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Exploring Day Center Activities in Norway: How do Employees Facilitate Participation for Workers with Intellectual Disabilities through Interaction and Social Support? An Ethnographic Study Cover

Exploring Day Center Activities in Norway: How do Employees Facilitate Participation for Workers with Intellectual Disabilities through Interaction and Social Support? An Ethnographic Study

Open Access
|Jul 2023

Full Article

Introduction

Work and employment are important and of great value both for society and on an individual level. The Norwegian version of work fare, the so-called work line, with its political goal of providing work for everyone as the foundation of all political decisions and social benefits, dominates our understanding of work today (St.meld.nr 35(1994–1995); Tøssebro et al. 2019). This understanding of work is thus the backbone of social and cultural integration in society (Hatland 2019), and contribution through work is often seen as both an individual right and a duty, in line with citizenship (Halvorsen et al. 2018). Using the conceptual apparatus of Berger and Luckmann (1966), we could argue that the meaning of work has become part of our everyday knowledge. Work is economically important for society, but for the individual it is also about participation, social status, social relations, experiences of purpose, and meaning in life, and it provides opportunities for self-realization, self-support, and independence (Engeset, Søderstrøm, and Vik 2015; Tøssebro et al. 2019).

But what if you lack access to ordinary work, as is the case with several groups in vulnerable positions in society, including persons with intellectual disabilities? Despite increases in rights and legislation over the years, research has repeatedly shown that most people with intellectual disabilities are not included in ordinary work (Kirsh et al. 2009; NOU 2016:17 2016; Tøssebro et al. 2019). Many attend municipal day centers, which can be seen as society’s attempt to offer them something resembling a workplace. Day centers offer both work and care but are often seen as primarily an arena for care (Engeset, Söderström, and VIk 2015; Søderstrøm and Tøssebro 2011). Day centers’ mandates are somewhat diffuse because the laws that regulate the services define it as activity, while in everyday speech and by users it is referred to as work. There is thus a duality in day centers in that they are not seen as workplaces on an equal footing with ordinary work, but at the same time they tend to resemble ordinary work as much as possible.

We have previously argued that day centers can provide people with intellectual disabilities with experiences of recognition through work, in line with Axel Honneth’s concept of recognition (Langemyhr and Haukelien 2022). This article contributes to the discussion on whether day centers can also be an arena for work. In addition, it provides new knowledge about everyday life at a day center, as well as insights into which social mechanisms enable participation, both social and in work tasks, for workers with intellectual disabilities.

According to Axel Honneth’s (2007) theory of recognition, recognition occurs in three forms: emotional recognition, legal recognition, and social appreciation. Emotional recognition is about mutual emotional appreciation and trust, and while Honneth claims that such recognition primarily belongs in familial relationships, other scholars, including Hanne Warming (2015), have argued that it can also occur within institutions. Legal recognition provides formal rights, what one can expect to get as a full member of a community, while social appreciation is about experiencing that one’s own contributions have value for others and are appreciated (Honneth 2007). All forms of recognition require reciprocity between the individual and society. Due to the importance of work in society, recognition through employment can be fundamental, and having a valued job can potentially provide all three kinds of recognition.

Having a workplace is important for people with intellectual disabilities, as well as for others. They can experience recognition through participation as workers at day centers because the arena represents a contrast to ordinary working life, which often excludes them (Langemyhr and Haukelien 2022). This serves as a background for this article. The empirical material is collected by the first author in a municipal day-center in Norway. In what follows, we investigate how participation is made possible through collaboration, adapted roles and social interaction, facilitated by the employees at the day center. We use the term ‘workers’ to designate service users in the day center, while the term ‘employees’ refers to professionals working with and supporting the service users. We have chosen to use these terms because that is how the participants at the day center distinguish between the two groups. The main question we ask in this article is, ‘How do employees facilitate participation for workers with intellectual disabilities through adapted roles and in social interaction at a day center?’

