[Challenges and Adaptation Strategies of Service Providers in Vocational Rehabilitation - A Mixed-Methods Analysis].

Aim of the study: The aim of this study was to identify current challenges faced by service providers (SPs) as well as those likely to arise in the future and the coping strategies to deal with them. Challenges are requirements externally imposed on the SPs and perceived by them as central to their work. We focus on SPs that offered disability-specific programs financed by the Federal Employment Agency in December 2016.

Method: The study is based on a mixed-methods design. In summer 2017, a quantitative online survey of SPs (n=266) was conducted, as well as in-depth qualitative guided interviews (44 representatives at 32 SPs) until mid 2019. Factor analysis (STATA) and analyses in the sense of Grounded Theory (MaxQDA) were carried out.

Results: The experts at the SPs addressed three main challenge contexts or types: 1. competitive framework conditions (such as decreasing numbers of participants, increasing price competition or rising cost pressure), 2. changes in the structure of participants (such as decreasing educational competencies, more participants with behavioral problems, mental illnesses or multiple disabilities) and 3. changing demands of the labor market (such as increasing importance of computer-based activities, higher demands on qualifications or decrease in simple tasks). For the first two types, SPs had clear and overarching strategies. For example, SPs responded to the first type by changing their facility portfolio or opening up to target groups. Concerning the second type, SPs responded - according to their specific contexts of action - with further training of the staff, arrangement of permanent positions or hiring of new staff (especially psychologically trained staff) as well as negotiations with the financers of vocational rehabilitation. The third type, however, presented a very broad picture with few clear, tangible, overarching strategies. In general, SPs also looked upon financers as having an obligation to further optimize the rehabilitation process, in particular, to adequate allocation of programs and the provision of more flexible and individualized program concepts.

Conclusions: There is no one-size-fits-all response to current and future challenges. However, the COVID-19 pandemic has shown that strategies for expected developments - such as the need to further develop digitization - must not be put on the back burner.