Figure 1
Initial organisation of care managers (CM), employment consultants (EC), and supervisors in two IBBIS teams.
Table 1
Barriers to normative integration among professionals, types of coping processes, and their implications (care managers: CM; employment consultants: ECs).
| Barriers | Coping strategies | Types of strategies | Possible implications | |
|---|---|---|---|---|
| Shared culture | Positioning and unsettled power balance between CMs and ECs | Informal hierarchy in which ECs have more power and control due to their legislative mandate | Macro-level influence through legislation | Overly unbalanced relationships might jeopardise engagement |
| ECs and CMs accepted to share control in some aspects | Meso-level negotiation | Informal power balance up for negotiation | ||
| High number of intersectoral relationships and part-time positions | Development of smaller intersectoral teams | Organisational change | Vulnerability (personal chemistry, staff turnover, holiday) in very small teams | |
| Working relationships established through shared experiences with each professional | Person-based collaboration | Time-consuming process | ||
| Shared norms | Diverging terminology for the person on sick leave | Management decision in favour of Jobcenter terminology | Top-down (confirmed by revised manual) | Acceptance by IBBIS professionals |
| Norms for supervision | Management decision to comply with mental health care approach to supervision, prompted by demands from CMs and ECs | Bottom-up | Acceptance and satisfaction among professionals | |
| Norms for professional approach during roundtable meetings | Negotiated with each professional | Meso-level negotiation | Perceived unpredictability between professionals | |
| Shared goals | Diverging professional, organisational, and project goals | Clear hierarchy between professional goals (documented in the revised manual) | Top-down (confirmed by the revised manual) | CMs are expected to be rather flexible Overly unbalanced relationship might jeopardise engagement |
| Paradigmatic shift in mindset among health care professionals facilitated by supervision |