Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Social Work

Program Name/Specialization

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Faculty/School

Lyle S. Hallman Faculty of Social Work

First Advisor

Dr. Gus Hill

Advisor Role

Supervisor

Abstract

This dissertation explores peer specialists’ experiences of exploitation, isolation, and co-optation within substance use health services in Ontario, and examines how these dynamics affect their wholistic health. Although scholarship in mad studies and peer support has identified these challenges, little attention has been paid to the toll this emotionally heavy work takes on the well-being of peer specialists. Peer support is a profession in which individuals draw on their own lived/living experiences to provide support to others undergoing similar experiences. While substantial research demonstrates that peer support improves the quality of life for individuals experiencing substance use-related distress, far less is known about how this intensive and emotionally demanding work impacts the wholistic health of peer specialists. This dissertation’s theoretical framework integrates governmentality, intersectionality, mad studies theory and wholism. Using a critical narrative inquiry methodology, specifically counternarratives and counter knowledge, the dissertation examines the experiences of 19 peer specialists delivering substance use health services. Together, they generated a rich set of counter-narratives illustrating various forms of exploitation, isolation, and co-optation. Through a process of co-constructed knowledge, new counter-knowledge emerged about peer support in substance use health services, most notably around peer specialists’ understanding of wholistic healing and how their work has profoundly disrupted it. A discussion then theorizes how these counter-narratives connect to governmentality, mad studies theory, and wholistic healing theory. Many recommendations are offered aimed at strengthening the profession of peer support, including guidance for social workers who practice alongside peer specialists. The dissertation concludes by outlining future research directions, including the potential role of the emerging concept of sobernormativity as a protective factor for peer specialists.

Convocation Year

2026

Convocation Season

Fall

Available for download on Sunday, July 15, 2029

Included in

Social Work Commons

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