Abstract
Photo-elicitation interviews are increasingly used within the health sciences, such as health psychology, to explore lived experience in ways that move beyond the limits of traditional interviewing. This paper provides a reflexive methodological, ethical, and practical examination of photo-elicitation through three distinct qualitative case studies; (1) food insecurity, (2) adjustment to a rare birthmark condition, and (3) social media experiences of adults with visible differences. Across all studies, participants generated their own photographs or screenshots, which were used to guide semi-structured or open interviews and analysed using different qualitative approaches, including reflexive thematic analysis and interpretative phenomenological analysis. The case studies demonstrate how photo-elicitation can deepen reflection, enhance recall and support participant-led meaning-making, particularly when researching sensitive, embodied or identity-related experiences. However, the method also introduces important challenges, including increased participant burden, recruitment implications, ethical complexity around privacy, consent and image use, and less predictable interview structures. We discuss how institutional ethical review processes shape the design, accessibility, and framing of photo-elicitation research, sometimes in ways that may unintentionally produce barriers to participation, including stigma. The paper concludes by offering practical guidance for health psychology researchers on designing, implementing and ethically managing photo-elicitation studies, emphasising the need for flexibility, transparency and ongoing reflexivity.
Introduction
This article discusses photo-elicitation interviews in the context of health psychology research, focussing on three case study examples from the authors to illustrate the dynamic and flexible nature of photo-elicitation, including how it can be used with different participant groups and methodologies. It also considers important ethical issues surrounding the use of photo-elicitation and how these can be navigated within health psychology research. In addition to reflecting on methodological practice, this article critically examines how institutional ethics review processes shaped, and were shaped by, the use of photo-elicitation across these case studies. We discuss how ethical governance and decision-making during research design can unintentionally present challenges in carrying out photo elicitation research, in some cases creating accessibility barriers and maintain the stigma that visual methods seek to overcome. Photo-elicitation presents a unique opportunity to explore sensitive topics, but in sensitive health contexts, these unique challenges must be negotiated.
Photo-elicitation interviews can be thought of as the insertion of a photograph(s) into an interview with the purpose of evoking deeper discussion around a research topic (Harper, 2002). The method was originally pioneered by John Collier (1957) in response to difficulties he and his research team encountered when attempting to understand families’ perspectives on housing quality. Conventional qualitative interview techniques were limited in their ability to capture participants’ lived experiences, leading Collier to experiment with the use of photographs as prompts for discussion. Van Auken et al. (2010) argue that participant-driven photo-elicitation, whereby the participant themselves takes or selects photographs to use within the research, prompts deeper reflection in participants, producing richer and more nuanced information. In Collier’s work (1957) he compared the output from both traditional interviews and photo-elicitation interviews, observing that interviews incorporating photographs tended to be longer and richer in content, suggesting that images triggered participants’ latent memories and supported more reflective engagement. Taking photographs is also a familiar act in modern society, whereas partaking in research is generally unfamiliar; photo-elicitation bridges this gap somewhat (Roger & Blomgren, 2019). This remains central to the appeal of photo-elicitation within qualitative research.
Beyond enhancing recall and narrative depth, photo-elicitation has been recognised for its potential to reduce the power, class, and knowledge imbalances that are inevitable in research. Van Auken et al. (2010) suggest that this approach can empower participants by positioning them as active contributors to the research process rather than passive respondents. Photo-elicitation has been praised for amplifying participants’ voices and redistributing power, particularly when researching minoritised, marginalised, or underserved groups (e.g., young people, individuals with learning disabilities, Azzarito, 2023). Photo-elicitation is therefore particularly valuable for exploring participants’ individual perceptions, as it encourages them to engage with and interpret a topic in personally meaningful ways (Collier, 1957; Palacz-Poborczyk et al., 2025).
Although the method is historically rooted in anthropology and sociology (Bates et al., 2017), it is becoming increasingly popular in health psychology and health research (Glaw et al., 2017). For example, photo-elicitation has been used to explore the lived experiences of informal caregivers for people living with dementia (Rayment et al., 2019) and to examine health-related perceptions and facilitators of health across diverse populations (Palacz-Poborczyk et al., 2025). Several health-related experiences are difficult to capture through language alone. For example, topics such as social inequalities, visible difference (i.e., conditions or injuries that affect appearance), or illness-related identity may be sensitive and challenging to discuss. Visual methodologies like photo-elicitation can provide a less intimidating, more participant-driven approach to these discussions. Moreover, in the current digital era, photographs, screenshots, and images are routinely used to communicate experiences, often naturally capture the lives and experiences of individuals through albums and social media feeds, and therefore visual methods resonate with participants’ everyday practices (Agúndez Del Castillo et al., 2024).
