Effects of cognitive behavioural therapy and return‐to‐work intervention for patients on sick leave due to stress‐related disorders: Results from a randomized trial

Salomonsson, Sigrid; Santoft, Fredrik; Lindsäter, Elin; Ejeby, Kersti; Ingvar, Martin; Ljótsson, Brjánn; Öst, Lars‐Göran; Lekander, Mats; Hedman‐Lagerlöf, Erik

doi:10.1111/sjop.12590

Cited by 28 publications

(41 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent meta-analysis (13) suggests that work-directed interventions (occupational therapy and multi-component work intervention incorporating work modification and support) combined with a clinical intervention can be effective in reducing sickness absence and that enhancing occupational or primary care with CBT and structured telephone outreach with care management that includes medication has the potential to reduce sick leave; however, the number of related studies is small. Salomonsson et al (14) performed a randomized trial that compared the effects of CBT, RTW intervention, and a combination of them (COMBO) on a stress subgroup (n = 152 with adjustment disorder or exhaustion disorder) and DepAnxIn subgroup (n = 59 with depression, anxiety disorders, or insomnia). The stress subgroup showed a superior reduction of stress-related symptoms after CBT compared to RTW intervention, but there was no significant difference between the COMBO and RTW intervention or CBT.…”

Section: Introductionmentioning

confidence: 99%

Frequency of Participation in a Return-to-Work Program Predicts Successful Work Restoration but Not Maintenance

Hoaki¹,

Terao

2021

Front. Psychiatry

View full text Add to dashboard Cite

Several predictors for work restoration and maintenance of restoration have been examined among employees with mood and/or anxiety disorders, but whether frequency of participation in a return-to-work (RTW) program can predict successful work restoration and maintenance remains unclear. In the present study, we attempted to investigate the hypothesis that the frequency of RTW program participation can predict successful work restoration and maintenance. Among seventy-seven patients attending an RTW program, the frequency of participation was positively associated with work restoration but not with maintenance. The result was in partial agreement (restoration) and partial disagreement (maintenance of restoration) with our hypothesis. Thus, the present study suggests that the frequency of participation in an RTW program can predict successful work restoration but not maintenance.

show abstract

Section: Introductionmentioning

confidence: 99%

Frequency of Participation in a Return-to-Work Program Predicts Successful Work Restoration but Not Maintenance

Hoaki¹,

Terao

2021

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…Most of these focus on psychological symptoms, e.g. [16] in order to reduce stress, but have so far only generated marginal outcomes [17]. There is not only a need for treatments for reducing psychological symptoms, but also for health promotion interventions for enabling individuals to improve their health and well-being [18].…”

Section: Introductionmentioning

confidence: 99%

Catching sight of well-being despite a stress-related disorder

Gunnarsson

Frisint

Hörberg

et al. 2021

Scandinavian Journal of Occupational Therapy

View full text Add to dashboard Cite

Background: Stress-related disorders cause suffering and difficulties in managing occupations and relationships in everyday life. A previous study of women with stress-related disorders, who photographed well-being and talked about the photographs in interviews, showed that moments of well-being still exist but further knowledge is needed about their perceptions of participating in such a study. Aim: To describe how people with stress-related disorders experience taking photographs related to well-being in everyday life and reflecting on and talking about these photographs. Material and methods: Twelve women, 27-54 years with stress-related disorders were recruited from primary healthcare centres. They participated in interviews based on the photographs and qualitative content analysis was used. Results: One theme 'catching a glimpse of and momentarily capturing well-being' and four categories were identified: 'Photographing moments of well-being visualizes well-being', 'Using photographs could either facilitate or complicate the narrative', 'Changing perspective in everyday life' and 'Creating recollections of well-being'. Conclusions and significance: Introducing a focus on well-being in everyday life despite living with a stress-related disorder might contribute a valuable complement to stress rehabilitation for occupational therapists and other health professionals. Using photographs as a basis for reflections about everyday life and health/well-being also seems positive for this group.

show abstract

“…Some trials found minute effects [6,7] and in one case even a trend to worsen the problems [8]. In contrast, the use of cognitive behavioral therapy (CBT) has accomplished increased well-being of individual patients presenting with psychosocial problems and psychologists now systematically apply CBT in many primary health care centers in Sweden [5,6,9]. However, when focusing on the effects of CBT treatment of patients to reduce sick leave, the trials give a more controversial impression.…”

Section: Introductionmentioning

confidence: 99%

Education of the primary health care staff based on acceptance and commitment therapy is associated with reduced sick leave in a prospective controlled trial

et al. 2021

View full text Add to dashboard Cite

Background The use of cognitive behavioral therapy (CBT) to cope with mental distress and pain issues has helped many patients in primary health care in Sweden. However, the effects of CBT to reduce sick leave has not been equally convincing. Acceptance and Commitment Therapy (ACT) is an evolution of traditional CBT and we aimed to study if education based on ACT of the staff rather than the patients could reduce sick leave in primary health care. Methods This was a prospective trial in 6 primary health care centers in Kalmar (total amount of registered subjects of 28,930) in which the staff (physicians, nurses and therapists) received group-based education according to ACT during 2018 and 2019. The effects were compared with 5 similarly sized control health care centers in the neighboring Region of Jönköping in which no such education took place. The main aim was to study changes in sick leave in the 6 primary care centers of Kalmar and to keep track of more general trends by studying sick leave also in Jönköping, letting sick leave in the year 2017 to be the reference period for both areas. Results The staff at the health care centers in Kalmar reported to having attended a mean of 5.2 ± 2 educational ACT-sessions with psychiatrist Kadowaki in Kalmar. Sick leave for ICD-10 F43 (reaction to severe stress and related adjustment-disorders) was reduced from a mean value of 28.7 ± 9.1ongoing sick leaves/month in 2017 to 22.6 ± 7.0 sick leaves/month in 2018 (-21%, p = 0.033) and to 18.1 ± 10 sick leaves/month in 2019 (-37%, p = 0.038). The corresponding sick leave for any diagnosis (total sick leave) was reduced from 132 ± 39 sick leaves/month in 2017 to 118 ± 38 sick leaves/month in 2018 (-11%, p = 0.056) and to 102 ± 37 sick leaves/month in 2019 (-21%, p = 0.021). The corresponding sick leave comparisons in the control health centers did not show any significant changes (all p-values ≥ 0.24). Conclusions Total monthly mean sick leave was reduced 21% in the health care centers in Kalmar during the second year of the educational ACT intervention of the staff while it was unchanged in Jönköping. This suggests a significant effect to induce a reduction in long-term sick leave for patients in primary health care in which the staff received education according to ACT. The results of this trial could serve as a basis for a randomized trial in order to ascertain causality. Trial registration Pre-registration November 9, 2018 on ClinicalTrials.gov with number NCT03737019.

show abstract

Effects of cognitive behavioural therapy and return‐to‐work intervention for patients on sick leave due to stress‐related disorders: Results from a randomized trial

Cited by 28 publications

References 42 publications

Frequency of Participation in a Return-to-Work Program Predicts Successful Work Restoration but Not Maintenance

Frequency of Participation in a Return-to-Work Program Predicts Successful Work Restoration but Not Maintenance

Catching sight of well-being despite a stress-related disorder

Education of the primary health care staff based on acceptance and commitment therapy is associated with reduced sick leave in a prospective controlled trial

Contact Info

Product

Resources

About