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.
Return-to-work self-efficacy (RTW-SE) is an important predictor of the duration until employees return to work after a sickness-related absence. The aim of the present validation study was to investigate the psychometric properties of the German RTW-SE scale. Data were obtained from three independent samples of employees who were in outpatient care due to mental disorders or musculoskeletal diseases (n1 = 301, n2 = 103, n3 = 104). Confirmatory factor analyses showed an inadequate fit for a one-factor solution and an acceptable fit for a two-factor model that distinguished by item-wording direction. To test whether the two factors represent substantively different dimensions of the construct or rather a statistical item-wording effect, two subscales were formed based on item-wording direction. As the subscales were not differentially associated with external measures, the one-factor solution may be considered appropriate. The scale showed good to excellent internal consistency values over time and across samples, had low retest reliability indices, and indicated construct validity based on moderate to high associations with cognitive and disease-related variables. The results further demonstrated the scale’s sensitivity to change. The RTW-SE baseline score predicted physical performance and pain-related psychological impairment after orthopedic rehabilitation. In multiple regression analysis, RTW-SE remained a significant predictor of pain-related psychological impairment but not physical performance, partially demonstrating the predictive validity of the scale. The German version of the RTW-SE scale demonstrated satisfactory results regarding its validity and reliability.
In diesem Beitrag wird die Rolle der Arbeit in der Psychotherapie thematisiert. Anhand der Beschreibung von arbeitsplatzbezogenen Ansätzen wird erläutert, wie arbeitsplatzbezogene Faktoren und Interventionen in die Psychotherapie integriert und wie Störungen behandelt werden, die mit dem Arbeitsplatz in Zusammenhang stehen. Störungsspezifische Therapieansätze werden dabei (exkurshaft) ebenso berücksichtigt.
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