“It’s Something That Will Stay With Me.” : A Qualitative Descriptive Study of the Experience of Participating in a Co-Produced Photovoice Study

Abstract

Photovoice is a participatory visual methodology that can be used to collect rich qualitative insights into sensitive issues. Photovoice lends itself to a co-production framework. This qualitative study evaluates the experience of participating in a co-produced photovoice project in a Recovery College setting. A sample of 18 participants participated in this study, which consisted of three rounds of seven photography workshops, followed by focus group discussions. Focus groups were audio recorded, transcribed, and analyzed using codebook thematic analysis. The study was co-produced within a Recovery College setting. Four themes were generated from the data analysis process. (1) Participants noted that they benefited from socialization with their peers as part of the project, which included sharing and commenting on photos, socializing within the sessions, and learning from each other. (2) Through the photovoice process, participants acquired substantial photography skills such as editing, captioning, and storytelling, while also becoming more aware of the visual richness of their world. (3) Participants were further stimulated to think differently about their experience of co-production, helping them reflect on the study topic, although some found the topic difficult to understand and translate into photographs. (4) Lastly, participants appreciated the design of the project, including the level of compensation, the workshop design and facilitation, and the support offered to participants. The themes are illustrated by subthemes and representative quotes. Participating in a co-produced photovoice project is a positive experience for participants, with many benefits in terms of skill development, personal growth and recovery, and deeper reflection. Aspects of the study that were co-produced were particularly appreciated by participants. These findings offer a replicable model for future photovoice initiatives aiming to optimize impact on participants while soliciting rich insights into research questions. Photovoice may be particularly relevant to Recovery Colleges and other co-production settings.

Introduction

Qualitative researchers are interested in identifying methods to solicit rich insights from their participants. Photovoice is one such method. Photovoice is a community-based participatory research method that uses expressive imagery, critical thinking, and dialogue by leveraging photography (Wang & Burris, 1997). This qualitative methodology can be used to help people visualize an issue, thereby helping them build a better understanding of their local communities, however they define them. Photovoice has three primary goals (Wang & Burris, 1997) (1) to give participants a way of documenting and reflecting upon the strengths and concerns in their community; (2) to encourage critical dialogue and knowledge generation about topical issues; and (3) to influence policymakers. The photovoice method challenges the conventional researcher-focused power dynamic by bringing community members into the center of the project (Johnston, 2016). In doing so, it generates rich qualitative insights that can be used to inform policy and services in a manner that is highly relevant to each local community.

The photovoice methodology is particularly well-suited to understanding the perspectives of vulnerable populations on sensitive, controversial, or stigmatized topics (Golden, 2020). For example, photovoice has been used to examine lived experience perspectives on rheumatoid arthritis (Donnelly et al., 2021), chronic pain (Kattari & Beltrán, 2021), cancer (Georgievski et al., 2018), and mental illness (Thompson et al., 2008). Recent applications during the COVID-19 pandemic include explorations of the barriers and facilitators of remote education (Doyumğaç et al., 2020), healthcare workers’ experience of the pandemic (Badanta et al., 2021), and youth perspectives on the COVID-19 vaccine (McKee et al., 2024). A meta-analysis shows that photovoice is effective in improving health knowledge and engaging and empowering marginalized populations (Halvorsrud et al., 2021). Photovoice might be particularly relevant to mental health recovery-oriented settings, given its demonstrated benefits.

Recovery Colleges were established in 2009 in the United Kingdom. They have since become one of the fastest-growing movements in mental health recovery, with sites around the world. A recent estimate is that there are now approximately 220 Recovery Colleges worldwide (Hayes et al., 2023; Perkins et al., 2012), including over 30 in Canada (Hayes et al., 2023). Recovery Colleges offer low-barrier educational programming that focuses on the mental health and well-being of their students. Courses offered are focused on topics about mental health and wellness, vocational skills, and life skills training (Perkins et al., 2018). Recreational and creative courses are also offered. Recovery Colleges take a recovery-oriented approach to programming, where recovery is considered a multi-faceted concept encompassed by personal journey toward living a life of meaning, and this recovery is defined by the individual themselves (Bonney & Stickley, 2008; Slade & Longden, 2015).

