ORCID

0000-0002-1503-5922

Keywords

Peer support, recovery, workforce, substance use disorder, health policy, health services

Abstract

This dissertation explores the evolving role of peer recovery workers (PRWs) in the U.S., focusing on the intersection of lived experience, professionalization, and structural barriers within recovery-oriented systems of care. PRWs, individuals with lived experience of substance use and recovery, are increasingly integrated into healthcare settings to support others in recovery. While their presence improves engagement and reduces stigma, the professionalization of this workforce raises questions about equity and sustainability. This three-manuscript dissertation explores PRWs’ occupational experiences, certification policies, and systemic challenges. The first manuscript is a systematized literature review identifying recurring themes of role ambiguity, low pay, burnout, and boundary challenges. Despite these barriers, PRWs report high job satisfaction and a strong sense of purpose. The review highlights the need for clearer role definitions, equitable compensation, and recovery-informed workplace policies to support and retain this vital workforce. The second manuscript presents findings from an empirical phenomenological study of 12 PRWs. Five key themes were identified: respect in recovery, centering the consumer, connection, expertise, and pay and benefits. Participants described the fulfillment they derive from peer work, as well as the structural challenges that threaten long-term sustainability. The study underscores the importance of institutional support, flexible working conditions, and recognition of lived experience as a form of expertise. The third manuscript is a reflexive thematic analysis of state-level peer certification policies across all 50 U.S. states and Washington, D.C. The manuscript identified themes shared across 49 policies including: the value of peers in multidisciplinary teams, experience before certification, cultural sensitivity, exclusionary language, and structural barriers. The analysis discusses how policy choices shape access to certification and influence public perceptions. Together, these manuscripts offer a comprehensive examination of the peer recovery workforce offering insights that can inform policies and practices that affirm lived experience, dismantle systemic barriers, and advance workforce equity.

Completion Date

2025

Semester

Fall

Committee Chair

Mona Shattell

Degree

Doctor of Philosophy (Ph.D.)

College

College of Nursing

Department

Department of Nursing Systems

Format

PDF

Release Date

12-15-2027

Document Type

Dissertation

Campus Location

UCF Online

Subjects

Peer counseling in rehabilitation; Recovery movement; Psychiatric social work--Research; Social work with drug addicts--Study and teaching (Graduate); Rehabilitation--Research

Available for download on Wednesday, December 15, 2027

Included in

Nursing Commons

Share

COinS
 

Accessibility Statement

This item was created or digitized prior to April 24, 2027, or is a reproduction of legacy media created before that date. It is preserved in its original, unmodified state specifically for research, reference, or historical recordkeeping. In accordance with the ADA Title II Final Rule, the University Libraries provides accessible versions of archival materials upon request. To request an accommodation for this item, please submit an accessibility request form.