Background

While intellectual disability is included as a condition in the ICD-10, it is an umbrella term that refers to cognitive functioning below the normal range without saying anything about the cause of the reduced function or the individual challenges it entails (Bakken 2020: 32; WHO 2016). People with this diagnosis have in common that they need some degree of support in daily life. As a group, they have a long history of being viewed as outsiders and of being stigmatized, including in working life (NOU 2016:17 2016). Most people with intellectual disabilities face significant barriers in the area of employment (Migliore et al. 2008; Vornholt et al. 2018). In Norway, work inclusion for people with all forms of disabilities has been a focus area in several government documents in recent years (Arbeids og sosialdepartementet 2021; Barne- likestillings- og inkluderingsdepartementet 2013; NOU 2016:17 2016; St.meld.nr 35(1994–1995)), and the right to work was further established through the ratification of the Convention on the Rights of persons with Disabilities (Skarstad 2019). A lot of effort has been put into establishing different forms of integration and inclusion work for persons with intellectual disabilities, but with little result (NOU 2016:17 2016; Tøssebro et al. 2019). It is challenging to get a clear picture of what kind of work offers currently exist for people with intellectual disabilities in Norway (Gjertsen, Melbøe, and Hauge 2021), but our overall impression is that they are on the fringes of, or outside, ordinary work (Reinertsen 2012; Wendelborg and Tøssebro 2018). People with intellectual disabilities are seldom formally qualified for ordinary jobs, and very few do ordinary work or receive a salary (Gjertsen, Melbøe, and Hauge 2021; Reinertsen 2015). Most either have no work offer at all or attend municipal day centers (Engeland and Langballe 2017).

In Norway, the focus, both politically and in research, tends to be directed at arenas other than day centers when it comes to work inclusion for people with intellectual disabilities (Engeset, Söderström, and Vik 2015; Proba 2016). Day centers are often not regarded as an arena for work even though most people with intellectual disabilities who have an activity and/or work offer attend municipal day centers (Tøssebro et al. 2019).

Municipal day centers

After the dissolution of institutions for people with intellectual disabilities in Norway in the 1990s, the municipalities were given the responsibility of providing services for this group, including day centers (NOU 1985:34). Day centers are regulated by the Act on Municipal Health and Care Services, which mandates the provision of meaningful day activities for those who need them (Helse- og omsorgstjenesteloven 2011). The figures on how many people with this diagnosis attend day centers in Norway vary, but it is assumed to be between 21 and 47.6% (Engeland and Langballe 2017; Reinertsen 2012). A report from the Norwegian Directorate of Health emphasized that there are economic differences between the municipalities in Norway, and the content, quality, and production in day centers vary from one municipality to another (Bærø 2019; Engeset, Söderström, and Vik 2015). Each municipality decides the scope, content, and organization of their offer (Nasjonalt kompetansemiljø om utviklingshemming 2021).

Day center participants do not have the same formal rights or obligations that workers in ordinary working life have. It is nevertheless the case that day center activities are designed to resemble ordinary work as much as possible, and many participants refer to these activities as work. Tasks and activities at day centers are generally more varied and not as production oriented as, for example, in sheltered work where, in contrast to day centers, they must have a certain financial turnover. Day centers are meant to provide differentiation according to workers’ abilities and their need for physical and social assistance and support (Hegdal and Thorsen 2007), and their offer often consists of a mixture of care, therapy, training, and work (Søderstrøm and Tøssebro 2011). Whereas workers are hired for sheltered work based on the company›s requirements, day centers must include everyone who is eligible for the service, regardless of diagnosis and functional level. Thus, day centers have workers with intellectual disabilities ranging from mild to severe or profound. Some can produce almost in the same way as the employees while others cannot and are offered other forms of activities, training, and care.

