“A Balancing Act”: Practitioners’ Experiences from a Supported Employment Program in Germany

Abstract Supported Employment (SE) is a client-centered intervention that supports people with mental illnesses to participate in competitive employment. The aim of this study was to gain deeper insight into SE practitioners’ experiences with implementing a SE intervention based on the Individual Placement and Support principles in a German setting. A qualitative descriptive study was conducted. The shared experiences of SE practitioners were explored through a focus group interview with practitioners from a SE program in the German city of Bielefeld (population approx. 330,000). Data analysis of the focus group transcript was guided by a phenomenological methodology following the steps of Colaizzi’s method. Four main themes were identified that all described different balancing acts for the practitioners when implementing SE: “I first have to learn with my participant where the pressure begins”: balancing encouragement and pressure; “That there is someone who listens to these things”: balancing support and setting boundaries; “I am available if you wish”: in between employer contact and non-disclosure; “Struggle through the system”: in between individual needs and external barriers. It seemed crucial for SE practitioners to build strong working alliances with their clients. In addition, while focusing on individualized coaching and clients’ preferences, the practitioners experienced barriers by the German care and welfare system. Defining and balancing their unique and multifaceted roles that characterize SE can be challenging within a new implementation project across similar welfare systems. The data used for this study were collected as part of a clinical trial called “IPS-ZIB” which was prospectively registered with the German register for clinical trials on 12/14/2020 (DRKS; ID: DRKS00023521).