Cognitive work hardening for return to work following depression: An intervention study

Wisenthal, Adeena; Krupa, Terry; Kirsh, Bonnie; Lysaght, Rosemary

doi:10.1177/0008417417733275

Cited by 15 publications

(9 citation statements)

References 71 publications

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“…This approach aligns with research findings that conflict at the workplace is predictive of recurrent sickness absence among workers returning following a mental health disorder such as depression (20). CWH has been scientifically studied (21,22) with research findings supporting its role in RTW following depression. The purpose of this case report is to build on this quantitative and qualitative research by offering a concrete example of how CWH can be utilized in clinical practice.…”

Section: Introductionmentioning

confidence: 77%

“…On the first day of CWH, the client completed three selfreport questionnaires that address constructs that can relate to RTW outcomes (21). The questionnaires were the Work Ability Index (WAI) ( 33), the Multi-Dimensional Assessment of Fatigue (MAF) (34), and the Beck Depression Inventory II (BDI-II) 1 (35).…”

Section: Treatment Interventionmentioning

confidence: 99%

“…First, it consisted of directed questions regarding the client's employment status to determine if she had returned to work or if she had remained on disability. Indeed this is considered to be the primary measure of RTW success (21). If working, the client was asked to rate her sense of well-being at work along three pre-defined categories:…”

Section: Follow Upmentioning

confidence: 99%

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Case Report: Cognitive Work Hardening for Return-to-Work Following Depression

Wisenthal

2021

Front. Psychiatry

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The growing number of mental health disability claims and related work absences are associated with a magnitude of human, economic and social costs with profound impact on the workplace. In particular, absences due to depression are prevalent and escalating. There is a need for treatment interventions that address the unique challenges of people returning to work following an episode of depression. Occupational functioning often lags depression symptom improvement which necessitates targeted treatment. Cognitive work hardening (CWH) is a multi-element, work-oriented intervention with empirical research supporting its role in return-to-work following a depressive episode. This case report details the use of CWH to prepare an individual to return to work following a disability leave due to depression. It illustrates how CWH bridges the functional gap between being home on disability and returning to competitive employment. The client presented is a 50 year old divorced woman who had been off work for approximately 2 years for depression precipitated by the terminal illness of her mother. She participated in a 4 week CWH program which addressed fatigue and decreased stamina, reduced cognitive abilities, outdated computer skills, and heightened anxiety. Work simulations enabled the rebuilding of cognitive abilities with concomitant work stamina; task mastery bolstered self-confidence and feelings of self-efficacy; and coping skill development addressed the need for stress management and assertive communication strategies. By program completion, the client's self-reported work ability had increased and both fatigue and depression symptom severity had decreased. Clinical markers of work performance indicated that the client was ready to return to her pre-disability job. Three months after completion of CWH, the client reported that she was at work, doing well and working full days with good stamina and concentration. This report provides insight into how CWH can be applied to return-to-work preparation following depression with positive outcomes.

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Section: Introductionmentioning

confidence: 77%

Section: Treatment Interventionmentioning

confidence: 99%

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Case Report: Cognitive Work Hardening for Return-to-Work Following Depression

Wisenthal

2021

Front. Psychiatry

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“…Instead, it might be useful to document and define a list of evidence-based services that an occupational therapist could provide. For example, it might be useful to document occupational therapy expertise in providing functional cognitive-behavioral assessments and interventions (Lysaght et al, 2008; Marfeo et al, 2017), cognitive work hardening (Wisenthal et al, 2018; Wisenthal & Krupa, 2013), supported employment (Marshall et al, 2014), and guidance regarding accommodations (Dewa et al, 2016), as these evidence-based approaches are congruent with the unique occupational perspective. Other services, such as health promotion, case management, and training, may also be relevant and important (Joyce et al, 2016) but are not as specific to occupational therapy expertise.…”

Section: Discussionmentioning

confidence: 99%

“…Occupational therapists have expertise in cognitive behavioural job demands analysis; this can facilitate return-to-work planning through a process of matching the abilities of the worker to the demands of the job (Lysaght, Shaw, Almas, Jogia, & Larmour-Trode, 2008). Another specific occupational therapy approach is cognitive work hardening, which uses progressively more difficult tasks to develop occupational performance skills, focusing on stress management, coping skills, interpersonal conflict resolution, and functional skills directly related to work (Wisenthal & Krupa, 2013; Wisenthal, Krupa, Kirsh, & Lysaght, 2018). Interventions to aid workers experiencing mental health concerns with recovery and return to work, such as cognitive behavioural therapy and problem-focused return-to-work programs, have strong evidence for both reducing symptoms and improving occupation-related outcomes (Joyce et al, 2016).…”

mentioning

confidence: 99%

Workplace mental health: Current practice and support needs of Ontario occupational therapists

Moll¹,

Heino²,

LeBlanc³

et al. 2018

Can J Occup Ther

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Background. Workplace mental health (WMH) is an important and expanding practice area for occupational therapists. Purpose. This cross-sectional study explores the current practices and support needs of Ontario-based occupational therapists in WMH. Method. Registrants from the provincial association who provide mental health and/or work-related services were invited to participate. Ninety-three therapists completed an online survey; 10 participated in follow-up focus groups. Analysis involved descriptive statistics of the survey data and content analysis of the focus group data. Findings. Return to work, reactivation, and functional cognitive assessment were the most commonly reported services. Key challenges were limited funding and training and lack of awareness of the occupational therapy role. Therapists emphasized the importance of raising the competence, credibility, and profile of occupational therapy in WMH. Implications. Defining the role of occupational therapy, developing training and resources, and advocacy are needed to advance occupational therapy practice within this rapidly changing field. Abré gé Description. La santé mentale au travail est un champ d'intervention important pour les ergothérapeutes qui est en pleine croissance. But. Cette étude transversale explore les pratiques actuelles et les besoins des ergothérapeutes de l'Ontario en matière de soutien dans le domaine de la santé mentale au travail. Méthodologie. Les membres de l'association provinciale qui offrent des services de santé mentale ou de santé au travail ont été invités à participer à l'étude. Quatre-vingt-treize ergothérapeutes ont répondu à un sondage en ligne, et 10 ergothérapeutes ont participé à des groupes de discussion de suivi. L'analyse comprenait des statistiques descriptives des données du sondage et une analyse de contenu des données découlant des groupes de discussion. Résultats. Le retour au travail, la réactivation et l'évaluation des fonctions cognitives comptaient parmi les services mentionnés le plus souvent. Les principales difficultés étaient le manque de financement, le manque de formation et la méconnaissance du rô le de l'ergothérapie. Les ergothérapeutes ont souligné l'importance de rehausser les compétences, la crédibilité et le profil de l'ergothérapie dans le domaine de la santé mentale au travail. Consé quences. Il sera primordial de définir le rô le de l'ergothérapie, de mettre au point des formations et des ressources et de faire des revendications en vue de promouvoir le rô le de l'ergothérapie dans ce domaine qui évolue rapidement.

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