“My patience has limits”: A qualitative study on how supervisors manage their conflicts of interest with employees who returned to work after mental health leave
Restricted accessResearch articleFirst published online 2026
“My patience has limits”: A qualitative study on how supervisors manage their conflicts of interest with employees who returned to work after mental health leave
Employees who return to work (RTW) after mental health leave are a vulnerable, yet understudied population. While work adjustments are often implemented to facilitate their return, these changes may conflict with the operational interests of supervisors.
Objective
The present study aims to understand the perspectives of supervisors on (1) work adjustments that conflict with their interests post-RTW, (2) the strategies they used to navigate these conflicts, and (3) reflections on their strategies. The Dual Concern Model was used as a framework for this study.
Methods
A qualitative design was employed, involving semi-structured interviews with 15 supervisors. Data were analyzed using reflexive thematic analysis.
Results
(1) Supervisors identified task adjustments and job changes as primary areas of conflict. (2) To manage their conflicts of interests with employees, supervisors primarily aimed for win-win solutions and compromises. Secondarily, other strategies were used, such a as dominating approach to prioritize organizational interests. (3) The majority of supervisors held a nuanced perspective on their management of perceived conflicts.
Conclusions
The study results cautiously suggest that supervisors play an important role in the sustainability of work changes after mental health leave.
ArendsIAlmansaJStansfeldSA, et al.One-year trajectories of mental health and work outcomes post return to work in patients with common mental disorders. J Affect Disord2019; 257: 263–270.
2.
de VriesHFishtaAWeikertB, et al.Determinants of sickness absence and return to work among employees with common mental disorders: a scoping review. J Occup Rehabil2018; 28: 393–417.
KeijsersLCEM. A constant balancing act: a qualitative study on how Dutch employees with depression experience presenteeism. Master’s Thesis, Maastricht University, the Netherlands, 2017.
WolvetangSvan DongenJMSpekléE, et al.Sick leave due to stress, what are the costs for Dutch employers?J Occup Rehabil2022; 32: 764–772.
7.
BernfortLPerssonJLinderothC, et al.Supervisor ratings of productivity loss associated with presenteeism and sick leave due to musculoskeletal disorders and common mental disorders in Sweden. Work2021; 68: 1091–1100.
8.
AndersenMFNielsenKMBrinkmannS. Meta-synthesis of qualitative research on return to work among employees with common mental disorders. Scand J Work Environ Health2012; 38: 93–104.
9.
GjengedalRGHRemeSEOsnesK, et al.Work-focused therapy for common mental disorders: a naturalistic study comparing an intervention group with a waitlist control group. Work2020; 66: 657–667.
10.
FranzsenDde WittPSaohatseL, et al.A conceptual framework for return to work for clients with major depressive disorder. Work2023; 74: 97–109.
11.
HedlundÅBomanEKristofferzonM-L, et al.Development and psychometric evaluation of a theory-based questionnaire measuring women’s return-to-work beliefs after long-term sick leave for common mental disorders. Work2023; 76: 109–124.
12.
JoosenMCWLugtenburgMArendsI, et al.Barriers and facilitators for return to work from the perspective of workers with common mental disorders with short, medium and long-term sickness absence: a longitudinal qualitative study. J Occup Rehabil2022; 32: 272–283.
13.
MaroisECoutuM-FDurandM-J. Feasibility evaluation of a return-to-work program for workers with common mental disorders: stakeholders’ perspectives. Work2020; 67: 331–343.
14.
NielsenKYarkerJMunirF, et al.IGLOO: an integrated framework for sustainable return to work in workers with common mental disorders. Work Stress2018; 32: 400–417.
15.
NielsenKYarkerJ. Thrivers, survivors or exiteers: a longitudinal, interpretative phenomenological analysis of the post-return-to-work journeys for workers with common mental disorders. Appl Psychol2024; 73: 267–295.
16.
DanielssonLElfMHensingG. Strategies to keep working among workers with common mental disorders – a grounded theory study. Disabil Rehabil2019; 41: 786–795.
17.
