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“Balancing on Skates on the Icy Surface of Work”: A Metasynthesis of Work Participation for Persons with Psychiatric Disabilities

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Abstract

Purpose To explore how persons with psychiatric disabilities experience facilitators of and barriers to participation in paid work in transitional, supported, and open employment settings, in order to provide guidance for efforts to attract and retain these persons in gainful employment as a key dimension of recovery and community life. Methods A metasynthesis was conducted using 16 qualitative studies published between 1990 and 2011. Results Ten themes, two phases, and an overarching metaphor were identified. The first five themes describe facilitators of and impediments to getting a job (getting off the bench): (1) fighting inertia; (2) taking control; (3) encouraging peers; (4) disruptions related to the illness; (5) lack of opportunities and supports. The next five themes represent facilitators of and impediments to working (skating on the ice); (6) going mainstream; (7) social cohesion; (8) clarity in role and responsibilities; (9) environmental factors; (10) managing self-disclosure. We chose as our overarching metaphor “Balancing on Skates on the Icy Surface of Work,” as we view both iceskaters and workers with psychiatric disabilities as needing to achieve and maintain their balance while being “on the edge” between various extremities. Conclusion We have shown that, for persons with psychiatric disabilities to “get off the bench” and “onto the ice” of employment, they may need to be supported in finding and maintaining their balance in new situations through a combination of learning new skills and competencies (learning how to skate) while receiving in vivo assistance from empathic and knowledgeable supporters (being coached while on the ice).

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Authors and Affiliations

  1. Department of Social Work, Volda University College, 6101, Volda, Norway

    Liv Grethe Kinn

  2. MoodNet Research Group, Bergen, Norway

    Liv Grethe Kinn

  3. Department of Clinical Psychology, University of Bergen, Bergen, Norway

    Helge Holgersen

  4. Faculty of Health Sciences, Oslo and Akershus University College, Oslo, Norway

    Randi W. Aas

  5. Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA

    Randi W. Aas

  6. Department of Psychiatry, Program on Recovery and Community Health, School of Medicine, Yale University, New Haven, CT, USA

    Larry Davidson

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  1. Liv Grethe Kinn
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  2. Helge Holgersen
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  4. Larry Davidson
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Correspondence to Liv Grethe Kinn.

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Kinn, L.G., Holgersen, H., Aas, R.W. et al. “Balancing on Skates on the Icy Surface of Work”: A Metasynthesis of Work Participation for Persons with Psychiatric Disabilities. J Occup Rehabil 24, 125–138 (2014). https://doi.org/10.1007/s10926-013-9445-x

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