Transdiagnostic group-based occupational rehabilitation for participants with chronic pain, chronic fatigue and common mental disorders. A feasibility study

Disabil Rehabil. 2018 Oct;40(21):2516-2526. doi: 10.1080/09638288.2017.1339298. Epub 2017 Jun 29.

Abstract

Purpose: The aim was to investigate the feasibility of introducing a novel transdiagnostic occupational rehabilitation program delivered in groups mixing participants with chronic pain, chronic fatigue and common mental disorders.

Materials and methods: Observational data on group climate and individual participation were triangulated with qualitative data from focus group interviews on the participants' experiences with transdiagnostic groups.

Results: The study included 222 participants receiving a temporary work disability benefit. Self-reported chronic pain (75%), chronic fatigue (79%), and mental distress (62%) were prevalent and the majority reported overlapping conditions (78%). Program completion among participants was high (96%). Those completing participated actively (95%) in the program. Overall group climate was stable with moderately high engagement. Participants with clinically confirmed mental disorders (22%) showed similar outcomes. Self-reported problems with "working in a group" prior to rehabilitation were not associated with how participants experienced group climate. Qualitative data supported the findings of positive participant experiences with transdiagnostic group settings.

Conclusions: Transdiagnostic groups showed high participation rates, moderately high group engagement across symptom profiles and positive participant experiences. Implementing transdiagnostic occupational rehabilitation in groups mixing participants with chronic pain, chronic fatigue and common mental disorders was feasible and acceptable to participants. Implications for rehabilitation Most research has been done on disorder-specific occupational rehabilitation programs, but emerging evidence supports a more generic approach. Transdiagnostic therapies, such as Acceptance and Commitment Therapy (ACT), have shown promising results for both somatic and mental disorders. The feasibility of implementing transdiagnostic rehabilitation groups, their acceptability to participants and the demand for such groups has not been established. This study indicates that it is feasible to introduce a novel transdiagnostic group-based occupational rehabilitation program for mixed groups of sick-listed participants with chronic pain, chronic fatigue and/or common mental disorders.

Keywords: Musculoskeletal disease; acceptance and commitment therapy; fatigue; group therapy; mental disorder; vocational rehabilitation.

MeSH terms

  • Adult
  • Chronic Disease / rehabilitation
  • Chronic Pain / rehabilitation*
  • Fatigue / rehabilitation*
  • Feasibility Studies
  • Female
  • Group Processes*
  • Humans
  • Male
  • Mental Disorders / rehabilitation*
  • Middle Aged
  • Occupational Therapy / methods*
  • Patient Compliance
  • Patient Participation
  • Young Adult