Improving health and productivity of depressed workers: a pilot randomized controlled trial of telephone cognitive behavioral therapy delivery in workplace settings
Received 5 December 2009; accepted 5 January 2010. published online 01 February 2010.
Abstract
Objective
To examine the feasibility of telephone-delivered cognitive behavioral therapy (T-CBT) in an occupational context, with reference to participant recruitment, treatment adherence, follow-up and effect.
Method
Eligible participants comprised all employees of a large communications company with authorized work absence due to mild/moderate mental health difficulties over a 10-month period. Fifty-three consenting participants were centrally randomized to 12 weeks T-CBT or usual care, with minimization on age, gender and illness severity. Primary (symptom severity) and secondary outcomes (self-rated work performance and productivity) were measured at baseline and 3-months via postal questionnaires. Intention-to-treat analysis comprised multiple regression modeling with adjustment for missing response predictors, minimization variables and baseline values.
Results
Twenty-three employees attended one or more T-CBT sessions. T-CBT was associated with medium–large effects sizes on clinical outcomes (0.63–0.77) and work productivity scores (0.75–0.88). Twenty-one patients failed to return 3-month primary outcome data. Non-respondents were more likely to be male and more severely ill.
Conclusion
Delivery of T-CBT in an occupational context is feasible with evidence of potential effect. Larger-scale trials are warranted. These studies demand assertive outreach or telephone-based assessment strategies in order to maximize participant recruitment and follow-up.
aSchool of Nursing, Midwifery and Health Visiting, University of Manchester, Manchester, M13 9PL, UK
bNational Centre for Primary Care Research & Development, University of Manchester, M13 9PL, UK
cDepartment of Health Sciences, University of York, York, YO10 5DD, UK
Corresponding author. Research Fellow, School of Nursing, Midwifery and Health Visiting, University of Manchester, Oxford Road, Manchester, UK M13 9PL. Tel.: +44 (0)161 306 7652.
ABSTRACT