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Effectiveness of Briefer Coping-Focused Psychotherapy for Common Mental Complaints on Work-Participation and Mental Health: A Pragmatic Randomized Trial with 2-Year Follow-Up

Abstract

Purpose The aim of this study was to assess short and long-term effectiveness of brief coping-focused psychotherapy (Brief-PsT) compared with short-term psychotherapy (Short-PsT) on work-participation (WP) and mental health. Both treatments were preceded by group education. Methods All participants were on, or at risk of, sick leave due to common mental complaints. Patients were selected for inclusion in this study based on levels of self-reported symptoms (‘some’ or ‘seriously affected’) of anxiety and depression. They were randomized to Brief-PsT (n = 141) or Short-PsT with a more extended focus (n = 143). Primary outcome was the transition of WP-state from baseline to 3 months follow-up. In addition, WP at 12 and 24 months follow-up were assessed. The secondary outcome, clinical recovery rate (CR-rate) was obtained from the Beck Depression and Beck Anxiety Inventories, at 2-year follow-up. In addition, self-reported mental health symptom severity, self-efficacy, subjective health complaints and life satisfaction were assessed. Results At 3 months follow-up, the increase in WP was significantly greater in Brief-PsT than in Short-PsT (p = 0.039). At 3 months, 60% in Brief-PsT and 51% in Short-PsT was at work, partial or full. Thereafter, these differences diminished, 84% and 80% were at work at 2-year follow up. The 2-year follow-up of the secondary outcome measurements was completed by 53% in Brief-PsT and 57% in Short PsT. CR-rate was significantly greater in Brief-PsT compared with the Short-PsT (69% vs. 51%, p = 0.024). Furthermore, there was a greater reduction in the number of subjective health complaints in Brief-PsT (4.0 vs. 1.9 p = 0.012). All other measurements favoured Brief-PsT as well, but did not reach statistical significance. Conclusions Brief coping-focused psychotherapy added to group education for persons with depression or anxiety complaints seemed more effective in enhancing early work participation compared with additional short-term psychotherapy of standard duration with more extended focus. Clinical recovery rate and decline of comorbid subjective health complaints at 2-year follow-up were also in favour of the brief coping-focused program.

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Data Availability

The data-file that the current analyses are based on, is owned by Vestfold Hospital Trust and are kept on a secure research-data-server. Application for access to the data file must be send to the Data-privacy agent at Vestfold Hospital Trust by e-mail to Forskning@siv.no.

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Acknowledgments

We would like to thank the participants for taking part in the study, and all therapists involved for their inspiring and enthusiastic help and participation. Also, thanks to Clive Bachelor for carefully reading the manuscript and providing critical comments concerning English language use. The study was funded by Vestfold Hospital Trust and Rapid-RTW program, South-Eastern Norway Regional Health Authority.

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Correspondence to M. E. A. Wormgoor.

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Conflict of interest

Aage Indahl is currently employed at the outpatient clinic. Eivind Andersen and Marjon E.A. Wormgoor were previously employed at the outpatient clinic of the current study. Jens Egeland and Marjon E.A. Wormgoor are currently employed in the Divisions of Vestfold Hospital Trust that runs the outpatient clinic of the current study. None of the authors have been clinically involved in the patient population of this study.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all individual participants included in the study.

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Wormgoor, M.E.A., Indahl, A., Andersen, E. et al. Effectiveness of Briefer Coping-Focused Psychotherapy for Common Mental Complaints on Work-Participation and Mental Health: A Pragmatic Randomized Trial with 2-Year Follow-Up. J Occup Rehabil 30, 22–39 (2020). https://doi.org/10.1007/s10926-019-09841-6

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Keywords

  • Mental health
  • Return to work
  • Psychotherapy
  • Sick leave