Fadyl Joanna, McPherson Kathryn, Nicholls David
Centre for Person-Centred Research, Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand.
School of Rehabilitation and Occupation Studies, Auckland University of Technology, New Zealand.
Sociol Health Illn. 2015 May;37(4):506-21. doi: 10.1111/1467-9566.12212. Epub 2015 Jan 7.
Vocational rehabilitation for people experiencing work disability is a social practice often situated within health services, but the social and political drivers and effects of this practice are rarely critically analysed in health research or policy. In this study we used a Foucauldian theoretical perspective to analyse the ways in which current vocational rehabilitation practices in New Zealand re/produce notions of worker and employee 'value', and how different approaches to vocational rehabilitation deploy current discourses about value. We also consider the subject positions produced through these different approaches and the identities and actions they make possible for people experiencing work disability. The analysis showed that notions about the importance of worker and employee value in a job market are pervasive in vocational rehabilitation, and reflect wider societal discourses. However, the deployment of those discourses in different approaches to vocational rehabilitation practice are diverse, producing different opportunities and constraints for people experiencing disability. We argue that an examination of these various opportunities and constraints at the level of practice approaches is important, as considerable time and resources are allocated to developing solutions to help those who do not thrive in the current systems, yet we rarely critique the premises on which the systems are based.
为有工作残疾的人提供职业康复是一种常处于健康服务范畴内的社会实践，但这种实践的社会和政治驱动因素及影响在健康研究或政策中很少受到批判性分析。在本研究中，我们运用福柯式理论视角来分析新西兰当前的职业康复实践如何重新/产生工人和雇员“价值”的观念，以及职业康复的不同方法如何运用当前关于价值的话语。我们还考量了通过这些不同方法产生的主体位置以及它们为有工作残疾的人所造就的身份和行动可能性。分析表明，关于工人和雇员价值在就业市场中的重要性的观念在职业康复中普遍存在，并反映了更广泛的社会话语。然而，这些话语在职业康复实践的不同方法中的运用是多样的，给有残疾的人带来了不同的机会和限制。我们认为，在实践方法层面审视这些不同的机会和限制很重要，因为大量的时间和资源被用于开发解决方案以帮助那些在当前体系中难以发展的人，但我们很少批判这些体系所基于的前提。
