Introduction

One of the key tenets of this edited volume is that the study of communication patterns during multi-agency welfare meetings is pertinent to the understanding of current social policies and their implementation and practices in everyday life. In this chapter, multiagency return-to-work meetings are explored with a focus on the emotional underpinnings of institutional practice assembling various parties of the rehabilitation process. In particular, attention is paid to alliances and the ways in which various alliances may or may not reflect sympathy towards service users and their troubles. To this end, the chapter leans on the concept of ‘sympathy’ as an emotion that bonds, especially in difficult times. However, as Candace Clark (1997) elaborates, sympathy or rather its lack thereof can magnify differences between those who are better off and those who are worse off. The aim is to discuss the context of multi-agency welfare meetings via the prism of sympathy and the role of alliances between service users, professionals and employers in promoting or discouraging spells of sympathy during such meetings.

The following section sheds light on the context of the Swedish work rehabilitation process and the institutional as well as emotional character of return-to-work meetings. Thereafter, the theoretical grounding based on the work of Candace Clark and her concept of ‘sympathy’ is presented. Following the presentation of methods is an analysis of several situations from two return-to-work meetings and a discussion about the place of sympathy and alliance in the institutional context.

The institutional and emotional landscapes of multiagency welfare meetings

The introduction of multi-agency return-to-work meetings in 2003 is written into wider changes regarding the social insurance system and the work rehabilitation of people on sick leave in Sweden. Critics conceive of it as an extension of the ‘intensified work-line strategy’ (Junestav, 2009), which brought an increased emphasis on activation and self-sufficiency among sick-listed persons and the tightening of sick leave entitlements (Melén, 2008). In parallel, the public discourse regarding sickness absence has changed. In contrast to previously being dominated by work conditions, stress and burnout as the reason for long-term sick leave, the media coverage has now become dominated by stories of the overuse and abuse of the generous social insurance system (Johnson, 2010).