Cognitively Oriented Behavioral Rehabilitation in Combination with Qigong for Patients on Long-Term Sick Leave Because of Burnout: REST—A Randomized Clinical Trial

  • Therese StenlundEmail author
  • Christina Ahlgren
  • Bernt Lindahl
  • Gunilla Burell
  • Katarina Steinholtz
  • Curt Edlund
  • Leif Nilsson
  • Anders Knutsson
  • Lisbeth Slunga Birgander



Despite an increase in the occurrence of burnout, there is no agreement on what kind of rehabilitation these patients should be offered.


Primary aim of this study was to evaluate effects on psychological variables and sick leave rates by two different group rehabilitation programs for patients on long-term sick leave because of burnout. Rehabilitation program A (Cognitively oriented Behavioral Rehabilitation (CBR) and Qigong) was compared with rehabilitation program B (Qigong only).


In a randomized clinical trial, 96 women and 40 men with a mean age of 41.6 ± 7.4 years were allocated to one of the two rehabilitation programs.


A per-protocol analysis showed no significant difference in treatment efficacy between the groups. Both groups improved significantly over time with reduced levels of burnout, self-rated stress behavior, fatigue, depression, anxiety, obsessive–compulsive symptoms, and sick leave rates. In an intention-to-treat analysis, patients in program A had fewer obsessive–compulsive symptoms and larger effect sizes in self-rated stress behavior and obsessive–compulsive symptoms compared to patients in program B.


This study showed no differences in effect between CBR and Qigong compared with Qigong only in a per-protocol analysis. Both rehabilitation programs showed positive effect for patients with burnout.


Randomized controlled trials Burnout Cognitive therapy Sick leave 



This study was funded by the Swedish Council for Working Life and Social Research (dnr 2003-0761), the Västerbotten County Council, and the Swedish Social Insurance Agency.


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Copyright information

© International Society of Behavioral Medicine 2008

Authors and Affiliations

  • Therese Stenlund
    • 1
    Email author
  • Christina Ahlgren
    • 2
  • Bernt Lindahl
    • 3
  • Gunilla Burell
    • 4
  • Katarina Steinholtz
    • 1
  • Curt Edlund
    • 5
    • 6
  • Leif Nilsson
    • 1
  • Anders Knutsson
    • 6
  • Lisbeth Slunga Birgander
    • 1
  1. 1.Department of Public Health and Clinical Medicine, Occupational and Environmental MedicineUmeå UniversityUmeåSweden
  2. 2.Department of Community Medicine and Rehabilitation, PhysiotherapyUmeå UniversityUmeåSweden
  3. 3.Department of Public Health and Clinical Medicine, Behavioral MedicineUmeå UniversityUmeåSweden
  4. 4.Department of Public Health and Caring SciencesUniversity of UppsalaUppsalaSweden
  5. 5.Department of Public Health and Clinical Medicine, Epidemiology and Public Health SciencesUmeå UniversityUmeåSweden
  6. 6.Department of Health SciencesMid Sweden UniversitySundsvallSweden

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