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Open Access 01-12-2014

How do Workers with Common Mental Disorders Experience a Multidisciplinary Return-to-Work Intervention? A Qualitative Study

Authors: Malene Friis Andersen, Karina Nielsen, Svend Brinkmann

Published in: Journal of Occupational Rehabilitation | Issue 4/2014

Abstract

Purpose Long-term sick leave due to common mental disorders (CMD) is an increasing problem in many countries. Recent reviews indicate that return to work (RTW) interventions have limited effect on reducing sickness absence among this group of sick-listed. The aims of this study were to investigate how sick-listed persons with CMD experienced participating in an RTW intervention and how workability assessments and RTW activities influenced their RTW-process, and to examine the working mechanisms of the intervention. The gained knowledge can help improve future RTW intervention design and implementation. Methods In-depth interviews were conducted with 17 participants on sick leave due to CMD who participated in an RTW intervention. Interviews were conducted at three time points with each participant. Principles of interpretative phenomenological analyses guided the analysis. Results The workability assessment consultations and RTW activities such as psychoeducative group sessions and individual sessions with psychologist could result in both motivation and frustration depending on the extent to which the RTW professionals practiced what we have termed an individual approach to the sick-listed person. Conclusions The individual approach seems necessary for the realization of the positive potential in the RTW intervention. However, the fact that RTW professionals are both the facilitators and the controllers of the sick-listed persons’ RTW process is an inherent paradox in the intervention, which can impede the necessary establishment of a high-quality relationship between the sick-listed persons and RTW professionals.

Bültmann U, Huibers MJH, Van Amelsvoort LPGM, Kasl SV, Swaen GMH, Kant U. Psychological distress, fatigue and long-term sickness absence: prospective results from the Maastricht Cohort Study. JOEM. 2005;47:941–7.PubMed

Bültmann U, Rugulies R, Lund T, Christensen KB, Labriola M, Burr H. Depressive symptoms and the risk of long-term sickness absence: a prospective study among 4747 employees in Denmark. Soc Psychiatry Psychiatr Epidemiol. 2006;41:875–80.PubMedCrossRef

Henderson M, Glozier N, Holland Elliott K. Long term sickness absence. BMJ. 2005;330:802–3.PubMedCentralPubMedCrossRef

Karpansalo M, Kauhanen J, Lakka TA, Kaplan GA, Salonen JT, Manninen P. Depression and early retirement: prospective population based study in middle aged men. Epidemiol Community Health. 2005;59:70–4.CrossRef

OECD. Sickness, disability and work: breaking the barriers: a synthesis of findings across OECD countries. OECD Publishing, 2010.

OECD. Sick on the job? Myths and realities about mental health and work. OECD Publishing, 2012.

Blank L, Peters J, Pickvance S, MacDonald E, Wilford J. Systematic review of the factors which predict return to work for people suffering episodes of poor mental health. J Occup Rehabil. 2008;18:27–34.PubMedCrossRef

Knudsen AK, Ïverland S, Aakvaag HF, Harvey SB, Hotopf M, Mykletun A. Common mental disorders and disability pension award: seven year follow-up of the HUSK study. J Psychosom Res. 2010;69:59–67.PubMedCrossRef

Borg V, Andersen MN, Kolte IV, Andersen MF. White paper on mental health, sickness absence and return to work. Copenhagen: National Research Centre for the Working Environment; 2010.

10.

Fossey E. Harvey Carol. Finding and sustaining employment: a qualitative meta-synthesis of mental health consumer views. Can J Occup Ther. 2010;77:303–14.PubMedCrossRef

11.

Arends I, Bruinvels DJ, Rebergen DS, Nieuwenhuijsen K, Madan I, Neumeyer-Gromen A et al. Interventions to facilitate return to work in adults with adjustment disorders. Cochrane Database Syst Rev. 2012;12. doi:10.1002/14651858.CD006389.pub2.

12.

Hoefsmit N, Houkes I, Nijhuis F. Intervention characteristics that facilitate return to work after sickness absence: a systematic literature review. J Occup Rehabil. 2012;22:462–77.

13.

Pomaki G, Franche ReL, Murray E, Khushrushahi N, Lampinen T. Workplace-based work disability prevention interventions for workers with common mental health conditions: a review of the literature. J Occup Rehabil. 2012;22:182–95.PubMedCrossRef

14.