Three Case Studies
In this article, we present three qualitative case studies that employ a photo elicitation approach. These case studies demonstrate how photo-elicitation can be used across varied research contexts and in combination with different qualitative methodologies, supplementing the methodological discussion by offering readers illustrative examples of the method in practice. They also provide space for the authors’ reflections on their experiences. While these case studies differ in topic and visual medium, all three employed participant-generated photo-elicitation as a central method. The aim of this article is to contribute to qualitative methodological debates by offering a reflexive account of using photo-elicitation interviews in health psychology. Rather than presenting photo-elicitation just as a data collection technique, we attend to how the research process, ethical decision-making and the production of qualitative knowledge differs by using this approach.
Methodological Considerations
When using photo-elicitation to explore a research topic, it is important to consider a number of practical and methodological issues. Photo-elicitation can strengthen qualitative research, and researchers should also consider how participant-led approaches may empower participants to talk openly about their lived experiences, as well as how this method may affect recruitment, participant numbers, and the demands placed on participants.
Enhancing the Interview Process
A widely cited strength of photo-elicitation is its capacity to enrich qualitative interviews (Meo, 2010). Photographs can prompt deeper reflection, enhance recall and facilitate richer narratives by triggering memories, emotions, and meanings that may not appear through traditional qualitative questioning alone (Clark-Ibanez, 2004; Holliday, 2000). Rather than responding solely to researcher-led questions and topic guides, participants are invited to guide the conversation through the photographs that have meaning to them.
Crucially, these photographs can either be researcher-generated or participant-generated depending on the nature of the study (Richard & Lahman, 2015). In all our case studies, participants generated their own photographs. While researcher-generated photographs have value, participant-generated images empower participants by allowing them to take control of the focus on the interview and more accurately reflect their perspectives, needs, and attitudes (Richard & Lahman, 2015). In the food insecurity study, participants took photographs of their food cupboards, supermarket shelves, or meal preparation spaces, which prompted reflections on affordability, access and dietary compromise, but also on emotions such as anxiety, shame, and resilience. In Guest and colleagues’ study (2024) with adolescents with CMN, the participants looked back through photographs in albums, on their phones, and social media to find examples that illustrated their experiences of adjusting to their condition, which were used to guide the interviews. Additionally, in Guest and colleagues’ (2025) study with adults with visible differences, participants used social media posts to illustrate their experiences of using social media and these were used to supplement the interviews.
Photo-elicitation is especially effective for visually grounded topics, where photographs themselves can convey much of the meaning (Copes et al., 2018). It is also valuable for exploring sensitive or difficult topics, such as food insecurity (Kamdar & Hernandez, 2022) or health conditions/injuries that are inherently visible by nature (e.g., visible differences; Guest et al., 2025). Participants can decide which photographs to discuss or to share and how to talk about them. Additionally, photo-elicitation can support engagement with participants who may feel uncomfortable with conventional interview formats. The implementation of this method is especially important when considering the inclusion of neurodiverse participants (Courcy & Koniou, 2024). Visual prompts provide alternative modes of expression, potentially making interviews more accessible and inclusive. Despite this, it is important to remain mindful that the use of photo-elicitation alone does not guarantee inclusivity; therefore, researchers must make additional efforts to ensure that their research is accessible (Courcy & Koniou, 2024).
Photo-Elicitation Approaches
Photo-elicitation encompasses a range of approaches, including participant-generated and researcher-generated images (Richard & Lahman, 2015), as well as variations such as photography, screenshots (Laws et al., 2018) and downloaded images. Each approach shapes the type of data produced. Participant-generated photographs may be more relevant to day-to-day lived realities, while choosing existing photographs from albums or posts from social media may capture lived experiences and identity. Researchers should therefore select approaches that align with their research questions and theoretical commitments, recognising that different methods produce different forms of knowledge.
