The aim of this study was to describe and analyze how caseworkers in the Swedish disability services deal with people disabled by road accidents. Data were collected by means of a web-based survey of 259 caseworkers, and a direct content analysis of open-ended questions was used to interpret and analyse the data. The conceptual toolbox consisted of Habermas' lifeworld-system dichotomy, social recognition, and concepts from human service organisation research. Dilemmas within the following areas were identified: interaction with the service users, experiences of communication, assessment of needs, and inter-organisational cooperation between health care and disability services. These difficulties occurred because of tensions between ‘lifeworld’ and ‘system’, and because social recognition and mutual communicative action were not easy to achieve when cognitive impairments distorted and prevented the development of an ‘ideal speech situation’. Inter-organisational cooperation was difficult because of different regulations and professional perspectives.

The purpose of this article is to contribute to knowledge about workplace-based prevention and rehabilitation programs by investigating effects on outcomes concerning employee health, psychosocial working conditions, sickness absence, sick-cases and rehabilitation indicators in 19 Swedish public human service workplaces including 311 individuals. Interviews with middle managers and an examination of documentation about prevention and rehabilitation interventions at the workplaces made it possible to group the workplaces in two workplace program groups — high versus low quality workplace-based prevention and rehabilitation programs. Statistical methods used were reliability tests, correlation analyses and t tests. Results indicate significant associations between changes in employee-judged stress and psychosocial working conditions, and changes in employee-judged health. The results concerning changes in employees’ health, stress and psychosocial working conditions (after workplace-based programs) showed significant differences between workplaces with high quality workplace-based programs compared with workplaces with low quality workplace-based programs, with the former having more favourable results. The study indicates that workplace-based prevention and rehabilitation programs with a broad change strategy and high levels of management and employee involvement can apply to small public sector workplaces.