A Narrative Literature Review: The Contribution of Experts by Experience to Diverse Forms of Social Work Teamwork

Abstract

A commitment to co-production in which social workers co-create research, knowledge, and practice with people from multi-disciplinary backgrounds and people with direct lived experience of accessing services, who are termed experts by experience (EbEs), underpins social work ethics and values. EbEs are understood to be people who use their experiences of accessing health and social care services to influence and change all forms of social work. Despite this, EbEs have, to date, had limited involvement in teamwork in social work practice, although their contributions to social work education, research and practice innovations, as peers in the team, are of growing significance. A narrative review was undertaken to explore the gap in the routine involvement of EbEs in different forms of social work practice-based teamwork. This narrative review identified three over-arching themes to understand how EbEs contribute to social work teamwork: involvement in team relationships and in decision-making, involvement in knowledge production, and involvement in health and social care practice innovations. However, it must be acknowledged that the everyday involvement of EbEs in social work, including in multi-disciplinary teamwork, apart from small pockets of mental health practice, such as peer support workers, is lacking. It appears that EbEs are involved in practice innovations, rather than everyday practice; therefore, despite social work’s political and ideological commitment to co-production, it is less advanced than is often claimed.

1. Introduction

A commitment to co-production in which social workers co-create research, knowledge, and practice with people from multi-disciplinary backgrounds and persons with lived experience of accessing health and social care services and their carers underpins social work ethics and values. Despite this, persons with lived experience of accessing services have, to date, had limited involvement in social work practice, although the contributions of such people to social work education, research, and practice innovations, who we term experts by experience (EbEs), are of growing significance. In the context of this article, EbEs are understood to be people who use their experiences of accessing health and social care services to influence and change all forms of social work (Fox 2016; Videmšek 2008). We contend that the social work profession is a fundamental advocate in health and social settings for enabling EbEs to co-create impact and change. Social workers often operate in multi-disciplinary teams, working alongside and building relationships with people from diverse professional backgrounds in different settings; thus, teamwork is an important aspect of social work (Iles and Auluck 1990; Mesec and Stritih 2015). In the article we explore social work’s commitment to coproduction and the forms of social justice that are advocated for by its profession, and we consider if and how EbEs form part of social work teamwork and then outline best practice examples and recommendations for future practice.

In this article, the term social work is understood to mean any activity, environment, or task where social work practitioners, professionals, or researchers may be found, either in multi-disciplinary and/or interprofessional teams and the related arenas of their practice. Social work is defined as a practice framed within the IFSW (2014) global definition, described to be a “practice-based profession and an academic discipline that promotes social change and development, social cohesion, and the empowerment and liberation of people.” Health care is similarly understood to mean a complex system of professional practices developed to promote health, prevent illness, and deliver assessment, treatment, and rehabilitation to support individual patients (Reeves et al. 2010). The term teamwork is understood as a form of work where social workers work together with other people, including professionals, to cocreate solutions with individuals, families, or groups (Čačinovič Vogrinčič 2002; Schmutz et al. 2019). It is an interdisciplinary collaboration in which each team member contributes their specific knowledge and experience. This article refers to interprofessional collaboration, multi-disciplinary working and interdisciplinary work. D’Amour et al. (2005) define the multi-disciplinary team as members of more than one profession working independently or in parallel on the same endeavours. In contrast to this, interdisciplinary teams “integrate and translate, themes and schemes shared by several professions”. They share a common goal, which “is based on an integration of the knowledge and expertise of each professional, so that solutions to complex problems can be proposed in a flexible and open mined way” (D’Amour et al. 2005, p. 120). Interprofessional collaboration (Green and Johnson 2015) occurs when two or more professions work together to achieve common goals and is often used as a means for solving a variety of problems and complex issues.

Moreover, a variety of terms are used to refer to people with experiences of accessing services that are traditionally described as service users or clients. In this article, we prefer the term expert by experience (EbE), or sometimes person with lived experience. In the context of this article, a person with lived experience is understood to be one who has direct experience of mental ill health symptoms; people with experience of caring have their own lived experiences of caring and are referred to as experts by caring. The terms EbE or person with lived experience are commonly used by Social Work England (SWE) (n.d.), the English regulator, and in Slovenia (Videmšek 2008) to denote a person who uses their lived experiences or personal experiences of either accessing social care, or caring for someone who does, to coproduce or work in partnership with social workers. They can either coproduce their own care or contribute to different kinds of practice, research, or education monitoring or development. In the context of this article, an EbE is referred to as a person who uses their expertise of direct lived experience of challenges and knowledge to impact and change systems, in contrast to a notion of the person who accesses services. This concept recognises the value of lived experience in gaining knowledge and expertise garnered from personal experience of accessing services (Pawson et al. 2003).

