The Critical Role of Case Managers in the Vocational Rehabilitation Process: Areas of Tensions and Challenges

Case management is a client-centred approach that plays a central role in transitioning to vocational rehabilitation, particularly for individuals with complex needs. It has become a critical intervention for helping individuals navigate the pathways to employment, especially for those facing significant barriers: disabilities, long-term unemployment, or chronic illnesses. The primary goal of case managers is to support insured individuals in integrating the knowledge and experiences gained during rehabilitation into their everyday lives, thereby fostering a sustainable return to working life. This support includes guiding them from inpatient or full-time outpatient care to their regular work environment (DRV Bund, 2023).

In vocational rehabilitation, case managers play a central role in identifying the individual’s vocational goals, assessing their functional capacities and barriers, developing a personalized intervention plan, and coordinating services across various health, social, and employment systems. Accordingly, case managers often operate in a field of tension between pedagogical-therapeutic expectations and their frequently non-pedagogical or therapeutic training.

The effectiveness of case management is often limited by systemic challenges, resource constraints, and external socio-economic factors, which are contradictory to a practical and individual case management approach, or the fact that effective case management requires seamless coordination across various systems – healthcare, social services, and employment agencies – which can be a significant challenge, especially for case managers. A concerted effort is needed to enhance intersectoral collaboration, increase resources, and address systemic barriers that impede vocational rehabilitation to maximize its potential. Moreover, empowering clients to take an active role in their vocational rehabilitation is essential for fostering long-term success in employment. This presentation examines how case managers deal with the limitations and challenges of case management in vocational rehabilitation. Using the Grounded Theory Methodology (Strauss & Corbin, 2010), expert interviews with case managers are analysed to highlight professionals' strategies to deal with these tensions.