A guiding principle of Recovery Colleges is co-production, in that educational courses are co-produced by community members with lived/living and learned expertise of mental health and/or substance use health, professional expertise, and the intersections between them, with the aim of supporting recovery (Perkins et al., 2012). Recovery Colleges have been shown to have positive outcomes for students in part by shifting the balance of power from medical professionals to people with lived/living experience (Toney et al., 2018). This power shift aligns with the goals and structure of the photovoice methodology, which also uses community engagement to shift power away from the professionals and toward the participants (Johnston, 2016) as a community-based participatory method. Photovoice is a relational process that can be transformative, where participants drive the work forward with their photographs, content, and experiences, which makes it particularly suited to a co-production setting (Huang et al., 2024).

Recovery Colleges and the photovoice methodology are a natural mutual fit given their shared perspective of amplifying lived experience voices. Nevertheless, despite the increasingly widespread use of photovoice as an engaging research methodology, there is a research gap around the experience of participating in a co-produced photovoice project in settings such as Recovery Colleges. A recent meta-analysis shows that participating in a photovoice project is associated with improvements in mental health and reductions in stigma (Adeboye et al., 2025). However, the studies reviewed were not necessarily embedded in a co-production framework, such as in the Recovery College setting. One study has used photovoice to examine the recovery journey in a Recovery College (Doroud et al., 2022). While findings are interesting from a recovery standpoint, that paper did not discuss the co-production of the photovoice project, the aspects of the photovoice process that are most meaningful for participants, or the experience of participating in a co-produced photovoice project. Given the natural fit between Recovery Colleges, co-production, and the photovoice methodology, the experience of participating in a co-produced photovoice process is of particular interest and remains unclear in the literature.

We co-produced a photovoice project within a Canadian Recovery College that holds co-production as a core value, known as the Collaborative Learning College (CLC). The primary photovoice results are presented elsewhere (Hawke et al., 2025). To better understand the experience of participating in a co-produced photovoice project in the Recovery College setting, we conducted a qualitative descriptive study within a photovoice project.

Method

The overarching photovoice project aimed to understand the personal impacts of co-production in Recovery College settings. The project was co-produced by the Research Subcommittee of the local Recovery College, the CLC Research Subcommittee, which brings together people with lived/living and learned expertise and intersecting identities. This paper presents the findings of an embedded qualitative descriptive study of the experience of participating in the co-produced photovoice project. We describe the co-production process in Table 1 and Appendix A using the GRIPP-2 checklist (Staniszewska et al., 2017). We further used the Standards for Reporting Qualitative Research (SRQR) checklist to describe the study from a qualitative perspective (O’Brien et al., 2014) (Appendix B).

Table 1.

Description of the Lived/Living Experience Co-Production Component of the Study

Domain	Description
1. Aim	The CLC Research Subcommittee came together to co-produce the study by leveraging the diversity within our lived and learned experiences. We aimed to collaborate by using our various forms of lived/living experience and professional experience in order to co-produce and conduct the research into the experience of Recovery Colleges.
2. Methods	We came together in 2023 to co-produce a Recovery College research agenda. As the inaugural project, we launched the photovoice project in February 2024. We held virtual two-hour meetings twice a month, with supplementary meetings when more time was needed. Our meetings were centered on the photovoice project and other topics as time allowed. The CLC Research Subcommittee co-produced the project, discussed the codebook, and co-authored the manuscript. The research analyst (RA) and research lead also met separately with the lived experience photographer to develop the findings. Two CLC Research Subcommittee members were also study participants.
3. Study results	We co-produced all aspects of the project, including the research question, the study protocol, the photovoice workshop structure and materials, the recruitment plan, the knowledge translation activities and products, as well as additional study materials. We collaborated to produce the qualitative codebook and select representative quotes to present in the manuscript. We worked together on the manuscript, including co-producing the materials in this table.
4. Discussion and conclusions	Co-production was fundamental to all aspects of the project. Co-production improved the clarity and relevance of the project, from discussing the research question to conducting the knowledge translation activities. Our dynamic and diverse perspectives helped to develop a sense of community.
5. Reflections and critical perspective	The practice of co-production has had various personal impacts on the different members of the CLC Research Subcommittee. These include academic, professional, and personal impacts. Some members report that it has fostered a sense of empowerment while being validating and increasing their commitment to the project. All members enhanced their knowledge about the photovoice methodology, research processes, and the experience of co-production.