Previous research has shown that having a job is as important for people with intellectual disabilities as for others, and the social aspect is often highlighted (Migliore et al. 2008; Olsen 2009). A study comparing day centers and sheltered work found that the social factors were equally good in these two offers, but that satisfaction related to production was lower in day centers (Reinertsen 2015). This may reflect the fact that day centers often focus less on production. Workers in day centers tend to do traditional work tasks, such as carpentry, packing or sewing, because these are the kind of tasks the workers prefer and master (Olsen 2003). Many workers experience self-efficacy through performing repetitive and predictable tasks rather than challenging new ones, which emphasizes the importance of matching workers’ personal capacities to the environmental demands (Garrels and Sigstad, 2019). Previous research has shown that workers with intellectual disabilities experience their activities at day centers as meaningful (Lysaght et al. 2017), but their work tasks and roles in this context do not necessarily correspond to what is appreciated in ordinary work and valued in society (Engeset, Söderström and Vik 2015).

In a hierarchy where work arenas are set up according to how closely they are linked to ordinary work, day centers will be at the very bottom (Tøssebro et al. 2019). This is perhaps due to the fact that day centers tend to have a low status; they are not defined in legislation as work, and we know little about what they do and what is produced there. This article is designed to address a knowledge gap related to day centers as an arena for work and which mechanisms of social interaction enable participation in this context.

Theoretical inspiration and philosophical foundation

Behind the Norwegian work line policy, in addition to economics, is a cultural belief that work has positive social consequences for the individual (Hatland 2019). A lot of work also has a socially therapeutic side. We regard meaningful work as something subjective and would argue that what matters is what makes sense for participants in each context, not necessarily the status or official mandate of the arena. Many in ordinary work would probably agree that the most important thing about having a job is not the product they make or service they provide, but the opportunities work offers for social community and self-development. There is no reason to think that this does not also apply to people with intellectual disabilities. Nevertheless, we would argue that both work tasks and social factors are important for a day center to be experienced as meaningful and for the workers to experience recognition in line with Honneth’s concepts (Langemyhr and Haukelien 2022). A key concept in this context is participation.

Our analysis led us to interaction theory and to Erving Goffman’s work on face-to-face interaction. Erving Goffman was an interactionist concerned with roles and interaction at the micro level (Aakvaag 2008). In his early work he drew inspiration from the theater and saw settings around interactions as a kind of stage (Goffman 1992). Later, he became more concerned with frames for interaction, the order of interaction, and impression management (Goffman 1956, 1974). His concepts of roles, frames, impression management, demeanor, and deference have inspired our work in this article. According to Goffman (1992), we play roles in all social interaction, and there are norms that apply to different roles. Being exposed as incompetent in a role normally leads to social sanctions. A frame around what is going on and a mutual understanding of the norms that apply in a situation are crucial for interactions not to fall apart (Aakvaag 2008). A common frame where everyone knows what the expectations are enables proper interaction and role performance. The terms pair demeanor and deference refer to how we seek both to preserve our own dignity as well as safeguard the other when interacting (Aakvaag 2008; Goffman 1956). In the analysis we show how the balance of demeanor and deference is skewed in many situations between workers and employees at the day center because the employees often exercise a disproportionately high degree of deference in interaction, especially within the care frame. This seems quite crucial for the workers’ experience of themselves. When norms or normal situational behavior are broken, we can use various forms of respectability strategies. According to Goffman, repair work is one such strategy, and it is described as how we in different ways correct or smooth over abnormal behavior, both for ourselves and for others (Aakvaag 2008). Repair work is thus similar to deference and demeanor, but we understand it to be even richer. in this article we use repair work to describe the exercise of deference and demeanor but also other forms of somewhat more one-sided repair: a hug, comfort, mediation of conflicts, etc.

We must emphasize that while Goffman and interaction theory serve as inspiration for our analysis and discussion, we have no fully developed theory. We use the concepts loosely, as Goffman did, to gain an understanding of what characterizes interactions between workers and employees at the day center.

Methodological approach

The study is a qualitative ethnographic study, and the design was chosen because we wanted to observe interactions in authentic situations (Fangen 2010). We contacted a municipal day center and were granted access and the opportunity to conduct participatory observation and recruit participants for interviews. This day center is relatively large by Norwegian standards, with about 150 workers with different challenges and diagnoses. According to the staff, more than half of the workers had been diagnosed with intellectual disability. The workers are assigned to different departments based on their own wishes and competence and their individual need for facilitation and assistance. They can apply to transfer to another department every six months. Some of the day center’s employees have a health and social work background, but most have an education in the subject that is relevant to the department’s production. Most of the workers have no formal education or training related to production before they start working at the day center but receive individually adapted training there. Both the design of the rooms and the equipment clearly show what is being produced in each department, like ceramics, carpentry, car repair, maintenance, graphic design, and textiles.

