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People with mental disorders, especially personality disorders, often face low acceptance at work. This is particularly problematic when returning to work after sick leave, because it impedes reintegration into the former workplace. This study explores colleagues’ reactions towards a problematic worker dependent on the returning person’s reintegration strategy: The returning person undertaking changes in their behaviour is compared with the person requesting adjustments of the workplace. In an experimental study, 188 employed persons read one of four vignettes that described a return-to-work-situation of a problematic co-worker. Across all vignettes, the co-worker was depicted as having previously caused problems in the work team. In the first vignette, the co-worker did not change anything (control condition) when she returned to work; in the second, she asked for workplace adjustments; in the third vignette she initiated efforts to change her own behaviour; and the fourth vignette combined both workplace adjustments and behavioural change. Study participants were asked for their reactions towards the problematic co-worker. Vignettes that included a behavioural change evoked more positive reactions towards the co-worker than vignettes without any behavioural change. Asking for workplace adjustments alone did not yield more positive reactions compared to not initiating any change. When preparing employees with interactional problems for their return to work, it is not effective to only instruct them on their statutory entitlement for workplace adjustments. Instead, it is advisable to encourage them to proactively strive for behaviour changes.
Negative work perception not changed in a short work-anxiety-coping group therapy intervention
(2016)
Background: Work anxiety is often associated with long-term sick leave and requires early intervention. Work anxieties are associated with negative work perception. Therefore, one aim in early intervention is a cognitive reframing of dysfunctional perceptions of workplace characteristics. Methods: A psychotherapeutic specialist conducted two group programs of four sessions each. One hundred twenty-three rehabilitation in-patients with work anxieties were randomly assigned either to a work anxiety-coping group or to a recreational group. The Short Questionnaire for Work Analysis (KFZA) was administered before and after the group treatment to measure perceptions of working conditions. Results: Participants from the work anxiety-coping group did not see their work in a significantly more positive light at the end of the intervention compared to participants from the recreational group. Conclusions: A short work anxiety-coping group did not initiate a consistent positive re-appraisal of work. Employers and occupational physicians should not expect positive changes of work perception when an employee returns from short medical rehabilitation including work-directed treatment. Additional support from the workplace must be considered, e.g. employer-physician-employee conversation preceding return to work, or (temporary) work adjustment.
Work anxiety is a potentially disabling mental health problem, which can cause (long-term) sickness absence. In many cases patients do not openly report their anxieties and tend to give externalizing explanations of inner problems. Therefore people with work anxiety may perceive their workplace more negatively than those without such anxiety. To investigate the relation between subjective work description and work anxiety. There were 148 inpatient participants and 8015 general population controls. Patients with work anxiety described their workplace significantly more negatively than patients without work anxiety and employees in the general population, with no differences in workplace descriptions between psychosomatic patients without work anxiety and the general population sample. The type of complaint about work conditions was related to the specific type of work anxiety. Reports about workplace burdens can be indicative of work anxiety and should prompt further in-depth assessments. The content of complaints about work conditions may point to the type of underlying work anxiety.
Objective: The aim of this study was to study the effects of a short-term cognitive behavior therapy on work-anxiety and sickness-absence in patients with work-anxiety. Methods: Three-hundred forty-five inpatients who suffered from cardiologic, neurological, or orthopedic problems and additionally work-anxiety were randomly assigned into two different group interventions. Patients got four sessions of a group intervention, which either focused on cognitive behavior-therapy anxiety-management (work-anxiety coping group, WAG) or unspecific recreational activities (RG). Results: No differences were found between WAG and RG for work-anxiety and subjective work ability. When looking at patients who were suffering only from work-anxiety, and no additional mental disorder, the duration of sickness absence until 6 months follow-up was shorter in the WAG (WAG: 11 weeks, RG: 16 weeks, P = 0.050). Conclusion: A shortterm WAG may help return to work in patients with work-anxieties, as long as there is no comorbid mental disorder.
