INN3plus
Responses by Axel Kobelt (German Pension Insurance Brunswick-Hanover), April 2025.
What were your goals in the project INN3plus?
In INN3plus, we wanted to support those insured individuals with mental health conditions who cannot be adequately served by the currently available services for participation in working life and medical rehabilitation, and whose reintegration into the labour market is thereby hindered. Our focus was on promoting employment by shaping individual living circumstances in a supportive way, to prepare and train the target group for reintegration into the labour market.
Within the INN3plus project, we combined psychotherapeutic, medical-rehabilitative, and vocational-rehabilitative services. The innovative nature of INN3plus consists in the provision of different services at the same time. These services are usually delivered sequentially and, from the perspective of the insured individuals, often in an illogical order.
Are there any topics and focal points that have turned out to be particularly important for you in the project when it comes to pursuing these goals? If so, which ones?
One particularly important aspect in the project was the interdisciplinary exchange within the team and between project partners. This enabled us to consider every challenge from multiple perspectives and develop comprehensive solutions that sustainably supported both the psychological and vocational integration of the participants. For instance, the challenges and barriers to employment identified among the participants were specifically addressed and processed in weekly case conferences.
Another important aspect was the application of the PSI model in the project. This application not just provided a shared foundation for understanding cases among the project stakeholders: it additionally helped to identify links between structural personality traits, symptom-related, biographical-social, and emotional barriers to participation and the motivation to re-enter working life. Based on the PSI model, the project team was able to define therapeutic and support priorities, the processing of which is a prerequisite for motivating individuals to take up employment again.
These insights enabled targeted interventions, which could be further developed in the main programme to sustainably improve vocational prospects.
A third central aspect was the participation-oriented rather than diagnosis-oriented approach, as it placed the focus on the active and sustainable integration of participants into the labour market.
What were key challenges you faced during the project, what strategies did you use to deal with those challenges?
A major challenge for us was the interdisciplinarity of the various partners working together in the project and their differing organisational structures. These differences made it difficult to coordinate activities and to flexibly adapt to the participant’s individual needs. This required increased investment in communication and coordination, which we addressed through regular project meetings and case discussions.
Another challenge was the delayed start of the project, as the first psychotherapist was not appointed until January 2021, instead and as planned in 2019. This delay had far-reaching effects on the project timeline, particularly on the achievement of key milestones. We addressed this staffing challenge by hiring several part-time psychotherapists instead of filling a single full-time position.
Working with external companies to arrange internships for the participants was also demanding. Especially during periods of high demand for internships, in response to unforeseen events such as the COVID-19 pandemic, or during seasonal fluctuations in the labour market, it was more difficult to find suitable placements. This led to delays in the professional development of some participants.
Based on the insights and experiences gained during the project, what measures do you as most important when it comes to fostering the project’s aim? What are your recommendations in this context? What insights gained during the project do you consider as most important?
Our experience in the project has shown that the most important factors in supporting the vocational rehabilitation of employable individuals with mental and physical illnesses to prepare participants in a targeted manner for integration into the labour market consist in
- individual therapy,
- close integration of psychotherapy, practical work support, and tailored interventions, and
- a flexible, needs-oriented adaptation of the programme.
Regarding cooperation among the project stakeholders, the regular exchange within the interdisciplinary team, already mentioned under above, proved to be essential for responding quickly to changes and individual needs.
The project results show that early and ongoing assessment of individual needs, as well as close collaboration within the interdisciplinary team, are critical to successful labour market integration. Continuous reflection on progress in individual therapy and interprofessional dialogue are a further key for success.
A significant insight from the project is that considering both mental and physical aspects is essential in rehabilitation to enable sustainable integration into the labour market. Considering individual factors in isolation, without recognising the interactions between psychological and physical aspects as well as contextual stressors, can significantly undermine the effectiveness of the programme. Additionally, it became clear that a purely diagnosis-oriented approach is less effective than the participation-oriented one. This last-mentioned approach, which focuses on the active involvement of participants in the labour market and their individual life circumstances, leads to significantly better outcomes in vocational integration.
Looking back on the aims and trajectory of INN3plus, where do you see a need for further research and which research questions would you name in this context?
The long-term effects of the measures should be examined to understand which factors contribute to sustainable reintegration. Furthermore, improved cooperation between medical, psychotherapeutic, and vocational rehabilitation services should be a key topic for future studies.
Project Goals
The INN3plus project aimed to help people with mental health problems who were not coping well with the usual programmes (i.e. rehabilitation, benefits for participation in working life). The aim was to prepare these people for working life more properly. To this end, medical, psychotherapeutic and vocational assistance were offered simultaneously - instead of one after the other as it is usually the case.
Key Topics
The close cooperation within the team from different specialisms (psychotherapy, medicine, work) was particularly important. Regular meetings enabled problems to be recognised early on and solved together.
The project used the PSI model, which helped to understand the participants' problems and treat them in a targeted manner, for example regarding motivation, life history or emotions.
Instead of just looking at diagnoses, the aim was to promote participation in working life. Hence, the guiding question was: How can someone return to work despite their illness?
Challenges Faced during the Project
Cooperation with many different organisations was difficult - they worked differently and first had to coordinate their activities.
The late start to the project due to staff shortages delayed many things.
The search for internships was particularly challenging in difficult times (COVID-19 pandemic, high demand).
Approaches to Address these Challenges
Regular team meetings were held to improve planning and coordination.
Several part-time psychotherapists were employed instead of just one full-time employee.
Despite difficulties in finding suitable placements for those taking part in the project, the team remained flexible and kept looking for new opportunities.
Key Insights
Individual therapy helps because it is personalised.
It is also important to combine therapy, practice and personal support; everything should be well-coordinated.
Both psychological and physical problems must be considered; separate approaches are not enough.
A participation-orientated approach (focus on the reality of life and professional participation) is better than a purely medical-diagnostic approach.
Recommendations Derived from the Project
Rehabilitation services should be flexible and individualised.
Close co-operation within the team is crucial for success.
Participants should receive holistic support at an early stage - with a view to their entire life circumstances.
Mental and physical aspects must be considered together, not separately.
Further Research Needs
The long-term impact of the support - i.e. how successful the return to work is in the long term - should be investigated.
Further research should focus on the co-operation between medical, psychotherapeutic and occupational rehabilitation. In addition, this collaboration should be improved.