Data collection

By combining the methods of participatory observation and interviews, we were able to collect information about what the participants did and how they talked about what they did. We looked for patterns in the day center’s social world, in line with an ethnographic approach (Creswell and Poth 2018). A combination of methods is recommended when informants have intellectual disabilities (Guneriussen 2010) due to possible challenges with communication and understanding. Our data material consists of notes from participatory observation and transcribed interviews. The data collection was done by the first author alone, while the analysis and writing involved a collaboration between authors.

Participatory observation

The first author conducted a total of 100 hours of participatory observation distributed among four departments at the day center. Participatory observation is well-suited to study relations and interactions (Thagaard 2013). The observations were made in several rounds, two to three days at a time. During the period of participatory observation, the first author was present and participated throughout the workday, alternating between an observing role and an interacting and communicating role (Fangen 2010). The workers were used to new people coming and going, and the employees said that everyone behaved as usual despite the researcher’s presence. She observed how the participants interacted, what work tasks they performed and in what way, and what kind of help they needed, as well as at what kind of roles they occupied throughout the day. Through participation, the researcher got to know the workers, which enabled her to create relationships and trust and to understand the workers’ different forms of communication. This was crucial for how some of the interviews were conducted and gave the researcher the opportunity to ask the workers questions about what she had observed and about things they had done together.

Interviews

The interviews were conducted towards the end of the data collection period. Sixteen workers with a diagnosis of intellectual disability, six employees and three managers participated in the interviews, a total of 13 women and 12 men aged 19–57 years. Most employees in permanent positions in the four departments were interviewed. Workers had to have been diagnosed with intellectual disability. All workers who met that criterion was asked to participate, and those who wanted to participate were interviewed. The topics were work, their thoughts and desires regarding work and what was good and bad about working at a day center. The interviews were theme-based and semi-structured, with open-ended questions (Thagaard 2013). The interviews of employees and managers lasted for about an hour. The interviews with the workers with intellectual disabilities lasted between 16 and 75 minutes and ended with a chat about how they experienced the interview situation. Because the first author had become acquainted with the workers prior to the interviews, these could be conducted without supervising employees present. Everyone gave written consent for the interview and for the conversations to be audio recorded.

Ethics

The main project has been approved by the Norwegian Center for Research Data (NSD), reference code: 276192, and the data material is stored in accordance with this agreement. The first author signed the municipality’s standard on confidentiality when collecting data. Prior to the data collection period, the four departments at the day center had received a letter with information about the project and a photo of the first author, which led to the participants being prepared beforehand. The participants gave oral consent before the period of participatory observation. Prior to the interviews, all participants gave written consent. The employees confirmed that all the workers we interviewed were competent to consent. Names used in this article are pseudonyms.

Data analysis

We did a thematic analysis of the of the field notes and the transcribed interviews (Braun and Clarke 2006; Johannessen, Rafoss, and Rasmussen 2018). The process of thematic analysis consists of four parts: preparation, coding, categorization, and reporting (Johannessen, Rafoss, and Rasmussen 2018). First, all the materials were read once to get an overview before being read more systematically, sorted, and coded. The analysis was inductive from the start, but it became more abductive towards the end of the process as we saw the contours of findings and began to think about theory. The field notes had several detailed descriptions of interactions, which were reread several times and analyzed in detail. The analysis revealed that participation, both socially and in work tasks, was possible because the employees (a) made it possible for the workers to alternate between roles and (b) did repair work in and after situations that arose.

Findings

The participants alternated between roles, and two main pairs of roles emerged through the analysis: worker/employee and care recipient/caregiver. The two pairs of roles had different frames of interaction. The workers’ behavior and needs determined which role set was enacted and which frame applied. When the participants were in the work frame, they collaborated on work tasks, but when a worker switched to the role of care recipient, the employees provided care and support and became caregivers. Repair work was done during and after situations and made the role switches possible without any social consequences for the workers. The following empirical example of Oda and Mari contains both role switching and repair work.

