Case Report: Cognitive Work Hardening for Return-to-Work Following Depression

Area of Science:

• Occupational therapy
• Psychiatry
• Rehabilitation medicine

Background:

• Mental health disability claims, particularly for depression, are increasing, causing significant workplace costs.
• Returning to work after depression is challenging as occupational functioning often lags symptom recovery.
• Targeted interventions are needed to bridge the gap between disability leave and competitive employment.

Observation:

• A case report details a 50-year-old woman on a 2-year disability leave for depression.
• The client participated in a 4-week Cognitive Work Hardening (CWH) program.
• The program addressed fatigue, cognitive deficits, outdated skills, and anxiety through work simulations and coping strategies.

Findings:

• The CWH program improved cognitive abilities, work stamina, self-confidence, and self-efficacy.
• The client reported increased work ability and decreased fatigue and depression severity.
• Clinical markers indicated readiness for return to work, with sustained positive outcomes three months post-intervention.

Implications:

• Cognitive Work Hardening (CWH) is an effective, targeted intervention for return-to-work preparation after depression.
• CWH addresses functional deficits that persist despite depression symptom improvement.
• This approach offers a viable solution for reducing the economic and social costs associated with mental health disability.