There is a dearth of research to address the involvement of experts by experience in social work teams, although in related fields of mental health, peer support workers play an increasing role in supporting mental health recovery (Repper et al. 2013; Rebeiro Gruhl et al. 2016). A narrative review (Sukhera 2022) was undertaken for this study, leading us to introduce some innovative practices which confirm the benefits of involving people with lived experience in social work teams for all members of the social care system. This paper explores this gap and argues for the involvement of EbEs in different forms of teamwork represented in social work practice, education, and research. The slogan “Nothing about us without us” (Bryden 2015), formulated by people with lived experiences in the 1980s, underlines this premise. Thus, this article highlights the key advantages that EbE involvement in different forms of teamwork brings, both for the social work profession and for people with direct lived experience themselves.

1.1. The Importance of Teamwork in Health and Social Care

The practice of teamwork has been at the centre of social organisations for many years. Teamwork in social work is defined as a co-creative process in which at least three members (professional workers and EbEs) are included as equals, who, in the process (through various forms) of joint work within a working relationship, strive to (co)contribute to the realisation of a common goal (most often the solution of a specific problem in such a way that those involved in the problem become participants in the solution) (Čačinovič Vogrinčič 2002; Rape Žiberna 2019, 2022; Schmutz et al. 2019). It is based on the equal participation of all members, on the flexible division of labour and on the primacy of tasks over roles. Teamwork is a process that describes interactions among team members who combine collective resources to resolve task demands. Teams are complex dynamic systems that evolve and adapt as members interact over time and situational demands arise (Mesec 1990). The team is a structure that is oriented towards a common aim and performance goals (Harris and Harris 1996), working on the basis of mutual solidarity, exhibiting a common approach and policy regarding their duties and responsibilities, being mutually responsible for each other, and sharing joint responsibility for the results achieved (Belbin 1981) It consists of members who have complementary but different skills and abilities (Belbin 1981). Možina (2002) considers that a team is a group that is characterised by how its members participate in decision-making and help each other to achieve their goals. It follows that all teams are groups, but not all groups are teams.

Teamwork in social work is understood to be a co-creative process (Čačinovič Vogrinčič 2002). Payne (1995) notes that teamwork in social work is based on the premise that members work together for a common goal through the development of group relationships and shared values. Professionals involved in a multi-disciplinary team are often expected to effectively cooperate or manage work in the form of setting and achieving demanding goals, maintaining complex interpersonal relationships, and performing extensive work tasks. Team performance is influenced by many factors, with much attention paid to the diversity of interdisciplinary team members and their team roles. Belbin (1981) and Fisher et al. (2001) assumed that five conditions must be met for an effective team, and Tuckman (1965) also underlined five stages of team development for the effective team to evolve (norming, storming, forming, performing, mourning).

Norsen et al. (1995) highlight a number of skills required for an interdisciplinary team to operate effectively: the importance of co-operation in a team based on mutual trust, the need to be assertive in order to express one’s viewpoint, the ability to accept and share responsibility in the group, and the skills to communicate effectively with colleagues and to be autonomous in a team that is effectively coordinated. These skills enable each professional group (Petrie 1976) to explore and understand his/her fellow team members’ cognitive maps. Moreover, an effective leader is required to manage such a team and to blend the different professional cultures represented in the group, but s/he needs to recognise any challenges that are inherent in the different professional identities (Weber and Karman 1991). Individual personalities and characteristics also contribute to the team dynamics, often blurring the issues of professional conflict with personal ones. Moreover, students from diverse professional backgrounds need opportunities to spend time together (Clark 2002), to learn to develop collaborative skills to work together in meaningful ways. Clark (2002) states that universities lack the innovation needed to develop interprofessional education effectively.

The interdisciplinary team is characterised by cooperation between members and direct integration of several disciplines at a new level of knowledge and behaviour. Interprofessional collaboration requires the development of a common language between different professionals but requires the social worker to preserve their social and professional identity. Sims et al. (2015) highlighted that interdisciplinary team members have areas of overlapping competencies and must share varying degrees of responsibilities. This can, however, lead to “role blurring” (Falk 1977; Mariano 1999; Sims et al. 2015), due to confusion as to where one’s practice boundaries begin and end. Role blurring can result in some team members feeling underutilised (having their role usurped), or in some members feeling they are doing everything (needing to usurp): a process Falk (1977) calls “role expansion”. Risks for conflict and burn-out are high unless good leadership and conflict resolution skills can rapidly address the issues; however, these skills are not routinely taught in professional universities or higher education institutions (Sims et al. 2015).

