Organizational and Structural Factors in Building the Therapeutic Alliance in a Work Rehabilitation Program With Injured Immigrant Workers in Quebec
Bibliographic record
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 7 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 interorganizational 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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.024 | 0.006 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".