Return to work: A comparison of two cognitive behavioural interventions in cases of work-related psychological complaints among the self-employed
Abstract
We investigated the effectiveness of cognitive behavioural therapy (CBT) and a combined intervention of workplace- and individual-focused techniques among self-employed people on sick leave owing to work-related psychological complaints (such as anxiety, depression, and burnout). Both interventions were based on CBT; however, one was conducted by psychotherapists and involved extensive CBT, while the other was delivered by “labour experts” and consisted of a brief CBT-derived intervention combined with both individual-focused and workplace interventions. One hundred and twenty-two self-employed people who had applied for sickness benefit from an insurance company enrolled in a randomized controlled design. These individuals were assessed before the intervention and then at 4 months and 10 months after the onset of the intervention. The outcome was assessed based on duration of sick leave until partial and full return to work and on psychological complaints. Significant effects on partial and full return were found in favour of the combined intervention: partial return occurred 17 and 30 days earlier in this group than in the CBT group and the control group, respectively. For full return to work, the difference was approximately 200 days. A decrease in psychological complaints was present in each condition but we found no significant interaction effects. The results suggest that work resumption should be addressed earlier in individuals receiving CBT. This insight is of value for the (scarce) literature concerning interventions for individuals who are on sick leave owing to work-related psychological complaints.
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The finding of no substantial difference on somatic and mental health outcomes between the two rehabilitation programs is in line with some earlier studies on individuals with musculoskeletal complaints and mental health disorders.
“No substantial difference on somatic and mental health outcomes between the two rehabilitation programs is in line with some earlier studies on individuals with musculoskeletal complaints [5, 32] and mental health disorders [9].”
Studies on return to work programs for individuals with mental health disorders have showed increased return to work, but no added reduction in symptoms.
“Studies on the effect of return to work programs for individuals with mental health disorders have also showed increased return to work, but no added reduction in symptoms [9, 10].”
The design of the WorkGuru stress management intervention is based on theoretical psychological principles whose efficacy has been proven in other studies for both face-to-face and online delivery.
“The design of the stress management intervention (WorkGuru) is based on clear theoretical psychological principles, the efficacy for which has been proven in other studies for both face to face delivery (for example: [55, 56]), and for online delivery (for example: [57, 58]).”
The results of studies on the treatment of sick-listed employees due to common mental health disorders are conflicting.
“Some research has been conducted on the treatment of employees who are absent from work (sick-listed employees) due to common mental health disorders, and the results of these studies are conflicting [23,24-27].”
From Short-Term Effects of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Randomized Controlled Trial (2014) · cites this paper as [24]
Some research has been conducted on the treatment of employees who are absent from work (sick-listed employees) due to common mental health disorders.
“Some research has been conducted on the treatment of employees who are absent from work (sick-listed employees) due to common mental health disorders, and the results of these studies are conflicting [23,24-27].”
From Short-Term Effects of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Randomized Controlled Trial (2014) · cites this paper as [24]
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- Authors
- Blonk, R. W. B., Brenninkmeijer, V., Lagerveld, S. E., & Houtman, I. L. D.
- Affiliations
- Netherlands Organisation for Applied Scientific Research (NL)
- Corresponding author
- Blonk, Roland W. B.
- Venue
- Work & Stress
- Publisher
- Informa UK Limited
- Published
- 2006-04
- Volume
- 20
- Issue
- 2
- Pages
- 129-144
- ISSN
- 0267-8373 (ISSN-L)
- 1464-5335
- OpenAlex
- W2139234433
- Cited by
- 280
- References
- 29
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 5 · 2023: 7 · 2022: 18 · 2021: 20 · 2020: 7 · 2019: 13 · 2018: 18 · 2017: 25 · 2016: 17 · 2015: 16 · 2014: 29 · 2013: 14 · 2012: 25
- FWCI
- 22.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Work & Stress (publishedVersion)
- TNO Repository (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- return to work, cognitive behavioral therapy, sick leave, self-employed workers, burnout, anxiety, depression, workplace interventions, sickness benefits, early intervention
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