Journal of Occupational Rehabilitation

, Volume 20, Issue 3, pp 299–310 | Cite as

A Matter of Trust? A Study of Coordination of Swedish Stakeholders in Return-to-Work

  • Christian StåhlEmail author
  • Tommy Svensson
  • Gunilla Petersson
  • Kerstin Ekberg


Introduction Stakeholder cooperation in return-to-work has been increasingly emphasized over the last years. However, there is a lack of empirical studies on the subject. This study explores different public stakeholders’ experiences of participating in Coordination Associations (CAs), a Swedish form of structured cooperation in return-to-work. The aim of the study is to determine the impact of stakeholder interests on the prerequisites for cooperation. Methods Thirty-five representatives from two CAs in eastern Sweden were interviewed regarding the aim, structure and strategies for their common work. Results Stakeholders’ actions are to a high degree determined by their institutional preferences and self-interest. In the CAs, the motives for cooperation differ, and although these differences supposedly could be overcome, they are in fact not. One of the stakeholders, the Public Employment Service, limit its interest to coordinating resources, while the other three wishes to engage in elaborated cooperative work forms, implying the crossing of organizational borders. This discrepancy can largely be attributed to the difficulties for representatives from state authorities in changing their priorities in order to make cooperation work. Conclusions Stakeholders’ interests have a high impact on the prerequisites for cooperation in return-to-work. By referring to organizational goals, stakeholders engage in non-cooperative behaviour, which threatens to spoil cooperative initiatives and to develop distrust in cooperative work forms. The results of this study expose the complexity of and threats to cooperation, and its conclusions may be used by return-to-work stakeholders in different jurisdictions to improve the possibilities for the development of cooperative structures.


Coordination Cooperation Return-to-work Welfare Trust Sweden 



We are grateful to the coordinators in the two CAs for their help in opening doors to the respondents in this study.


