Effects of rehabilitative psychotherapy on labour market success: Evaluation of a nationwide programme

Abstract

Aims: Psychotherapy is a widely used treatment for mental disorders, but whether it also improves employment and other labour market outcomes remains inconclusive. This study examined the effectiveness of a nationwide subsidized psychotherapy programme using extensive register-based data. Methods: The sample consisted of individuals who applied for rehabilitative psychotherapy in Finland in 2009–2012 ( n = 35,083). Prior to 2011, some applications were rejected due to the limited budget that the central government provided for the programme. From 2011, all eligible applicants were granted rehabilitation. We used propensity score matching to create balanced samples of those who received a negative decision in 2009–2010 ( n = 2047) and those who were granted rehabilitative psychotherapy in 2011–2012 ( n = 12,046) in terms of their sociodemographic background characteristics, prior labour market attachment and health status. Results: We found that compared to the applicants who were not accepted to the programme, the granted applicants with similar background characteristics had, on average, a six-percentage-point higher employment rate, €2100 higher annual earnings and a six-percentage-point lower probability of becoming a disability benefit recipient five years after their first application. Further sensitivity analyses confirmed that these results were not biased, for example, by differences in macroeconomic conditions during the follow-up. Conclusions: Quasi-experimental research design showed that rehabilitative psychotherapy was significantly associated with better labour market outcomes. Although several relevant background factors were included in the matching analysis, it is possible that some unobserved factors explain both access to psychotherapy and subsequent labour market outcomes.

Psychotherapy and change in mental health-related work disability: a prospective Finnish population-level register-based study with a quasi-experimental design

“…We found that participating in rehabilitative psychotherapy marked a decline in depression-related or anxiety-related work disability in comparison to the counterfactual trend. Our findings are in accordance with a recent Finnish register-based longitudinal study, 26 which found that rehabilitative psychotherapy was associated with an improvement in the employment and other labour market outcomes of the recipients of rehabilitative psychotherapy. Our findings are also in agreement with those of studies reporting the beneficial effects of psychotherapy on depression and anxiety.…”

Psychotherapy duration and work disability: A prospective Finnish register study

“…Evidence suggests that, at a population level, long-term psychotherapy might be linked to decreased work disability. [15][16][17] However, a more detailed analysis has revealed that among individuals who were granted a disability pension, 11-60 psychotherapy sessions were associated with a partial or full return to work, whereas longer psychotherapies did not. 18 In addition, some evidence suggests that short-term therapies are linked with quicker improvement in workability, while long-term psychotherapy offers more enduring gains.…”

“…Implementing these findings to community‐based samples, with greater population diversity and varying psychotherapy durations, is not straightforward. Evidence suggests that, at a population level, long‐term psychotherapy might be linked to decreased work disability 15–17 . However, a more detailed analysis has revealed that among individuals who were granted a disability pension, 11–60 psychotherapy sessions were associated with a partial or full return to work, whereas longer psychotherapies did not 18 .…”

The association of sociodemographic characteristics with work disability trajectories during and following long-term psychotherapy: a longitudinal register study

“…After the referral, a patient needs to find an available psychotherapist from the private healthcare sector. Results from two recent studies suggest that rehabilitation was associated with somewhat better labor market outcomes [ 31 , 32 ]. However, there is no information on whether occupational status or area of residence influence work disability progress during and after rehabilitation and to what extent disability trajectories have differed among individuals who started rehabilitative psychotherapy after it became accessible to all eligible for the benefit.…”