Petrie (1976) emphasises that each profession has a different “cognitive map” and that “…quite literally, two opposing ‘disciplinarians’ can look at the same thing and not see the same thing…” (p. 35). The cognitive map develops because of the educational and socialisation experiences of the students of each profession, built on each student’s own unique cognitive and constitutional make-up. This map is a major component of the culture of each profession. However, a major challenge facing proponents of effective interprofessional working is to provide opportunities for team members to understand each other’s cognitive maps (Hall 2005, p. 190). Iles and Auluck (1990) reflect on the early involvement of interprofessional team working in social work, identifying the difficulties of interprofessional working in an East Dorset (England) community drugs team. They noted the suspicion and difficulties of people from different professional groups working together and how their disciplinary approaches impacted team cohesion. Such early difficulties (Iles and Auluck 1990) reflect issues faced by peer support workers (Rebeiro Gruhl et al. 2016), who play a team role in current mental health services.

1.2. Involving EbEs in the Team

Despite the plurality of social work theories, the dominant theme underpinning social work practice is that of social inclusion (Abrahamson 1995; Trbanc 1996; Sayce 2000; Giddens 2000; Repper and Perkins 2003; Leff and Warner 2006; Sheppard 2006; Staub-Bernasconi 2007, 2009; Leskošek 2010; Videmšek 2012). We believe that an inclusive society is one that provides equal access for all and at the same time ensures that the voice of every member of society is heard; not just the voice of one group of people. Videmšek (2012) states that social movements in the 1970s and 1980s brought many innovations to the profession of social work. Social movements led to the implementation of social change, leading to the development of community services and person-centred practice at the micro level, in which individuals direct their own lives. Research (see, e.g., Ramon 2003; Zaviršek and Videmšek 2009; Videmšek 2011, 2017) acknowledges the importance of people with lived experience, and their contribution is significant. Ramon (2003, p. 16) states, “the knowledge of people with personal experience was hidden for many years and was often defined by experts as invalid”; thus, we argue that EbEs have their own, original, experiential knowledge (Pawson et al. 2003) or, as defined by Haaster and Koster (2007), knowledge “from the ground up”, based on lived experience. The inclusion of EbEs contributes to the creation of new knowledge: knowledge which is based on experience [experiential knowledge] (Videmšek 2011, 2012, 2017).

In the social work profession, power relations are a central focus; thus, the concept of strengthening power (Saleebey 2002; Čačinovič Vogrinčič 2002; Videmšek 2008) is fundamental in practice. Differences between decision makers and power holders are not random, but are socially constructed and systematic, and have a potentially large impact on people’s lives. Therefore, the inclusion of EbEs from diverse backgrounds (disabled people, non-normative gender expression and identity, different economic classes, ethnicity) in forms of interdisciplinary and interprofessional teamwork is necessary because our social relations shape our practices of knowledge (how we create, interpret, use it) and contribute to epistemic practices.

In order to support the integration of EbEs into the social work team, there needs to be respect for the value of knowledge informed by the EbE perspective, alongside that of practice wisdom (Pawson et al. 2003); such values need to be instilled in social workers right from the start of their qualification training in order to enable power to be shared. Social Work in England was one of the first professions in 2002 (Department of Health 2002) to mandate lived experience involvement in pre-qualifying education, with social work regulators (Social Work England (SWE) 2021) requiring lived experience educator contributions within the profession’s pre- and post-qualifying education courses in the recruitment and selection of students, programme development, and in all aspects of teaching, learning, and assessment. Fox et al. (2023) describe EbE coproduction in a role-play assessment; the EbEs possess equal power in the decision-making processes alongside that of their academic colleagues. This equalisation of power differentials at the level of social work education leads to contexts in which EbEs may become a valued part of the social work team, overcoming many of the difficulties reported above by peer support workers (Rebeiro Gruhl et al. 2016), who use their expertise by experience to play a specific role in UK mental health services. Furthermore the history of the EbE involvement in teaching in Slovenia shows that one of the major obstacles for its development was that professionals perceived the EbE to be needy and dependant, not respecting the competency developed from their expertise based on alternative and valid knowledge (Schultz 2007). Thus, when EbEs are perceived to be incapable of managing their own lives, then lecturers consider them to be unable to work as lived experience educators and academic peers. Zaviršek and Videmešk (2009), in their early work, noted that paternalistic perspectives often predominated when lecturers first posited, including the voice of the EbE; lecturers were concerned that an “unknown teaching situation might trigger trauma, stress, and can re-traumatise the person”. The conceptual opposition to such paternalism is developed within resilience-oriented work, in which the EbE is presented as competent and strong, alongside their need for social care support. Resilience is most often defined as the ability to resist and to skilfully manage one’s own life with the capacity to emerge from difficult situations with greater strength and resources than before (Schultz 2007). The results of resilience research have emphasised that EbEs may possess particular personality traits which can serve as protective factors when meeting stress: they have learnt how to seek solutions, be inventive, persevere, and be flexible (Schultz 2007).

