Establishing Individual Care Plans for Rehabilitation Patients: Traces of Self-Targeting in the Norwegian Universal Welfare State

Abstract

Reflecting an international trend of collaborative governance, several countries have introduced planning devices for cross-sectoral service coordination for complicated and long-lasting individual cases. This article examines one such device, the individual care plan (ICP) that was introduced in 2001 in Norway. Despite strong national-political imperatives, the ICP remains significantly underused. To understand why, this article examines the experiences with ICP among the staff working in municipal coordinating units of rehabilitation, and caseworkers in the local labour and welfare services. In focus groups, they discuss a vignette concerning a patient with traumatic brain injury. They laud the ICP for providing momentum to the physical and vocational rehabilitation. Yet, they acknowledge that it is too rarely applied. Through abductive-retroductive recontextualisation, the article identifies a practice of de facto self-targeting; physically and mentally incapacitated patients are themselves to request an ICP. We argue that this mechanism may emerge from propensities of the rehabilitation programme and, eventually from an ambiguity in the Norwegian welfare model balancing universalism and local autonomy.

Keywords

• Critical realism
• Individual Care Plan
• Rehabilitation
• Social services
• Service Universalism