Advocacy
20%of exam
Self-AdvocacySystems AdvocacyPerson-Centered LanguageShared Decision MakingResource Linkage
Ethical Responsibility
30%of exam
Confidentiality LimitsMandatory ReportingScope of RoleBoundariesDe-EscalationDocumentation
Mentoring and Education
20%of exam
Peer MutualitySelf-DisclosureEmpowermentRapport BuildingAdult Learning
Recovery/Wellness Support
15%of exam
Stages of ChangeMotivational InterviewingStrengths-BasedGoal SettingCo-Occurring Referral
Harm Reduction
15%of exam
Quick Facts
- Exam
- CRSS/PR Examination
- Credential
- Illinois CRSS
- Questions
- 75 (65 scored)
- Time
- 2 hours
- Pass
- 500 / 800 scale
- Domains
- 5 (IC&RC PR)
- Blueprint
- July 2025
- Renewal
- 40 CEUs / 2 yrs
Exam Numbers to Know
75 questions, 2 hours, 500 to pass
65 scored plus 10 pretest200 to 800 scale500 is the pass score90-day minimum retest wait
CRSS vs CPRS (Illinois)
CRSS
- CRSS/PR written exam
- Not IC&RC reciprocal
CPRS
- IC&RC PR exam
- Reciprocal ICPR credential
Same domains, different reciprocity
Advocacy Roles
- Self-Advocacy
- Person speaks for own needs
- Individual Advocacy
- CRSS backs one person
- Systems Advocacy
- Change policy for many
- Person-Centered Language
- Person first, not diagnosis
- Self-Determination
- Individual sets own goals
- Shared Decision Making
- Team and person choose together
- Natural Supports
- Non-service people who sustain recovery
Self-Advocacy vs Systems Advocacy
Self-Advocacy
- Person speaks for self
- One person, one voice
Systems Advocacy
- Change policy for many
- Broader than one case
Micro voice vs macro change
Advocacy Tasks
- Multiple Pathways
- No single valid recovery route
- Holistic Approach
- Mind, body, spirit, environment
- Employment Pathway
- Work supports recovery goals
- Education Pathway
- School supports recovery goals
- Rights and Responsibilities
- Explain both, don't just do
- Resource Linkage
- Connect to chosen resources
- Warm Handoff
- Active connection, not just referral
5 PR Domains
A-E-M-R-H = 20/30/20/15/15
A: Advocacy 20%E: Ethics 30%M: Mentoring 20%R: Recovery 15%H: Harm reduction 15%
Training Domains vs Exam Domains
Training Model (4)
- Governs training, supervision hours
- 2007 Role Delineation Study
Exam Blueprint (5)
- Governs actual exam content
- Effective July 2025
4 for training; 5 for exam
Which Domain Applies?
- Peer defers all decisions to doctor→Advocacy(Self-determination)
- Peer discloses possible child abuse→Ethical Responsibility(Mandatory report)
- Peer wants to vent, not advice→Mentoring and Education(Rapport, listening)
- Peer ambivalent about quitting→Recovery/Wellness Support(Motivational interviewing)
- Peer still using, wants safety tips→Harm Reduction(No abstinence required)
- Peer's provider dismisses their view→Advocacy(Shared decision making)
- CRSS feels triggered by peer's story→Ethical Responsibility(Disclose to supervisor)
- Peer needs housing before therapy goals→Recovery/Wellness Support(Basic needs first)
Confidentiality and Reporting
- Confidentiality Limit
- Not absolute; safety overrides it
- Mandatory Reporting
- Report abuse or neglect now
- Risk Indicator Response
- Act on relapse or self-harm signs
- Documentation Duty
- Required, not optional paperwork
- Policy Compliance
- Follow employer privacy rules exactly
- Chain of Command
- Resolve issues inside the agency
- Progress Check-In
- Ask satisfaction with recovery goals
- 988 Lifeline
- Suicide and crisis referral number
Boundary Red Flags
No money, romance, or expensive gifts
No lending moneyNo romantic relationshipsNo expensive giftsReport dual relationships
Ethical Duty vs Written Policy
Ethical Judgment
- Your own values call
- Can conflict with policy
Privacy Policy
- Employer's written rules
- Still binding even if unclear
Both required; policy still binds
Safety Escalation Picker
- Suicidal statements or warning signs→988 Lifeline or ER(Immediate safety)
- Suspected abuse or neglect→Mandatory report now(No consent needed)
- Rising agitation, tension→De-escalation techniques(Calm voice, space)
- De-escalation not working→Agency protocol, call staff(Follow chain of command)
- Ethical concern with a colleague→Chain of command(Not unilateral action)
- CRSS personally impaired or triggered→Disclose to supervisor(Self-monitoring duty)
Boundaries and Practice
- Scope of Role
- No diagnosing, prescribing, or therapy
- Professional Boundary
- No romance, loans, or big gifts
- Dual Relationship
- More than one role, same person
- De-Escalation
- Calm voice, space, choices offered
- Trauma-Informed Care
- Assume trauma; avoid re-traumatizing
- Cultural Awareness
- Notice how culture shapes beliefs
- Cultural Competency
- Skills to work across cultures
- Cultural Humility
- Keep learning from each person
Mentoring Education vs Advocacy Linkage
Mentoring Task
- Inform about options
- Educate, don't connect
Advocacy Task
- Actively connect to resource
- Warm handoff, not just info
