Background and Aims:Work plays an important role in adults' well-being, irrespective of health status. Vocational rehabilitation can enable people with mental illness to return to open employment. A narrative approach was used to explore how individuals with a mental illness made sense of their work-related experiences. Methods and Results: Four Clubhouse members in open employment for at least 6 months completed in-depth, semistructured interviews, from which narratives were created to reveal events, significant persons and actions that assisted these individuals to resume work. Woven into the participants' stories were four 'impelling forces' contributing to a sense-of-self as a worker. These impelling forces were: support from significant others, the personal meaning of work, experiences within the Clubhouse programme, and the ongoing struggle with illness. Implications for occupational therapy practice are discussed. Conclusion: The findings of this study urge occupational therapists and others to provide opportunities to provide on-going support to people with a mental illness who seek paid employment.

A threshold concept that captures the essential nature of occupational therapy is likely to be (highly) troublesome in terms of a learner's acquisition of it. Rather than simplifying these learning 'jewels' educators are encouraged to sit with the discomfort that they and the learner may experience as the learner struggles to grasp them. Moreover, they should reshape their curricula to provoke such struggles if transformative learning is to be the outcome.

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A deeper understanding of the supervisory role and associated skills required for new graduate therapists is needed. Support from senior colleagues and workshops conducted by the university to up-skill the therapists are recommended.

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