Power, Agency and Participant-Led Methods
Photo-elicitation is often described as a participant-led method due to its potential to shift power within the participant-researcher relationship (Azzarito, 2023; Van Auken et al., 2010). Photo-elicitation partially mitigates this power imbalance by allowing participants to represent their lived experiences and situate the data within contexts defined by their own perspectives and experiences. As noted previously, participant-generated photographs are more empowering, as they enable participants to play a more active role in shaping the data and guiding the research conversation (Richard & Lahman, 2015).
Across the case studies presented in this paper, participants generated their own photographs, so had freedom to decide what to capture and how to interpret them. In some cases, interviews challenged the researchers’ initial expectations, leading to revisions of and deviations from the topic guide. For example, in the food insecurity study, participants emphasised the role of social relationships on their eating behaviours rather than attributing poor diet to the specific food items available to them. In the social media and visible difference study, semi-structured interviews were used within the photo-elicitation interviews. The researchers found that having the example of social media posts allowed the participants to help the team understand their experiences in greater detail. Many of the participants spoke about gaining confidence showing their visible difference online, and having photographs within the interviews helped to illustrate this topic. On the other hand, in the study with adolescents with CMN, the interviews were open, which allowed the participants to guide the interviews and discuss topics that were most relevant to their experiences. The researcher asked the participants to describe each photograph in turn and explain how it related to their experiences of adjustment, and how it made them feel, which then led to discussions of their experiences. Using photo-elicitation therefore aided this by providing a point of reference for the interviews and reducing the power imbalance by letting the young people control the narratives.
It is, however, important to remember that visual methods such as photo-elicitation do not fully eliminate power imbalances (Van Auken et al., 2010). Researchers retain control over key part of the study design like the instructions, analysis and dissemination. Although the focus is on participants’ lived experiences, it is important to provide clear instructions and a photo assignment to ensure that the conversation remains relevant to the research topic. While this is a key component of photo-elicitation, it also reinforces the researcher’s position of power. Photo-elicitation therefore goes some way in mitigating power imbalances, where the researcher and participants work cooperatively to produce knowledge but ultimately the researcher has the power to listen to and represent the participants (Ortega-Alcázar & Dyck, 2012). Therefore, photo-elicitation requires ongoing reflexivity regarding how researcher decisions shape and respond to participants’ contributions and how photographs and narratives are interpreted and represented (Fawns, 2020).
Sampling and Study Design
Photo-elicitation is often more resource-intensive and time-consuming than traditional qualitative interviews. Participants are asked to complete additional tasks, such as taking photographs or generating screenshots, and interviews may be longer and less structured. Researchers and participants might also have to manage additional consent procedures and documentation over the publication and use of photographs arising from the study. This might suggest that photo-elicitation may carry with it additional participant burden (Burton et al., 2017).
As a result, sample sizes may be smaller than initially anticipated or take longer to achieve. In the food insecurity case study, recruitment took longer than expected; we aimed to recruit ten participants within a two-month period however, we ultimately recruited nine participants over approximately nine months. Potential participants declined due to the perceived burden of participation or dropped out before the final interview if they found the photo-taking period challenging. This is something that has been identified by other researchers using similar visual methodologies (Booth & Booth, 2003; Burton et al., 2017). Any researcher intending to use photo elicitation should be aware of this barrier, and take it into consideration when designing their study. Despite this, a small sample may hold more (and sufficient) information on the research topic negating the need to have a large sample. This is the concept of information power (Malterud et al., 2016). Researchers should therefore plan for longer recruitment periods, manage smaller samples and prioritise richness and quality of data. It is also important to be transparent with potential participants about time commitments and expectations is essential to support informed consent and minimise drop out. The CMN study used IPA, which seeks to gain an in-depth and nuanced understanding of lived experiences, including looking at both similarities and differences between participants. This approach suited photo-elicitation because it enabled the participants to reflect on their own experiences through personal photographs that held meaning for them. Additionally, as IPA requires small samples, recruitment barriers were not such an issue for the study. It is also an important reflection that some individuals will not feel comfortable sharing their photographs and therefore this method can deter them from taking part. This is something to reflect on in relation to each individual study, including considering how this might impact the topic being explored. For example, in the social media and visible difference study, the researchers were surprised at how positive the participants’ attitudes towards social media were; however, they reflected that individuals with more favourable experiences may be most likely to feel comfortable sharing their posts with an interviewer.
