Retrospective review of work transition narratives: Advancing occupational perspectives and strategies

2.1 Review approach and sampling

This review was conceptualized by the first author (one of the column editors for Narratives on Work Transitions) as a basis for synthesizing and bringing to light the valuable contributions learned through lived experiences and their collective contribution to advancement of knowledge about the occupational transitions of work. A retrospective review was conducted of a convenience sample of all of the work transition narratives published in the journal WORK from 2009–2019, N = 14. The review focused on the identification and description of mechanisms people used to move ahead and to make sense of their in-transition experiences. The initial data selection, extraction and summary data were consistent with scoping review stages, 3–5 in the Arksey and O’Malley framework for reviews (Stage 3: data selection criteria, Stage 4: charting the data, Stage 5: collating, summarizing and reporting the results including a descriptive, numerical or word summary and a thematic analysis) [4].

2.2 Data selection and extraction

In this review, Stage 3 of the Arksey and O’Malley framework included data selection of demographic data for describing the sample and included year, place, and type of transition. Specific work transition strategies were informed through the development of a template. The development of the data extraction template was aligned with Stage 4 of the Arksey and O’Malley framework to organize the charting of data (strategies or mechanisms used) to address micro level challenges (individual level challenges) and macro level (social and transactional systems or structural issues policy challenges).

This team intentionally gained a common understanding of occupational transitions through reading articles on work transitions and occupational science [1, 2]. Researchers reflected on the literature of barriers and challenges and identified macro social issues challenges such as lack of people or support networks, macro transactional challenges such as financial, normative expectations, legislation, policy inequities, and micro challenges at the individual level such as, conflicting beliefs, values, worker identity, lack of knowledge, confidence, or skills. These micro and macro categories were used to chart, in excel software, the mechanisms (steps, actions and strategies) that people used to address, navigate or negotiate around these challenges.

To develop consistency in data extraction an inductive approach [5] was used by the researchers to identify what people did or resources they tapped or drew upon that helped them move forward. For instance, people often used strategies to try and make sense of what to do, and when and how to navigate their in-transition experiences of work disruption or change. Team members independently read the narratives and asked “what were the mechanisms that helped people address or make sense of micro or macro level challenges in the in-transition experience?”. This involved reading the narratives to find what people reported they did, the approaches they used and how the steps they took moved them forward. Researchers identified words or phrases to identify define the types of mechanisms as well as extracted examples for use in describing and characterizing aspects of the mechanisms.

2.3 Researchers and credibility strategies

The team of researchers comprised, a senior researcher in work transitions and two Masters of Science (post professional level) students. All researchers had 20 plus years experience as Occupational Therapists in public and private systems in supporting persons through work transitions. This team conducted the review, collation, and analysis of the data. Given that these were accounts of lived experience it was important to support the validity of the synthesis of learnings in this study by the involvement and engagement of one of the authors of the accounts involved in the review [6]. One of the graduate student researchers published a work transition narrative and was involved in all of the steps in the review and publication.

2.4 Analysis and synthesis of charted data

Researchers used Stage 5 of the review framework by Arksey and O’Malley to identify the types of mechanisms used in the narratives. The research team used a dialogic and consensus-based method to discuss the extracted data and agree on all of the types of approaches evident in the narratives. Consensus was achieved through describing the mechanisms and identifying common categories supported by quotes or text from the accounts. Final steps involved rereading the accounts with the types of mechanisms in mind to identify any missed strategies or steps. No new mechanisms were identified. The final mechanisms and descriptions are reported in Table 3. Table 4 provides a summary chart of the mechanisms in each narrative account.

In this review the mechanisms helped people find ways to move forward, take steps, develop confidence, and build awareness of the self and reflect on the situation. These actions also helped build momentum in tackling the macro level constraints and challenges. Table 3 provides the details and definitions of the mechanisms. The first column in Table 3 lists the 7 categories of mechanisms: anchors, catalysts, champions, coming to terms, learning, critical conversations, and critical reflection. Column 2 in Table 3 provides a description of the mechanisms and column 3 provides examples using quotes from the narratives. Table 4 demonstrates the summary of chart of mechanisms that were enacted by people in each narrative.

4.1 Advancing lived experience knowledge of the micro and macro level issues in work transitions

The goals of the Narratives on Work Transitions column were to provide knowledge of lived experience to understand strategies used to support work transitions and for others to tap knowledge that may be relevant to them. Findings across the 14 published papers resulted in the identification of 7 categories of mechanisms. The organization of the mechanisms into categories in Table 3 reveals more explicitly the insights into what people did in the transition experience in relationship to the barriers they faced. Table 4 highlights that within each narrative multiple strategies were used through their in-transition experiences. Drawing on anchors gave people strength to face the many constraints that made it difficult to know where to begin to start the journey. Access to catalysts and champions were essential to the impetus to initiate steps and begin to plan and formulate goals. Coming to terms and letting go are needed to be able to learn about the self. This learning then enabled the establishment of new expectations, helping people to move through transitions. Developing new perspectives about the self as a worker were also used by people and were focused on being a human occupational being in context and developing an awareness of a new lens that of being a worker in context of balancing daily life. While these mechanisms provide potentially useful actions that others may take, they also point to the existence of barriers and challenges that one must navigate or negotiate. The findings reinforced the regular consideration and contemplation of how to deal with the macro level issues and challenges that existed in each person’s context.

