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Browsing by Author "Meershoek, A"
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Disembodied abilities: Sick role and participation in 'activating' return-to-work practices 2013, Article / Letter to editor (Social Science & Medicine, vol. 96, (2013), pp. 9-16)In 'active welfare states', labour participation is regarded essential for being part of and contributing to society. In the striving for an increase in labour participation of people who were considered (partly) disabled for work, not 'disabilities', but 'abilities' are put centre stage in vocational rehabilitation programmes. In this article we explore what this change in focus means in practice. We do this by investigating tensions experienced by participants of vocational rehabilitation practices that aim at facilitating return-to-work for people with disabilities. Our analysis derives from stories that clients and professionals told about daily experiences with disability, vocational rehabilitation and (labour) participation. These stories illustrate the logic embedded in vocational rehabilitation practices. Our analysis demonstrates that this logic, that focuses on will power, stable abilities and employability, hampers the realization of labour participation for a part of the population. We conclude that a logic of embodiment in which lived experiences of clients are acknowledged and in which it is explored what clients are concretely able to do in a specific context may be better equipped to facilitate return-to-work. (C) 2013 Elsevier Ltd. All rights reserved. -
A sociological perspective on "the unmotivated client": public accountability and professional work methods in vocational rehabilitation 2013, Article / Letter to editor (Disability and Rehabilitation, vol. 35, iss. 10, (2013), pp. 809-818)Purpose: This study aims at a sociological understanding of the concept of (un)motivation in order to provide clues for improving vocational rehabilitation (VR) support. Method: (Un)motivation is understood as the product of the interaction between clients and professionals in an institutional context. To gain better understanding of this construction of (un)motivation, in depth-interviews are held with 14 VR professionals. Based on the stories professionals told about their professional practices, we analysed the ways in which they guide their clients during their VR path within the institutional context of the Dutch welfare state. Results: "The unmotivated client" is a judgment that arises in the interaction between professional and client if the institutional goals of VR are not achieved. Two work methods are distinguished in which this judgment takes shapes in various ways, namely "Professional as a Signpost" and "Professional as a Personal Guide". Conclusions: Professionals work in a dichotomous public accountability framework with a strong focus on labour participation. This causes professionals to look for ways out of VR paths in which labour participation is not achieved. The construction of "the unmotivated client" is such a way out. An alternative way out is to explicitly value clients' (intermediary) achievements.
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Going beyond vocational rehabilitation as a training of skills: return-to-work as an identity issue 2012, Article / Letter to editor (DISABILITY & SOCIETY, vol. 27, iss. 1, (2012), pp. 81-93)In western welfare states, labour participation is increasingly considered a vital aspect of taking part in society. Vocational rehabilitation programmes are intended to support people in the process of returning to work. These programmes pay much attention to the skills that clients need to develop in order to return to work. We argue, however, that vocational rehabilitation is more than the acquirement of skills, and that further attention should be paid to clients' 'identity work' processes. Based on 45 life-stories, we present an analysis of the identity work expressed by people with a work disability in the Netherlands. We describe 'separative', 'integrative', and 'pending' processes of identity work. The presented typology can help vocational rehabilitation professionals become more sensitive to clients' processes, and supports more inclusive vocational rehabilitation.
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The 'Empowered Client' in Vocational Rehabilitation: The Excluding Impact of Inclusive Strategies 2012, Article / Letter to editor (Health Care Analysis, vol. 20, iss. 3, (2012), pp. 213-230)In vocational rehabilitation, empowerment is understood as the notion that people should make an active, autonomous choice to find their way back to the labour process. Following this line of reasoning, the concept of empowerment implicitly points to a specific kind of activation strategy, namely labour participation. This activation approach has received criticism for being paternalistic, disciplining and having a one-sided orientation on labour participation. Although we share this theoretical criticism, we want to go beyond it by paying attention to the practical consequences of understanding empowerment as an activation strategy. Inspired by the field of Science and Technology Studies, we will explore the meaning of empowerment and activation in concrete practices of vocational rehabilitation in the Netherlands. Our analysis is based on the narratives of people with a work disability about their lives and the vocational rehabilitation programmes they participated in. We present five illustrative cases that how empowerment is 'done' in the practice of vocational rehabilitation and its unintended effects. Our analysis demonstrates that activation strategies seem to be caught in a paradox: instead of including people in society, they have excluding consequences. Vocational rehabilitation professionals can go beyond this paradox by learning from the ways in which empowerment is 'done' by clients in vocational rehabilitation programmes.
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The needs of people with a longterm work disability regarding rehabilitation support in the Netherlands. 2009, Article / Letter to editor (European Journal of Public Health, vol. 19, iss. suppl. 1, (2009), pp. 69-70)
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