Andersen MF, Nielsen KM, Brinkmann S. Meta-synthesis of qualitative research on return to work among employees with common mental disorders. Scand J Work Environ Health. 2012;38:93–104.PubMedCrossRef

15.

Fadyl J, McPherson K. Return to work after injury: a review of evidence regarding expectations and injury perceptions, and their influence on outcome. J Occup Rehabil. 2008;18:362–74.PubMedCrossRef

16.

MacEachen M, Clarke J, Franche RL, Irvin E. Systematic review of the qualitative literature on return to work after injury. Scand J Work Environ Health. 2006;32:257–69.PubMedCrossRef

17.

Cowls J, Galloway E. Understanding how traumatic re-enactment impacts the workplace: assisting clients’ successful return to work. Work. 2009;33:401–11.PubMed

18.

Hillborg H, Svensson T, Danermark B. Towards a working life? Experiences in a rehabilitation process for people with psychiatric disabilities. Scand J Occup Ther. 2010;17:149–61.PubMedCrossRef

19.

Pittam G, Boyce M, Secker J, Lockett H, Samele C. Employment advice in primary care: a realistic evaluation. Health Soc Care Community. 2010;18:598–606.PubMedCrossRef

20.

Aust B, Helverskov T, Nielsen MB, Bjorner JB, Rugulies R, Nielsen K, et al. The Danish national return-to-work program—aims, content, and design of the process and effect evaluation. Scand J Work Environ Health. 2012;38:120–33.PubMedCrossRef

21.

Järvholm B. How should methods for return to work be evaluated? Scand J Work Environ Health. 2012;38:89–91.PubMedCrossRef

22.

Winzor G, Poulsen OM, Andersen I, Andersen MF, Andersen MH, Aust B et al. Det Store TTA-Projekt. Proces- effekt- og økonomisk evaluering (The Danish RTW-Program. Process-, effect- and economic evaluation). Copenhagen: National Research Centre for the Working Environment (NRCWE), 2012.

23.

Smith JA. Reflecting on the development of interpretative phenomenological analysis and its contribution to qualitative research in psychology. Qual Res Psychol. 2004;1:39–54.

24.

Smith JA, Larkin M, Flowers P. Interpretative phenomenological analysis, theory, method and research. Calif: Los Angeles; 2009.

25.

Biggerstaff D, Thompson A. Interpretative phenomenological analysis (IPA): a qualitative methodology of choice in healthcare research. Qual Res Psychol. 2008;5:214–24.CrossRef

26.

Kleinman A. Patients and healers in the context of culture, an exploration of the borderland between anthropology, medicine and psychiatry. Berkeley: University of California Press; 1981.

27.

Andersen MF, Brinkmann S. Nye perspektiver på stress (New perspectives on stress). Aarhus: Klims Forlag; 2013.

28.

World Health Organization. ICD-10, International statistical classification of diseases and related health problems. 2007. World Health Organization.

29.

Alonzo A. An illness behavior paradigm: a conceptual exploration of a situational-adaptation perspective. Soc Sci Med. 1984;19:499–510.PubMedCrossRef

30.

Alonzo AA. Everyday illness behavior: a situational approach to health status deviations. Soc Sci Med Part A. 1979;13:397–404.CrossRef

31.

Coutu MF, Baril R, Durand MJ, Cote D, Rouleau A. Representations: an important key to understanding workers coping behaviors during rehabilitation and the return-to-work process. J Occup Rehabil. 2007;17:522–44.PubMedCrossRef

32.

Coutu MF, Durand M-J, Baril R, Lebrecque ME, Ngomo S, Coté D, et al. A review of assessment tools of illness representations: are these adapted for a work disability prevention context? J Occup Rehabil. 2008;18:347–61.PubMedCrossRef

33.

Gannik D. Situational disease: elements of a social theory of disease based on a study of back trouble. Scand J Prim Health Care Suppl. 2002;20:25–30.PubMedCrossRef

34.

Leventhal H, Meyer D, Nerenz D. The common sense representation of illness danger. In: Rachman S, editor. Contributions to medical psychology. New York: Pergamon Press; 1980. p. 7–30.

35.

Leventhal H, Diefenbach M. Illness cognition: using common sense to understand treatment adherence and affect cognition interactions. Cognit Ther Res. 1992;16:143–63.CrossRef

36.

Leventhal H, Weinman J, Leventhal EA, Phillips LA. Health psychology: the search for pathways between behavior and health. Annu Rev Psychol. 2008;59:477–505.PubMedCrossRef

37.

