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Can a ‘return-to-work’ agenda fit within the theory and practice of CBT for depression and anxiety disorders?

Published online by Cambridge University Press:  07 April 2010

Matthew Wesson  and
Matthew Gould
Matthew Wesson*
Affiliation:
Ministry of Defence, Department of Community Mental Health Portsmouth, Hampshire, UK
Matthew Gould
Affiliation:
Ministry of Defence, Department of Community Mental Health Portsmouth, Hampshire, UK
*
*Author for correspondence: Mr M. Wesson, Department of Community Mental Health, PP6 Sunny Walk, HMNB Portsmouth, Portsmouth, Hampshire PO1 3LT, UK. (email: matthew.wesson776@mod.uk)
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Abstract

Helping service users to return to work has emerged as a key therapeutic objective of the Improving Access to Psychological Therapies (IAPT) initiative. IAPT programmes implement National Institute for Health and Clinical Excellence (NICE) guidelines, especially cognitive behaviour therapy (CBT), for people suffering from anxiety and depression. However, relatively little research has been conducted to date into whether, or how, cognitive behavioural interventions can help individuals return to work. This paper reviews literature and research into CBT and occupational outcomes and considers whether a return-to-work agenda may jeopardize the therapeutic alliance which is suggested to be necessary for effective CBT. Moreover, through the use of clinical examples from our practice, we suggest ways in which employment issues might be integrated into CBT for depression and anxiety disorders. We conclude that a return-to-work agenda can be utilized during therapy while maintaining a collaborative and secure therapeutic relationship, especially, perhaps if work issues are embedded within the formulation. However, further research is needed, not only to determine whether CBT can help individuals return to work but also how CBT might best integrate a return-to-work agenda.

Keywords

CBTemploymentIAPToccupational mental healthoutcomes
Type
Practice article
Information
the Cognitive Behaviour Therapist , Volume 3 , Issue 1 , March 2010 , pp. 27 - 42
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

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References

Recommended follow-up reading

Hashtroudi, A, Paterson, H (2009). Occupational health advice in NICE guidelines. Occupational Medicine 59, 353–356.CrossRefGoogle ScholarPubMed
NICE (2009). Managing long-term sickness absence and incapacity for work (http://www.nice.org.uk/nicemedia/pdf/LTSDraftGuidance.pdf). Accessed 18 June 2009.Google Scholar
Widay, S, Dovey, D (2005). All in the mind? Occupational Health 57, 25–28.Google Scholar

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