovery. Less than 5% of patients decline services, and the relationships she builds typically last well beyond the eight-week mark. “Years later, I’ll run into someone at a restaurant who is doing so well, absolutely glowing because they got married, or got their kids back. Having been with that person during a key part of their journey is such a rewarding experience.” On any given day, Angela will see up to six patients, and her team of more than 100 peer specialists employed by RWJ Barnabas Health System will see 24,000 patients a year throughout New Jersey.
The work is rewarding but also emotionally challenging at times. The best advice Angela got during training is the importance of taking care of herself to reduce burnout. This means self-care every day, going to counseling, and setting clear boundaries between work and her own recovery. What helps is that Angela is not alone in this work. She has a team of other peers, social workers, nurses, and doctors that work together supporting patients, meeting during daily rounds to discuss challenging cases and celebrate wins. There’s also been a push across New Jersey to better integrate the different types of peers—those who work in community, crisis peers, and long term peers—to have a cohesive workforce across the state.
“Once my patients make a decision to better themselves, miracles happen,” says Angela. While the nature of substance use continues to change, Angela’s commitment to remaining teachable, authentic, and available for her patients remains firmly in place.