Being attentive to a strength and resilience perspective is a prerequisite of inviting the EbE into the teaching process. It is important not only for the EbE to share their story, but also for the social work student to become aware of the EbE’s strengths, resources, and abilities; this is a prerequisite for the EbE to become part of the social work team.

Based on the literature review, we focused on the following research questions:

• How is the EbE involved in social work?
• What can the inclusion of EbEs in the interdisciplinary/interprofessional team bring to the social work profession?

The meanings of the terms were defined at the beginning of the article.

2. Materials and Methods

A narrative review was undertaken for this article. Such an approach allows researchers to describe what is known on a topic while conducting a subjective examination and critique of an entire body of literature (Sukhera 2022). They can be particularly useful for exploring topics that are under-researched (Sukhera 2022). We surveyed the literature written in English and Slovene and identified research focused on work and cooperation in a team, with an emphasis on the material related to the role of people with lived experience in teamwork. The narrative process was influenced by the positionality of the authors; the first author is a first-language English-speaking EbE, as well as a social work academic (Fox 2016) and the second author is a first-language Slovene-speaking academic who also speaks and writes in English. Both authors have a commitment to ensuring the representation of lived experience in all forms of social work teaching and research, both in their respective countries and beyond (Fox 2016; Videmšek and Fox 2018; Videmšek 2009).

This narrative review was undertaken according to a model recommended by Ferrari (2015), using a search of the most well used databases for health and social care professionals. The literature search was undertaken in December 2024 and January 2025. The electronic search included Google Scholar, Applied Social Sciences Index and Abstracts (ASSIA), JSTOR, and SCOPUS. A limitation of our search is the non-use of the Web of Science database; in future work, we would utilise this. The inclusion criteria for the database literature search were all types of articles: articles published in the databases identified above, full text articles published in English and Slovene, and articles published from 2015 to 2025. English and Slovene were chosen because these are the spoken languages of both authors; however, Slovenia provides material that is only accessible to Slovene-speaking readers and, thus, this analysis makes this material accessible to a wider audience. The review adds knowledge to the Anglo-Saxon presentation of social work, further developing the evidence base for the profession. Social work education was established in Slovenia in 1955. During the socialist regime, it developed partly under the influence of politics and partly independently, with its own research-oriented work. After Slovenia’s independence in 1991, the curriculum changed within Slovenia, which was influenced by partnerships with various international organisations and in response to the Slovene social and political context (Rihter and Mešl 2024). In accordance with the narrative literature methods (Sukhera 2022), some grey literature and some limited references predating 2015, which were already known to the authors, were included in the analysis. Furthermore, there is little written about teamwork in social work in Slovenia; thus, older articles and grey literature were selected to add further value to the analysis. A total of 90 articles were reviewed, spanning from 2002 to 2025.

A viability search was initially undertaken in Google Scholar with the keyword teamwork. The search engine returned many records that were not related solely to social sciences. Further search terms were added to lead to the refinement of the search string vocabulary identified below. An indication of some hits is recorded.

»service user involvement« OR (Service User AND Carer Participation in Social Work) OR (user participation) AND (teamwork) OR (teamwork AND social work) OR (work as a team).

ASSIA: 1298 Titles screened—nothing relevant

Google Scholar—Over 1.2 million hits received. First 30 pages of most relevant views. Four titles found and four downloaded.

In Jstor, four titles were returned and screened.

From the articles retrieved in the first round of the search, additional references were identified by a manual search among the cited references and from studies known to the authors. In this narrative review, we also included studies from nursing and allied healthcare, due to the paucity of the literature. These health care examples shed additional light on the EbE’s contribution to social work because many of the findings are cross-relatable.

This narrative review reveals that the involvement of EbE and, in some cases, their carers, in interdisciplinary/interprofessional teamwork and social work teamwork, is under-developed, with a dearth of literature in this area. The paucity of literature identified from the electronic searches required us to draw upon our own knowledge to contribute to the evidence base we present. Articles were critically appraised using Critical Appraisal Skills Programme (Critical Appraisal Skilsl Programme (CASP) n.d.; Long et al. 2020) against their relevance to the research questions and included the following subjective evaluation by the two authors (Sukhera 2022), in accordance with a narrative review methodology. The authors separately reviewed different parts of the literature (based on language expertise and additional areas of expertise) and then separately analysed numerous articles, using thematic analysis according to Aveyard (2019). Following this process, the authors met and discussed the literature, agreeing on the final themes, which were influenced partly by their positionality as social workers, with one author being an EbE (JF) (Fox 2016) and both authors having a strong commitment to EbE involvement in all forms of social work; they both contributed to different parts of the write-up.