BertilssonMNiederbergerRde RijkA. Work accommodations for employees with common mental disorders and associated manager related determinants: a cross-sectional study among Swedish managers. Disabil Rehabil2024; 46: 4256–4275.
18.
TimsMBakkerABDerksD. Examining job crafting from an interpersonal perspective: is employee job crafting related to the well-being of colleagues?Appl Psychol2015; 64: 727–753.
19.
StochkendahlMJMyburghCYoungAE, et al.Manager experiences with the return to work process in a large, publicly funded, hospital setting: walking a fine line. J Occup Rehabil2015; 25: 752–762.
20.
TegninkoHBTGouinM-M. The constituents of trust in the context of return to work following a work disability: A scoping review and a thematic analysis. J Occup Rehabil2025. Epub ahead of print 11 September 2025. DOI: 10.1007/s10926-025-10327-x.
21.
PruittDGRubinJZ. Social conflict: escalation, stalemate, and settlement. Random House, 1986.
22.
BlakeRMoutonJ. The managerial grid: the key to leadership excellence. Gulf Publishing Company, 1964.
23.
RahimMA. Managing conflict in organizations. 4th ed.Transaction Publishers, 2011.
ArendsIvan der KlinkJJLvan RhenenW, et al.Predictors of recurrent sickness absence among workers having returned to work after sickness absence due to common mental disorders. Scand J Work Environ Health2014; 40: 195–202.
26.
Hoefsmit N, Bos R and Houkes I. The roles of supervisors in the prolonged implementation of work-related strategies of employees after sick leave due to common mental disorders, http://osf.io/52esw (2023, accessed 15 July 2024).
27.
PolitDFBeckCT. Nursing research: generating and assessing evidence for nursing practice. 8th ed.Wolters Kluwer Health/Lippincott/Williams & Wilkins, 2008.
Amberscript. Convert your audio and video into subtitles and text, https://www.amberscript.com/nl (n.d., accessed 15 July 2024).
31.
BraunVClarkeV. Thematic analysis. A practical guide. Sage, 2021.
32.
Atlast.Ti. Turn your data into qualitative insights, faster and easier, https://atlasti.com. (n.d., accessed 15 July 2024).
33.
TongASainsburyPCraigJ. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care2007; 19: 349–357.
MerrittACEffronDAMoninB. Moral self-licensing: when being good frees us to be bad. Soc Personal Psychol Compass2010; 4: 344–357.
37.
HoefsmitNde RijkAHoukesI. Work resumption at the price of distrust: a qualitative study on return to work legislation in The Netherlands. BMC Public Health2013; 13: 153.
38.
BauerTNGreenSG. Development of leader–member exchange: a longitudinal test. Acad Manag J1996; 39: 1538–1567.
39.
EdwardsJRShippAJ. The relationship between person-environment fit and outcomes: an integrative theoretical framework. In: OstroffCJudgeTA (eds) Perspectives on organizational fit. Jossey-Bass, 2007, pp.209–258.
40.
Kristof-BrownALZimmermanRDJohnsonEC. Consequences of individuals’ fit at work: a meta-analysis of person–job, person–organization, person–group, and person–supervisor fit. Pers Psychol2005; 58: 281–342.
41.
SikoraAStegmannRSchröderUB, et al.Work ability during the return to work process: results from a mixed methods follow-up study among employees with common mental disorders. J Occup Rehabil2026; 36: 248–261.
42.
BeerdaDCEGreidanusMAde RijkAE, et al.The SME tool supporting employers of small- and medium-sized enterprises during the return to work of employees on long-term sick leave: study protocol for a randomized controlled trial and for a process evaluation. Trials2024; 25: 541.
WitkampAEngelenMde RuigL, et al.De theorie en praktijk van re-integratie tweede spoor. Panteia, De Beleidsonderzoekers en SEO Economisch Onderzoek, 2016.
45.
de RijkACarrasco-NegüeKHoukesI. The cross-country comparison model for labor participation (CCC model for LP) of persons with chronic diseases. J Occup Rehabil2022; 32: 225–240.