Despite the additional participant burden that may accompany photo-elicitation and other visual methodologies, it is important to also reflect on the positive experiences associated with photo-elicitation. In the food insecurity case study, some participants fed back that they found the process rewarding and that it helped them gain greater insight into their eating patterns. For example, one participant reflected on patterns of eating during periods of reduced food availability that they had not previously noticed and, as a result, planned to make changes to improve their diet.
Ethical Challenges
As with any qualitative psychological research, we must consider the ethical requirements and challenges (Stainton Rogers & Willig, 2017). Here, we discuss the ethical challenges associated with using photo-elicitation, including privacy, confidentiality and obtaining informed consent.
Privacy and Confidentiality
Privacy and confidentiality present significant ethical challenges in photo-elicitation research (Copes et al., 2018). Photographs may inadvertently capture identifiable individuals, locations, or sensitive information. Clear guidance is essential to help participants avoid capturing identifiable individuals where possible or to obscure faces, names, or locations. Researchers must also decide how to handle images that cannot be fully anonymised and whether they can be included in analysis or dissemination.
In the food insecurity case study, participants were instructed to avoid taking photographs with any identifiable features, such as people’s faces, phone numbers and registration plates. This approach meant that we did not encounter any confidentiality issues with the photographs obtained. Nevertheless, procedures were in place should an issue arise: photographs could be edited to obscure identifiable features, used solely for the interview, and excluded from any formal dissemination.
However, in the CMN and social media studies, no restrictions were imposed on what photograph participants could select for the study because the research team wanted participants to be able to freely choose photographs that best represented their experiences, which often include their relationships with others. To address this, the researchers only used the photographs for the purposes of the interviews and did not publish any photographs within the manuscript. For the CMN study, a table was included as an appendix which gave general descriptions of the photographs. For the social media study, general descriptions were only included within the results section where the contents of the photograph were relevant to the example quotes.
Informed Consent, Dissemination and Transparency
Numerous ethical issues also arise when considering how the photographs intend to be used. At every stage of the photo-elicitation study, it is important to be transparent and open to potential participants on what is expected from them and how their data will be used (Copes et al., 2018). Informed consent, therefore, extends beyond participation in an interview to include the collection, storage, analysis, and potential dissemination of photographs. Participants should understand how their images may be used, where they may appear, and how they will be stored and anonymised. Photographs may only be used during the interview stage of the study then discarded, or they might be used in conference presentations or publications. Some researchers may even choose to analyse the photographs (Croghan et al., 2008); however, this approach introduces additional methodological challenges. In the case studies presented in this paper, the photographs were not analysed to avoid imposing researcher interpretations onto participant-generated images. The photographs were used only to facilitate the interviews. For example, In Guest et al.’s (2024) study, the researchers also reflected that the photographs served the purpose of facilitating the interviews and often did not hold meaning on their own. Therefore, they were not analysed but were described within the results section only where they were relevant to excerpts of data.
Regardless of how the photographs are used, consent should be treated as an ongoing process. Participants may change their minds about the use of particular images, and researchers must be prepared to respect requests to withdraw or restrict visual data, where possible, even at later stages of the research process. For example, in the food insecurity case study, participants were able to indicate on their consent forms whether they were comfortable with their photographs being used in dissemination (i.e., presentations and publications). Importantly, declining this did not preclude participation, it simply meant that the photographs would be used for the interview only. Participants who agreed to their photographs being used in dissemination were asked at both the beginning and end of the interview to confirm their ongoing consent. Offering separate consent options for image reproduction allows participants to retain control over how their visual data are shared, whilst not preventing them from participating. Researchers should also consider how images may be interpreted by audiences beyond the research context and whether dissemination could risk harm or misrepresentation. This can be even more challenging where personal photographs are potentially already in the public domain, such as social media posts. In the social media and visible difference study, the researchers were aware that if they were to publish any of the social media posts that participants discussed, they could be searchable online, even if some of their content was obscured. Given that this would breach anonymity of participants and others included in them, the decision was made not to disseminate any of the visual data. Researchers wishing to carry out photo-elicitation interviews, should consider these ethical issues in relation to their specific projects. There are also published guidelines, which can help with study planning (Bugos et al., 2014; Copes et al., 2018).