  1. 1.
    Brunarski D, Shaw L, Doupe L. Moving toward virtual interdisciplinary teams and a multi-stakeholder approach in community-based return-to-work care. Work. 2008;30(3):329–36.PubMedGoogle Scholar
  2. 2.
    Franche R-L, Baril R, Shaw W, Nicholas M, Loisel P. Workplace-Based Return-to-Work Interventions: Optimizing the Role of Stakeholders in Implementation and Research. J Occup Rehabil. 2005;15(4):525–42.CrossRefPubMedGoogle Scholar
  3. 3.
    Friesen MN, Yassi A, Cooper J. Return-to-work: The importance of human interactions and organizational structures. Work. 2000;17(1):11–22.Google Scholar
  4. 4.
    Loisel P, Durand M-J, Berthelette D, Vézina N, Baril R, Gagnon D, et al. Disability Prevention: New Paradigm for the Management of Occupational Back Pain. Disease Manage Health Outcomes. 2001;9(7):351–60.CrossRefGoogle Scholar
  5. 5.
    Loisel P, José-Durand M, Baril R, Gervais J, Falardeau M. Interorganizational collaboration in occupational rehabilitation: perceptions of an interdisciplinary rehabilitation team. J Occup Rehabil. 2005;15(4):581–90.CrossRefPubMedGoogle Scholar
  6. 6.
    MacEachen E, Clarke J, Franche R-L. Systematic review of the qualitative literature on return to work after injury. Scand J Work Environ Health. 2006;32(4):257–69.PubMedGoogle Scholar
  7. 7.
    Esping-Andersen G. The three worlds of welfare capitalism. Cambridge: Polity Press; 1990.Google Scholar
  8. 8.
    Rothstein B, Steinmo S. Restructuring politics: institutional analysis and the challenges of modern welfare states. In: Rothstein B, Steinmo S, editors. Restructuring the welfare state: political institutions and policy change. New York: Palgrave MacMillan; 2002.Google Scholar
  9. 9.
    de Bakker FGA, den Hond F. Introducing the politics of stakeholder influence: a review essay. Business & Society. 2008;47(8):8–20.Google Scholar
  10. 10.
    Rowley TJ, Moldoveanu M. When will stakeholder groups act? An interest- and identity-based model of stakeholder group mobilization. Acad Manage Rev. 2003;28(2):204–19.CrossRefGoogle Scholar
  11. 11.
    Korpi W, Palme J. The paradox of redistribution and strategies of equality: welfare state institutions, inequality, and poverty in the Western countries. Am Sociol Rev. 1998;63(5):661–87.CrossRefGoogle Scholar
  12. 12.
    OECD. Transforming disability into ability: policies to promote work and income security for disabled people. Paris: Organisation for Economic Co-Operation and Development (OECD); 2003.Google Scholar
  13. 13.
    Prins R. Integrated services in rehabilitation—on coordination of organization and financing: synthesis report: European Commission; 2006.Google Scholar
  14. 14.
    Jakobsson B, Bergroth A, Schüldt K, Ekholm J. Do systematic multiprofessional rehabilitation group meetings improve efficiency in vocational rehabilitation? Work. 2005;24:279–90.PubMedGoogle Scholar
  15. 15.
    Patton MQ. Qualitative research and evaluation methods. 3rd ed. London: Sage; 2002.Google Scholar
  16. 16.
    Swedish Government. Finansiell samordning inom rehabiliteringsområdet (Financial coordination in the rehabilitation field), Government bill 2002/03:132.Google Scholar
  17. 17.
    Dirks KT, Ferrin DL. The role of trust in organizational settings. Organization Science. 2001;12(4):450–67.CrossRefGoogle Scholar
  18. 18.
    Rothstein B. Just institutions matter: the moral and political logic of the universal welfare state. Cambridge: Cambridge University Press; 1998.Google Scholar
  19. 19.
    Hardy C, Phillips N, Lawrence T. Distinguishing trust and power in interorganizational relations: forms and facades of trust. In: Lane C, Bachmann R, editors. Trust within and between organizations. New York: Oxford University Press; 2000.Google Scholar
  20. 20.
    Zucker LG. Production of trust: institutional sources of economic structure, 1840–1920. Res Org Behav. 1986;8:53–111.Google Scholar
  21. 21.
    Luhmann N. Trust and power: two works. Chichester: Wiley; 1979.Google Scholar
  22. 22.
    Lane C. Introduction: theories and issues in the study of trust. In: Lane C, Bachmann R, editors. Trust within and between organizations. New York: Oxford University Press; 2000.Google Scholar
  23. 23.
    Cox R, Lippel K. Falling through the legal cracks: the pitfalls of using workers’ compensation data as indicators of work-related injuries and illnesses. Policy Practice Health Safety. 2008;6(2):63–84.Google Scholar
  24. 24.
    Lippel K. Therapeutic and anti-therapeutic consequences of workers’ compensation. Int J Law Psychiatry. 1999;22(5–6):521–46.CrossRefPubMedGoogle Scholar
  25. 25.
    Powell WW, DiMaggio PJ. The new institutionalism in organizational analysis. Chicago: University of Chicago Press; 1991.Google Scholar
  26. 26.
    Simon HA. Administrative behavior: a study of decision-making processes in administrative organizations. 4 ed. New York: The Free Press; 1947/1997.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Christian Ståhl
    • 1
    • 2
    Email author
  • Tommy Svensson
    • 3
    • 4
  • Gunilla Petersson
    • 3
  • Kerstin Ekberg
    • 1
    • 2
  1. 1.National Centre for Work and Rehabilitation, Department of Medical and Health SciencesLinköping UniversityLinköpingSweden
  2. 2.HELIX VINN Excellence CentreLinköping UniversityLinköpingSweden
  3. 3.Department of Behavioural Sciences and Learning, Division of SociologyLinköping UniversityLinköpingSweden
  4. 4.Nordic School of Public HealthGöteborgSweden

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