Shaw L, Segal R, Polatajko H, Harburn K. Understanding return to work behaviours: promoting the importance of individual perceptions in the study of return to work. Disabil Rehabil. 2002;24:185–95.PubMedCrossRef

38.

Danish Data Protection Agency. [homepage from the Internet] www.datatilsynet.dk. Accessed 22 Mar. 2013.

39.

Giorgi A, Giorgi B. The descriptive phenomenological psychological method. In: Camic PM, Rhodes JE, Yardley L, editors. Qualitative research in psychology: expanding perspectives in methodology and design. Washington, DC: American Psychological Association; 2003. p. 243–73.

40.

Marks D, Murray M, Evans B, Willig C, Woodall, Sykes CM. Health psychology—theory, research & practice. SAGE Publications, 2005.

41.

Nicholls C, Glover L, Pistrang N. The illness experiences of women with fibroids: an exploratory qualitative study. J Psychosom Obstet Gynaecol. 2004;25:295–304.PubMedCrossRef

42.

Willig C. Introducing qualitative research in psychology. Open University Press, 2007.

43.

Leventhal H, Forster R, Leventhal EA. Self-regulation of health threats, affect, and the self. In: Aldwin C, editor. Handbook of health psychology and aging. New York: Guilford Press; 2007. p. 341–66.

44.

Corbiére M, Shen J. A systematic review of psychological return-to-work interventions for people with mental health problems and/or physical injuries. Can J Commun Ment Health. 2006;25:261–88.CrossRef

45.

Aas RW, Ellingsen KL, Linøe P, Möller A. Leadership qualities in the return to work process: a content analysis. J Occup Rehabil. 2008;18:335–46.PubMedCrossRef

46.

Cornelius L, Klink J, Groothoff J, Brouwer S. Prognostic factors of long term disability due to mental disorders: a systematic review. J Occup Rehabil. 2011;21:259–74.PubMedCentralPubMedCrossRef

47.

Franche RL, Krause N. Readiness for return to work following injury or illness: conceptualizing the interpersonal impact of health care, workplace, and insurance factors. J Occup Rehabil. 2002;12:233–56.PubMedCrossRef

48.

Høgelund J. In search of effective disability policy. Comparing the developments and outcomes of Dutch and Danish disability policies. Amsterdam: Amsterdam University Press, 2003.

49.

Nieuwenhuijsen K, Verbeek JHAM, de Borer AGEM, Blonk RWB, van Dijk FJH. Predicting the duration of sickness absence for patients with common mental disorders in occupational health care. Scand J Work Environ Health. 2006;32:67–74.PubMedCrossRef

50.

Schuring M, Burdorf L, Kunst A, Mackanbach J. The effects of ill health on entering and maintaining paid employment: evidence in European countries. Epidemiol Community Health. 2007;61:597–604.CrossRef

51.

Haugli L, Maeland S, Magnussen LH. What facilitates return to work? Patients’ experiences 3 years after occupational rehabilitation. J Occup Rehabil. 2011;21:573.PubMedCentralPubMedCrossRef

52.

Hubertsson J, Petersson I, Arvidsson B, Thorstensson C. Sickness absence in musculoskeletal disorders: patients’ experiences of interactions with the Social Insurance Agency and health care. A qualitative study. BMC Public Health. 2011;11:107.PubMedCentralPubMedCrossRef

53.

Lynöe N, Wessel M, Olsson D, Alexanderson K, Helgesson G. Respectful encounters and return to work: empirical study of long-term sick-listed patients’ experiences of Swedish healthcare. BMJ Open. 2011;1:2.CrossRef

54.

Müssener U, Söderberg E, Svensson T, Alexandersson K. Encouraging encounters: sick-listed person’ experiences of interactions with rehabilitation professionals. Soc Work Health Care. 2008;46:71–87.PubMedCrossRef

55.

Norlund S, Fjellman-Wiklund A, Nordin M, Stenlund T, Ahlgren C. Personal resources and support when regaining the ability to work: an interview study with exhaustion disorder patients. J Occup Rehabil. 2012;. doi:10.1007/s10926-012-9396-7.

56.

Svensson T, Karlsson A, Alexanderson K, Nordqvist C. Shame-inducing encounters. Negative emotional aspects of sickness-absentees’ interactions with rehabilitation professionals. J Occup Rehabil. 2003;13:183–95.PubMedCrossRef

57.