Participants

Eighteen participants took part in the study. Eligible participants were involved in a Canadian Recovery College, were aged 16 or over, and were living in Canada. We recruited participants from communities across Canada using email and the X social media handle of the Centre for Addiction and Mental Health (CAMH), as well as by circulating e-flyers to Canadian Recovery Colleges. Interested potential participants contacted the lived experience Research Analyst (RA) for screening and consent. We continued recruiting for the photovoice study until three waves of the photovoice workshops were filled and launched, which resulted in 21 photovoice participants and 18 participants (85.7%) attending post-workshop focus group discussions. We conducted the study out of CAMH, in Toronto, Canada.

Procedure

After eligibility screening, participants provided electronically signed consent using the WebEx and REDCap (Harris et al., 2009) systems in an individual virtual meeting. They then provided demographic information on REDCap. The co-designed demographic form asked participants about their age, gender, geographical region, ethnic or cultural background, highest level of education, current employment status, and other descriptive factors. Participants were then scheduled into a series of seven photovoice workshops (90 min each). Workshops were co-facilitated by the lived experience RA and a photographer with lived experience. Compensation was provided throughout the project: $40 for consent and the demographic survey, $60 for each workshop, $80 for attending the focus group, a $40 one-time honorarium for extra time spent on the project, and $40 for the photo gala at project completion. We received approval from the CAMH Research Ethics Board (#2024-073).

Focus Groups

Focus groups took place the week after the completion of each round of photovoice workshops and were co-facilitated by the RA and a research coordinator. Participants submitted their final photographs in advance. They then attended one of the four focus groups conducted across the study, with three to seven participants each, where they discussed their final photos. Focus groups were recorded and transcribed by WebEx, then thoroughly proofed and corrected by the RA.

The co-designed semi-structured focus group guide aimed to help participants reflect on the photographs that they selected and generate dialogue about the impact of co-production in Recovery College settings. Results on the impacts of co-production are reported elsewhere (Hawke et al., 2025). Embedded in the same overall focus group guide were questions about the experience of participating in the photovoice project. This consisted of four primary co-produced questions about the study experience and one co-produced wrap-up question, which were supplemented by additional probing questions. The primary questions were as follows: (1) How did participating in this project & photovoice make you feel? (2) What did you get out of this experience? (3) How does this experience impact you as a photographer moving forward? (4) What is something that someone shared in the workshops or focus group that resonated with you? (5) If you can reflect back on everything we talked about today, what is one thing you would want people to take from today?

Data Analysis

We used codebook thematic analysis (Fereday & Muir-Cochrane, 2006), which is a qualitative analysis approach that is well aligned with the teamwork undertaken in a co-produced project. After the first two focus groups, the focus group facilitators and the lead scientist developed the codebook through discussion of the content of the transcripts. The RA and scientist brought the codebook to the CLC Research Subcommittee, as well as to meetings with the lived experience photographer, where it was discussed and refined. Discussion revolved around the codes in the codebook in relation to the content expressed in the transcripts and lived experience-driven interpretations of them. The RA then coded the transcripts using the codebook, maintaining constant openness to new codes that were present in the data and data excerpts that did not fit within the existing codebook. Through iterative discussion with the team, including the CLC Research Subcommittee and lived experience photographer, with a constant return to data excerpts, the codebook was refined and themes were generated. This analytical process included multiple cycles through transcripts with the aim of forming a coherent coding representation of participant dialogue. The ongoing collaboration with the CLC Research Subcommittee members and the lived experience photographer enhanced trustworthiness.

Positionality

The CLC Research Subcommittee is a group of people with lived/living, learned, and intersecting expertise. The members are consistently involved in co-production and experience the positive impacts on themselves and the projects they conduct. Members continually discussed their thoughts on co-production. They acknowledge the potential of a bias toward positive impacts of co-production and the photovoice experience and, therefore, made a consistent effort to remain open to all impacts and experiences in their work.

