A cognitive-behavioral return-to-work program: effects on pain patients with a history of long-term versus short-term sick leave

A cognitive-behavioral return-to-work focused program was evaluated in a ra ndomized controlled design, and the effects were compared between two group s of women with musculoskeletal pain. One group of patients (n = 36) had a history of long-term sick leave (>12 months) at the start of the program an d the other (n = 36) had a history of short-term sick leave (2-6 months). T he outpatient treatment program, conducted by a psychologist, included 12 s essions with the primary aim to help the patients return-to-work. The treat ment first included teaching of coping strategies such as applied relaxatio n, stress management, graded activity training and pacing. Thereafter the p atients were taught how to manage difficulties at their return-to-work and how to generalize coping strategies to different risk factors at their work places. The control condition received treatment-as-usual. The results sho wed that the cognitive-behavioral return-to-work program was more effective than the treatment-as-usual control condition in reducing the number of da ys on sick leave for patients on short-term sick leave, but not for patient s on long-term sick leave. The treatment program also helped the patients o n short-term sick leave to increase their ability to control and decrease p ain and to increase their general activity level compared to the control co ndition. These results underscore the need for an early return-to-work focu sed rehabilitation to prevent long-term sick leave and disability. (C) 2001 International Association for the Study of Pain. Published by Elsevier Sci ence B.V. All rights reserved.