Boundaries and moral injury Practicing self-care and community care as a certified peer specialist through setting boundaries (whether individually in one’s own life or mutually with a peer) is central to effective peer support. This is necessary: • To have capacity for compassion and empathy. • To have equitable relationships which means more capacity for generosity. • To have self-confidence, self-esteem, and self-respect. • To attain mutuality in relationships. • To get more of what is desirable and to get less of what is undesirable. • To get control over our time, efforts, and life. • To recognize when community with other certified peer specialists can be a resource. Another reason for the certified peer specialist to set boundaries about what is and is not okay is to lessen the potential impacts of moral injury. Moral injury is a concept that emerged from mutual support among military veterans. Through this work, it was discovered that, for some veterans, the pain and trauma experienced in combat was related to profound injuries to one’s moral code and values. For instance, if someone had entered a war with a desire to be of service to others—but was expected to carry out orders that directly contradicted this value—a moral injury could then occur. The concept of moral injury can be generalized beyond the experience of war veterans to include anyone who is pressured to betray their moral compass or values system. The mental health and substance use systems and the agencies within them are continuously learning, growing, and changing to meet the needs of individuals. A certified peer specialist may find that the system’s response may be at odds with their core beliefs. Certified peer specialists have reported the following difficult situations within their work settings. Consider how these might be examples of moral injury: • A certified peer specialist who values seeing the peer through a strengths-based lens is required to use deficit-based language in documentation. • A certified peer specialist is required by the employing agency to involve police and call 911 when the person they support does not identify as being in crisis or consent to their involvement. • A certified peer specialist is asked to connect a person they are supporting to a recovery pathway that the certified peer specialist feels is harmful. • A certified peer specialist who is expected to participate in developing a treatment plan for their peer when the peer is not present or involved in any way.
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