Wessel M, Helgesson G, Olsson D, Juth N, Alexanderson K, Lynöe N. When do patients feel wronged? Empirical study of sick-listed patients’ experiences with healthcare encounters. Eur J Public Health. 2012;23:230–35.

58.

Östlund GM, Borg KE, Wide P, Hensing GKE, Alexanderson KAE. Clients’ perceptions of contact with professionals within healthcare and social insurance offices. Scand J Public Health. 2003;31:275.PubMedCrossRef

59.

Svensson T, Müssener U, Alexandersson K. Pride, empowerment and return to work: on the significance of positive social emotions in the rehabilitation of sickness absentees. Work. 2006;27:57–65.PubMed

60.

Duncan B, Miller SD, Wampold BE, Hubble MA. The heart & soul of change: delivering what works in therapy. Washington, DC: American Psychological Association; 2010.

61.

Norcross JC. Psychotherapy relationships that work, evidence-based responsiveness. New York: Oxford University Press; 2011.CrossRef

62.

Lambert MJ, Barley DE. Research summary on the therapeutic relationship and psychotherapy outcome. In: Norcross JC, editor. Psychotherapy relationships that works. New York: Oxford University Press; 2002. p. 17–32.

63.

Kazdin AE. Nonspecific treatment factors in psychotherapy outcome research. J Consult Clin Psychol. 1979;47:846.PubMedCrossRef

64.

Horvath AO, Del Re AC, Flückiger C, Symonds D. Alliance in individual psychotherapy. In: Norcross JC, editor. Psychotherapy relationships that works. New York: Oxford University Press; 2011. p. 25–69.CrossRef

65.

Rogers C. The necessary and sufficient conditions of therapeutic personality change. J Consult Psychol. 1957;11:95–103.CrossRef

66.

Elliott R, Bohart AC, Watson JC, Greenberg LS. Empathy. In: Norcross JC, editor. Psychotherapy relationships that works. New York: Oxford University Press; 2011. p. 132–52.CrossRef

67.

Hougaard E. Psykoterapi, teori og forskning (Psychotherapy, theory and research). Copenhagen: Dansk Psykologisk Forlag; 2009.

68.

Coutu M, Baril R, Durand M, Cóté D, Cadieux G. Clinician-patient agreement about the work disability problem of patients having persistent pain: why it matters. J Occup Rehabil. 2013;23:82–92.PubMedCrossRef

69.

Wesson M, Gould M. Can a ‘return-to-work’ agenda fit within the theory and practice of CBT for depression and anxiety disorders? Cogn Behav Ther. 2010;3:27–42.

70.

Malterud K, Thesen J. When the helper humiliates the patient: a qualitative study about unintended intimidations. Scand J Public Health. 2008;36:92.PubMedCrossRef

71.

Norcross JC, Lambert MJ. Introduction. In: Norcross JC, editor. Psychotherapy relationships that works. New York: Oxford University Press; 2011. p. 3–24.CrossRef

72.

Söderberg S, Jumisko E, Gard G. Clients’ experiences of a work rehabilitation process. Disabil Rehabil. 2004;26:419–24.PubMedCrossRef

73.

Law M, Baptiste S, Mills J. Client-centred practice: what does it mean and does it make a difference? Can J Occup Ther. 1995;62:250–7.PubMedCrossRef

74.

Elvins R, Green J. The conceptualization and measurement of therapeutic alliance: an empirical review. Clin Psychol Rev. 2008;28:1167–87.PubMedCrossRef

75.

Fishman DB. From single case to database: a new method for enhancing psychotherapy, forensic, and other psychological practice. Appl Prev Psychol. 2001;10:275–304.CrossRef

76.

Fishman DB, Neigher WD. Publishing systematic, pragmatic case studies in program evaluation: rationale and introduction to the special issue. Eval Program Plann. 2003;26:421–8.CrossRef

77.

Fishman DB, Neigher WD. Publishing systematic, pragmatic case studies in program evaluation: collateral on a ‘promissory note’. Eval Program Plann. 2004;27:105–13.CrossRef

Title: How do Workers with Common Mental Disorders Experience a Multidisciplinary Return-to-Work Intervention? A Qualitative Study
Authors: Malene Friis Andersen
Karina Nielsen
Svend Brinkmann
Publication date: 01-12-2014
Publisher: Springer US
Published in: Journal of Occupational Rehabilitation / Issue 4/2014
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-014-9498-5

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How do Workers with Common Mental Disorders Experience a Multidisciplinary Return-to-Work Intervention? A Qualitative Study

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