benefits
first two years, the number of claims fell by
56 per cent and the days away from work
fell by 52 per cent (see Table 1).
HOW IT WORKS
The strategy works by combining returnto
work-focused cognitive behavioural
therapy (CBT) with disability case management.
Together, they often increase the
employee’s wellbeing and decrease the employer’s
overall expenses.
WHAT IS COGNITIVE
BEHAVIOURAL THERAPY?
CBT comes from the theory that how we
think about and interpret our feelings is an
unconscious choice – something outside
of our control. These behaviours lead us
to establish firm beliefs about our identity,
about “who” and “what” type of person we
are. If a person is exposed to adverse or
negative challenges, there is the risk that
they will believe a negative reaction is
beyond their control: “This is who I am.”
This can increase emotional distress. An
example of this is in cases of depression
where repeated negative thoughts (or
rumination) can often make the symptoms
of the illness worse.
In CBT, the employee learns to question
their own firm beliefs, opening up
new roads for personal growth and building
a different way of being in the world.
During the treatment, the person learns
to become aware of dysfunctional thinking
and behaviour and develops new
interpretations of it during a gradual reintroduction
to the stressful situation.
HOW CBT SUPPORTS THE
DISABILITY MANAGEMENT
PROCESS
One of the most important factors for
success in the program, and overall
Number of Claims
Average Duration
(in days) of Complex
Mental Health Claims
Pre-Program Not available 86
Post-Program – Year One 2014 61 57
Post-Program – Year Two 2015 34 45
Percentage Change 56% 52%
and sustaining healthy lifestyle habits such
as exercise, relaxation, social interaction
and others.
ENHANCING RESILIENCE
Resilience is a person’s ability to properly
adapt to negative life situations and adversity.
This could be family or relationship
problems, health problems or workplace
and financial worries, among others. How
a person copes with these situations can
be influenced by anything from personality
to social relationships, cultural context
to the environment. When the employee
understands and believes that resilience
is a process they can learn through therapy
and self-work, then it becomes easier to
focus on building the skills that will prepare
them to address their problems. They
can do this in a way that is not detrimental
to themselves or their workplace.
It is also important to understand the
psychological demands of the job and
design the return to work accordingly.
These include: cognition, critical thinking,
Table 1: Complex Mental Health Cases
disability outcomes, is the support of the
HR department and the wider organization.
It is vital that workplaces, as well
as teams, support the employee’s unique
situation and are not adversarial. The
culture of the company must also embrace
and support return to work. When
the employee knows that their employer,
healthcare providers and disability case
managers have their best interest at heart,
it significantly improves the success of a
timely and sustainable return to well-being
and productivity.
WHEN THE EMPLOYEE UNDERSTANDS AND BELIEVES THAT
RESILIENCE IS A PROCESS THEY CAN LEARN THROUGH THERAPY AND
SELF-WORK, THEN IT BECOMES EASIER TO FOCUS ON BUILDING THE
SKILLS THAT WILL PREPARE THEM TO ADDRESS THEIR PROBLEMS.
In the program, the treating psychologist
understands how to utilize the skills,
strategies and resources of disability case
managers. This makes a big difference to
the outcome. The case managers have a
strong focus on the employee’s progress
during treatment and how it fits into a
return-to-work plan. Disability management
programs also focus on psychosocial
rehabilitation; that is, building the confidence
and ability of the person to the
point where they can take an active part in
work, community and normal life.
By working closely together, the
therapist and the disability case manager
are able to build the employee’s resilience
and ensure that the person has the
confidence to return quickly back into an
active working role. The program also has
a holistic approach to help develop longterm
resilience and coping skills – for
example, personal “homework” strategies
social interaction, memory, etc. The
disability management and therapy teams
must understand the essential nature of the
employee’s job. Some jobs are “achievement
oriented,” for example, they need traits
of effort, persistence, concentration and
initiative; others may be “interpersonal,”
with focus on co-operation, teamwork and
concern for others.
Crucially, programs need to be closely
supervised and monitored to ensure the
return to work is sustained. They should
also identify if and when any additional
treatments are needed to improve the
overall outcomes. It is believed this
program will lead to continued long-term
positive outcomes. n
Liz R. Scott, Ph.D. is the principal of
Organizational Solutions Inc. Carl Dalton is
a registered social worker and vice-president
of Dalton Associates Psychological Services.
50 ❚ MAY/JUNE 2016 ❚ HR PROFESSIONAL