Beyond the management of images themselves, ethical practice also extends to how information about the study was communicated to potential participants. Across the case studies, we reflected critically on whether standard institutional templates for participant information sheets (PIS) were accessible and proportionate to the populations involved. This reflection led to important negotiations with ethics committees in the food insecurity case study. While ethics review is designed to protect participants, it may inadvertently introduce barriers to inclusion, particularly when researching sensitive or potentially stigmatised populations. As standard, health research studies often implement lengthy PIS’s outlining detailed information about data handling, confidentiality, risk management and withdrawal procedures. However, given the sensitive nature of food insecurity, and the likelihood that participants were already managing financial strain, stress, and competing life demands, we the research team were concerned that a lengthy, densely written document could be overwhelming or exclusionary. We were particularly mindful that if participants were unwilling to read the entire PIS, they were likely unable to provide fully informed consent. We therefore proposed to the ethics committee a condensed single-page PIS written in clear, accessible language.
Some existing literature corroborates this approach, explaining that information sheets should be kept as short as possible (Hudson et al., 2023). This document retained all essential components of informed consent, such as the purpose, procedures, risks, confidentiality, image use, storage and withdrawal, but removed duplication and technical terminology and jargon. Additional detail remained available upon request. Approval of this one-page PIS required explicit justification that accessibility itself constituted an ethical priority rather than a procedural shortcut. Importantly, condensing the PIS did not remove any necessary information for providing consent. Instead, it enhanced clarity and engagement. Participants reported that the information was easy to understand and that they were able to read and ‘digest’ the contents. This also revealed how institutional ethics processes can unintentionally resort to using standardised forms and templates which do not account for the unique challenges presented by alternative methodologies. For visual methodologies such as photo-elicitation, which already require additional justification regarding image capture and use, researchers should also critically evaluate whether standard documentation practices genuinely serve participant understanding or primarily serve institutional risk management. Additionally, where photo-elicitation may help to include individuals who may find more traditional qualitative methods inaccessible, such as children and individuals living with learning disabilities, it is particularly important that study documentation is also clear, appropriate, and accessible.
Challenging Stigmatisation of Participants
A further ethical reflection concerns how participant groups and research topics may be unintentionally stigmatised during ethical review of qualitative methodologies, like photo-elicitation (Gabbidon & Chenneville, 2021). Photo-elicitation has the ability to explore sensitive topics in an empowering way, but researchers should be cautious and consider the potential risks. All three case studies involved groups potentially subject to societal stigma: individuals experiencing food insecurity, adolescents with a visible congenital condition, and adults living with visible difference. In each case, ethics review required extensive consideration of potential risks, including distress, vulnerability, reputational harm and psychological sensitivity and an acknowledgement that photo-elicitation might present additional ethical considerations. For example, if conducting research with economically disadvantaged groups, one must be mindful not to mis-stereotype and stigmatised with broader social assumptions about poverty and risky behaviours.
Concerns could also be raised about what participants might photograph, and the ethicality of inviting them to take photographs. Although framed as a precautionary consideration, these discussions could implicitly suggest that participants might document socially stigmatised aspects of low-income life rather than focusing on food-related experiences or the lived realities of food insecurity. Millum et al. (2019) discusses the role of overprotection and vulnerability when researching stigmatised groups; they suggest that labelling groups as vulnerable has a stereotyping effect, where they are then overprotected in research. This overprotection potentially adds too many barriers or restrictions to participation, therefore posing the risk of silencing the lived experiences of food insecurity, or other health related matters. While it is appropriate for researchers to consider worst-case scenarios in order to safeguard participants and researchers, we should challenge our own misconceptions before engaging in such research. Researchers (alongside ethics review panels) should avoid paternalism or excluding participants based on assumptions around vulnerability (Gabbidon & Chenneville, 2021). It is important to remember that ethics panels may still be unfamiliar with this methodology, and so a negotiation must be achieved where participants are protected from stigmatisation. Additionally, researchers must also recognise the adverse role that stigma has on stigmatised or marginalised groups when engaging with research and healthcare. Therefore, qualitative researchers must take their own precautionary measures when designing studies ahead of seeking ethical approval. Community-based participatory research approaches, like photo-elicitation, are one example of how participants may be empowered, thus reducing the prevalence of stigma (Gabbidon & Chenneville, 2021). Gabbidon and Chenneville (2021) also make additional suggestions on minimising the stigmatisation of participants in qualitative health research; researchers should use respectful, non-stigmatising language when designing their research questions and design. These should be clearly explained to participants, and researchers must be transparent around data collection and informed consent procedures in order to build trust. When research involves populations experiencing social challenges, there is a danger, even unintentionally, of introducing stigma during data collection, analysis and dissemination. Gabbidon and Chenneville (2021) suggest that researchers must make a conscious effort to avoid reinforcing stereotypes or deficit narratives when analysing qualitative data. At this stage, positionality and reflexivity should be practiced, in order to identify and acknowledge how our identity and biases influence our interpretation of the data. Depending on the nature of the study and analysis used, this is where using member checking or co-analysis with the target population may be appropriate, elevating the voices of those with lived experience, might be appropriate (Birt et al., 2016). Member checking provides the opportunity for participants to engage with the interpreted data and indicate whether they agree with the co-constructed knowledge.