Oda and Mari are workers in the textile department, which is housed in a large L-shaped room with several workstations. At one end of the room is a big worktable and at the other a workstation for silk and shelves for storage. From the big worktable one can see through the glass doors into the day center’s shop and over to the other side of the building where the canteen is. On this day, Oda and Mari were sitting by the big worktable in the center of the room together with four other workers and one employee. Two other workers sat by their sewing machines along the window wall. Mari was having a bad day. She said she was in a bad mood and had placed herself very close to the employee. Oda sat at the other end of the table knitting. Mari hardly did anything. The employee tried to get her to knit, to sort pins, to sort some yarn, but she did not feel like any of it. She just wanted the employee’s full attention all the time. The employee acted calmly and gave her attention but continued conversing with all the others around the table, too. As time passed, Oda looked more and more irritated. She tried to say something a couple of times, but Mari interrupted her. Suddenly, Oda stood up and ran to the toilet sobbing. The other workers did not seem to take much notice, but the employee got up and went over to a shelf where she took out some earphones and gave Mari some music to listen to and an unconnected microphone so that she could mime and pretend to perform the songs. Mari went over and stood by a wall and mimed to the music. Then the employee went out to look for Oda. After about ten minutes they came back together. Oda was calm and sat down by the table and continued her work, and the employee sat by Oda’s side for a while. After a little while more, Mari also came back and sat by the table and started to sort some yarn.

Alternation of roles

Oda and Mari switched roles from workers to care recipients, and the frame of their interaction with the employee changed accordingly. The employee did the necessary repair work with them, which allowed them to reenter the work frame. The main roles at the day center are worker and employee, and the norm is that everyone is there to work. The employees are there to lead the production and supervise the workers, but also to create a good and safe social environment and to provide support and care to those who need it. The aim is to make the work go smoothly, preferably to get the group in a workflow, but the situation with Oda and Mari illustrates that this is not always the case.

‘We cannot be here without adults,’ said Anne one day when the last employee had to leave work early, leaving her and four other workers ‘alone’ for the last 30 minutes of the day. Many workers at the day center saw the employees as managers, bosses and ‘adults,’ even though the day center aims to give the impression that everyone is a colleague and an equal. Another worker said the following about an employee: ‘She is an adult and an employee you know, not a [service] user like me.’ These two statements exemplify how important it is for the workers that the employees provide care and security in addition to being their colleagues. Many workers needed regular confirmation and contact with an employee to participate in work tasks and maintain their role as workers.

For example, one time, a worker named Are was working independently with sawing plates in the carpentry department. Suddenly he stopped. He looked confused and walked around. It looked like he was close to tears. He seemed to no longer be in a worker role. An employee walked over to him, put his arm around his shoulders and said something in his ear. After a short time, Are calmly continued with the work he was doing.

Some workers were independent most of the day while others needed a lot of assistance. The amount of support everyone needed varied. Those who worked a lot got recognition for it, and those who worked less or not at all got recognition for other things. The work and the social ‘flow’ often changed or stopped as soon as the employees left the room. The employees’ presence was important for the workers to participate in social interactions and for production and workflow. We observed that the switch in roles from worker to care-recipient tended to happen if the employees left the room, if there was an argument or conflict between workers, or if something unforeseen happened. One time, both employees in a department went into the breakroom to talk and left eight workers alone for a while. When the employees left, the mood in the room changed; some workers laughed and gestured, and one began to tickle two of the others. At the other end of the room, two workers began to dance instead of doing work. The employees saw what was happening but waited a while before coming back. When they did, the workers stopped tickling each other and started working again. One employee said loudly, but not strictly, ‘Hey! Stop dancing and start working’ to those who were dancing, and then everyone started working again.

