Department of Health Ethics and Society, Research School CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Disabil Rehabil. 2013 May;35(10):809-18. doi: 10.3109/09638288.2012.709303. Epub 2012 Aug 20.
This study aims at a sociological understanding of the concept of (un)motivation in order to provide clues for improving vocational rehabilitation (VR) support.
(Un)motivation is understood as the product of the interaction between clients and professionals in an institutional context. To gain better understanding of this construction of (un)motivation, in depth-interviews are held with 14 VR professionals. Based on the stories professionals told about their professional practices, we analysed the ways in which they guide their clients during their VR path within the institutional context of the Dutch welfare state.
"The unmotivated client" is a judgment that arises in the interaction between professional and client if the institutional goals of VR are not achieved. Two work methods are distinguished in which this judgment takes shapes in various ways, namely "Professional as a Signpost" and "Professional as a Personal Guide".
Professionals work in a dichotomous public accountability framework with a strong focus on labour participation. This causes professionals to look for ways out of VR paths in which labour participation is not achieved. The construction of "the unmotivated client" is such a way out. An alternative way out is to explicitly value clients' (intermediary) achievements.
• In vocational rehabilitation (VR) there exists the risk that a perceived lack of motivation is only considered a personal problem in stead of a social issue. • Reconsideration of the public accountability framework of VR may lead to more inclusive VR support in which a differentiated concept of participation is valued. • Lessons can be drawn from the articulation of achievements made in VR paths that are now considered unsuccessful. • For more inclusive VR support, the specific situation and situated needs of clients need to be taken as a starting point instead of a primary focus on the final goal of labour participation.
本研究旨在从社会学角度理解（缺乏）动机这一概念，以期为改善职业康复（VR）支持提供线索。
（缺乏）动机被理解为客户和专业人员在制度背景下相互作用的产物。为了更好地理解这种（缺乏）动机的构建，我们对 14 名 VR 专业人员进行了深入访谈。基于专业人员讲述的关于他们专业实践的故事，我们分析了他们在荷兰福利国家的制度背景下指导客户进行 VR 路径的方式。
如果 VR 的制度目标没有实现，“缺乏动机的客户”这一判断就会出现在专业人员和客户的互动中。我们区分了两种工作方法，即“专业人员作为指路牌”和“专业人员作为个人指导”，这两种方法以不同的方式塑造了这种判断。
专业人员在注重劳动参与的二元公共问责制框架内工作。这导致专业人员寻找出路，以摆脱那些无法实现劳动参与的 VR 路径。“缺乏动机的客户”的构建就是这样一种出路。另一种出路是明确重视客户（中介）的成就。
在职业康复（VR）中，存在一种风险，即认为缺乏动机仅仅是个人问题，而不是社会问题。
重新考虑 VR 的公共问责框架可能会导致更具包容性的 VR 支持，其中更重视参与的差异化概念。
可以从被认为不成功的 VR 路径中所取得的成就的表达中吸取教训。
为了更具包容性的 VR 支持，需要以客户的具体情况和特定需求为出发点，而不是主要关注劳动参与的最终目标。
