Weak relational ties and ineffective communication in vocational rehabilitation: a case study of people on long-term sick leave with common mental disorders.

PURPOSE: To explore how collaborative challenges are experienced and navigated among vocational rehabilitation professionals, including case workers (CWs) and general practitioners (GPs), and citizens on long-term sick leave due to common mental disorders. METHODS: A qualitative case study in two Danish municipalities, including semi-structured interviews with seven citizens and seven GPs, and six focus group interviews with 31 CWs. Data were analysed inductively using systematic text condensation followed by abductive interpretation informed by relational coordination theory. RESULTS: Collaborative challenges among citizens, CWs, and GPs stemmed from weak relational ties and were reinforced by counterproductive communication. Lack of shared goals turned collaboration into a competition over the agenda, perpetuated by campaigning communication aimed at persuading others of one's perspectives. Lack of shared knowledge made collaboration feel laborious, exacerbated by clarifying communication aimed at reducing ambiguity. Lack of mutual trust and respect contributed to perceiving collaborators as adversaries, sustained by self-protective communication strategies aimed at shielding oneself from criticism. CONCLUSION: Collaborative challenges in vocational rehabilitation can be understood as self-reinforcing cycles of weak relational ties, negative collaborative experiences, and counterproductive communication. Strengthening relational coordination may improve collaboration for people on long-term sick leave due to common mental disorders.