This joint endeavour ensured that the findings were brought together to incorporate different fields of practice and perspectives, which were captured through the language and specialist knowledge of both researchers. Sukhera (2022) notes ‘narrative reviews offer researchers the ability to synthesise multiple points of view and harness unique review team perspectives, which will shape the analysis. Therefore, insights gained from a narrative review will vary depending on the individual, organizational, or historical contexts in which the review was conducted’. However, a simultaneous strength and limitation of a narrative literature review, as found in our process, is that it does not identify all the literature available as a systematic literature review might (Demiris et al. 2019) and the process is influenced by positionality, as was our search. Therefore, we are conscious of our own positionality (Fox 2016; Videmšek and Fox 2018) and have reflected on its impact on our analysis. However, as identified by Sukhera (2022) and in accordance with Ferrari (2015), a narrative review is flexible and adaptable, allowing a search to be iterative and responsive to the author’s inductive and critical thinking process; thus, this review had multiple cycles of electronic and citation searching, which enabled the authors to illuminate the topic. We used our own knowledge of the literature to inform the discussion (in accordance with Sukhera 2022), alongside that of the research we identified. This included some material outside the inclusion criteria that were identified and included, as discussed above. We note a limitation to be that such a review is unlikely to be replicable; this is an identified weakness of the narrative review process, as opposed to a systematic review. However, conversely, a narrative review allows the authors to illuminate issues in an under-explored topic, drawing on their own expertise and positionality, and using multiple perspectives to inform an effective analysis of the evidence (Sukhera 2022; Ferrari 2015). In accordance with this iterative and adaptive process, neither a PRISMA diagram nor a meta summary of data are provided; however, a full list of references used to elucidate the topic is provided in

Table 1. References sourced for review.

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3. Results

We aimed to consider the involvement of the EbE in diverse forms of social work teamwork and outline the contribution which involvement brings to all team members. Social work as an academic discipline (Orme 2003) is often considered to be invisible because academics are often required to be involved in practice alongside high teaching loads. Thus, because social work research (Orme 2003) is often interactive and therefore time-consuming, this often leads to chronic under-funding; therefore, the findings are often published in textbooks instead of refereed journal articles, which may be another potential reason for the comparatively weak position (Orme 2003, p. 120).

A review of the Slovenian literature shows that teamwork is necessary in solving complex situations. There are some doctoral dissertations (Mesec 1990; Rape Žiberna 2019; partly also Rafaelič 2015), master’s dissertations (Možina Florjanc 2009; Kos 2022), and articles (Možina 2002; Urek and Eržen 2014; Maj 2012; Martin 2013; Žajdela 2012; Flaker et al. 2024; Mesec and Stritih 2015; Rafaelič 2015; Cefuta 2019; Rape Žiberna 2019; Rape Žiberna 2022) A monograph covering the meaning of the term teamwork in social work is in its preparation (Rape Žiberna, Jurček eds.). In his doctoral dissertation, Mesec (1990) considered the necessary components of teamwork in the context of community development to be both the setting of formal goals and a strategy for achieving goals. Rape Žiberna (2019) noted that only in social work is the EbE included in the team. To ensure that EbEs contribute effectively to the team, she argues that it is necessary to ensure that basic components of inclusion are advocated for, such as time, preparation, and trust. EbE involvement in teams should be essential for all forms of knowledge production in social work (Zaviršek and Videmšek 2009; Videmšek 2012). Furthermore, Martin (2013, p. 87), an English author, reinforces this and adds that EbE involvement in the social work team can contribute to the development of wider interdisciplinary knowledge, whilst noting that EbE involvement is still often a distinct value of the social worker’s professional identity, rather than of nursing, clinical, or allied health professional identities. This situation may, however, be changing as more EbEs are involved in the professional education of health, medical, and allied health qualifying professionals, as well as that of the social work profession (Seetharaman et al. 2025).

The review demonstrates that researchers address the aspect of membership or the participation of professionals in teamwork; however, the presence of the EbE (at a team meeting or his membership in the team) is rarely mentioned in the Slovene context. There are some examples of studies written in English considering the importance of teamwork in social work, but there is a dearth of research on the involvement of EbEs in social work teamwork. The narrative review led us to outline three topics of EbE involvement in teamwork: EbE contribution to relationships in teamwork and involvement in decision-making, EbE involvement in knowledge production and EbE participation in health and social care innovations.

