Plusieurs membres du LABRRI qui travaillent en collaboration ont signé des articles sur leur projet en lien avec les réadaptations des personnes immigrantes ayant subi des lésions professionnelles.
Mistrust among injured immigrant workers: A conceptual framework, WORK journal
Arsenault, Côté et Dubé
BACKGROUND: In Quebec, injured workers have access to medical assistance, wage replacement indemnities, and rehabilitation measures, with most injuries resolved easily. However, a small percentage of cases require a lengthy rehabilitation process, which is particularly complex when involving immigrants. The therapeutic alliance is at the heart of the process, involving mutual trust and confidence and a degree of consensus about the therapeutic interventions to be used and, ultimately, the return to work. OBJECTIVE: This article delves into the concept of mistrust as more than the absence of trust, and sheds light on its role in the rehabilitation process of immigrant workers. METHOD: Drawing from a literature review on mistrust of immigrants in the healthcare setting and comprehensive studies on the rehabilitation process, a conceptual framework for understanding mistrust in this context is proposed. RESULTS: Vulnerable situations, such as precarious employment and/or temporary immigration status, create fertile ground for mistrust. Negative experiences with healthcare professionals or systems further exacerbate mistrust, as do social stigmas within the rehabilitation system. Cross-cultural miscommunications such as differences in communication styles or beliefs about illnesses further complicate matters, emphasizing the need for culturally sensitive approaches. CONCLUSION:Addressing mistrust requires understanding its origins and consequences, as well as providing guidelines for practitioners to enable them to recognize and manage it effectively. Further research is crucial to deepen our understanding of mistrust among immigrant workers and develop strategies for promoting trust and cooperation throughout the rehabilitation process.
KEYWORDS: Mistrust, Immigrant Worker, Rehabilitation, Occupational Health and Safety, Healthcare, Therapeutic Alliance
Organizational and structural factors in building the therapeutic alliance in a work rehabilitation program with injured immigrant workers in Quebec, NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy
Côté, Arsenault et Dubé
Abstract
The therapeutic alliance is central to occupational rehabilitation, particularly for immigrant workers who face unique challenges of migration and of social and occupational integration. This study explores the development and maintenance of this alliance between immigrant workers with compensated work injuries and their care providers during work rehabilitation. Using ethnography, semi-structured interviews, and focus groups, the qualitative case study involved seven injured immigrant workers and their interdisciplinary clinical team. The study identified several factors that weakened the alliance, including administrative complexity, conflicting views on pain and disability, cultural stereotypes, and inter-organizational communication issues. Many of these challenges were systemic and structural, occurring outside the clinic, complicating the rehabilitation process, and potentially prolonging the duration of disability. This paper discusses these systemic issues and their implications for the rehabilitation of immigrant workers.
Keywords: Therapeutic alliance; occupational rehabilitation; immigrant workers; systemic barriers; organizational and structural factors
