Increasing work participation for people with work disabilities: towards evidence based welfare-to-work services

The primary aim of this thesis was to study how the effectiveness of welfare-to-work (WTW) services that municipalities provide for people with work disabilities can be increased, and how the professional expertise of WTW professionals can be enhanced. The ultimate goal is to increase the sustainable work participation of people with work disabilities. This was achieved by assessing the experiences and needs of individuals receiving these services, evaluating whether Individual Placement and Support (IPS) and Participatory Workplace Intervention (PWI) are effective in municipal practice and why (not), and identifying areas for improving their implementation. The studies presented in this thesis do not provide evidence that implementing IPS and/or PWI in municipal practice will enhance WTW services for people with work disabilities in terms of reducing the time until starting sustainable paid employment. Even though statistically significant effects were not found for the primary outcome, the statistically significant effect on a broader secondary outcome – i.e. days until starting any paid employment, a trial placement, or regular education – along with the high satisfaction expressed among professionals, suggest that IPS might be a promising intervention for this target group. However, if IPS is to be implemented further in the municipal setting, practical guidelines should be developed on how to integrate employment services and healthcare services. Certain elements of PWI, especially the three-way conversation, were considered valuable by job coaches and could therefore be incorporated to improve welfare-to-work services. However, more research is needed to determine the best way to implement this in practice. Finally, further research is required to assess whether combining these elements of IPS and PWI leads to improved employment outcomes.