3.1. EbE Contribution to Relationships in Teamwork and Involvement in Decision-Making

The first theme considers EbE involvement in decision-making interdisciplinary teams and the relationship between different members of the team, professions, and the environment. Social workers often have a key role in interdisciplinary teams. Some of the older literature (Videmšek 2009; Škerjanc 2010; Urek and Eržen 2014; Rafaelič 2015) confirms that EbEs are a key or central role within the team. Urek and Eržen (2014, p. 174) state that teamwork in social work includes “[…] as a rule, the user […]”, while Flaker et al. (2024, p. 155) define the user and other non-professionals (people who are important to the user) as team members in personal planning and the implementation of services. Rafaelič (2015, pp. 80, 188) reinforces that EbEs should be equal members in project teams or events teams; however, they are less involved in planning (work, innovations, etc.) (Rafaelič 2015, p. 188). However, this practice is not common, and EbE involvement appears to be an exception, rather than a rule.

Mc Auliffe (2009), drawing on the work of Herod and Lymbery (2002), highlighted that the most easily identifiable way in which social workers bring something unique to the multidisciplinary team is through the values and orientation of the social worker. Social work has a commitment to anti-oppressive values, which makes it unique amongst health and social care professions (Torkington et al. 2004, in Mc Auliffe 2009, p. 131). Moreover, in the UK, social work has led the health and care professionals in focusing on the utility, and more so validity, of lived experience involvement in social work education (Anghel and Ramon 2009; Fox 2020; Jobling and Sayuri 2023), research (Rose et al. 2010) and practice (Edwards and Parkinson 2021). Thus, lived experience is seen to be a valid source of knowledge in social work (Videmšek 2011, p. 306; Pawson et al. 2003; Social Work England (SWE) n.d.).

Øvretveit (1993) (in Payne 1995, p. 104) summarises six possible forms of lived experience involvement in decision-making in social work practice, education, and research; these levels range from none, information, and consultation, through to equal role, user-oriented, and self-determination (This resembles the ladder of involvement presented by Arnstein (1969)). Payne (1995, pp. 104, 105) states that lived experience involvement should not be deferred until the care planning stage; rather a constant exchange of ideas is necessary, with the need for people accessing services to participate in meetings in which decisions are made. Payne (1995, pp. 99–103) specifically highlights that it is very important to report the agreed actions from the team meeting to people using services, particularly if they are not already present. In the UK, Ross et al. (2014) highlights the importance of collaborative forms of health and social care governance in building relationships and making decisions. Such collaborative governance processes should take account of lived experience perspectives and support interaction with professional groups to provide a better format of quality assurance and to improve services for people with long-term conditions.

Moreover, despite the premise of the need to involve people in collaborative healthcare, Terry and Coffey (2019) undertook qualitative interviews with mental health nurses, student mental health nurses and patients in England, in which patients were not involved in decision-making or involved in their own care. The study found that patients often experienced nurses as being too busy to interact with them or involve them in undertaking care planning processes; moreover, nurses themselves also focused on undertaking administrative tasks, rather than interacting directly with patients. Such experiences are transferable to social care, in which social workers often report that they undertake most of their time managing administration, record-keeping, and form-filling, despite a desire to have more contact time with people accessing services (Bee 2017), and thus find themselves unable to involve people accessing services so effectively in decision-making processes. Furthermore, Terry and Coffey (2019) found that the student mental health nurses reflected on the limited contact that mental health nurses had with patients and reported very few experiences of nurses working directly with patients. Thus, despite policy commitments to involve patients and people accessing services in decision-making about their lives and the commitment to recovery-oriented practice—this rarely happens in the experience of these research participants. People accessing services believed that power imbalances hindered their involvement in care planning.

Furthermore, in knowledge that is transferable to social work, Giacco et al. (2017) undertook focus groups, with people accessing services, carers, and clinicians to understand the importance of involving carers in decision-making and care planning on inpatient wards in the UK. They noted that information should be given to carers right from the start, and specifically during care planning and discharge planning. However, often, organisational factors such as busyness on the wards and low staffing levels impact the capacity to involve carers effectively. It was noted that clinicians felt there should be a whole team approach to involving carers, with the responsibility delegated to one or two team members. This suggests that the involvement of people accessing services and their carers in healthcare teamwork is still far away, as experiential knowledge and choice for patients are still disregarded and devalued.