Purpose Persons with work-anxieties are especially endangered for work capacity impairment and sick leave. Work capacity impairment is not directly due to symptoms but due to illness-related capacity disorders. Work capacity impairments can be described on different dimensions (e.g., social interaction, decision making and judgment, endurance, mobility). Understanding the type of work capacity impairment is important for reintegration interventions. This is the first study to investigate work capacity impairment in risk patients with different work-anxieties. Results Patients with different work-anxieties were impaired in different capacity dimensions: Work-related social anxiety went along with clinically relevant impairment in capacity of assertiveness (M = 2.40), anxiety of insufficiency went along with impaired capacity of endurance (M = 2.20), and work-related generalized worrying was accompanied by impairment in the capacity for decision making (M = 1.82). Specific capacity impairment dimensions were related to sick leave duration, while a global work ability prognosis was not. Conclusions The capacity approach is useful to describe work impairment more precisely and beyond symptoms. On this basis, reintegration-focusing interventions such as capacity training (e.g., social interaction training) or work adjustment (e.g., reducing exposure with interactional work tasks) can be initiated.
Ein großer Anteil der Erwerbstätigen ist aufgrund gesundheitlicher Einschränkungen einmalig oder mehrfach in seiner Berufsbiografie längere Zeit arbeitsunfähig. Auf Grundlage etablierter psychologischer Konstrukte und empirischer Befunde wurde ein spezifisch arbeitsbezogenes Inventar für Job-Coping und Rückkehrintention (JoCoRi) entwickelt. Der Selbsteinschätzungsfragebogen wurde an drei unabhängigen Stichproben (N = 243, N = 337, N = 111) von Rehabilitationspatienten aus Psychosomatik, Orthopädie, Kardiologie und Neurologie geprüft. Faktorenanalytische Ergebnisse der ersten Stichprobe bestätigen eine mehrfaktorielle Struktur. Das Inventar enthält 30 Items in 7 Skalen: 1. Arbeitsbezogene Rückkehrintention und -planung, 2. Arbeitsbezogene Selbstwirksamkeitserwartung, 3. Arbeitsbezogene Selbstberuhigung und Selbstinstruktion, 4. Arbeitsbezogene externale Kontrollüberzeugung, 5. Aktives Coping am Arbeitsplatz, 6. Bedeutung der Arbeit, 7. Kontrollüberzeugung bzgl. der Arbeitsaufnahme. Die Varianzaufklärung liegt bei 68 %. 25 Items haben Hauptladungen > .60. Interne Konsistenzen und Trennschärfen sind überwiegend zufriedenstellend. Die Modellgüte der konfirmatorischen Faktorenanalyse ist überzeugend. Das Modell ist in einer unabhängigen Stichprobe stabil (N = 337). Die Skalen wurden mit inhaltlich analogen Globalkonstrukten validiert. Die mehrfaktorielle Struktur kann in der zweiten Stichprobe repliziert werden. Eine längsschnittliche Analyse der dritten Stichprobe prüft die prädiktive Validität der Rückkehrintentionsskala; sie wird hinsichtlich Arbeitsunfähigkeitsdauer und Arbeitsfähigkeitsstatus bestätigt.
Background: Occupational therapy is an important co-therapy in psychiatric therapy. It is a common belief that no risks are associated with occupational therapy. Negative effects caused by group therapy, especially occupational therapy, have not been in the focus of research yet. In this study we want to illustrate possible types and intensities of group side effects through occupational therapy. Patients and Methods: Patients of an inpatient rehabilitation facility filled out the Adverse Treatment Reaction Group Checklist. The checklist contains 47 items divided in six dimensions: group size, content, group participants, group outcome and global. The self-rating used a 5-point likert scale (0 = not at all; 4 = verymuch, extremely stressful) and gives information about types and intensities of the side effects. Results: 88.9 % of 45 patients reported negative effects of occupational group therapy. 28.9 % of the patients rated the side effect as at least severe. Discussion: Occupational therapy is associated with side effects as every other group therapy. Possible side effects caused by group therapy should be considered while planning and implementing occupational therapy.