Additionally, considering implementing patient public involvement and engagement (PPIE) from conception to dissemination of the study can overcome these issues by ensuring the study is meaningful to the population and that these novel or unfamiliar methods are sensitive, acceptable and appropriate. In the food insecurity study, PPIE was informally used for this purpose. Importantly, participants in this case study engaged thoughtfully and reflexively with the photo-elicitation task. Participants’ images reflected lived experiences of being food insecure with several participants describing the process as engaging and enlightening, offering space to reflect on their eating and purchasing behaviours in spite of their experienced and internalised stigmatisation.
Despite these ethical complexities and the need for careful negotiation and consideration of study design and institutional review processes, photo-elicitation remains a particularly valuable and engaging qualitative methodology for working with marginalised or stigmatised populations (Roger & Blomgren, 2019). The familiar and accessible act of taking photographs can foster participant engagement and reflection, enabling individuals to communicate aspects of their lived experience that may be difficult to through words alone. Visual methods can therefore help to counteract the historical silencing, stereotyping or stigmatisation of voices, supporting more inclusive, participant-centred research that recognises participants as knowledgeable contributors rather than passive subjects.
Implementation Challenges
Researchers considering the use of photo-elicitation should be aware of a number of practical implementation challenges. These include providing clear instructions to participants, deciding how data will be collected, structuring interviews effectively, and taking steps to minimise participant burden.
Giving Instructions
Providing instructions to participants for photo-elicitation requires a careful balance between flexibility and clarity. Overly vague prompts may result in irrelevant photographs, while overly specific instructions risk leading participants and constraining them, which can undermine the benefits of the use of participant-driven photo-elicitation. As noted previously, a goal of photo-elicitation is to empower participants, so providing overly leading instructions may give more power back to the researcher. Therefore, when setting instructions researchers should consider the breadth of information they want to collect and what aspect of the participants’ lives they want to focus on, whilst trusting participants to document their own lived experiences (Torre & Murphy, 2015). In the food insecurity study, broad but focused prompts were used to allow flexibility while maintaining relevance. A photo assignment was set that briefly asked participants to take photographs that reflected their day-to-day experiences of living with food insecurity. Suggestions included photos of the foods they saw, obtained and ate (to document their food environment) but it was emphasised that they should take any photos that reflect what it means to be food insecure. In the social media and visible difference study, the researchers gave the participants specific instructions about the types of social media posts they wanted them to include, to help focus the interviews. However, in the CMN study, the researchers were careful not to give the participants too many instructions so as not to lead them to select photographs that they thought the research team would want them to use. They were instructed to find five photographs that they felt showed the positive aspects of having CMN. To increase their confidence, the team stated that the photographs could be old or new, include objects, people, or things that remind them of the positive aspects of CMN. This approach meant that the participants all selected different photos of personal significance, which helped ensure the interviews were participant-led and inductive. Whilst primarily an issue of implementation, it is important to consider the ethical challenges associated when designing a photo assignment.