Indeed, as far back as 2002, Beresford (2002) stated that all too often in team meetings in health and social work, the voice of people accessing services is overheard or lost. Beresford identified this type of involvement to be tokenism, in which it is simply the co-presence of people with lived experience, without the real possibility of cooperation. Urek (2017) also warns that it is necessary to ensure that user participation does not become tokenistic. Jahlia et al. (2015) reflect on both consumerist and democratic models of user involvement in service users’ choices about the support required during health transition meetings when moving into independent housing. The study revealed that a range of decision-making approaches were initiated, from a consumerist focus on enabling the service user to express independent decisions about the care they wanted and needed, to service choices negotiated between user and professional, to decisions made by professionals in a paternalistic stance. Again, such healthcare knowledge can be transferred to the EbE’s experience of involvement in decision-making in social care. The importance of adequately preparing people with lived experience for cooperation in teamwork is also emphasised (e.g., in an interdisciplinary team, an individual project group), which they also see as one of the tasks of social workers. Belbin (1981) shows that a group can only be effective if there is cooperation within it and if each has a common goal underpinned by trust. This premise links to our second theme of the involvement of EbEs in knowledge production.

3.2. EbE Involvement in Knowledge Production

EbEs consistently support the development of health and social care research in the UK and, increasingly, in Europe, including Slovenia; the second theme thus identifies how they are often involved in different forms of knowledge production (Zaviršek and Videmšek 2009; Videmšek 2012). EbEs have long argued that they should be equal and equitable members of the health and social care research team, as they know what it is like to experience an issue (National Institute for Health Research (NIHR) n.d.); this experiential knowledge is key to their effective participation. Grundy et al. (2017) delivered co-produced training to mental health professionals about care planning in mental health as part of a research study. Mental health professionals appreciated the authenticity represented by EbEs and carers about their experiences. More recently, Fraser et al. (2017), in the same study as Grundy et al. (2017), reported on the EbEs’ perspectives of delivering the training to mental health professionals. The EbEs reported both the difficulties of engaging with care coordinators who knew them and of managing some negativity from professional participants about the training. They identified the need for support and supervision to manage some of these negative reactions. This illustrates the difficulties for some EbEs of working in a ‘team’ and in participating in a study in which professionals may be less supportive of their involvement and less sensitive to their needs and the endemic power imbalances. Moreover, this study identifies the importance of supporting EbEs in managing any concerns, particularly any resistance from staff, emphasising the importance of supervision.

Thus, in order to involve EbEs effectively, it is necessary to provide basic prerequisites that enable inclusion: enabling an even distribution of power, providing time for teamwork and preparing EbEs for the meeting, and providing any adjustments or support required at all stages of the research process. De Simoni et al. (2023) highlight the specific nature of ensuring that patient and public involvement (PPI) in research is well resourced and effectively supported. The term patient and public involvement (PPI) is used to describe the involvement of people with lived experiences, often in healthcare and allied healthcare settings. They note that PPI requires support that is well informed by both research and professional staff, who can ensure that it includes involvement at all stages of the research process, from the pre-funding development of a proposal to post-research implementation.

3.3. EbE Involvement in Teamwork in Health and Social Care Practice Innovations

The third and final theme links to the involvement of EbEs in teamwork in health and social care practice innovations. From our own background and knowledge, we are aware of many innovative practice developments which support the EbE in co-creating their own care through teamwork; this may involve working in teams with professionals, social networks, other experts by experience and family members. Ramon (2021) highlights the potential of family group conferences (FGCs) in adult mental health care, although they were originally developed in New Zealand (Love 2000) for child protection within the Māori community. FGCs (Bredewold and Tonkens 2021) draw on the involvement of family, community, and individuals in making decisions about the life of a person with lived experience. FGCs focus on the network to help the person to make decisions and develop an action plan to progress—as in effective teamwork. FGCs (Edwards and Parkinson 2021) have been used in a variety of settings in social work and build on the strengths approach and person-centred care within a systemic model (Bredewold and Tonkens 2021). Moreover, the solutions and action plans derive from the expertise of the social network and the EbE; decisions about the interventions they need (Lupton 1998) are thus closer to their needs and requirements as they reflect the perspective of the person and those around him/her. Bredewold and Tonkens (2021) proposed that essential factors for effective implementation of FGCs based on teamwork include the need for positive and consistent support from both professionals and the social network, and the importance of structured and facilitated involvement.

