"Because you just get stuck in this hamster wheel" - experience and narratives of work-family conflicts among patients in psychosomatic rehabilitation.

BACKGROUND: Workplace problems are among the most common reasons for entering psychosomatic rehabilitation (PR). Parents with mental disorders (MD) often face additional caregiving demands alongside combined work and family responsibilities. However, this issue has received little attention in rehabilitation research so far. This so-called Work-Family Conflict (WFC) is associated with depression, anxiety, and other mental health conditions, yet little is known about how patients with MD experience and interpret these conflicts. METHODS: We conducted a secondary qualitative analysis of 32 semi-structured interviews with parents with MD undergoing inpatient PR in Germany. Using a typifying content analysis approach, we combined deductive and inductive category formation to examine recurring ways in which these patients experienced and internally processed WFC. In addition, we developed narrative case summaries to explore how participants link work-related stress, family demands, and their MD to the decision to seek rehabilitation. RESULTS: We identified eight empirically derived intrapersonal manifestations of WFC, e.g. Self-Sacrifice, Invisible Loneliness, and Threat to Self-Identity. These manifestations offer an experiential perspective on WFC, capturing recurring patterns of thoughts, emotions, and behaviors. In addition, 13 distinct narrative scenarios emerged, illustrating the diverse explanatory relationships participants constructed between work-related stress, family demands, MD, and their need for rehabilitation. While several patterns overlapped with symptoms of depression or burnout, patients framed them as distinct experiences that captured their everyday struggles with balancing roles. CONCLUSIONS: WFCs represent a clinically relevant dimension of psychosocial burden in parents with MD undergoing PR. Explicitly addressing WFC in clinical assessment and treatment may improve case formulations, validate patients' lived experiences, and inform individualized rehabilitation strategies. Recognizing WFC as a distinct source of distress may therefore enhance patient-centered psychosomatic care. Future longitudinal research may clarify how WFC relates to rehabilitation outcomes such as symptom reduction, return to work, and quality of life.