Results

The demographic characteristics of the participants are presented in Table 2. The majority of participants were Canadian-born, English-speaking women with a post-secondary level of education. Four themes were generated from the data, each illustrated by subthemes and representative quotes, as per Table 3.

Table 2.

Demographic Characteristics of the N = 18 Focus Group Participants

Demographic characteristic		n (%)
Gender	Man	1 (5.6)
	Woman	14 (77.8)
	Transgender/non-binary	3 (16.7)
Born in Canada	Yes	15 (83.3)
English as a first language	Yes	16 (88.9)
Ethnic/cultural background	White	9 (50.0)
	Indigenous peoples	3 (16.7)
	East Asian	2 (11.1)
	South Asian	2 (11.1)
	Middle Eastern	1 (5.6)
	Multiple backgrounds	1 (5.6)
Currently employed	Yes	12 (66.7)
Currently receiving financial support	Yes	7 (38.9)
Highest level of education	High school or less	1 (5.6)
	Some post-secondary	4 (22.2)
	Post-secondary degree/diploma/certificate	13 (72.2)

Table 3.

Themes and Subthemes Generated From the Data

1. Benefited from socialization with peers	a) Socialization in sessions
	b) Sharing and commenting on photos
	c) Learning from each other
2. Acquired photography skills	a) Editing, captioning, and storytelling
	b) Became more aware of the visual richness of their world
3. Thought about their experience of co-production in a different way	a) Enhancing reflection on their co-production experiences
	b) Challenging to understand co-production and translate it into pictures
4. Appreciated the design of the project	a) Level of compensation
	b) Workshop design and facilitation
	c) Participant support

Theme #1: Benefited From Socialization With Peers

Participants shared that socializing with peers was present in every stage of the photovoice project. They emphasized that photovoice fostered beneficial opportunities for socialization through sharing and commenting on photos, socializing in workshop sessions, and peer-to-peer learning.

Participants described the socialization during sessions as a central part of the photovoice experience. They highlighted how they “really enjoyed meeting the other people that were part of the workshop and seeing their work and watching their journey.” (Participant 1) Many felt that over the seven weeks, they were able to “get to know” one another not only through sharing photography, but also through shared experiences that, although unique, brought everyone together. The support of peers was key to the relational space, by “sharing [their] experiences” and “validating each other’s thoughts, opinions, and pictures.” (Participant 2) For some, the most impactful aspect was “meeting all the people with lived and living experience that are working with the recovery college(s),” (Participant 3) which expanded their understanding of Recovery Colleges and normalized diverse recovery journeys. Participants emphasized that the social side of photovoice was a great experience that allowed for many different types of socialization and conversations to happen: “We’ve had a lot of intellectual conversations. We’ve had a lot of artistic conversations. They’ve been like, get to know you—We’ve all shared a lot of who we are. It’s been like a lovely experience.” (Participant 4) This socialization translated into a mutual commitment, with participants describing that being in this environment made them want to “keep doing more, keep striving and doing better by the people that are my peers,” (Participant 3), turning fellowship into motivation and care. Socialization is seen as an integral part of the photovoice process, sparking creativity, building connections, and broadening participants’ experience.

Sharing and commenting on photos functioned as a social catalyst. Each week, participants shared their photography and gave other participants the opportunity to offer specific, affirming feedback, creating a space for them to feel seen and valued. Participants spoke about how their appreciation of the photo sharing process permeated the group, noting “over the last seven weeks (…) it’s been great having everyone share different photos (…) your enthusiasm (…) really stood out and resonated with me.” (Participant 2) They described how sharing and commenting on photos offered an entry point for connection. Photos and captions didn’t just interest other participants, but moved them: “[It] gives me goose bumps.” (Participant 5); “they just stir me emotionally.” (Participant 6) Participants linked this experience to the climate of mutual courage to share, noting how participants “made [themselves] vulnerable” and that “some kind of trust in others” (Participant 7) existed in the group. In this way, commenting became a practice that required care and appreciation of one another. Some participants felt inspired by the other participants’ artistry, “seeing everyone’s beautiful photography was really inspiring.” (Participant 8) The cumulative effect created a sense of gratitude and appreciation among the group in witnessing one another’s lives: “I’m really grateful for everyone who shared (…) it’s a privilege to get a glimpse into your lives and what you find important.” (Participant 9) Together, these exchanges transformed sharing and commenting into a social space where recognition, trust, and creative momentum were built.

