An episode of the Changing the Conversation podcast
Judy Fox shares insights on integrating peer recovery support services with host Livia Davis. This episode is part of a series where we share the wisdom amassed by recovery leaders over the past 5 decades and reflect on the journeys that have laid groundwork for today’s recovery movement.
December 15, 2025
[Music]
Livia Davis, Host (00:05): Hello, and welcome to Changing the Conversation. I’m your host, Livia Davis, Chief Learning Officer at C4 Innovations. Today’s conversation is part of a podcast series called “Learning From Our Recovery Elders to Inform Our Work as Recovery Leaders”. This series delves into the profound wisdom amassed by recovery leaders over the past five decades. Through conversation and reflective storytelling, we illuminate the journeys of those who have laid the groundwork for today’s recovery movement. Our aim is to not only preserve their invaluable insights, but also to inspire current and future leaders in the ongoing pursuit of recovery.
(00:49):
By understanding the history and by hearing from our recovery elders, we hope to inform the path forward for the next 50 years. My guest today is Judy Fox calling in from Rhode Island. Judy is the previous Senior Health Promotion Specialist at the Rhode Island Department of Behavior Healthcare Developmental Disabilities and Hospitals, a department managing Rhode Island’s statewide efforts to train, certify, and coordinate the peer recovery workforce. She also worked for 17 years as part of an innovative re-entry program for incarcerated women to support their transition into the community. Her career also includes a position as staff attorney at the Rhode Island Legal Services focusing on civil law practice. Hello, Judy. Thank you for joining us today.
Judy Fox, Guest (01:39): Hi, Livia. Good to see you.
Livia (01:42): Judy, you’ve been working in the field of recovery for many years. Many states still aspire to better integrate mental health and substance use services, and I know you did a lot of work to integrate those services at the state level in Rhode Island to better serve people in the community. Could you share one or two strategies you used to promote that integration?
Judy (02:06): Sure. When I started working for the state Department of Behavioral Health, it was my first experience really working directly with behavioral healthcare. My first reaction is that separating substance use disorders and mental health, with regard to peer recovery services, made no sense. That what was being developed was two separate fields that, really, were very overlapping and focusing on similar things. My objective, really, when I started working there, was to try to unite substance use and mental health with regard to peer support services, so that they could be more effective and more coordinated.
(03:03):
My strategy, really, was to focus on both as chronic diseases and to really talk about the similarities between them rather than the differences. Because I had a legal background and I worked on policies before, it was very clear to me that the field would benefit much more if the two were united and that they were focused on working together to both educate people about how they were similar and how they affected each other. By working together, especially at a time when there was a possibility of getting Medicaid reimbursement for the services, that the end result would be much more long-lasting and impactful for the people that needed the services.
Livia (04:02): Thank you, Judy. I know in some of the work with Medicaid, you were able to work on some regulations or codes to ensure that the supervision of peers was allowed by a peer professional. Can you talk a little bit about that specific strategy? Because that might be of interest to other states.
Judy (04:27): Possibly some of my intuition just came from my work with women leaving prison, but it was clear to me that peers really understood the field and understood all the nuances that were needed to develop a good peer community and that people who had lived experience were in the best position to really understand and direct other people who were entering the field. The idea that the field would be controlled only by people who were trained clinical people in social work seemed to be too limiting and too narrow. As we worked to develop the standards for who could supervise peers, I really pushed and encouraged the training and recognition of peers as supervisors. It took a while. We actually invited experts to come in and meet with supervisors who were professional social workers and those who had elevated themselves from peer recovery specialists to supervisors, and we talked about supervision and how that could work if they were done by both peers and trained social workers. It was a lot of talking together and respecting where each other was coming from and understanding the value each brought to supervision.
Livia (06:12): Thank you, and I think it’s fair to say that Rhode Island was probably a frontrunner in terms of allowing both peers and clinicians to supervise the peer workforce. And I know that some of the language in the standard and the code has been emulated by other states, so thank you, Judy. A big part of your career was also working with women in prison, and I know that you published articles about that work and that you’re still involved. Could you talk about the impact of that project and why people should think about getting involved?
Judy (06:48): Working with incarcerated women really changed my life and changed the lives, I would say, both of the volunteers and the women in prison. I think what I learned early on that really helped guide what I did was that these women were not that much different than me. But for the fact that my mother happened to have a college education, I might’ve ended up in the same situations as a lot of the women. We were working with moms who really had nonviolent histories and had suffered a lot of trauma. Because of all the trauma they had experienced and because of the lack of healthy role models as children, these women were unable to trust people around them and really lacked positive role models to emulate to really develop and grow as healthy human beings. Both watching the women who were served and the volunteers interact, I was able to observe the change that occurred when these women started to develop healthy relationships and the volunteers were able to really forge some of them lifelong friendships with these women.
(08:22):
But also, I guess most importantly was to see how much they valued the experience and how new it was for them to be around a positive role model, who they could rely on to learn about healthy lifestyles, what to do if you just wanted to have a good time without using drugs, and how to really forge ahead in a world that was very unfamiliar to them. To-date, I still have relationships with a lot of these women and we check in and it’s more of a friendship at this point.
Livia (09:03): Do you have some thoughts about why people should get involved in projects such as this?
Judy (09:10): People who have gotten involved in this kind of work have told me that they’ve learned a lot about themselves and about what really matters to people who have … Women, especially who have had difficult lives and end up in prison. The criminal justice system, especially with regard to women, is not going to change a lot unless we provide these people with what they really need. And for women, it really is learning how to live a healthy lifestyle, how to trust other people, and how to really integrate into the community.
