OTQualitativeWork (Reading, Mass.)2025

Implementing Supported Employment in the Norwegian Labor and Welfare Administration - Experiences from employment specialists and critical implementation issues.

Walter Schönfelder, Cathrine Arntzen, Thomas Johansen

PMID 39973710

WHAT IT FOUND

Employment specialists delivering supported employment in Norway experienced severe burnout and near-total turnover within 18 months.

Isolation, unpredictable high workloads, and strict efficiency monitoring were cited as the primary drivers of this collapse in team stability.

Key findings

01Six months after the study ended, only one of the first-generation employment specialists remained in each team, indicating almost complete turnover.

02Specialists reported losing team identity and feeling lonely because the role requires spending significant time in the field rather than the office.

03Workload was perceived as continuously exceeding limits, with specialists describing a permanent feeling of never having enough time and an unpredictable schedule.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The study was conducted in a specific Norwegian context, so the findings may not transfer to other national systems or healthcare structures. As a qualitative study with a small sample (two teams), the results cannot be generalized on a purely empirical basis. The researchers were actively involved in the process, which may have influenced the participants' reflections and the data collected.

Declared interests

The study was financed by The Norwegian Labour and Welfare Services (NAV), the organization where the employment specialists worked. The authors declared no potential conflicts of interest.

The easy way to misread this

Do not interpret the high turnover as a failure of the supported employment methodology itself. The paper attributes the burnout to the specific organizational conditions in the Norwegian Labour and Welfare Administration, such as isolation and efficiency monitoring, rather than the clinical approach.

Read it on PubMed →