CPSS Ethics & Cultural Competency 5 — Questions and Answers
Question 1: A peer specialist working with a peer who holds strong religious beliefs about mental illness should:
- Challenge beliefs that conflict with a medical model of mental health
- Respect and integrate the peer's spiritual framework into their recovery support (Correct answer)
- Refer the peer to a chaplain and end the peer support relationship
- Avoid the topic of religion entirely during sessions
Correct answer: Respect and integrate the peer's spiritual framework into their recovery support
Cultural competency includes respecting and integrating spiritual and religious frameworks that are meaningful to the peer's recovery.
Question 2: Which of the following actions would violate the ethical principle of beneficence in peer support?
- Encouraging a peer to set goals aligned with their own values
- Pressuring a peer to accept housing options the specialist prefers (Correct answer)
- Sharing information about community resources
- Accompanying a peer to a first appointment for emotional support
Correct answer: Pressuring a peer to accept housing options the specialist prefers
Beneficence requires acting in the peer's best interest as defined by the peer; imposing the specialist's preferences violates this principle.
Question 3: A peer specialist who over-identifies with a peer's experience and begins making decisions for them is exhibiting:
- Exceptional empathy and dedication
- A loss of professional boundaries that undermines peer autonomy (Correct answer)
- Trauma-informed care in practice
- Appropriate use of lived experience
Correct answer: A loss of professional boundaries that undermines peer autonomy
Over-identification can lead to enmeshment and taking control away from the peer, violating the ethical principle of self-determination.
Question 4: In North Carolina, a Certified Peer Support Specialist is required to report child abuse or neglect because:
- Peer specialists choose to report as a professional courtesy
- They are mandatory reporters under state law, overriding confidentiality (Correct answer)
- Only licensed clinicians are legally obligated to report
- Reporting is required only if the peer gives written permission
Correct answer: They are mandatory reporters under state law, overriding confidentiality
North Carolina law designates certain professionals, including peer specialists, as mandatory reporters of child abuse, superseding confidentiality.
Question 5: Social determinants of health such as housing instability, poverty, and unemployment are relevant to cultural competency in peer support because:
- They only affect peers who are already in crisis
- They shape mental health outcomes and vary across racial and cultural communities (Correct answer)
- Peer specialists are not responsible for addressing social factors
- Addressing them falls outside the scope of peer support services
Correct answer: They shape mental health outcomes and vary across racial and cultural communities
Cultural competency includes understanding how social determinants disproportionately affect certain communities and influence recovery.
Question 6: Which behavior best demonstrates that a peer specialist is practicing ethical 'mutuality'?
- Sharing detailed personal trauma to make the peer feel understood
- Using shared lived experience selectively to foster hope without centering the specialist's story (Correct answer)
- Treating every peer interaction as a mutual therapy session
- Building a friendship outside of work with peers who have similar experiences
Correct answer: Using shared lived experience selectively to foster hope without centering the specialist's story
Ethical mutuality uses the specialist's lived experience purposefully to inspire hope while keeping the focus on the peer's recovery.
Question 7: A peer specialist notices they are feeling burned out and frequently frustrated with peers. The ethically appropriate response is to:
- Continue working to demonstrate commitment to the mission
- Seek supervision, self-care support, or temporary reduced caseload to protect peers and self (Correct answer)
- Find new peers to work with who are less challenging
- Keep the feelings private to avoid appearing unprofessional
Correct answer: Seek supervision, self-care support, or temporary reduced caseload to protect peers and self
Ethical practice requires specialists to recognize burnout and take steps to protect both their own wellbeing and the quality of care they provide.
CPSS Ethics & Cultural Competency 5
A peer specialist working with a peer who holds strong religious beliefs about mental illness should: