Journal of Occupational Rehabilitation最新文献

{"title":"Disability, Job Satisfaction, and Workplace Accommodations: Evidence from the Healthcare Industry.","authors":"Yana van der Meulen Rodgers, Lisa Schur, Flora M Hammond, Renee Edwards, Jennifer Cohen, Douglas Kruse","doi":"10.1007/s10926-025-10316-0","DOIUrl":"10.1007/s10926-025-10316-0","url":null,"abstract":"<p><strong>Purpose: </strong>This paper examines the extent to which job satisfaction, requests for accommodations, and the likelihood of a request being granted vary by disability status. We further analyze whether being granted workplace accommodations moderates the relationship between work satisfaction and disability.</p><p><strong>Methods: </strong>We use a novel survey of healthcare workers centered on disability status, perceptions of work experiences, and the provision of accommodations. The data are used in a descriptive analysis and multiple regressions to examine the moderating effect of accommodations on the relationship between disability and indicators related to job satisfaction.</p><p><strong>Results: </strong>Results show that people with disabilities have more negative perceptions of their work experiences than people without disabilities. Although people with disabilities are more likely to request accommodations than people without disabilities, they are equally likely to have their requests wholly or partly granted. Regression results indicate that the negative relationships between disability status and most measures of work experience are largely eliminated when accounting for the disposition of accommodation requests. The main exception is turnover intentions, in which the adverse relationship with having a disability does not change even when an accommodation is granted. Partly granting accommodations is helpful only for some metrics of job experience.</p><p><strong>Conclusion: </strong>Our paper shows that fully granting accommodations can go a long way to closing the disability gap in job satisfaction between people with and without disabilities.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":" ","pages":"824-837"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"He was Threatened and Told to Cooperate\": Immigrant Worker Experiences with the Workers' Compensation System in the Canadian Context.","authors":"Sonja Senthanar, Bahar Ahmadi, Gillian Creese, Suhail Marino, Christopher B McLeod, Mieke Koehoorn","doi":"10.1007/s10926-025-10307-1","DOIUrl":"10.1007/s10926-025-10307-1","url":null,"abstract":"<p><strong>Purpose: </strong>To understand immigrant workers' experiences when navigating the workers' compensation system for access to benefits following a work injury or illness.</p><p><strong>Methods: </strong>Interviews were conducted with 17 injured immigrant workers recruited in British Columbia through partnerships with settlement organizations, social media and professional networks. A situational analysis approach was used to analyze interview data and to identify contextual reasons for immigrant workers' experience with the workers' compensation system.</p><p><strong>Findings: </strong>The findings describe a tension between how the workers' compensation system is intended to work and how injured immigrant workers experienced the system. Workers described challenges with accessing and communicating with their case managers for timely access to benefits, work accommodation that did not align with their needs and disrupted their rehabilitation, and complicated claim trajectories stemming from perceptions of procedural unfairness. Immigrant workers described how these experiences were perpetuated by their different contexts including language barriers, unfamiliarity with the workers' compensation system, and their identity as immigrant workers.</p><p><strong>Conclusion: </strong>This study identifies contextual factors for the experiences of immigrant workers, within the Canadian context, for consideration by workers' compensation system in the management of injury and illness to reduce inequities where they may exist.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":" ","pages":"737-748"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description of Managers' Competencies in Diversity, Equity, and Inclusion: A Scoping Review.","authors":"Alexandra Lecours, Mélissa Laliberté, Andrée-Anne Drolet, Lily Bellehumeur-Béchamp, Roxanne Bédard-Mercier, Marie-Josée Drolet, Samuel Turcotte, Camille Gauthier-Boudreault, Claude Vincent, Marie-Michèle Lord, Jocelyne Kiss, Isabelle Feillou","doi":"10.1007/s10926-025-10315-1","DOIUrl":"10.1007/s10926-025-10315-1","url":null,"abstract":"<p><strong>Purpose: </strong>Organizations are increasingly integrating a diverse workforce, bringing both opportunities and challenges. To harness the benefits of diversity while addressing its complexities, the adoption of diversity, equity, and inclusion (DEI) principles is essential. These principles are particularly important in ensuring optimal accommodation for people returning to work after a period of disability, to take account of their multifaceted realities. Managers are pivotal in implementing and overseeing these initiatives, yet their specific roles and the required competencies remain underexplored. This study aimed to provide a comprehensive overview of the competencies managers need to effectively uphold DEI principles.</p><p><strong>Methods: </strong>We conducted a scoping review to collect and analyze information from 21 manuscripts, following a systematic five-step process.</p><p><strong>Results: </strong>The analysis identified seven core competencies and 28 sub-competencies that managers must exhibit to promote DEI in organizations. The seven competencies include the following: (1) communicating effectively with individuals; (2) managing DEI-related conflicts with diligence; (3) identifying and improving personal challenges related to DEI; (4) demonstrating transparency toward individuals; (5) acting as a role model to promote DEI at all levels; (6) facilitating the full potential of individuals; and (7) creating a team dynamic that fosters a sense of belonging for all individuals.</p><p><strong>Conclusion: </strong>This study underscores the critical role managers play in fostering inclusive environments, not only by promoting diversity but also by implementing fair workplace accommodations that facilitate the return to work of employees following a period of disability. This framework provides a foundation for future research on managerial practices in DEI.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":" ","pages":"617-642"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward the Search for Clinical and Cognitive Variables that Affect Employment in LATAM: a Multicenter Study.","authors":"Sandra Vanotti, Michael Jaworski, Oscar Daniel Ayala, María Sol Román, Federico Martín González, Carolina Abulafia, Juan Iglesias Passada, Lara Bardoneschi, María Laura Saladino, Fernando Cáceres, Miguel Ángel Macías Islas, Ralph H B Benedict","doi":"10.1007/s10926-025-10318-y","DOIUrl":"10.1007/s10926-025-10318-y","url":null,"abstract":"<p><strong>Background: </strong>In response to rising unemployment rates among people with multiple sclerosis (PwMS) and poor working conditions in Latin America (LATAM), MS experts established the Quality-of-Life working group. This study aims to: (i) describe occupational outcomes and employment status among PwMS in LATAM; (ii) investigate the relationship between different levels of disability and ES; and (iii) Quantify accommodation use and explore potential clinical, cognitive, and sociodemographic predictors of job accommodations in LATAM.</p><p><strong>Methods: </strong>A total of 86 PwMS were recruited from Argentina, Chile, Colombia, Mexico, and Paraguay, of whom 79 (91%) had a relapsing-remitting phenotype and 61 (70.9%) were women. The assessment protocol included the Brief Visual Memory Scale (BVMS), the Brief International Cognitive Assessment for MS (BICAMS), the MS Neuropsychology Screening Questionnaire, the Beck Depression Inventory II (BDI-II), the Fatigue Severity Scale (FSS), and a socioeconomic status (SES) survey.</p><p><strong>Results: </strong>(i) Based on employment status characteristics, 47 PwMS (54.6%) were classified into the work-stable group, 18 PwMS (20.9%) into the work-challenged group, and 21 PwMS (24.4%) into the work-loss group, additionally clinical and sociodemographic characteristics are described. (ii) Hierarchical cluster analysis ranked PwMS into three groups based on cognitive and physical disability levels, showing that a lower level of disability was linked to a higher likelihood of maintaining stable employment. (iii) Job accommodations were predicted by greater self-awareness of cognitive impairment, higher socioeconomic status, higher education, and higher physical disability, all contributing to increased use of workplace accommodations.</p><p><strong>Conclusion: </strong>Physical and neuropsychological disability increase the likelihood of being classified in the work-loss group, while factors such as self-awareness of cognitive impairment, socioeconomic status, level of disability, and education are associated with greater utilization of job accommodations. The work-loss rate among PwMS in LATAM was nearly three times higher than the general unemployment rate, underscoring the significant impact of MS on employment.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":" ","pages":"838-851"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of IMPRovE: A Multicomponent Intervention to Increase Adherence to Guideline Recommendations for the Diagnosis and Management of Work-Related Mental Health Conditions in General Practice.","authors":"D Mortimer, V Camões-Costa, K Nolidin, S Chakraborty, J Kenardy, B Brijnath, J Enticott, M Kidd, S Reid, A Collie, D Mazza","doi":"10.1007/s10926-026-10440-5","DOIUrl":"https://doi.org/10.1007/s10926-026-10440-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the cost and cost-effectiveness of a multicomponent intervention to increase general practitioners' (GPs) adherence to guideline recommendations for diagnosis and management of work-related mental health conditions (the Guideline).</p><p><strong>Methods: </strong>Economic evaluation from Australian health system and societal perspectives based on data from a pragmatic hybrid III parallel cluster randomised controlled trial (IMPRovE) that ran from December 2020 to December 2022.</p><p><strong>Results: </strong>The IMPRovE intervention generated a statistically significant improvement in GP adherence scores of 0.98 on 0 to 9 scale (95%CI: 0.38 to 1.58). We found no evidence for a significant between-group difference in total quality-adjusted life days (QALDs) per patient to trial-end (adjusted mean difference: -1.9, 95%CI: -24.2 to 20.3), productivity gains per patient to trial-end (adjusted mean difference: $5,818, 95%CI: -$12,346 to $23,982), or total health sector costs per patient to trial-end (adjusted mean difference: -$2,703, 95%CI: -$6,025 to $620). Under conservative assumptions, we find a significant between-group difference in total health sector cost per GP (adjusted mean difference: -$14,278, 95%CI: -$21,358, -$7,198). For improving GP adherence to the Guideline, we can be 95% confident that the IMPRovE intervention is more cost-effective than waitlist control from a health system perspective (when we set aside productivity gains). This remains the case even when improvements in GP adherence carry zero value.</p><p><strong>Conclusion: </strong>The IMPRovE intervention is likely to be more cost-effective than waitlist control for increasing GP adherence to Guideline recommendations. We were unable to draw strong conclusions regarding the cost-effectiveness of the IMPRovE intervention for improving patient outcomes.</p><p><strong>Trial registration: </strong>ACTRN12620001163998, November 2020.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-Occupational Aspects in Liver Transplant Candidates and Recipients: A Retrospective Cohort Study.","authors":"Dorian Quelard, Hugo Delhaye, Pauline Houssel-Debry, Baptiste Giguet, Thomas Uguen, Caroline Jezequel, Edouard Bardou-Jacquet, Christophe Paris, Florent Artru, Anastasia Saade","doi":"10.1007/s10926-026-10442-3","DOIUrl":"https://doi.org/10.1007/s10926-026-10442-3","url":null,"abstract":"<p><strong>Background: </strong>Liver transplantation (LT) restores survival and quality of life in patients with end-stage liver disease, yet return-to-work (RTW) remains challenging. Employment status before transplantation is a major predictor of post-LT reintegration, but socio-professional factors are rarely assessed during the pre-transplant period, particularly in the post-COVID era.</p><p><strong>Methods: </strong>We retrospectively included all adult LT candidates, aged 18-64 years and eligible to work, who performed elective pre-transplant evaluation at Rennes University Hospital between June 2022 and December 2023. Retired patients were excluded. We aimed to investigate the socio-professional aspects of working age liver transplant candidates and characterize their socio-professional trajectory one year after LT. Socio-demographic, medical, and occupational data were collected at baseline and one-year post-LT. Working patients were defined as those engaged in income-generating activity. Logistic regression was used to identify factors associated with employment before and after LT.</p><p><strong>Results: </strong>Among 141 LT candidates (65% male, median age 56), 31% [24-40] were working at evaluation. Working patients were younger, less frequently manual workers, and more often held higher educational levels or access to remote work. In multivariable analysis, higher education independently predicted pre-transplant working status (aOR 2.99, 95%CI 1.18-7.63; p = 0.02). Eighty-six patients underwent LT. At one year, RTW prevalence was 31 [21-41] %, with no increase compared to baseline. RTW was more likely among those working before LT (aOR 9.67, 95%CI 3.06-35.09; P < 0.001) and inversely associated with younger age and post-LT vascular complication. Patients resuming work reported higher quality of life.</p><p><strong>Conclusion: </strong>In this cohort, only one-third of LT candidates were working, and RTW at one year remained limited. Pre-transplant working status and education level were key determinants, while disability insurance hindered reintegration. Early socio-professional support, workplace adaptations, and occupational health consultation are critical to optimize post-transplant occupational activity.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beliefs About Working with Health Problems and Support at Work as Predictors of Sick Leave at Post-treatment and at Follow-Up: Secondary Analyses of a Randomised Controlled Trial with Registry Data.","authors":"Marianne Tranberg Bjørndal, Ragne Gunnarsdatter Hole Gjengedal, Kristian Pihl Frederiksen, Hilde Dallavara Lending, Kåre Osnes, Marit Hannisdal, Odin Hjemdal","doi":"10.1007/s10926-026-10438-z","DOIUrl":"https://doi.org/10.1007/s10926-026-10438-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates the predictive value of the newly identified factors Beliefs about working with health problems and Support at work for patients on sick leave due to common mental disorders. The aim was to explore the validity of the two factors in a new sample, investigating the factor structure, reliability and construct validity. Further the predictive value was assessed from pre-to post-treatment and at 6- and 12-months follow-up using sick leave data from national registries.</p><p><strong>Methods: </strong>The study had a longitudinal design conducting secondary analyses with data from a randomised controlled trial (N = 236). The patients filled out self-report questionnaires and sick leave data were collected from national registries.</p><p><strong>Results: </strong>The principal component factor analysis identified the two factors, Beliefs about working with health problems and Support at work, with strong internal consistency α = 0.79 and 0.85 respectively. At pre-to post-treatment both factors separately predicted number of days on sick leave. Beliefs about working with health problems also predicted number of days on sick leave from post-treatment to 6- and 12-months follow-up.</p><p><strong>Conclusion: </strong>These findings highlight key predictors for return to work. Beliefs about working with health problems is especially important, predicting up to 12-months post-treatment. These factors can easily be assessed and addressed in therapy and increased focus may help more patients return to work.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Discomfort: The Role of Negative Affect in Requesting Workplace Accommodations for Employees with Disabilities in the United States.","authors":"Daniel Keays, Shengli Dong","doi":"10.1007/s10926-026-10439-y","DOIUrl":"https://doi.org/10.1007/s10926-026-10439-y","url":null,"abstract":"<p><strong>Purpose: </strong>Workplace accommodations play a critical role in promoting equitable employment outcomes for people with disabilities (PWDs), yet the accommodation request process remains complex and emotionally charged. Drawing on Social Cognitive Theory (SCT) and Social Cognitive Career Theory (SCCT), this study examined how negative affect influences workplace accommodation request intention through self-efficacy and outcome expectancy.</p><p><strong>Methods: </strong>A cross-sectional survey was administered to 725 employed adults with disabilities across the United States. Structural equation modeling (SEM) was conducted to test direct and indirect relationships among negative affect, accommodation-related self-efficacy, outcome expectancy, and request intention.</p><p><strong>Results: </strong>Negative affect did not directly predict the intention to make an accommodation request. However, negative affect significantly reduced both self-efficacy and outcome expectancy. Self-efficacy, in turn, was a strong positive predictor of request intention, suggesting a mediating mechanism through which emotional experiences influence behavioral intentions. Contrary to prior literature, outcome expectancy did not significantly predict request intention in the final structural model. Multi-group analyses revealed no statistically significant differences in path coefficients between visible and invisible disabilities or between majority and minority racial groups, although variations in coefficient magnitudes warrant further investigation.</p><p><strong>Conclusion: </strong>Findings extend SCT and SCCT applications to disability employment by clarifying the affective-cognitive mechanisms underlying accommodation decision-making. The results underscore the central role of self-efficacy in mitigating the adverse effects of negative affect and highlight the need for interventions that strengthen self-evaluative beliefs during emotionally salient workplace interactions.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Process Evaluation of a Problem-Solving Intervention with Workplace Involvement for Employees on Sickness Absence Due to Common Mental Disorders in Swedish Primary Health Care.","authors":"Ida Karlsson, Lydia Kwak, Ute Bültmann, Gunnar Bergström, Iben Axén, Elisabeth Björk Brämberg","doi":"10.1007/s10926-026-10441-4","DOIUrl":"https://doi.org/10.1007/s10926-026-10441-4","url":null,"abstract":"<p><strong>Purpose: </strong>This process evaluation examined the implementation of a problem-solving intervention with workplace involvement (PSI-WPI) for employees with common mental disorders, developed to reduce sickness absence. The aim was to understand factors influencing the \"problem-solving in primary care\" (PROSA) effect evaluation, which showed no significant difference in sickness absence days between PSI-WPI and care-as-usual (CAU).</p><p><strong>Methods: </strong>PSI-WPI included a five-step process typically delivered over three sessions by primary care rehabilitation coordinators. Process outcomes assessed were reach, dose delivered, dose received, fidelity and dose response. Data came from questionnaires, medical records, and registry data. Kruskal-Wallis tests assessed associations between number of PSI-WPI sessions and sickness absence days. A post hoc analysis explored characteristics of employees receiving no, one or ≥ three PSI-WPI sessions.</p><p><strong>Results: </strong>PSI-WPI coordinators reported slightly more face-to-face sessions and three-part meetings, whereas CAU coordinators reported more telephone sessions. Coordinator support was received by 85% of PSI-WPI participants compared to 43% of CAU; 41% PSI-WPI participants received ≥ three sessions. Employees receiving ≥ three sessions had significantly more sickness absence days during 18-months follow-up than those receiving none.</p><p><strong>Conclusion: </strong>The intervention was largely delivered as intended and supported by sufficient training and resources. Dose-response findings suggest the intervention was primarily delivered to employees with more complex needs, highlighting the importance of accounting for preintervention sickness absence and targeting support. Future studies should strengthen implementation planning, refine theoretical assumptions, and ensure alignment between intervention design and participant needs, particularly when adapting return-to-work interventions from occupational health services to primary health care.</p><p><strong>Trials registration number: </strong>The trial was registered at ClinicalTrials.gov, identifier: NCT03346395 on January 12th, 2018.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Price and Prize for Employment or Education: a Qualitative Study Examining Facilitators and Barriers from the Perspectives of Service Providers working in Supported Employment and Education and Experts by Experience with Psychosis Spectrum Disorders.","authors":"Josefine Winther Davy, Benjamin Thorup Arnfred, Carsten Hjorthøj, Julie Midtgaard, Merete Nordentoft, Marianne Melau","doi":"10.1007/s10926-026-10433-4","DOIUrl":"https://doi.org/10.1007/s10926-026-10433-4","url":null,"abstract":"<p><strong>Purpose: </strong>Many with psychosis spectrum disorders are not in education, employment, or training. The present study aimed to describe the facilitators and barriers surrounding competitive employment or advanced education.</p><p><strong>Methods: </strong>Qualitative data were collected through first three interviews with service providers working in SEE (N = 3), followed by two focus groups with experts by experience with schizophrenia spectrum disorders (N = 13). The interviews and focus group discussions were audio taped and transcribed, enabling reflexive thematic analysis.</p><p><strong>Results: </strong>Three themes, each compromising two subthemes, were identified. The participants described the (1) Price and prize of work and study, including (1.1) Breaking points and (1.2) Motivations. In (2) Facilitators: The importance of individualized support, interventions were viewed as either (2.1) Fruitful or (2.2) Futile. The participants described (3) Barriers: Managing the invisible in conjunction with (3.1.) Symptoms and (3.2) Handling stigma.</p><p><strong>Conclusion: </strong>Experts by experience with psychosis spectrum disorders are highly motivated to pursue education or employment. Both benefits and challenges of this were identified. While work or study was seen as meaningful and confidence-building, it could also worsen symptoms or trigger first episode psychosis. Professionals taking a special interest in job-seeking were valued, though factors like lacking social skills and stigma formed barriers. Overall, the findings highlight strong motivation alongside a need for flexible, individualized approaches that balance opportunities with mental health risks.</p>","PeriodicalId":48035,"journal":{"name":"Journal of Occupational Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}