Participants described peer interaction as an educational part of the photovoice process. They highlighted learning from each other about how to facilitate, articulate, contribute, and observe. One participant described, “I’ve learned a lot from this group (…) how to facilitate, how to share my perspective, and just strengthen my voice (…) I can just kind of sit back and learn too, which has been really nice.” (Participant 10) Similarly, participants described that listening to others as they looked at images helped them build richer insights. “I found the way people spoke about photos (…) so valuable. Some had such sharp eyes—pointing out a metaphor or the way the light struck something (…) I learned a lot from everybody else’s perspectives.” (Participant 6) At the same time, exposure to unfamiliar topics broadened their horizons: “there are things I’ve never heard about and it’s nice to hear perspectives about them.” (Participant 11) Finally, participants emphasized how creativity and differences can lead to mutual learning and growth: “Thanks for everyone for all these weeks. I can honestly say that I GREW in capital letters.” (Participant 3) Socializing around shared images fostered reflection, inspiration, and even personal expansion that participants may not have reached alone.

Peer socialization—via sharing and commenting, informal rapport, and reciprocal learning—was the central mechanism through which photovoice built connection, sharpened skills, and catalyzed creative and personal growth.

Theme #2: Acquired Photography Skills

Through the photovoice process, participants described developing skills in captioning, editing, and storytelling, while becoming more attuned to the visual richness in their everyday environments. Participants described gains in their photography practices, either building a new craft or deepening an existing craft: “I really just loved it (…) [I was] able to learn more about photography ‘cause I’m not a photographer (…) I’ll be taking a lot of this into my life (…) maybe thinking about doing some photography with our Recovery College.” (Participant 12) For some participants, building photography skills was intertwined with well-being, with one participant sharing, “I learned a lot of new skills. I also, well, it was like a stress relief.” (Participant 13) Participants described their experience of developing new skills in the areas of photo editing, photo captioning, and telling stories. Captions emerged as a powerful tool that changed how photos were seen and understood: “the idea of captioning was really interesting (…) having these personal stories attached to them really changed how I saw them” (Participant 6). Many described that the use of captioning better highlighted their voice and confidence in telling stories through images. Participants reported becoming better photographers and intentional storytellers. For some, storytelling was supported by “learning some new techniques (…) things to watch for as you’re taking photos—motion, patterns, lines, texture.” (Participant 6) This helped broaden perspectives on what to photograph and techniques for how to do it. Participants described identifying their personal niche through this process: “I’ve been choosing different photos (…) I think I’ve found my niche (…) seeing old buildings and abandoned structures opened my eyes.” (Participant 2).

Through learning photography skills, participants described that photovoice sharpened and expanded their perception of their visual world. One participant described how “this experience has taught me to be more attentive, so I notice things (…) I’m aware and sensitive to more things that I wouldn’t be otherwise.” (Participant 8) One participant discussed a new deliberate engagement with their surroundings: “My love for photography keeps growing and everything that I’m taking pictures of now is so intentional and I’m really noticing all the things around me.” (Participant 2) Others described how they will “be taking a lot of this into my life.” (Participant 12) One participant described that “I now feel I can reach for my camera more often as a way to convey feelings and thought(s).” (Participant 14) For these participants, learning to become more aware of their surroundings and how to use photography as a tool for expression has given them a new way to look at the world, convey their thoughts, and process feelings and emotions.

In addition to teaching concrete photography skills, photovoice also fostered a habit of attentive seeing that allowed participants to use photography to express their experiences beyond the project.

Theme #3: Thought About Their Experience of Co-Production in a Different Way

Participants discussed that photovoice led them to rethink co-production differently. It enhanced their reflection on their own experiences, but also revealed the difficulties of understanding co-production and translating their experience of it into images.

