[Shaping Transitions: Access and Pathways in Vocational Rehabilitation]

Transition from medical to vocational rehabilitation not only mark the change from one institution or programme to the next, but are also biographically significant and vulnerable phases for the rehabilitants. The organisation of this transition is therefore of great importance. The present study analyses transitions from medical to vocational rehabilitation from the perspective of four research projects. The article addresses key hurdles, control mechanisms and subjective experiences in the transition process.

The data basis comprises qualitative interviews, focus groups, document analyses, as well as standardised and open questionnaire surveys in various vocational rehabilitation institutions (BFW and BTZ) and medical rehabilitation institutions. The evaluation was conducted using a combination of qualitative content analysis (Kuckartz, Mayring), grounded theory (Glaser & Strauss), and descriptive statistical methods.

The results can be grouped into four thematic focus areas that chronologically describe the transition process: 1) the path to vocational rehabilitation, 2) information and support for vocational rehabilitation, 3) access to and referral to vocational rehabilitation, and 4) the start of and arrival in vocational rehabilitation. It became evident that the transitions were characterized by institutional fragmentation, information deficits and unclear responsibilities. It was often the case that individuals seeking vocational rehabilitation services did so on an opportunistic basis, or through their own personal initiative. The coordination of counselling services was suboptimal, and the formal referral processes appeared to lack transparency and were sometimes arbitrary. Vulnerable groups, such as those grappling with addictions or other mental health problems, were particularly susceptible to the impact of these barriers. However, there were documented instances of successful transitions, particularly when early, continuous counselling was provided, and individual circumstances were given due consideration.

Successful transition management requires clear responsibilities, standards for counselling and referral, and better integration of medical and vocational rehabilitation. It is crucial to integrate institutional routines within the rehabilitants' biographies.