These lived experiences point to the need for more critical questioning of what is required for persons who are not able to tap inner strength, and / or draw on past experiences in confronting some macro level challenges. Also, the need to question current contexts and programs where people do not have equitable access to champions or opportunities to continuously learn about the self as a valued occupational human being, or to take a risk to try something new and / or develop new expectations to be a worker. Such inquiry into current program components and mechanisms within the employment and social development systems level or work rehabilitation programming level might reveal opportunities for program enhancements and possible ways to support greater equitable and occupationally focused transition supports.

4.2 Development of informal and formal occupational mindfulness in work transition practice

One of the questions the researchers asked in undertaking this review was ‘how do people make sense of their in-transition experiences’? In identifying mechanisms, people offered insights into overcoming impasses and the things that helped them build toward resumption or engagement in work. Underscoring many of these mechanisms is the cultivation of awareness, not only of how to move through challenges, but of self as a human occupational being that contributes through work. The cultivation of such awareness was an informal process and supported many of the people in viewing themselves as a worker and as well as new ways to become or continue to be a worker and a valued member of society [7]. The concept of occupational mindfulness was noted by Elliot [8] as a process that cultivates awareness that facilitates participation in, engagement in, and alignment with the need for activity. Others have noted that informal and formal processes of occupational mindfulness approaches lend to improved health and wellbeing for people with stress related or other conditions [9, 10]. Specific approaches using occupational mindfulness for those experiencing work loss were not found in the literature.

Researchers of this review posit that occupational mindfulness for persons in work transitions is about generating and facilitating awareness of valuing the self as an occupational human being within the complexity of uncertainty, confines of opposing ideas, altered life and work contexts, altered capacities, and expectations of self by others. In the narratives people tapped into and drew on specific mechanisms and strategies that were part of the processes of generating awareness of what an individual can do to view oneself and become a worker in the fullness of life that is underscored by challenges, such as constraints and uncertainties. Given, that work transitions are not easy, and that the interplay of micro and macro level issues will shape the course of occupational transitions, the following occupational mindfulness (informal and formal) components are offered for consideration for individuals and programs in cultivating awareness to facilitate movement through work transitions:

Foster awareness of the value of self as an occupational human being.

Most of the actions and efforts of the people in the narratives in this review were focused on the goals of resuming work or entering new work. The review of narratives did not reveal strategies that people used to change systemic or structural or attitudinal barriers rather they revealed how people transitioned around the given contextual constraints. Individuals living with uncertainty and instability while in transition were actively trying to meet or confront systems in society that expected them to do things in particular ways as opposed to trying to change society itself. Beyond doing of specific tasks, they used an occupational lens in approaching the situations they encountered by considering who and what they desired through and from work.

Currently, work losses and disruptions continue to exist and thus there remains an ongoing need for people to access strategies and approaches in navigating the daunting path back to work whether it is through changes due to a health condition or unanticipated situations. Research into work transition programs and practices are warranted that can integrate an occupational lens that values workers, supports workers as occupational human beings, and through engagement in occupations where workers can experience health and wellbeing. In addition, occupational mindfulness awareness and the mechanisms gleaned through lived experience may have the potential to support other people who reflect on these mechanisms and enact the ones they can in times of work transition.

4.3 Future research in equitable work transitions

Research on the mechanisms found through this review and the occupational mindfulness awareness strategies that are posited may lend to further identification of the breadth of strategies that may be beneficial to expediting and promoting valued participation into work. Goodman et al. [11] noted that occupational mindfulness has the potential to support more on the ‘how people do’ that enables them to become. Thus, the continued investigation of the strategies that support transitions into work is recommended. For instance, work rehabilitation programs, along with supported employment, and work re-entry programs might also consider the integration of lived experience mechanisms for use by others experiencing work loss or disruptions. In this review only a few transitions were not related to health conditions, thus due to the limitations in the types of work transitions offered in these narratives, further research into transitions due to natural disasters such as fires or life course transitions, such as youth experiencing or living with disabilities or disadvantages, persons experiencing resettlement and / or bridging programs into work in new countries may yield more nuanced strategies as well as insights into and micro and macro issues and challenges.

Other limitations of the narratives reviewed revealed that most viewpoints and experiences of persons were from Eurocentric or Western world contexts. Further research from people from other contexts may yield new contextual insights into strategies. Issues of intersectionality beyond health and disability were not evident within this sample. Thus, more knowledge is needed to understand other inequities that may be faced in work disruptions with a focus on inquiry into inclusive strategies that might reveal more knowledge on equitable occupational transitions for work. Overall, the importance of considering an occupational perspective in future research is needed specifically into strategies that can reduce the macro level systemic or structural inequities or other issues that contribute to the pervasiveness of ongoing work transition challenges, along with the inequities that people encounter based on social locations and different types of work transitions. For example, consideration of the transformational ways that an occupational perspective can open opportunities for work are needed at policy or within workplace practices when changes impact workers. One such way is to forefront the salience of human occupational participation and transitions in policy and in decision making when work changes are known and anticipated [12]. Current research into how system transformations have come about, and how they are guided by knowledges that include occupational perspectives from occupational science are warranted to advance knowledge on how greater equity in work transitions and mobility can be achieved.