eBehandling - Health and Work for Patients in Specialist Mental Health Care

Conditions studied

Anxiety, Depression

About this study

Mental health problems and disorders affect one in every five amongst the working- age adults in the countries of the Organization for Economic Cooperation and Development. This constitutes a major public health challenge that also has large implications for work participation and productivity. Major depression and anxiety are the most prevalent of the mental disorders and are therefore named common mental disorders (CMD). CMD have become a major cause of work absenteeism, with 30% of all sick leave in Norway being due to CMDs in 2024. Early interventions addressing psychological aspects and vocational challenges related to work have shown a positive effect on return to work. Therefore, finding ways to increase availability and reduce barriers to evidence-based treatments seems a viable route to reducing mental health's impact on sick leave and absenteeism. Research show that improvement in symptoms from ordinary psychotherapy has little impact on sick-leave. The same results have been found for internet-based cognitive therapy (ICBT). One of the challenges in specialised mental health care is that the work focus has been an additive or extended part of the treatment, not integrated in the treatment itself. Several studies have been conducted on psychological treatments that specifically target return to work for people with CMDs. Systematic reviews have shown that work-focused therapy has a small, but significant effect over treatment as usual on return to work and finds that 20% more workers in the intervention groups had returned to work, compared to control groups. The availability of traditional therapy is scarce and there is an need for new effective ways of delivery. internet-based cognitive therapy has been shown to be as effective as traditional therapy in many systematic reviews and meta analysis and seems a good approach to reach the goal of increasing availability. To account for the heterogene group of people on sick leave the investigators have created a transdiagnostic, work-focused internet-based cognitive behaviloural therapy program. This study aims is to is to investigate the utility and use of this treatment program for patients with common mental health disorders on sick leave or work assessment allowance. This includes the user experience of participation and experienced utility of the treatment program.

Interventions

• Behavioral: Transdiagnostic, work-focused Cognitive Behavioural Therapy — Transdiagnostic, work-focused Cognitive Behavioural Therapy focuses on core mechanisms that creates and maintain illness in depression and anxiety. Namely reducing avoidance and/or suppression of unwanted thoughts, avoidance of meaningful activity and increase cognitive flexibility while under psychological stress.

Primary outcomes

• Degree of Sickleave (baseline, 6 weeks, 12 weeks, 6 months and 12 months)
• Return to Work Self-efficacy 11 (baseline, 6 weeks, 12 weeks, 6 months and 12 months)

Eligibility information

Study locations

• Sykehuset Vestre Viken, Oslo, Bærum 1346 Norway
• Sykehuset Innlandet, Lillehammer, Innlandet 2609 Norway
• Vinderen DPS, Oslo, Oslo 0373 Norway
• AHus DPS Grorudalen, Oslo, Oslo 1067 Norway
• Sykehuset i Vestfold, Tønsberg, Vestfold 3103 Norway
• University of Bergen, Bergen, Vestland 5007 Norway
• Bjørgvin DPS (Helse Bergen), Bergen, Vestland 5113 Norway
• Solli DPS, Bergen, Vestland 5227 Norway
• Sykehuset i Østfold, Fredrikstad, Østfold fylke 1603 Norway