Valuing Lived Experience As Expertise: Peer Support Workers Modeling Hope and Recovery In Crisis Response

Background/Rationale
Peer support workers (PSWs), individuals with lived experience of mental health and/or substance use challenges who are trained and accredited to provide emotional, social, and recovery-oriented support, are increasingly embedded within behavioral health systems. Crisis and emergency settings present unique conditions, including time pressure, acute emotional distress, and clinically dominated decision-making, where the value of lived experience is both most visible and contested. Yet, limited attention has examined how lived experience functions as a form of expertise in these high-intensity environments, particularly within deficit- and symptom-focused crisis contexts, or how it fosters resilience and promotes recovery among individuals in crisis.

Methods
This qualitative study draws on first-hand accounts from PSWs engaged in behavioral health crisis response services. Five focus groups (N=23) were conducted with PSWs currently working in crisis response programs across New York City. Discussions explored how PSWs conceptualize lived experience, the key features shaping their practice, how lived experience informs their work with clients, and how lived experience-based approaches shape client engagement and recovery in crisis settings. Focus groups were audio recorded, transcribed verbatim, and analyzed using a thematic analysis approach.

Results
Thematic analysis showed that lived experience is frequently devalued in traditional mental health settings that prioritize clinical assessments and symptom management. Participants emphasized that experiential knowledge, gained through direct encounters with mental health systems, was central to establishing credibility, trust, and relational depth with clients in crisis. PSWs described how this knowledge provided the language, empathy, and patience necessary to connect with clients, particularly when clients struggled to articulate their needs. Participants also highlighted that embodying recovery as a peer modeled hope and possibility beyond diagnostic labels. Through relational presence and advocacy within interdisciplinary teams, PSWs centered clients’ voices and fostered belonging in crisis environments that may otherwise feel alienating.

Conclusion and Implications
Findings suggest that lived experience functions as a resilience-informed, identity-affirming form of expertise that challenges clinically oriented models of care. When recognized as legitimate knowledge, peer support practices offer relational ways of knowing that validate clients’ lived realities and promote belonging and recovery in crisis settings. These findings highlight the value of peer support by demonstrating how lived experience expands dominant conceptions of expertise.

Importantly, these findings have significant implications for social work education and practice. Social work education should explicitly recognize lived experience as a valid and complementary form of expertise alongside clinical knowledge. Training programs should incorporate peer-informed, relational learning opportunities that prepare students/ or current practitioners to engage collaboratively with PSWs. Such approaches can strengthen competencies in relational engagement, trauma-informed practice, and recovery-oriented care. Integrating peer-informed perspectives into curricula and field education may also help address hierarchical dynamics, reduce stigma, and enhance future social workers’ capacity to engage in equitable, recovery-focused, and person-centered practice.