Training peer recovery specialists in behavioral activation: preliminary outcomes and predictors of competence

Abstract

Abstract Background: The peer recovery specialist (PRS) workforce has rapidly expanded to increase access to substance use disorder services for underserved communities. PRSs are not typically trained in evidence-based interventions (EBIs) outside of motivational interviewing, though evidence demonstrates the feasibility of PRS delivery of certain EBIs, such as a brief behavioral intervention, behavioral activation (BA). However, characteristics that predict PRS competency in delivering EBIs such as BA remain unknown, and are critical for PRS selection, training and supervision if the PRS role is expanded. This study aimed to explore the outcomes of a brief PRS training in BA and identify predictors of competence. Method: Twenty PRSs completed a two-hour training on PRS-delivered BA. Participants completed baseline and post-training assessments, including role plays and assessments of PRS characteristics, attitudes towards EBIs, and theoretically-relevant personality constructs. Role plays were coded for competence (BA specific and PRS skills more broadly, ie., PRS competence) and changes were assessed from baseline to post-training. Linear regression models tested factors predicting post-training competence, controlling for baseline competence. Results: There was a significant pre-post change in BA competence (t = -7.02, p= <0.001) such that post-training competency was higher. Years working as a PRS significantly predicted post-training BA skills (B=.16, p=.005). No variables predicted post-training PRS competence. Conclusions: This study provides preliminary evidence that BA may be appropriate for dissemination to PRSs through brief trainings, particularly for PRSs with more work experience. However, additional research is needed to examine predictors of competence among PRSs.