Table 4 Supporting quotes for themes and subthemes

Individual experiential knowledge and peer-exchange build transferal pathways

Q1

“In Turning Points, I learned to respect and take care of myself.” (Female participant 1, peer-led program)

Q2

“I feel like I'm getting some concepts on, in my own life. But not only do I get the concepts, I also get what it means to me and how we move on from here…” (Female participant 2, peer-led program)

Transfer to more profound relationships

Q3

“(Before) When I had guests, I could stay for three hours, then I had to go to bed. AND that changed anyway. The social anxiety and the general anxiety were reduced because there was some processing in being in the group.” (Male participant 2, IMR)

Transfer to better self-care

Q4

“I probably use the action plan most, I think. As a tool

When I need to do something, it is nice to have an action plan of when to do it and how much to do it and how to do it…

I must prioritize my energy. Having a full-time job is plenty for me. But then I have two young children, and a wife and so it … and a family and friends and stuff like that. So, I will have to prioritize if I have an arrangement with my friends like I had yesterday for example when there was football, well I know how to do it but then I probably must be careful about plans just around that day, right? So, these are some things that one thinks about. So, I'm sure that I to some extent can live a normal life.” (laughs) (Male participant 1, peer led program)

Q5

“For me the most important point was … It is OK to relax… It's like… mmm… it's like a war where you step back and it’s OK. Because then you can win next time.”

(Female participant 4, peer-led program)

The role of peer-support in facilitating transfer

Q6

“Every time I went home I was totally… (breathing deeply…) oh no, I can't go anymore, I've done something wrong, said something wrong, I can't… It was just like exercising—I can go next time. And I can stand it, I can handle it and the others are not a notch worse or better. And it was … it took a lot of training.” (Female participant 5, peer-led program)

Q7

“One of the peer workers. I sometimes sit and think, is it me you are describing or is it yourself? Which is fun, after all. And interesting. Also, because there is one here where I could ask her very specific questions. Where I could say, eh. now what if a lot of people invite you out in a week, then it will simply be too much. How do you handle it then?” (Male participant2, peer-led program)

Q8

“The thing about it is that you want the teacher to be healthy. But also sick because you want to mirror yourself, but also to be healthy because they must show that the course helps. And if they are not healthy and they say that now is the fifth time I’m teaching here. Then you think. Hell!! Then it doesn't work! If you haven't recovered.” (Male participant 3, peer-led program)

Illness intrusiveness and overlooking environmental obstacles generate transferal gaps

Q9

“I have a lot of guilt about the things that I can't do, and I think that, or I know, it is like that for many of us, you feel ineffective, useless and impossible, right? And you take that very personally. And then you learn that you can say a lot of it really isn’t me who can’t get it right, it is the symptoms that are there and a lot of others also have the same. The symptoms. They all go round believing that it is them who can’t get themselves up from the chair. Where they sit. And then go over and do the dishes or something. They can't, and it feels very personal. When in fact, there are a lot of people who feel that way. That are struggling with that. So that's a symptom. And that means, I think, a great deal that you can throw some guilt away.” (Female participant 5, peer-led program)

Living with chronic condition as an unreliable companion

Q10

“But I have a melancholy side, which I think is probably because of the way I have lived my life, or relationships, or childhood or something else that makes me have such dark thoughts. Yes, it changes back and forth. I have fewer symptoms, but it still fills me up somehow. I think it would be nicer if I could do the things I feel like and the things I think I need. It can be buying Christmas presents or going to Christmas lunch or going to lectures or… Things like getting up and out the door. One day I do something and the next day I can't.” (Female participant 2, IMR)

Q11

“The group suffered from the fact that there were persons there who were very good at playing therapists. Now you just … you just have to do this, you just have to do that… why don't you, and no … now you have to … take a phone call and all that… and you sit and feel so bad that you can't even go to the bathroom, right? It is kind of, we must improve our situation, all the time. And it's not always possible.” (Female participant 5, peer-led program)

Facing real-life challenges

Q12

“It can be a little bit… with people who are “healthy”. Healthy in inverted commas, OK? Then you can be a little, oh they are looking at me. I'm such a… and so on… So, I withdraw and… keep a low profile. Not standing out in the crowd… But feel that I do that anyway. Like there's a big elephant in the room yelling, she's mentally ill, just look at her, right?” (Female participant 6, peer-led program)

Q13

“I'm not going to complain … I've gotten a lot better. And quality of life has improved. But not working and being on sick leave… Then, it doesn't matter that much anyway … so I really must practice patting myself on the back. Because I still have to say, well, it doesn’t matter … because I have no job.” (Male participant 3, peer-led program)

A different path—the enabling role of individualized support

Q14

“It's very nice because it is in many ways a kind of open offer, which means that I actually have the freedom to act.” (Male participant 1, IPS)

Q15

“I am really happy with my employment specialist because he, he can accommodate me and my oddities and he helps and supports and so I am allowed to try some things myself … because … if I can then it is f***ing fine, that I can myself but when it is hard for me then he supports me in it.” (Female participant 1)

Having access to patient and flexible support through difficult times

Q16

“When I'm not feeling well, I tend to isolate myself a bit. Take care of myself, in a way … and it is nice, when he (the employment specialist) sends me an SMS … just checking up, how are you? Finding out where I am … right now … and should there be more on the table … should we have more contact … should we have less … uhhh … is it because it's going well or is it because it is not going well … so yeah, find out where I am right now and what is needed.” (Female participant 1, IPS)

Q17

” When my husband left me… I felt like h… Well, we put it on hold, but we didn't give up … well, because, there were just a few months where I just didn't go out and look for jobs and these things, because I couldn't … uhhh … and it helped. I was very, very fond of her (the employment specialist)” (Female participant 2 – IPS)

Someone to depend upon

Q18

“The fact that I felt listened to and taken seriously and sometimes even received constructive criticism … also made me believe more in myself and therefore I also dared to do some more things. I think if I hadn’t had the support from the employment specialist that I’ve had … then I don’t think I would have dared to call those companies and ask … Can I send an unsolicited application and where should I send it? Because then I’d have been afraid of the rejection almost as soon as I introduced myself.” (Female participant 3- IPS)

Q19

“He (the employment specialist) has given me a different experience. When I call him and say there is a problem, well he takes it seriously … he tries to look at it and see if he can solve it. He calls around and he sets things in motion and in many cases, well it turns out he can do a whole lot of things … which many mental health professionals have not mentioned at all as an opportunity…” (Male participant 3, IPS)

A natural foundation for utilizing skills and building confidence

Q20

“It (work) gives me some stability. I have problems with structure. It gives me some content … in my week … that I do something … it gives me …identity. … It gives me stability and I can combine it with the rest of my daily life … so I can have a normal week. So, I'm not just lying at home and lying on the bed. And that is important” (Male participant 4 – IPS)

Q21

“I did go to college and I found out … I was actually really good at it … well … like getting As !!!! And I was both surprised and proud. And then I changed my education plan … because I found that there were some things … I was pretty good at them and I didn't know.” (Female participant 1, IPS)

Q22

“During the periods when I worked, it meant a lot. My health has improved … I have had fewer admissions … shorter admissions … less medication consumption uhhh so in general just an increase in my standard of living … so from the purely psychiatric point of view, but also a question that I … that in my daily life I feel better and I have better finances, I can do more things and some things like that.” (Male participant 2, IPS)