title: The 'empowered client' in vocational rehabilitation: the excluding impact of inclusive strategies.
abstract: In vocational rehabilitation, empowerment is understood as the notion that people should make an active, autonomous choice to find their way back to the labour process. Following this line of reasoning, the concept of empowerment implicitly points to a specific kind of activation strategy, namely labour participation. This activation approach has received criticism for being paternalistic, disciplining and having a one-sided orientation on labour participation. Although we share this theoretical criticism, we want to go beyond it by paying attention to the practical consequences of understanding empowerment as an activation strategy. Inspired by the field of Science and Technology Studies, we will explore the meaning of empowerment and activation in concrete practices of vocational rehabilitation in the Netherlands. Our analysis is based on the narratives of people with a work disability about their lives and the vocational rehabilitation programmes they participated in. We present five illustrative cases that how empowerment is 'done' in the practice of vocational rehabilitation and its unintended effects. Our analysis demonstrates that activation strategies seem to be caught in a paradox: instead of including people in society, they have excluding consequences. Vocational rehabilitation professionals can go beyond this paradox by learning from the ways in which empowerment is 'done' by clients in vocational rehabilitation programmes.
authors.affiliation: Research School CAPHRI, Department of Health Ethics and Society, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. Lineke.vanHal@maastrichtuniversity.nl
authors.forename: Lineke B E
authors.initials: LB
authors.lastname: van Hal
authors.forename: Agnes
authors.initials: A
authors.lastname: Meershoek
authors.forename: Frans
authors.initials: F
authors.lastname: Nijhuis
authors.forename: Klasien
authors.initials: K
authors.lastname: Horstman
mesh_terms: D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D011209:Power, Psychological; D036301:Qualitative Research; D012050:Rehabilitation, Vocational