Background Common mental disorders are one of the leading causes for sickness absence and early retirement due to reduced health. Furthermore, a treatment gap for common mental disorders has been described worldwide. Within this study, psychotherapeutic consultation at work defined as a tailored, module-based and work-related psychotherapeutic intervention will be applied to improve mental health care. Methods This study comprises a randomised controlled multicentre trial with 1:1 allocation to an intervention and control group. In total, 520 employees with common mental disorders shall be recruited from companies being located around five study centres in Germany. Besides care as usual, the intervention group will receive up to 17 sessions of psychotherapy. The first session will include basics diagnostics and medical indication of treatment and the second session will include work-related diagnostics. Then, participants of the intervention group may receive work-related psychotherapeutic consultation for up to ten sessions. Further psychotherapeutic consultation during return to work for up to five sessions will be offered where appropriate. The control group will receive care as usual and the first intervention session of basic diagnostics and medical indication of treatment. After enrolment to the study, participants will be followed up after nine (first follow-up) and fifteen (second follow-up) months. Self-reported days of sickness absence within the last 6 months at the second follow-up will be used as the primary outcome and self-efficacy at the second follow-up as the secondary outcome. Furthermore, a cost-benefit assessment related to costs of common mental disorders for social insurances and companies will be performed. Discussion Psychotherapeutic consultation at work represents a low threshold care model aiming to overcome treatment gaps for employees with common mental disorders. If successfully implemented and evaluated, it might serve as a role model to the care of employees with common mental disorders and might be adopted in standard care in cooperation with sickness and pension insurances in Germany. Trial registration The friaa project was registered at the German Clinical Trial Register (DRKS) at 01.03.2021 (DRKS00023049): https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023049.

Although individualized and ICF-oriented implementation of rehabilitation treatment requires knowledge of relevant contextual factors, there is a lack of operationalized documentation and measurement tools to evaluate these factors. Therefore, an ICF-oriented semi-structured interview was designed. 20 contextual factors were externally assessed whether they negatively affected mental functioning and participation of psychosomatic patients. Additionally, psychometric scales were applied. Six relevant impairing contextual factors were identified. Contextual factors significantly correlated with psychometric scales. Patients with higher contextual impairment showed significantly higher psychological stress levels. Anamnesis of contextual factors at the beginning of psychosomatic rehabilitation yields important information for therapy planning. Further research on contextual factors in medical rehabilitation is needed.

(1) Background: A new health care offer called ‘psychotherapeutic consultation in the workplace’ is an early and effective intervention for employees with common mental disorders. Although cost-effective, it lacks a broader roll-out. This might be attributable to undefined context, mechanisms of change, and a lack of communication; therefore, this study explores how the new model works and where problems occur. (2) Methods: Semi-structured interviews on motivation, expectations and experiences with 20 involved experts. Experts were members of the company health promotion team, service users, and cooperating mental health specialists. Analysis was conducted with ATLAS.ti. (3) Results: The conceptual framework comprises three main topics: (a) structured implementation concept; (b) persons involved, shaping the concept’s processes; (c) and meaning and function of the offer within the given context. Concerning (c) we found three potential areas of conflict: (1) intra-corporate conflicts, (2) conflicts between company and employee, (3) and conflicts between the company health promotion and the health care system. Category (c) comprises the offer’s core characteristics which were described as low-threshold and preventive. Furthermore, the offer was perceived as convenient in handling, confidential, and having immediate impact on a person’s well-being. (4) Conclusions: Here we define structures, address the needs of the involved persons, and communicate foreseeable areas of conflict influences whether the implementation of the intervention succeeds.

ZusammenfassungFragestellungZiel der Studie ist die Ermittlung der Faktorenstruktur der Readiness for Return to Work Scale (RRTW) sowie die Überprüfung ihrer Gütekriterien für Patienten in der psychosomatischen Rehabilitation in Deutschland. Die RRTW misst die Motivation, ins Erwerbsleben zurückzukehren bzw. im Erwerbsleben zu bleiben. Material und MethodenAn einer Stichprobe von n=152 arbeitsfähigen und n=145 arbeitsunfähigen Patienten der psychosomatischen Rehabilitation wurden Faktorenstruktur, Itemgüte sowie externe Validität überprüft.ErgebnisseFür arbeitsfähige Patienten wurden die Faktoren „Handlungserprobung“ und „Aufrechterhaltung“ gefunden, die 59,2% der Varianz erklärten, sowie für arbeitsunfähige Patienten die Faktoren „Absichtslosigkeit“, „Absichtsbildung“ und „Vorbereitung“ (56,7%). Die internen Konsistenzen lagen zwischen Cronbachs α=0,72 und α=0,81. Die Itemgüte war zufriedenstellend. Pearson-Korrelationen zeigten höhere Zusammenhänge mit konstruktnahen Fragebögen als mit Symptomfragebögen in die zu erwartenden Richtungen.DiskussionEine Kulturgebundenheit der RRTW ist zu diskutieren. Die gefundene Faktorenstruktur sollte mittels konfirmatorischer Faktorenanalyse geprüft werden. SchlussfolgerungenDie deutsche Version der RRTW ermöglicht eine ökonomische Erfassung der Motivation zur Rückkehr ins Erwerbsleben. Aus der Einteilung in Motivationsstadien lassen sich klinische Implikationen ableiten.

Work motivation represents a relevant construct in rehabilitation success but is strongly influenced by individual factors. During rehabilitation, individual problems which influence work motivation should be taken into account more strongly.