Educate first, then link
Mentoring Relationship
- Peer Mutuality
- Equal relationship, not expert-patient
- Self-Disclosure Limit
- Serves them, not the CRSS
- Self-Care Modeling
- CRSS models recovery-oriented living
- Rapport Building
- Consistency plus nonjudgmental listening
- Empowerment
- Grow their control, not yours
- Hierarchical Trap
- Acting as authority breaks mentoring
Mentoring Skills
- Self-Directed Change
- They choose the behavior goal
- Communication Coaching
- Teach skills, don't just use them
- Conflict-Resolution Coaching
- Build their skill, not solve it
- Resource Education
- Inform options; advocacy then links
- Adult Learning
- Connect to goals; practice actively
- Life-Skills Building
- Capacity building, not doing for them
Stages of Change Order
Precontemplation, Contemplation, Preparation, Action, Maintenance
Pre: not considering yetContemplation: ambivalentPreparation: planning itAction: making changesMaintenance: sustaining changes
Motivational Interviewing vs Persuading
Motivational Interviewing
- They explore own reasons
- Collaborative, non-confrontational style
Persuading
- CRSS argues for change
- Often backfires with ambivalence
Guide reasons, don't argue them
Recovery Frameworks
- Strengths-Based Approach
- Start from what already works
- Stages of Change
- 5 stages of readiness to change
- Motivational Interviewing
- They explore their own reasons
- Crisis Sign Recognition
- Notice warning signs early
- Co-Occurring Referral
- Recognize; refer, don't diagnose
- SAMHSA Recovery
- Self-directed life, full potential
Recovery Planning
- Basic Needs First
- Housing, food, safety before goals
- Group Facilitation
- Manage dynamics, not one-on-one coaching
- Short-Term Goal
- One small step this week
- Long-Term Goal
- Housing, work, or bigger milestone
- Support Mapping
- List who and what already helps
- Individual-Chosen Goals
- Person picks, CRSS doesn't assign
Harm Reduction Reminder
Meet them where they are now
No abstinence preconditionOffer tools, not lecturesBias stays with the CRSSNaloxone reverses opioid overdose
Harm Reduction vs Abstinence Model
Harm Reduction
- No abstinence required first
- Meets person where ready
Abstinence Model
- Requires stopping use first
- One of many pathways
Both legitimate, different starting points
Recovery Pathway Picker
- Peer wants full abstinence→12-step or clinical program(One valid pathway)
- Peer using opioids, not stopping→Harm reduction plus MOUD(Non-abstinence pathway)
- Peer values faith community→Faith-based pathway(Still a valid pathway)
- Peer wants no religious framing→Secular pathway(Still a valid pathway)
- Peer in precontemplation stage→Explore ambivalence only(Don't push action steps)
- Peer in action stage→Support concrete change steps(Ready to act now)
Harm Reduction Principles
- No Abstinence Requirement
- Support given without requiring abstinence
- Meet Them Where Ready
- No forced next step
- Bias Awareness
- Don't impose personal abstinence belief
- Lived-Experience Led
- People who use drugs lead it
- Reduce Consequences
- Lower harm, not require quitting
- Non-Abstinence Pathway
- Legitimate, different from abstinence models
Harm Reduction Tools
- Naloxone
- Reverses an opioid overdose
- Fentanyl Test Strips
- Detect fentanyl in a substance
- Wraparound Services
- Housing, medical, and food access
- Safer-Use Information
- Reduce risk without stopping use
- Overdose Education
- Proactive, before an overdose happens
- MOUD
- Medication for opioid use disorder
- Ancillary Services
- Support beyond substance-use treatment
Common Traps
Self-advocacy vs systems advocacy
Self-advocacy is one person ≠ Systems advocacy changes policy
Confidentiality vs mandatory reporting
Confidentiality protects most information ≠ Reporting duty overrides it for abuse
Cultural competency vs cultural humility
Competency is having skills ≠ Humility is ongoing self-reflection
Mentoring vs hierarchical expertise
Mentoring is peer-to-peer ≠ Expert stance breaks mutuality
Harm reduction vs abstinence-only
Harm reduction needs no abstinence ≠ Abstinence-only cannot be imposed
Illinois training vs exam domains
Training uses four old domains ≠ Exam uses five 2025 domains
Ethical judgment vs written policy
Judgment can feel justified ≠ Policy violation still counts
CRSS vs CPRS reciprocity
CRSS is Illinois-only, not reciprocal ≠ CPRS uses IC&RC's reciprocal ICPR
Last Minute
- 1.Ethics domain carries heaviest weight 30%
- 2.Harm Reduction domain added July 2025
- 3.75 questions: 65 scored, 10 pretest
- 4.2-hour time limit, computer-based test
- 5.Pass = 500 on 200-800 scale
- 6.Retest wait: 90 days minimum
- 7.4 consecutive fails trigger remediation
- 8.Renewal: 40 CEUs every 2 years
- 9.Illinois training uses 4 old domains
- 10.Exam blueprint uses 5 domains now
- 11.CRSS is not IC&RC reciprocal
- 12.Boundaries: no loans, romance, big gifts
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