Effects of a Multidisciplinary Stress Treatment Programme on Patient Return to Work Rate and Symptom Reduction: Results from a Randomised, Wait-List Controlled Trial

Abstract

Background: To evaluate the efficacy of a multidisciplinary stress treatment programme. Methods: General practitioners referred 198 employed patients on sick leave with symptoms of persistent work-related stress. Using a waitlisted randomised controlled trial design, the participants were randomly divided into the following three groups: the intervention group (IG, 69 participants); treatment-as-usual control group (TAUCG, 71 participants), which received 12 consultations with a psychologist, and the waitlisted control group (WLCG, 58 participants). The stress treatment intervention consisted of nine 1-hour sessions conducted over 3 months. The goals of the sessions were the following: (1) identifying relevant stressors; (2) changing the participant's coping strategies; (3) adjusting the participant's workload and tasks, and (4) improving workplace dialogue. Each participant also attended a mindfulness-based stress reduction (MBSR) course for 2 h a week over 8 weeks. Results: The IG and TAUCG showed significantly greater symptom level (Symptom Check List 92) reductions compared to the WLCG. Regarding the return to work (RTW) rate, 67% of participants in the IG returned to full-time work after treatment, which was a significantly higher rate than in the TAUCG (36%) and WLCG (24%). Significantly more participants in the IG (97%) increased their working hours during treatment compared with the participants in the control groups, TAUCG (71%) and WLCG (64%). Conclusions: The stress treatment programme - a combination of work place-focused psychotherapy and MBSR - significantly reduced stress symptom levels and increased RTW rates compared with the WLCG and TAUCG.

Return to work after work-related stress: a randomized controlled trial of a work-focused cognitive behavioral intervention

“…Our study sample is demographically comparable to those of other Danish SMI studies (22)(23)(24)30). It was comprised of mostly women in their mid-forties employed in the public sector.…”

“…Less is known about effective treatments to facilitate return to work (RTW) among patients with clinically significant complaints (3,18,19). Only a limited number of randomized controlled trials (RCT) have tested the effect of CBT based interventions for stressed workers on sick leave (10,(20)(21)(22)(23).…”

“…For example, studies have combined CBT with a graded approach to RTW and work assignments (20,21) or with workplace dialogue and mindfulness (23). Group-based CBT reduced self-reported absenteeism in one waitlist controlled study (22); however, other studies have not accelerated RTW by CBT using individual (10,24) or group formats (10).…”

“…If one used only the first week with no transfer payment indicating sick leave, then temporary administrative breaks, such as holidays or payment changes, could easily be misinterpreted as RTW. Studies often examine RTW without clearly specifying what is meant by the term full or lasting RTW (10,20,23). Biering et al (31) advocated the use of registers like DREAM as an opportunity to use a measure reflecting sustainable work resumption (ie, in this case four consecutive weeks of work resumption).…”

Stress professionnel et infarctus du myocarde

“…Nous manquons toutefois de données plus ciblées sur des populations à risque coronarien. Des techniques récentes inspirées de la méditation transcendantale, désignées par le terme anglo-saxon de mindfulness, ce qui est généralement traduit en français par « thérapie par la pleine conscience », se sont largement développées ces dernières années et semblent donner des résultats au moins aussi intéressants que les approches cognitives et comportementales plus classiques, en matière de réduction du stress perçu [26]. Ces techniques se basent en effet non pas sur la recherche assidue d'une solution aux problèmes ressentis, ni sur l'éva-cuation de l'esprit de toute pensée source d'inconfort ou d'anxiété, mais sur l'adoption d'une position d'observateur, neutre, non sélective et non jugeante, à l'égard de toute pensée, sensation physique ou émotion traversant le champ de conscience.…”