Insights into cognitive work hardening for return-to-work following depression: Qualitative findings from an...

Workplace mental health disability claims are rising with concomitant challenges to return-to-work (RTW) success. Cognitive work hardening (CWH) addresses work re-entry issues including fatigue, coping skills, and reduced cognitive abilities which are relevant for people returning to work following an episode of depression.

To gain insight into underlying factors contributing to CWH's effectiveness in RTW preparation following depression.

Twenty-one individuals on paid disability leave due to depression completed a four week CWH treatment intervention prior to returning to work. At program completion and at three months follow up, participants provided qualitative information regarding their experience of the intervention in the form of written questionnaires and interviews. Data were analyzed using a directed approach to content analysis.

Intervention elements perceived by participants as helpful included structure, work simulations, and simulated work environment. Main treatment gains reported by participants related to routine, self-confidence, stamina, and cognitive abilities. Personal agency, empowerment, and skill development emerged as important consequences of interventions for RTW following depression.

Study findings enhance understanding of CWH with relevance to clinical practice. Key intervention elements deemed important for RTW are discussed and may provide guidance for other work-re-entry programs.