Supported employment coaches’ difficulties and facilitators with clients diagnosed with personality versus other disorders: A qualitative study

Abstract

Aim: People with severe mental illnesses (SMI) face different occupational challenges than those diagnosed with personality disorders (PD). Supported employment (SE) has been validated for SMI patients but its effectiveness for individuals with PD remains unclear, and the reasons for this potential difference have not been explored. This study aimed to identify differences in SE practice for clients with SMI and those with PD. Methods: Six SE job coaches were interviewed about their experiences. A thematic analysis was run. Results: More difficulties and facilitators were mentioned regarding clients with PD than regarding clients with other SMI. For both, patients’ symptoms were reported to negatively affect their (re)integration into the job market. However, in contrast to that of clients with SMI, the relation between symptoms and SE success for clients with PD involved difficult behaviors and their negative impact on the therapeutic relationship. Conclusion: In summary, SE practice seems to be undermined by PD and could benefit from adaptations, such as specific training for SE teams to help them in managing clients with this disorder.

Keywords

• Supported employment
• Personality disorders
• Mental disorders
• Vocational rehabilitation