Repair work

Repair work was done in different ways, depending on the situation and on what kind of support and care the individual worker needed. Some workers also did repair work for themselves or for each other. Repair work could be comfort, physical contact, words of encouragement, some time for oneself, mediation, a conversation, or other things. It could also be to overlook unacceptable behavior, praise something more than necessary, smooth over a situation, or make someone feel better.

In the example of Oda and Mari, the repair work consisted of providing Oda with comfort and care and giving Mari time to herself with another activity. They needed different support to reenter the work role, and the employee provided this for them. In the case of Are from the carpentry department, physical contact and supportive words from an employee helped him resume his role as a worker.

Our empirical material shows that the employees’ body language and tone of voice changed when the frame did. In the worker/employee role set they talked to the workers in the same way and tone as they did to each other, as equals. In the care recipient/caregiver role set, they often spoke with softer voices like one might use to speak to a minor or someone in need of care.

One day, two workers, Stine and Catrine, were sitting and working calmly side by side on their computers. Suddenly, they started to argue about something, and Stine left the room crying angrily. An employee went after her. Both came back after a few minutes and the employee helped Stine to sit at another table and do other tasks for a while. In an interview sometime later, Stine explained: ‘Sometimes an employee must separate me and her, if it is a catfight, as it’s called. So, then an employee must sit between us sometimes. Sometimes I get along with someone, and then suddenly there’s a struggle. It’s a battle for space. Or rank.’ Stine later told the first writer in an interview that she thinks that there are too few employees at the day care center, and that if it were up to her, she would want an employee to sit next to her all day.

John, another worker, said in an interview, ‘Not everyone understands that they must not be too hard on me, but they do the best they can. Sometimes it gets too hard and then I cringe. Then I get inside myself like a ball, and then I cannot unwind from that ball by myself.’ If he is talked to in a way he finds ‘too hard,’ everything becomes difficult, and he needs time and peace. John explained in an interview that he knows how much time he needs to recover but needs help, and that one employee in particular is good at helping him.

Not all repair work required an employee. The workers could also support each other. Anne and Per were sitting next to each other and working when the researcher asked them about a clock that was placed between them, which they used to know when it was time for a break. Anne said: ‘I cannot understand this kind of digital clock and it’s a bit embarrassing.’ ‘It doesn’t matter,’ Per replied, ‘because I help you with that. You understand analog clocks, and many other things!’

Discussion

We found that the two main role sets that apply at the day center are worker/employee and care recipient/caregiver. Each set of roles had a frame of interaction that all participants are aware of. ‘Work’ can be seen as a frame, in Goffman’s sense, of something that defines what is going on, or ought to go on, in each situation (Aakvaag 2008; Goffman 1974). Work is the primary and preferred frame in the activities at the day center. It is clear from both the way they are set up and the quality and size of the equipment and machinery in them that the rooms are for production. Goffman (1992) would call this ‘scenery,’ and it signals ‘work.’ In line with normalization theory, day centers seek to resemble valued parallels as much as possible (Tøssebro et al. 2019). Like most day centers in Norway, this center does so with its scenery. The frame of work is characterized by predictability and stability. Everyone knows what to do and what their work tasks are. The more predictability, the better, as this allows both workers and employees to participate, maintain a workflow, and keep up production. We observed, however, that it was the employees, and not the equipment or scenery, who were the most important factor in maintaining the work frame. Their presence was, itself, a form of facilitation for participation, and they kept everyone in their work roles. One could say that the employees were directors of what unfolded at the day center, steering and controlling the dramaturgical development in the situations that arose (Goffman 1992).

The other frame of interaction belongs to the care recipient/caregiver role set. This secondary frame, which we call the care frame, is not about work but about receiving or giving different kinds of support and care. Within this frame, ordinary work norms do not apply. The care frame is characterized by spontaneity and flexibility: situations must be resolved then and there. There tends to be less equality between workers and employees within this frame because one needs help from the other. Others have written about how a similar role set, namely the adult/child role set, can be difficult to get out of (Olsen 2009). But the possibility to switch to a care recipient role can also be something that makes the day center a safe place for the workers. The workers need the care and support provided in the care frame to be able to switch back to the work frame, which underlines the importance of the employees’ role as care providers. The care frame, which is perhaps unique to the day center, is an important facilitator of participation; repair work within the care frame is what makes it possible reenter the work frame.

