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Introducing motivational interviewing in a sickness insurance context: Translation and implementation challenges
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, HELIX Competence Centre.ORCID iD: 0000-0003-3310-0895
Linköping University, Department of Behavioural Sciences and Learning, Work and Working Life. Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Competence Centre.ORCID iD: 0000-0002-2486-2663
2017 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688Article in journal (Refereed) Epub ahead of print
Abstract [en]

Motivational interviewing (MI) is a conversational method to support clients in need of behavioral change. In an organizational reform, most Swedish sickness insurance officials were trained in MI to promote clients’ return to work (RTW) after sick leave. The aim of this article is to investigate experiences of introducing MI as a tool to promote clients’ RTW within a sickness insurance context, with a special focus on the translation and implementation of the method. Methods A qualitative approach, comprising 69 interviews with officials, managers, and regional coordinators on two occasions. The material was analyzed through qualitative content analysis. Results Officials were positive about MI, but the application was limited to using certain tools with extensive individual variation. Officials struggled with translating MI into a sickness insurance context, where the implementation strategy largely failed to o er adequate support, due to low managerial priority, competing initiatives, and a high workload. Results of the educational intervention could therefore be seen on an individual but not an organizational level. Conclusions In order to translate MI into a sickness insurance context, training needs to be supported by organizational approaches that promote collective learning and sharing of experiences among officials. The results also illustrate how a method cannot be assumed to be implemented simply because training has been provided. Consequently, the application of the method needs to be carefully monitored in studies of interventions where MI is claimed to be used, in order to measure its effectiveness. 

Place, publisher, year, edition, pages
Dordrecht: Springer, 2017.
Keyword [en]
motivational interviewing, return to work, rehabilitation, social security, insurance, disability
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Other Medical Sciences not elsewhere specified
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URN: urn:nbn:se:liu:diva-142909DOI: 10.1007/s10926-017-9731-0OAI: oai:DiVA.org:liu-142909DiVA, id: diva2:1155882
Available from: 2017-11-09 Created: 2017-11-09 Last updated: 2018-04-17

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Ståhl, ChristianGustavsson, Maria
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Division of Community MedicineFaculty of Medicine and Health SciencesHELIX Competence CentreWork and Working LifeEducation and SociologyFaculty of Arts and Sciences
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