"People with depression or anxiety may take a lot of sick leave to address their problems," said the study's lead author, Suzanne Lagerveld, of the Netherlands Organization for Applied Scientific Research (TNO). "However, focusing on how to return to work is not a standard part of therapy. This study shows that integrating return-to-work strategies into therapy leads to less time out of work with little to no compromise in people's psychological well-being over the course of one year."
The study reveals that employees who received such targeted therapy were able to return to work sooner, did not suffer adverse effects and showed significant improvement in mental health over the course of 1 year.
Researchers followed 168 employees in the Netherlands who were on sick leave due to psychological problems such as anxiety, adjustment disorder and minor depression. Seventy-nine employees from a variety of jobs received standard, evidence-based cognitive-behavioral therapy, while the rest received cognitive-behavioral therapy that included a focus on work and the process of returning to work.
In the work-focused group, psychotherapists addressed work issues in an early phase and used work and the workplace as mechanisms or context to improve the client's mental health. For example, therapists explained to their clients how work can offer structure and self-esteem, characteristics beneficial to clients' recovery. They also helped clients draft a detailed, gradual plan for returning to work, focusing on how the client would engage in specific tasks and activities.
The participants in the work-focused group fully returned to work on average 65 days earlier than the participants in the standard therapy group, and they started a partial return to work 12 days earlier. Those in the work-focused therapy engaged in more steps to fully return to work, gradually increasing their hours and duties. Almost all the participants in the study – 99 percent – had at least partially returned to work at the 1-year follow-up. Most participants resumed work gradually, with only 7 percent going directly from full sick leave to full-time work.
All participants had fewer mental health problems over the course of treatment, no matter which type of therapy they received, with the most dramatic decrease in symptoms occurring in the first few months.
"Being out of work has a direct effect on people's well-being. Those who are unable to participate in work lose a valuable source of social support and interpersonal contacts," said Lagerveld.
Encouraging these workers to get back on the job has financial benefits as well. When an employee returns to work earlier than estimated, an employers saves about 20 percent, an average of $5,275. This amount is based on wages paid during sick leave and did not include additional costs of productivity loss and hiring replacements.
The study was published online in American Psychological Association's Journal of Occupational Health Psychology.