Researchers examining worker roles in a day center found that the context made it possible for workers with intellectual disabilities to participate on their own terms and experience purpose and meaning (Engeset, Söderström, and Vik 2015). This is consistent with our findings related to roles. We will further argue that the possibility to alternate between roles and frames is important for the workers to be able to participate and experience recognition, in addition to mastering work tasks. Day centers aim to provide workers with a safe and satisfactory workplace while maintaining production. Employees must find a balance between running a workplace, where work norms rule, and creating a safe and supportive place to be, where care and recognition are provided. Day center employees not only lead work but also deal with the challenging behavior of some of the workers (Hegdal and Thorsen 2007). The center in our study appeared to attempt to take care of both role sets by hiring employees with a health and social educational background in addition to craftsmen.

Work roles are developed in the context of a workplace (Engeset, Söderström, and Vik 2015). It is likely that the roles at the day center are a distinctive product of that sheltered context, and although they might not be transferrable to other arenas, the roles have value and function there. However, the roles, especially the roles of care recipient/caregiver, might be so different from roles elsewhere in society that the workers will never be able to qualify for other types of work.

There were various reasons why workers broke frame and switched to a different role. When it happened because they were struggling to master something or got upset, they got comfort and care, but when it happened because they wanted to switch roles, they got a break from the demands of the worker role. The example from the carpentry department, where the workers started to dance and play when the employees left the room, shows how this balance is practiced. The employees gave the workers a break, but when they came back and asked them to go back to work everyone re-entered the work frame. Some workers seemed to break the work frame more easily than others. And they could; there were no sanctions. To be exposed as misrepresenting a role can be humiliating and lead to a person losing their reputation for good (Goffman 1992). At the day center, participants alternated between roles without any social consequences and without losing status or recognition as workers. Had someone in an ordinary workplace behaved like Mari, this would have been ‘breaking frame’ (Goffman 1974: 345) and would have disrupted the whole setting. Instead of breaking frame and being sanctioned for doing so, the participants at the day center just switched to the more flexible frame of care. The employees managed to pick up on these cues and change the frame (Goffman 1974). We observed that the employees were flexible and quick to change frames when necessary. It appeared that neither Oda nor anyone else saw the way Mari was behaving as inappropriate. This is probably because they were all familiar with both frames and knew that ‘everything is allowed’ within the frame of care.

The workers acted strategically in many situations. The example of John taking time to himself illustrates how he does his own repair work and decides for himself and is respected for that. It seemed that some workers took on the support role for each other by adopting a different frame, in line with how Honneth (2007) describes people of the same social status giving recognition to each other. This is probably learned from their own experience with the employees’ way of acting and a sign of socialization to a lifeworld with a richer variety of schemata and understanding of frames.

Our analysis showed that much of the repair work at the day center was characterized by deference and demeanor. These concepts refer to how a person seeks to safeguard both their own and other’s dignity in interactions and are thus a part of impression management (Aakvaag 2008; Goffman 1956). Both can be exercised in different ways in symmetrical and asymmetrical relations (Goffman 1956). At the day center, the employees did repair work by ignoring inappropriate behavior, smoothing over situations that could have damaged someone’s reputation, comforting workers, and mediating in conflicts.