(09:56):
For me, it was a win-win situation in that not only was I helping somebody else, but at the same time, I was helping myself and actually I felt like I was helping my own children. I have two daughters, who I was raising while I was working at the prison, and I realized how important it was to role model a healthy lifestyle and healthy behavior, and it forced me to address my own issues, my own personal issues, which I saw were impacting my own children. It’s both a service to the community and a service to ourselves as women and to our families.
Livia (10:39): It sounds like such an important win-win-win that has been central to your life for a very long time. I so agree with you, service to others and volunteering, it’s always a two-way street. And I sometimes wonder who gets more benefit from it. I certainly have done volunteering myself and just felt the incredible gift it is to interact with other people and learn from each other and travel a road together, so thank you for that. Judy, you have experience working in state government to promote recovery supports at a state level, as we just talked about earlier. Could you share some of the lessons learned that allowed you to use that platform to advance recovery?
Judy (11:25): First of all, I’d like to start off by saying working in state government is probably the most difficult thing I have done in my career. I really had to enter it with a very thick skin and understand that what I was doing and what I cared about was not necessarily what was genuinely the focus of what people were dealing with around me. But I started from the ground level and understood that possibly people were not as receptive because they didn’t really understand about peer recovery services and lived experience and the value it adds to the whole process of recovery and healing. I really took it upon myself to educate people where I worked and outside of the department about recovery. At one point, I had a pizza party for people in my department, so they would come and listen to peer recovery advocates.
(12:36):
They would listen to them about their stories and why they were doing their work and why it was important, so that they would understand where I was coming from. I looked for allies both within the department and outside the department who could support me and help advocate for the integration of recovery services within state departments. What I understood by listening to other people who were advocating for the same thing was how big a paradigm shift this was for everybody within behavioral health that until peer recovery services came along, it was a very traditional, somewhat top-down model where professionals were providing services, but there was not the voice of the consumer to advocate for what they needed and how they needed to do it. Maybe it was easier for me because my lifelong desire was not necessarily to be in the field of behavioral health, but I came to it kind of through the back door.
(13:56):
It was clear to me that recovery support services needed to be as valued as treatment services. That’s still a work in progress, but some departments now are developing separate units for recovery support services where the services are given equal value and weight within the department. I think that’s critical if recovery support services are to survive. They must be considered as an equal partner with treatment and they should be integrated with each other. It’s a slow process, but it is beginning to happen. I think, most importantly, the hard part about working within a state department, if you’re person with lived experience is to not feel isolated and to feel that there are other people there who are also supporting you, because otherwise you’d feel overwhelmed.
Livia (14:58): Thank you so much, Judy. I know that personally, I have learned a lot from you in the decade that I have known you. I know that part of your experience, all your experience and your legal background and you being unafraid of talking to other departments and bringing your legal background has all helped with some conversations also with policymakers and Medicaid centers, which has helped to develop some standards to develop the infrastructure needed to support recovery support services.
(15:36):
Looking at the platform of the role that you have to allow that, I think is just something that I take away from your work at Rhode Island as an important piece and from talking to other people in states in roles such as yours, claiming the power, if you will, that can come with a platform in the state and not being alone and trying to find out how do you build the confidence to advance recovery is all part of what I believe you have done beautifully when you are at the state department in Rhode Island, so thank you. As we wrap up, Judy, for today, I just want to ask you, what keeps you going?
Judy (16:22): I try to take everything I’ve learned from all these experiences and incorporate them into my own life and how I move forward in the world. I’m much kinder to myself and my expectations of myself and focusing on balancing my own needs and the needs of family and friends and the community. I’m very committed to volunteer work and serving my community, but I constantly have to be reminding myself to take care of my own needs first. I think women in general, and especially women who end up in the criminal justice system or with serious behavioral health issues, have been taught to sublimate their needs for those of others. That’s a hard thing to unlearn and to change the balance of. But what keeps me going is realizing that every day I can check myself and improve my own life and improve my own happiness. And also, when I do that, it impacts people around me.
(17:47):
Having two grown daughters too keeps me checked and focused because they’re still always watching what I do and how I behave. You want the most for your kids, and that is an innate drive that keeps you going. And to realize that focusing on yourself and treating yourself well also helps them see the importance of it. And also, what I’ve learned about behavioral health is the chronicity of the disease and the fact that it is a lifelong process that we have to accept. Nobody wants to have a chronic illness and it’s hard to acknowledge, but accepting it rather than fighting it and working on moving forward and celebrating the small increments of change or giving yourself positive reinforcement when you see little changes in yourself really makes a difference. It really is striving for a life balance that we all need to have, but may not come naturally for a lot of us and accepting that it’s going to be work. Some days you just don’t want to do the work and that’s okay and accepting that’s okay. That’s what keeps me going.
Livia (19:18): Thank you so much, Judy. I think that the balance and taking care of oneself, especially when one is in position of giving as much as many of us do, who are women in behavior health or reentry, as you say, or even state government is critical. Thank you for your insights. Judy Fox, thank you for joining us today.
Judy (19:43): Thank you for having me. This has been a wonderful opportunity for me to reflect on my own life, so I appreciate that. And to our listeners, join us next time on Changing the Conversation.
Erika Simon, Producer (19:51): Visit C4Innovates.com and follow us on LinkedIn and YouTube for more resources to grow your impact. Thank you for joining us. This episode was produced by Erika Simon and Christina Murphy. Our theme song was written and performed by Peter Hanlon. Join us next time on Changing the Conversation.