Metacognitive Beliefs as Predictors of Return to Work After Intensive Return-to-Work Rehabilitation in Patients With Chronic Pain, Chronic Fatigue and Common Psychological Disorders: Results From a Prospective Trial

Purpose The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results Seven electronic databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability. Electronic supplementary material The online version of this article (doi:10.1007/s10926-016-9690-x) contains supplementary material, which is available to authorized users.

Cognitive therapy techniques are applied to an ever-increasing range of psychological disorders. However, both basic methods and general theory of therapy have evolved more slowly. Although cognitive therapy is based on experimentally testable concepts derived from cognitive psychology, an integration of these areas capable of explaining cognitive-attentional phenomena and offering treatment Implications remains to be achieved. In this paper, we outline the Self-Regulatory Executive Function (S-REF) model of emotional disorder, which integrates information processing research with Beck's schema theory. The model advances understanding of the roles of stimulus-driven and voluntary control of cognition, procedural knowledge (beliefs), and of the interactions between different levels of information-processing. It also accounts for cognitive bias effects demonstrated in the experimental psychopathology literature. The model presents implications concerning not only what should be done in cognitive therapy, but how cognitive change may be most effectively accomplished.