According to Goffman (1956, 1992), all interactions involve rituals of deference and demeanor, including interactions between employees in ordinary working life. The difference is that at the day center, the balance between participants in these rituals is often skewed. The employees exercised a disproportionate amount of deference in interactions with the workers, especially within the care frame. On the other hand, deference and demeanor were more evenly balanced in the work frame. Many workers had more control over their appearance within the work frame than within the care frame. We saw examples of employees making a big deal out of it if they themselves had made a mistake, probably to give workers an opportunity to do repair work in the form of deference for the employees, thereby equalizing the social balance between them. This could be perceived as artificial, but it seemed to have little significance for the workers. This might be because many workers are used to receiving help and being inferior. The employees’ exercise of deference and demeanor in their interactions with the workers could be seen as what Goffman (1992) would describe as false play. However, we interpret this as an expression of their desire to help the workers participate, master tasks, and experience recognition. Goffman writes that false play, or misleading behavior, can occur when interacting with others or when performing a role, and that the intent behind false play can be both good and bad (Goffman 1992). The day center employees engage in false play with good intentions, and we understand their practice of deference and demeanor as preventive repair work within the work frame, as repair work within the care frame, and as recognition of the workers as both proper workers and receivers of care. It is nevertheless the case that the repair work carried out at the day center is unlikely to occur in other arenas in society, which probably makes it easier for workers to take on respectable roles there than elsewhere. The premise of impression management is different in day center context.

Another relevant concept from Goffman (1992) is personal facade, which can be divided into external and internal features based on what kind of information stimuli are conveyed in what he calls appearance and manner. Appearance is what is visible about a person, and manner is how one behaves and speaks. Like demeanor, personal facade is also a part of impression management. We can only control parts of our personal facade (Goffman 1992: 29), and many people with intellectual disabilities can experience their diagnosis as a barrier that affects the impression they give others of themselves. They may experience feeling trapped by society’s view of them as disabled (Berger and Luckmann 1966: 166).

Conclusion

The most important facilitators for participation at the day center are how the employees make role alternation possible by customizing the frames of interaction and how they do repair work during and after situations. We all need some kind of facilitation to participate in working life. What distinguishes day centers from other arenas of work is the amount of facilitation and support workers with intellectual disabilities need compared to others. The day center is a place for work, but not just work. The day center observed in this study manages to create a place whose character is ambiguous and that is experienced as both a workplace and as a safe place where support and care are provided. Although day centers are not defined as workplaces according to legislation, service users do work-like activities there and refer to it as work.

The workers, like others, have internalized the socially constructed values of work, and they want to meet society’s expectations. Our empirical material suggests that day centers can give these individuals the experience of work they desire. Because most people with intellectual disabilities are not included in ordinary work, day centers stand out as important arenas for recognition through work. Our findings emphasize the importance of the presence of employees for people with intellectual disabilities at day centers as a basis for participation and for experiencing the other social benefits of work.

Day centers can be an arena where workers can participate and use their resources to perform work tasks they experience as meaningful and which they can compare to other forms of work they know of. At the same time, in a certain sense, the roles the employees perform could be considered as an example of what Goffman (1992) calls false play. The workers will not receive this kind of facilitation anywhere else. One can therefore ask whether it has only good consequences for the workers. It is possible that the special features of the day center lead workers to stay there and thus not develop social skills they could learn if they were included in an ordinary workplace. In other words, this well-intentioned social facilitation ends up holding them back and keeping them sheltered from society. A possible consequence if the frame of care becomes too dominant is that workers with intellectual disabilities will continue to be considered vulnerable and we will continue to shelter and protect them.

We would nevertheless argue that day centers can provide recognition to people with intellectual disabilities through participation in the sense advocated and theorized by Honneth (2007), and that this has value despite the sheltered context. Day centers can provide work experience for a people who need a lot of facilitation to participate, including the possibility of switching between roles. Knowledge of how to facilitate participation for people with intellectual disabilities at day centers may contribute to making these spaces, which are the only workplaces available to many of them, as meaningful as possible. We thus argue that this day center is also a place for work.

Funding Information

Funded by USN (University of South-Eastern Norway). The article is part of an ongoing PhD.

Competing Interests

The authors have no competing interests to declare.

DOI: https://doi.org/10.16993/sjdr.986 | Journal eISSN: 1745-3011
Language: English
Page range: 229 - 240
Submitted on: Nov 29, 2022
Accepted on: Jun 29, 2023
Published on: Jul 26, 2023
In partnership with: Paradigm Publishing Services

© 2023 Lise Ellingsen Langemyhr, Hans Einar Hem, Heidi Haukelien, published by Stockholm University Press
This work is licensed under the Creative Commons Attribution 4.0 License.