Systemic and structural factors in building the therapeutic alliance in a work rehabilitation programme with injured immigrant workers

Type de document

Communications orales

Date de la conférence

2024-06-10

Langue

Anglais

Nom de la conférence

Workers’ Health and Return to Work in a Changing World of Work Conference

Lieu de la conférence

Ottawa (Ontario)

Résumé

The therapeutic alliance plays a central and fundamental role in the work rehabilitation process. This alliance is defined by the quality of the therapeutic relationship (mutual understanding and trust), and this takes on particular importance regarding immigrant workers, who may face additional challenges related to their migratory and occupational integration pathways or related to adaptation to their new social and cultural environment. This presentation reports the findings of an exploratory study designed to document the development and perpetuation of the therapeutic alliance between immigrant workers who have suffered a compensated work injury and their care providers in a return-to-work context. Three methodological approaches were used for this case study: ethnography, semi-directed interviews and focus groups. A clinic offering a return-to-work programme agreed to participate in the project. Three researchers carried out participant observation daily over several months, accumulating over 900 hours of presence in the field, including participation in the clinic's weekly team meetings. Eight injured workers, all from migrant backgrounds, participated in the interviews. All the participants in this study, although not the subject of the study, were in a variety of precarious and vulnerable situations: low income, part-time work, lack of social benefits, pending regularisation of migration status, social isolation, or faced with limited French language skills. Findings: Several weakening and alliance-breaking factors were identified, including a sense of injustice, the importance of pre-injury work and distrust of the system. Many of the factors leading to weakening or breaking of alliances were external to the clinic and occurred at multiple levels, making this a systemic and structural issue. It is these systemic and structural issues that will be discussed in this presentation and how they can lead to a more complicated rehabilitation process for immigrants.

Mots-clés

Réadaptation professionnelle, Vocational rehabilitation, Travailleur immigrant, Immigrant worker, Structure de l'emploi, Occupational structure

Numéro de projet IRSST

2014-0013

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