Data Collection Practicalities
Researchers must also consider how participants will capture and share their photographs, if choosing participant-generated data. For example, considering whether participants’ have access to devices that capture photographs, are digitally literate, and what their preferred methods for sharing photographs are. When identifying potential participants, it is important to consider whether they have access to a camera or smartphone and if they are confident in using them (Lumia et al., 2022). In the food insecurity case study, we offered participants both a smartphone with a camera and some instructions on how to use it to take a good photograph. Uptake for these was extremely low as the majority of participants already have access to smartphones. Similarly, some researchers opt to provide participants with digital or disposable cameras (Tonge et al., 2013). This approach was deemed inappropriate in the food insecurity study seeing as taking photographs on a camera would likely draw unnecessary attention to participants when taking photographs in public but may be more effective in other populations or for research with children who are unlikely to own smartphones.
Offering flexible submission options for sharing photographs should also be considered. In the food insecurity study, participants were encouraged to share their photographs via email or WhatsApp. The latter was preferred by all participants, as it was something they routinely used day to day and was easier to share photographs than email. This is a simple example of how we can reduce barriers to participation. When using photo-elicitation methods to explore social media, much content online is now video-based, and the comments sections may provide further relevant reflection for participants. Indeed, in Guest et al.’s (2025) study, some of the participants preferred to open up their social media accounts during their interviews rather than discussing the provided screenshots. Therefore, researchers may consider allowing participants to share their social media streams in real time, including showing videos.
Interview Structure
Photo-elicitation interviews are often less structured and more participant-led than traditional qualitative interviews. Semi-structured topic guides become “living” documents that are adapted in response to the photographs that participants bring. For example, in the food insecurity study a participant making use of a food bank would produce different photographs than a participant who did not, meaning that the questions asked would vary. While this flexibility can enhance richness, it also requires researchers to be comfortable with unpredictability in photo-elicitation interviews. By using a semi-structured topic guide, core questions can be asked, branching off into associated questions (Jamshed, 2014) relating specifically to the types of photographs generated. On the other hand, in the CMN study, open interviews were used, meaning that the photographs were used to facilitate the entire interview, with relevant follow up questions including asking the participants to explain more and reflect on how they felt guiding the interviews. This enabled the topic to be led by the participant and facilitated organic conversation; however, this can be a daunting method, particularly for less experienced interviewers. It also requires the researcher to continually make judgements about whether the discussion is deviating too far from the research aim.
Participant Burden, Inclusion and Neurodiversity
As noted previously, the additional tasks involved in photo-elicitation may increase participant burden and deter participation (Booth & Booth, 2003; Burton et al., 2017). Researchers should manage expectations carefully and remain flexible regarding timelines and scheduling, particularly if working with participants managing health conditions. Despite this, photo-elicitation may be beneficial in that it offers an alternative for participants who find traditional interviews uncomfortable, including some neurodivergent individuals (Courcy & Koniou, 2024). Visual prompts can reduce pressure to maintain eye contact, provide concrete reference points and support diverse communication styles. Visual approaches present the opportunity to make research more accessible, but caution should be exercised (Courcy & Koniou, 2024). Emerging literature suggests that visual methods may enhance inclusivity when thoughtfully implemented but this link needs further investigation.
Conclusion
This article has offered a discussion of photo-elicitation in health psychology, drawing on two qualitative case studies to explore its methodological, ethical, and practical implications. Across all studies, participant-generated visual materials shaped not only the content of interviews but also researcher–participant dynamics, ethical decision-making and the nature of the data produced.
Photo-elicitation facilitates rich, situated, and participant-led accounts, particularly in relation to embodied and sensitive experiences. However, these affordances were accompanied by challenges, including increased participant burden, ethical complexity and less predictable interview structures. Importantly, photo-elicitation did not simply add images to qualitative interviews, but actively reconfigured the research process, requiring flexibility and ongoing reflexivity.
Crucially, our reflections indicate that ethical governance structures themselves shape what kinds of research are possible and who is able to participate. Decisions regarding PIS’s, risk framing and photograph usage or dissemination are not just ethical requirements but are also related to questions of accessibility, power and stigma. Negotiating approval for a one-page PIS and challenging deficit-based perceptions of vulnerability were central methodological and ethical considerations. For qualitative researchers considering photo-elicitation, we recommend careful consideration of study design, ethical protocols and accessibility from the outset. By engaging critically with both the possibilities and limitations of photo-elicitation, qualitative researchers can make informed decisions about when and how visual methods are most appropriate for their research aims.
Footnotes
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.