National Association of Peer Specialists (NAPS)

Pre-Conference Peer Specialist Training

Training Description

DBSA Peer Specialist

training prepares people

who live with mental

illnesses to use their

experiences to work

with others as peer

specialists. Facilitated

by nationally-recognized

trainers, this comprehensive

course delivers a

foundation in recovery

principles, intervention

techniques, and ethical

practice. Curriculum

focuses on the use of

peer-delivered services

to support the recovery

of others. DBSA Peer

Specialist training is

delivered in affiliation

with Appalachian

Consulting Group, Inc.,

innovators of the

Georgia Certified Peer

Specialist Project that

pioneered Medicaidbillable

peer support

services.

Training topics include:

• Role of peer support in recovery

• Problem solving with individuals

• Effective listening and the art of asking questions

• Combating negative self-talk

• Dissatisfaction as an avenue for change

• Facilitating Recovery Dialogues©

• Peer specialist ethics … and more

Who Can Participate

• Individuals age 18 or older with personal

experience as consumers of mental health

services who wish to use this experience

to assist others

• Those willing to publicly identify as a person

living with a mental illness

[Please do NOT apply if you do not meet

these first two standards.]

• DBSA especially encourages people who currently

hold a peer specialist position or who

are actively seeking such a position (paid or

volunteer) to apply, although this is not a

requirement to participate.

• DBSA actively seeks a diverse group of

training applicants with respect to race,

gender, age, sexual orientation, diagnosis,

and disability.

Requirements

Training participants must commit to

• attend and actively participate in five full

days of training.

• participate in discussion and role-plays utilizing

solely their personal experiences as mental

health consumers rather than any clinical

roles or training.

• take a written certification examination

within four weeks of training completion.

Location

The Westin, 70 Yorktown Center,

Lombard, IL 60148

Dates

Training begins on Monday, August 16, 2010,

at 9:30 a.m. and ends on Friday, August 20,

2010, at approximately 12:00 p.m.

Registration Fee

$950 per person
includes training fee and all

training materials, beverage breaks, light

breakfast (Monday–Friday), and post-training

certification testing. Registration fees will be

due at a later date.
Do not submit paymentwith this application. Fee does NOT include

hotel accommodations, travel, or meals other

than breakfast. Participants are responsible for

paying these costs or obtaining outside funding

support.

DBSA has reserved a block of rooms at
The

Westin. For reservations, call toll-free (888)627-9031

, and be sure to request the “Depression

and Bipolar Support Alliance room block.”

The rooms are reserved at $110.00 per night

plus tax (single or double).

Reservation cut-off date is July 25, 2010.

After that date, reservations will be accepted

based on availability at the regular room rate.

Room cancellations must be made no later

than 72 hours before your scheduled arrival

date.

ALL APPLICATIONS MUST BE

RECEIVED BY DBSA NO LATER

THAN JULY 8, 2010.

Please mail or fax your completed application to:

Peer Services Department

DBSA

730 North Franklin Street, Suite 501

Chicago, Illinois 60654

Phone: (800) 826-3632

Fax: (312) 642-7243

E-mailed applications are NOT accepted.

Do not submit payment with this application.

This is an application only and does not guarantee

you will be selected. All applicants will be notified

of their status no later than July 15, 2010.

Registration payment will be due at that time.

Selection: Enrollment is limited, and

participants will be selected through a

competitive application process.

DBSA Peer Specialist Training

August 16–20, 2010

Lombard, Illinois

Application for Participation

2010 DBSA Peer Specialist Training

August 16–20, 2010

Please answer the following

questions to the best of your

ability. This is not a “test”

about right and wrong

answers. Your responses

will help us get to know you

and will assist the Selection

Committee in identifying

and selecting qualified applicants.

Make sure to answer

all questions and sign your

application. Write your

answers on a
separate sheetof paper, and submit them

along with this application.

If you handwrite your answers,

please make sure they

are readable.
THANK YOU!

1. Understanding and Interest

A. Why do you want to become a peer specialist?

B. What makes you a good candidate to work with other consumers in the mental

health field?

2. Recovery Experience

A. What does recovery mean to you?

B. What were/are important factors in your own recovery?

C.What types of experiences have you had in assisting, or advocating for, consumers

of mental health services (for example, support group leadership, selfadvocacy,

public testimony, programs you started, etc.)? Please be specific.

3. Environment and Access

A. Do you currently hold a position where you will use the skills gained through

Peer Specialist training and certification?
�� Yes �� �� NoIf yes, do you receive pay for this position? �� �� Yes �� �� No

Position title/location

B. Are you a current candidate for a position where you will use the skills gained

through Peer Specialist training and certification? ��
�� Yes �� �� No

If yes, will you receive pay for this position? �� �� Yes �� �� No

Position title/location

NAME

STREET ADDRESS

CITY STATE ZIP

PHONE NUMBER(S)

FAX NUMBER E-MAIL

NOTE ANY SPECIAL ACCOMMODATION REQUESTS

Please initial all items below to indicate your understanding of each:

I certify that I have personal experience as a consumer of mental health services.

If I am chosen as a training participant, I understand that I am responsible for funding my

own registration fee, travel, hotel accommodations, and meals other than breakfast.

I understand that participating in the DBSA Peer Specialist training does not guarantee me

employment or a volunteer position.

I understand that payment is due by August 2, 2010.

YOUR SIGNATURE PLEASE ALSO PRINT YOUR NAME

Important: Each individual state or service delivery system sets its own peer specialist training

and certification standards. Please check local requirements with your state certification body,

office of consumer affairs, or service delivery system before making the decision to participate

in this training course. DBSA can provide you with information on training curriculum content.

Demographic Information

Please provide the following

optional information to help

ensure diversity of the training

group. Aside from using aggregate

numbers, DBSA will not

maintain or use this information

in any way.

GENDER

�� Male �� Female

AGE

�� 18–25

�� 26–39

�� 40–55

�� 56+

PHYSICAL DISABILITY

�� Yes �� No

ETHNICITY

�� Asian/Pacific Islander

�� American Indian

�� Black

(not of Hispanic origin)

�� Hispanic

�� White

(not of Hispanic origin)

�� Other

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