The photovoice process gave participants time to reflect on co-production and express their reflections about it in photographs and shareable insights. Several participants emphasized that creating and discussing images gave them an opportunity to voice insights they would not have otherwise had, which helped to develop an understanding of co-production. “This study, just learning new things about myself and having the experience to be able to talk about some things that I haven’t really been talking a lot about has really shaped my understanding.” (Participant 8) Others noted that photovoice encouraged them to think about and discuss the impact that co-produced spaces in Recovery Colleges have had on them: “Sometimes, we don’t stop and think about what the impact Recovery College has had on us or the specific details to our mental health journey (…) So being able to articulate that and put those words together is just really eye-opening.” (Participant 2) Images and narrative creation functioned as a mirror for participants’ identities within co-production, revealing their experiences and participation in unexpected ways. Some participants described how their experience in the project helped them locate themselves within Recovery Colleges: “I think my photographs express who I am and I think they express who I am in the Recovery College.” (Participant 5) The discoveries made were sometimes surprising: “It’s not what you expect, but it’s there.” (Participant 9) These findings suggest that participants’ reflections were enhanced through the use of images, which helped them develop a deeper understanding of their co-production experiences.

Some participants struggled to understand co-production and conceptualize it visually. One person reflected: “I went through a long period of time when I was like, ‘what is co-production? What does that even mean?” (Participant 6) Another described staying engaged despite the uncertainty: “I’ve been confused the whole time (…) I’m happily participating, but (…) what is the point? What is the thesis statement that got this study going?” (Participant 14) Skepticism began to soften as the process unfolded, yet several accounts make it clear that conceptual understanding took time and for some may have never fully developed. Another challenge participants highlighted was translating the concept of co-production into a visual image. Participants questioned how to capture something so broad within a photograph: “I was also a little bit skeptical at the beginning, I was like, how am I going to take a photo that encapsulates a whole concept like that?” (Participant 15) For some, the concept remained elusive: “I often can’t wrap my brain around the concept and [it] coming out as an image.” (Participant 14) The abstract nature of co-production posed both a conceptual and representational hurdle, making photovoice a space for gradual, sometimes unfinished sense-making rather than a quick or easily captured insight.

Theme #4: Appreciated the Design of the Project

Participants discussed their appreciation of the project’s design, highlighting the compensation, thoughtful workshop design and facilitation, as well as the participant supports available throughout the project.

Participants framed compensation as a key strength of the project’s design, highlighting both recognition and real-world impact: “really appreciated the chance to be involved (…) the honoraria’s were awesome. I don’t know how you guys got the funding for that, but—good on ya.” (Participant 12) Participants described concrete benefits, such as “funding my groceries for several weeks.” (Participant 4) These accounts point to the importance of securing funding that enables substantial honoraria, which can help reduce participation barriers, acknowledge lived-experience expertise, and make engagement more sustainable. At the same time, the logistics of the honoraria sometimes blunted accessibility: “The [gift] cards were a difficult aspect in getting them to a person” (Participant 14), suggesting that a more streamlined delivery would further strengthen equity.

Participants described the photovoice workshops as intentionally structured, with weekly prompts that were paired with skill instruction and attentive facilitation that created a supportive, responsive learning environment. “We had intention each week (…) coupled with a bit of learning (…) to the captioning (…). It was just all in all a very well organized, very intentional, very engaging.” (Participant 2) Participants highlighted that the facilitation exceeded expectations: “I didn’t expect the level and the depth of the training, but it’s something that will stay with me.” (Participant 3) For some participants, the skills carried on beyond the project “what I learned (…) with still photography, ethics, techniques, editing and captioning has been very important for my beginning path, for my Etsy shop, and possibly a photo book or children’s books I may author.” (Participant 1) Finally, participants valued the photovoice experience enough to call for replication and emphasized its broader impact: “I strongly state that Recovery College workshops like this one and perhaps others to be created are very important for transforming individuals, families, and communities.” (Participant 1) The design and structure of the workshops and attentive facilitation made this project enjoyable and substantive, leaving participants with practical skills, new ways of seeing, and momentum to carry photography into their lives. Some even urged that this photovoice project should be replicated across other Recovery Colleges and similar settings.

