Journal of Occupational Rehabilitation

, Volume 15, Issue 3, pp 377-392

First online:

Secondary Prevention of Work Disability: Community-Based Psychosocial Intervention for Musculoskeletal Disorders

  • Michael J. L. SullivanAffiliated withDepartment of Psychology, University of Montreal
  • , L. Charles WardAffiliated withV.A. Medical Center
  • , Dean TrippAffiliated withDepartment of Psychology, Queen’s University
  • , Douglas J. FrenchAffiliated withDepartment of Psychology, University of Moncton
  • , Heather AdamsAffiliated withDepartment of Psychology, University of Montreal
  • , William D. StanishAffiliated withDepartment of Surgery, Dalhousie University

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Introduction: One objective of the present research was to examine the degree to which psychological risk factors could be reduced through participation in a community-based psychosocial intervention for work-related musculoskeletal disorders. A second objective was to examine whether psychosocial risk reduction had an effect on the probability of return to work. Methods: Participants were 215 Workers Compensation Board claimants with work-related musculoskeletal disorders who had been absent from work for an average of approximately 7 months (M = 28.8 weeks, range = 4–100 weeks) and were referred to a community-based multidisciplinary secondary prevention program in Nova Scotia, Canada. Results: In the current sample, 63.7% of participants returned to work within 4 weeks of treatment termination. The percentage reductions in targeted risk factors from pretreatment to posttreatment were as follows: catastrophizing (32%), depression (26%), fear of movement/re-injury (11%), and perceived disability (26%). Logistic regression indicated that elevated pretreatment scores on fear of movement and re-injury (OR = 0.58, 95% CI = 0.35–0.95) and pain severity (OR = 0.64, 95% CI = 0.43–0.96) were associated with a lower probability of return to work. A second logistic regression addressing the relation between risk factor reduction and return to work revealed that only reductions in pain catastrophizing (OR = 0.17, 95% CI = 0.07–0.46) were significant predictors of return to work. Conclusions: The results of the present study provide further evidence that risk factor reduction can impact positively on short term return to work outcomes. Significance: Outcomes of rehabilitation programs for work disability might be improved by incorporating interventions that specifically target catastrophic thinking. Community-based models of psychosocial intervention might represent a viable approach to the management of work disability associated with musculoskeletal disorders.


psychosocial risk factors occupational disability secondary prevention catastrophizing rehabilitation work-related musculoskeletal disorders return to work