Open Dialogue and the Hearing Voices Network (Corstens and Schnackenberg 2021) focus on co-producing care with the EbE, utilising teamwork to recognise people with lived experience as experts. Romme and Escher’s (1993) ground-breaking research led to the development of the Hearing Voices Network (HVN). Hearing voices groups (Payne et al. 2017) have utilised peer support to enable voice hearers to normalise such anomalous experiences and share coping mechanisms. Open dialogue (OD) (Steingard 2021; Putman and Martindale 2021; Mosse et al. 2023) places talking in social networks as a precedent to taking medication and underlines the importance of communication and understanding of mental health causes. In open dialogue, the process is led by professionals, whilst in HVN, the experience is supported by peers in the hearing voices group. Furthermore, peer workers have an important place to play in OD (Nelson et al. 2021) and can help to bring a fresh perspective, as they share an experience that enables people to understand and relate to that mental health experience.

Thus, we have highlighted the ways in which people with lived experience are involved in health and social work and the benefits that the inclusion of EbEs can bring to the interdisciplinary/interprofessional team and its contribution to the social work profession. We have outlined three topics of EbE involvement in teamwork: relationships in teamwork and involvement in decision-making, knowledge production, and innovations. The next section discusses the findings, and the conclusions identify the usefulness of involving EbEs in social work teamwork.

4. Discussion

To fully involve EbEs in a meaningful way, social workers need to acknowledge the EbE’s and carer’s right to autonomy and independence; this extends to ensuring that they can be recognised as a team member in practice situations, research, and education. In UK mental health, peer support workers with their own experience of mental distress have become commonly employed in mental health teams and inpatient care (Repper et al. 2013). Their own lived experience of recovery (Rebeiro Gruhl et al. 2016) enables them to be alongside people experiencing mental distress and to assist them in their recovery, because peer support workers can bring authentic lived experience to this encounter and be a person who can model a recovery process. However, some peer support workers have reported (Rebeiro Gruhl et al. 2016) that they are required to undertake mundane roles and lack training and support to reach their potential, thus reducing their role efficacy, highlighting a concern that they are not a full and valued member of the team. Such issues have been faced, both now and in the past, when social workers have worked in interdisciplinary teams (Iles and Auluck 1990), enabling us to reflect on this development.

The inclusion of people with lived experience in teamwork continues to enhance the place of expertise by experience in all social work teamwork processes. Postle (2002) argues that social work has always been and still is carried out in a state of uncertainty and tension, implementing both care and control and intervening between the state and the individual. From her point of view, social work involves working ‘between the idea and the reality’ (Postle 2002, p. 335) and needs to be brave in its development. In the many diverse social work fields, respect for lived experience can be lacking and their involvement in their own care is limited. Staub-Bernasconi (2007), as far back as the late 20th century, highlighted that shared responsibility does not mean that the EbE is solely responsible for their care; before that, the concept of independent living noted how people could live independent lives with support. Shared responsibility thus requires a partnership approach, as in different forms of shared decision-making in health care (Ramon et al. 2021), with a focus on shared risk-taking and management. Fox et al. (2025) outlined innovations in a closed ward for people with a personality disorder, as patients were given more self-responsibility and autonomy and were enabled to take limited and managed risks, acknowledging and empowering them in their own care as full members of the multi-disciplinary care team focused on coproducing their care plan with them, rather than performing it on them. Thus, involvement of EbE in teamwork once again echoes the slogan “Nothing about us without us” (Bryden 2015), formulated by people with lived experiences in the 1980s.

5. Conclusions

In this article, we have identified the ways in which EbEs are involved in teamwork: contributing to relationships in teamwork and involvement in decision-making, participation in knowledge production, and involvement in teamwork in health and social care practice innovations. However, it must be acknowledged that the everyday involvement of EbE in multi-disciplinary work, apart from small pockets of mental health practice, such as peer support workers, is lacking. It appears that EbEs are involved in practice innovations rather than everyday practice. Thus, despite social work’s political and ideological commitment to co-production, it is less advanced than is often claimed. The issues of power imbalance and lack of control remain when experts by experience are not fully involved in all aspects of teamwork.

There are many advantages to involving people with lived experience in the team for both the organisation and the individual, including people with lived experience and those who practice as social workers:

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Participation in the decision-making process.

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Strengthening the power of an expert from experience, better self-image, and personal wellbeing.

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Mutual complement of knowledge and skills among team members, with exchanging of ideas and dynamic and interesting work.

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Members offer each other emotional support and acceptance, making it easier for them to form their professional identity.

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The flow of knowledge and experience between service users and practitioners enriches knowledge and enhances creative thinking, contributing to innovation.

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More authentic and relaxed communication.

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Collaborative climate.

Such collaboration enhances innovation for all members of the partnership and evidences how coproduction with people with lived experience and their carers contributes to the effectiveness of social work teamwork in all aspects of practice, education, and research.