Personalized support—through check-ins, extra meetings, and responsive troubleshooting—was integral to the project, creating safety and guidance that enabled participants to fully engage in the photovoice project. Several participants described that the optional one-on-one meetings provided scaffolding that helped them translate their ideas into images: “I met with Shelby and Sean (…) to figure out a concept for the final photos.” (Participant 3) Participants emphasized that the manner of support was warm, patient, and hands-on, making the project and workshops more motivating and genuinely transformative. For some, this created a transformation in practice and confidence: “You have been so patient with me. I send you like a million pictures and you make them look organized (…) Thank you so much for all the support (…) it’s been kind of life changing for me.” (Participant 5) Relational support made photovoice accessible and equitable—sustaining week-to-week engagement and leaving participants with greater confidence, practical skills, and images that conveyed their stories on co-production.

Taken together, fair honoraria, intentionally designed and well-facilitated workshops, and responsive one-on-one support made the project accessible and engaging—enabling meaningful participation, tangible skills, and momentum beyond the study, offering a replicable model for future photovoice initiatives.

Discussion

This qualitative descriptive study examined the experience of participating in a co-produced photovoice study in a Recovery College setting. Results showed that participants benefited from the safe social space that was created, where they acquired new photography skills and thought deeply about their experience of co-production, which was the topic of the photovoice study. They also appreciated the design of the project, which was a direct result of the co-design process. Results show that participating in a co-designed photovoice project can have a range of positive impacts on the individuals involved.

In mental health, personal recovery is described as living a purposeful and meaningful life regardless of the symptoms associated with mental health challenges. It involves numerous components and multiple pathways in the form of a journey, including social and relational aspects, peer support, strengths development, meaningful living, and hope, in a holistic manner (Ellison et al., 2018; Jacob, 2015). Some of the impacts of participating in a co-produced photovoice project appear to advance the recovery of the participants. Notably, they discussed the social benefits of participation, peer-based learning, and skill development through a transformative life experience. This suggests that photovoice can be considered a research method that helps advance personal recovery in the mental health sector, further illustrating the alignment between photovoice and the Recovery College’s philosophy, purpose, and outcomes (Ebrahim et al., 2018; Thériault et al., 2020). Future longitudinal research is needed to determine whether and to what extent the positive impacts of photovoice on personal recovery are maintained over time.

Participants expressed appreciation for the design of the study. This is an important finding in the context of a co-produced photovoice study that took place in a co-produced Recovery College setting, among participants with experience of co-production. Lived/living experience engagement in research has been demonstrated to have positive impacts on many aspects of the research project, including positive impacts on research participants (Sheikhan et al., 2023). Co-production empowers, advances identity, and improves self-esteem (Mayer & McKenzie, 2017). The current findings take those results one step further to show the specific benefits of having all parts of a research study be co-produced in a way that aligns with recovery-oriented values. Specifically, the aspects of the study that were appreciated were directly co-produced by the CLC Research Subcommittee or facilitated by the staff who have lived/living experience, such as the honorarium structure, the workshop content, and the individual check-ins. This provides further evidence for the positive impacts of co-production at the research participant level.

For qualitative researchers, soliciting rich insights into the experiences of their participants is a key research objective. One of the advantages of qualitative research over quantitative approaches is that qualitative perspectives provide deeper, richer, and more complex insights into real-world issues compared to quantitative work (Oranga & Matere, 2023). However, not all qualitative approaches are equal in this regard. Our results show that photovoice leads participants to think deeply about the topic at hand and generate rich findings, perhaps even more so than other qualitative approaches like individual interviews, since participants engage with the subject matter over a longer time period and are thereby encouraged to reflect more deeply upon it. Applying a visual method to their reflection may also enhance the depth of their insights (Marshall, 2007). Photovoice blends a visual methodology with the extended period of reflection that may lend itself to particularly rich reflections on the research question at hand. While this study suggests some of the impacts of photovoice, future research might consider directly examining the mechanisms of action by which photovoice derives a richness of data.

