Effectiveness of Self-Help Interventions to Reduce Work Disability: A Rapid Mixed Methods Systematic Review

To assess the effectiveness of self-help interventions in reducing work disability and improving work- and health-related outcomes among individuals with musculoskeletal, anxiety, and/or depressive conditions; to explore lived experiences with self-help interventions; and to integrate quantitative and qualitative findings to guide future research and implementation.

We conducted a rapid mixed methods systematic review following World Health Organization (WHO) and Cochrane Rapid Reviews Methods Group guidance. We included randomized controlled trials (RCTs), quasi-experimental, qualitative, and mixed methods studies published in English since 2007. Eligible studies evaluated self-help interventions targeting musculoskeletal, anxiety, and/or depressive conditions in working-age adults (18-65 years). Quantitative outcomes included functioning, return-to-work, productivity, and self-efficacy; qualitative outcomes reflected user experiences. Risk of bias was assessed using RoB 2, ROBINS-I, and CASP tools. Findings were synthesized narratively by intervention types and outcome domain.

Eight studies met inclusion criteria: five RCTs, two quasi-experimental, and one qualitative. All seven quantitative studies were rated high risk of bias. Short-term improvements were observed in disability and physical quality of life in two exercise-based trials, but effects on work participation were inconsistent and generally below thresholds for clinical importance. Cognitive-behavioral and psychoeducational programs produced small improvements in self-efficacy and presenteeism, and relaxation and educational interventions showed no meaningful effects. The qualitative study highlighted workplace barriers such as productivity pressures and limited opportunities for movement that constrained engagement.

Self-help interventions may modestly improve self-management, disability, and coping in the short term but show limited and inconsistent evidence for reducing work disability. Their effectiveness likely depends on adherence, contextual support, and integration into workplace environments. Future high-quality, co-designed, context-sensitive studies are needed to clarify effectiveness, safety, and sustainability in real-world settings. PROSPERO registration: CRD42023472934, registered on October 16, 2023; modified March 17 2025.