Activating welfare recipients with health complaints: Reasons for failure of a cognitive training programme

Activating welfare recipients with health complaints: Reasons for failure of a cognitive training programme In western welfare states, a trend towards activation has led to the development of interventions aimed at welfare recipients with health complaints. Forms of coercion are increasingly applied within this activation policy. An example of this approach is the Dutch project Healthy to Work (HtW) which developed and evaluated an intervention combining an exercise program with cognitive training. Although HtW had been selected as an example of good practice, a randomized clinical trial did not show beneficial effects. This cognitive training programme based on rational-emotive therapy has not been studied separately as yet. Therefore, an in-depth qualitative study was conducted to examine reasons for failure. A purposive sample of six trainers were interviewed. The results indicated that trainers encountered problems with the heterogeneity of participants and different problems, expectations and labour market obstructions than expected beforehand. The mandatory nature of HtW had a negative effect on motivation of both participants and trainers. The discussion questions the assumption that coping style and cognitions of welfare recipients with health problems are the main obstacles to finding work, and the policy to ignore physical limitations of participants. We suggest that in this complex area of practice, improvement can be achieved by allowing trainers to adapt and learn during the process, while also reflecting on normative aspects, and by taking perspectives of welfare recipients themselves into account. Het activeren van uitkeringsgerechtigden met gezondheidsklachten: Oorzaken voor het falen van een cognitief trainingsprogramma Een groeiende nadruk op de activering van uitkeringsgerechtigden heeft in veel Westerse verzorgingsstaten geleid tot de ontwikkeling van interventies die gericht zijn op uitkeringsgerechtigden met gezondheidsklachten. Vormen van dwang, zoals verplichte participatie, worden meer ...