However, participants also found the concept of co-production abstract and difficult to capture in a visual way. We did include exercises to help participants conceptualize co-production, such as taking a picture representing community and belonging, authentic self, unexpected beauty and differences, working together, and the process of change. This helped some participants progress to understanding how to capture co-production, but some still struggled. Confusion around the concept and terminology of co-production has been discussed in the literature, as the term ‘co-production’ is not used consistently, nor is a single approach applied consistently (Slattery et al., 2020; Vargas et al., 2022). Despite our participants’ personal experience with co-production as an inclusion criterion, together with the co-produced nature of the study, co-production was a challenging concept for them to visualize and photograph, which may have impacted the findings. Future photovoice researchers are encouraged to think about whether their research question lends itself to visual imaging and to consider forming a question that participants can connect with on an emotional and visual level to ease the photovoice process. In the presence of more abstract topics such as co-production, individual support and check-ins may be a mitigating strategy required to help some participants frame the topic in the form of visual images; alternatively, non-visual arts-based approaches might be considered.

It is important to note that photovoice relies on visual modes of engagement and expression, thus limiting its accessibility for people with visual impairments or those who prefer non-visual styles of expression. Other complementary arts-based approaches might be more accessible to a broader population by expanding upon photography to include a broad range of art forms, such as the written or spoken word (e.g., poetry, prose), movement (e.g., dance), sound (e.g., music, recordings), and other visual arts (e.g., painting, collage) (Chilton & Scotti, 2018; Miller, 2021). Indeed, a wide range of arts-based research approaches have been applied by community-based research teams, with innovative findings (Coemans & Hannes, 2017). Future research might consider which types of arts-based methodologies are best suited to different populations and research questions, from visual to more abstract topics.

Strengths and Limitations

A key strength of the project is that people with lived/living experience were engaged in all aspects of the project in a co-production framework. Study activities were designed by a co-production team, including people with lived/living experience, and were conducted by a research analyst and photographer with lived/living experience. The project aligned with the values and practices of Recovery Colleges. Accessibility considerations were kept in mind throughout the project, for example, by providing cameras, the option of e-gift cards or physical gift cards for honoraria, and individual check-ins to those in need. Nevertheless, there were some limitations to the project. While we made efforts to ensure participant diversity, it is possible that the perspectives of certain equity-deserving subgroups were missed. Notably, only one participant identified as a man, leaving gaps as to the experiences of men in co-production settings. Given the voluntary nature of participation, those who decided to participate might have had more positive experiences of co-production, which may have influenced the findings. Conducting the study activities virtually made it possible to recruit a national sample and eliminated travel barriers, but this prevented the in-person interaction from which some participants might have benefited. It should also be noted that these findings are limited to Canadian Recovery College settings. Future research should expand beyond these settings, exploring the impact of co-produced photovoice studies in equity-deserving populations.

Conclusions

This study showed that participating in a co-produced photovoice project is a positive experience for participants, with many benefits to their personal growth and recovery. The co-production and lived/living experience leadership of the project was particularly appreciated, demonstrating the natural fit between the photovoice methodology and the Recovery College setting. Concrete research questions that can be visualized are encouraged; alternatively, extra support may help participants visualize abstract concepts. These findings offer a replicable model for future photovoice initiatives aiming to optimize the impact on participants, while soliciting rich personal insights into the research questions, which may particularly flourish within Recovery Colleges and other co-production settings.

Supplemental Material

Supplemental Material - “It’s Something That Will Stay With Me.”: A Qualitative Descriptive Study of the Experience of Participating in a Co-Produced Photovoice Study

Supplemental Material for “It’s Something That Will Stay With Me.”: A Qualitative Descriptive Study of the Experience of Participating in a Co-Produced Photovoice Study by Lisa D. Hawke, Shelby McKee, Holly Harris, Sean Patenaude, Amy Hsieh, James Svoboda, Maral Sahaguian, Gail Bellissimo, Kelly Lawless, George James, Jordana Rovet, and Sophie Soklaridis in International Journal of Qualitative Methods.

Supplemental Material

Supplemental Material - “It’s Something That Will Stay With Me.”: A Qualitative Descriptive Study of the Experience of Participating in a Co-Produced Photovoice Study

Supplemental Material for “It’s Something That Will Stay With Me.”: A Qualitative Descriptive Study of the Experience of Participating in a Co-Produced Photovoice Study by Lisa D. Hawke, Shelby McKee, Holly Harris, Sean Patenaude, Amy Hsieh, James Svoboda, Maral Sahaguian, Gail Bellissimo, Kelly Lawless, George James, Jordana Rovet, and Sophie Soklaridis in International Journal of Qualitative Methods.