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Capacity-Oriented Behavior Therapy in Mental Disorders Mental disorders come along with the impairment of activities and capacities of daily live. Behavior therapy often uses capacity trainings for improving compensatory behavior, beside symptom reduction as such. This article gives an overview on how behavior therapy techniques can be used to improve compensatory behavior in different capacity domains that were conceptually derived from the International Classification of Functioning, Disability and Health (ICF) and which are often impaired in mental disorders.
Workplaces contain by their very nature different anxiety-provoking characteristics. When workplace-related anxieties manifest, absenteeism, long-term-sick leave, and even disability pension can be the consequences. In medical-vocational rehabilitation about 30-60 % of the patients suffer from workplace-related anxieties that are often a barrier for return to work. Even in mentally healthy employees, 5 % said that they were prone to ask for a sick leave certificate due to workplace-related anxieties. Future research should focus on workplace-related anxieties not only in rehabilitation, but more earlier, i. e. in the workplace. The concept of workplace-related anxieties offers ideas which can be useful in mental-health-oriented work analysis, employee-workplace-fit, and job design.
Purpose: Work-related anxieties are frequent and have a negative effect on the occupational performance of patients and absence due to sickness. Most important is workplace phobia, that is, panic when approaching or even thinking of the workplace. This study is the first to estimate the prevalence of workplace phobia among primary care patients suffering from chronic mental disorders and to describe which illness-related or workplace-specific context factors are associated with workplace phobia.
Methods: A convenience sample of 288 primary care patients with chronic mental disorders (70% women) seen by 40 primary care clinicians in Germany were assessed using a standardized diagnostic interview about mental disorders and workplace problems. Workplace phobia was assessed by the Workplace Phobia Scale and a structured Diagnostic and Statical Manual of Mental Disorders-based diagnostic interview. In addition, capacity and participation restrictions, illness severity, and sick leave were assessed.
Results: Workplace phobia was found in 10% of patients with chronic mental disorders, that is, approximately about 3% of all general practice patients. Patients with workplace phobia had longer durations of sick leave than patients without workplace phobia and were impaired to a higher degree in work-relevant capacities. They also had a higher degree of restrictions in participation in other areas of life.
Conclusions: Workplace phobia seems to be a frequent problem in primary care. It may behoove primary care clinicians to consider workplace-related anxiety, including phobia, particularly when patients ask for a work excuse for nonspecific somatic complaints.