Employing empathy in recovery support

Addiction can feel like an alienating thing, a struggle few can truly understand. It can feel insurmountable, too big a hole to climb out.

But Arkansas Blue Cross and Blue Shield employs people with lived experience of recovery to help people struggling with addiction find their way forward.

“Arkansas Blue Cross was the first to establish a dedicated behavioral health team to support members who are faced with mental health or substance use disorders,” said Tojuana Greenlaw, lead peer support specialist for Arkansas Blue Cross. “And we’re the first insurance organization to hire full-time peer support specialists to be an integral part of that team. Because we understand first-hand what they’re up against, we can make a huge difference in getting someone engaged with their own recovery.”

Invested in recovery

Now 14 years clean and sober, Greenlaw helped start the Arkansas Blue Cross team in 2023, but she’s been working in peer support since 2011, shortly after she completed her own recovery program. She calls her own journey “a long road.”

As a young adult, she watched her choices dwindle as substance usage took over her life. A recovery program full of caring professionals changed her trajectory. It helped her so much, she realized she’d found her life’s work. Greenlaw entered the behavioral health support profession the following year as a certified drug and alcohol counselor and later certified as a peer support specialist.

“It was important to me to be able to use my experience of recovery to help others.”

Peer support is a relatively new field, and Greenlaw said a lot of people don’t yet understand what peer specialists do, how they’re qualified and how they can help members of workforces. But she said after they learn of the resources available, they tend to be enthusiastic about the service. “We get a lot of questions about what we do and how we do it because it’s so new,” she said. “Overall, I think everyone is excited about it. A lot of people are happy to hear that Arkansas Blue Cross has decided to help in this way and offer peer support. We have a good response when people learn what we’re doing.”

Training, certification and multidisciplinary support

The first qualification to be a peer support specialist is a lived experience of recovery. But Greenlaw said she wants more people to understand the professionalism of those in the field. Beyond having at least two years of sobriety, becoming a peer support specialist requires specialized training, testing and certification by the State of Arkansas, 500 hours of work experience, additional hours of supervisory or specialty experience, then continuing education to maintain that certification. Greenlaw said Arkansas is the only state that has three levels of peer support specialist certification: core, advanced and supervisor certifications. Greenlaw has all three.

“I’m a firm believer that it takes a team to treat the whole person; it’s not just one person’s responsibility,” she said. “We need everyone on our behavioral health team—nurses, social workers, peer support specialists—to help make that person whole. When something a member needs is out of our peer support specialists’ scope of expertise, we have others to help meet that need. When they need clinical care management beyond behavioral health, we have that available, too.”

Meeting the reluctant where they are

She said one reason peer support specialists are effective is because people who need help with substance disorders aren’t necessarily ready to receive it.

“We have some members who are all for the program, but others may take a bit. You have to build that relationship,” Greenlaw said. “A lot of times when you’re talking with someone who has substance use disorders or mental health issues, they don’t have a lot of trust. And there’s often a lot of shame and guilt they carry about it. So, naturally, they might not want to engage at the outset, but we work to build rapport with each individual. Once we build that rapport, they’re more apt to be on board with the peer support.”

Greenlaw said seeing the members make progress helps motivate the team. She said one of her members is a woman who started out “not very receptive” to the service. But Greenlaw kept reaching out to her, eventually encouraged her to enter a treatment program, and from there into transitional living. “She’s still sober to this day,” she said. “I’ve seen the immense progress from where she started to where she is now, building back her family connections and other successes. She’s been a big success story.”

Empathy, not sympathy

Because peer support specialists once experienced such reluctance to seek help, they have an advantage at building rapport with members.

“We’re coming at this from a position of empathy, which is so important,” Greenlaw said. “If you start feeling sorry for people, you’ll be less effective. Being able to have the empathy to say, ‘Hey, I personally understand some of the things you’re going through, or I understand where you’re coming from,’ helps.”

But she said her job doesn’t stop at empathizing with them. Peer support specialists also must nudge them out of their rut, show them recovery is not out of reach. “My next question for them after they acknowledge they need help is: ‘What do you want to do now?’” Greenlaw said. “Because we know there’s a problem, but do we stay in the problem, or do we move towards a solution? We have the empathy to say, ‘I get it,’ but then gently ask, ‘What’s the next process? What’s the next step?’ Not staying there. Because too often people get stuck.”

Listening and inspiring

The behavioral health team gets referrals from many sources, internally and externally. Although much of the work is by telephone calls, Greenlaw said the team is also out in the community. They introduce themselves to members at hospitals, ERs, drug treatment facilities and other providers. “We go to different facilities where our members are to make contact with them there. We let them know we’re here for them to support them into the next level of life.”

She said peer support specialists meet the members wherever they are on their journey. They customize their support to what each member wants and needs. “It’s all about them at the end of the day. The same approach doesn’t work for everyone. You’ve got to be able to listen well to make that connection, empower them to reach for those goals. You’ve got to provide the extra support they need in the way they personally need it.

“What I find rewarding about it is that I was once there. I know what’s possible. I know that recovery is possible, that living a well life is possible,” Greenlaw said. “Sometimes it’s hard if you don’t have that support or you don’t know the right direction to go. You can stay in your mess for a long time. But being able to say, ‘I’ve had this experience, and I can help,’ that’s everything for me.”\

For help connecting to the Arkansas Blue Cross behavioral health team, visit mymindhelp.com or call 800-225-1891.