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Multidisciplinary Intervention and Acceptance and Commitment Therapy for Return-to-Work and Increased Employability among Patients with Mental Illness and/or Chronic Pain: A Randomized Controlled Trial

Author

Listed:
  • Erik Berglund

    (Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-75122 Uppsala, Sweden)

  • Ingrid Anderzén

    (Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-75122 Uppsala, Sweden)

  • Åsa Andersén

    (Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-75122 Uppsala, Sweden)

  • Lars Carlsson

    (Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-75122 Uppsala, Sweden
    Centre for Clinical Research Dalarna, Uppsala University, SE-79182 Falun, Sweden)

  • Catharina Gustavsson

    (Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-75122 Uppsala, Sweden
    Centre for Clinical Research Dalarna, Uppsala University, SE-79182 Falun, Sweden)

  • Thorne Wallman

    (Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-75122 Uppsala, Sweden
    Centre for Clinical Research Sörmland, Uppsala University, SE-63188 Eskilstuna, Sweden)

  • Per Lytsy

    (Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-75122 Uppsala, Sweden
    Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institute, SE-17177 Stockholm, Sweden)

Abstract

Background: People on long-term sick leave often have a long-lasting process back to work, where the individuals may be in multiple and recurrent states; i.e., receiving different social security benefits or working, and over time they may shift between these states. The purpose of this study was to evaluate the effects of two vocational rehabilitation programs, compared to a control, on return-to-work (RTW) or increased employability in patients on long-term sick leave due to mental illness and/or chronic pain. Methods: In this randomized controlled study, 427 women and men were allocated to either (1) multidisciplinary team management, i.e., multidisciplinary assessments and individual rehabilitation management, (2) acceptance and commitment therapy (ACT), or (3) control. A positive outcome was defined as RTW or increased employability. The outcome was considered negative if the (part-time) wage was reduced or ceased, or if there was an indication of decreased employability. The outcome was measured one year after entry in the project and analyzed using binary and multinomial logistic regressions. Results: Participants in the multidisciplinary team group reported having RTW odds ratio (OR) 3.31 (95% CI 1.39–7.87) compared to the control group in adjusted models. Participants in the ACT group reported having increased employability OR 3.22 (95% CI 1.13–9.15) compared to the control group in adjusted models. Conclusions: This study of vocational rehabilitation in mainly female patients on long-term sick leave due to mental illness and/or chronic pain suggests that multidisciplinary team assessments and individually adapted rehabilitation interventions increased RTW and employability. Solely receiving the ACT intervention also increased employability.

Suggested Citation

  • Erik Berglund & Ingrid Anderzén & Åsa Andersén & Lars Carlsson & Catharina Gustavsson & Thorne Wallman & Per Lytsy, 2018. "Multidisciplinary Intervention and Acceptance and Commitment Therapy for Return-to-Work and Increased Employability among Patients with Mental Illness and/or Chronic Pain: A Randomized Controlled Tria," IJERPH, MDPI, vol. 15(11), pages 1-12, October.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:11:p:2424-:d:179568
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    References listed on IDEAS

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    1. Van der Klink, J.J.L. & Blonk, R.W.B. & Schene, A.H. & Van Dijk, F.J.H., 2001. "The benefits of interventions for work-related stress," American Journal of Public Health, American Public Health Association, vol. 91(2), pages 270-276.
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    1. Cristiano Barreto de Miranda & João Silvestre Silva-Junior & Gisele Aparecida Fernandes & Frida Marina Fischer, 2020. "Trends in the Cumulative Incidence of Vocational Rehabilitation Indicators in Brazil, 2007–2016," IJERPH, MDPI, vol. 17(11), pages 1-8, June.
    2. Erik Berglund & Emilie Friberg & Monika Engblom & Åsa Andersén & Veronica Svärd, 2022. "Coordination and Perceived Support for Return to Work: A Cross-Sectional Study among Patients in Swedish Healthcare," IJERPH, MDPI, vol. 19(7), pages 1-11, March.
    3. Katarina Aili & Therese Hellman & Magnus Svartengren & Katarina Danielsson, 2022. "Including a Three-Party Meeting Using the Demand and Ability Protocol in an Interdisciplinary Pain Rehabilitation Programme for a Successful Return to Work Process," IJERPH, MDPI, vol. 19(24), pages 1-13, December.
    4. José-María Figueredo & Cristina García-Ael & Andrea Gragnano & Gabriela Topa, 2020. "Well-Being at Work after Return to Work (RTW): A Systematic Review," IJERPH, MDPI, vol. 17(20), pages 1-27, October.

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