From: Work-related medical rehabilitation in patients with mental disorders: the protocol of a randomized controlled trial (WMR-P, DRKS00023175)
Work-related psychosocial groups
Work-related functional capacity training
Work-related assessments are performed to plan and design therapeutic interventions individually. Diagnostic measures are also needed to develop recommendations for adapting the patient’s job environment.
The aims of social counseling in WMR are providing information about the various possibilities for supporting work participation and working out solutions for individual occupational and social problems.
The aim of work-related psychosocial groups is to learn how to deal with work-related conflicts.
The aim of work-related functional capacity training is to increase the capacity to cope job demands.
Work-related assessments determine individual rehabilitation needs by comparing work-related physical and psychosocial functional capacity with the patient’s job demands. Assessment of functional capacity and job demands is performed by interviews, tests and questionnaires. The rehabilitation team uses standardized profiling to contrast individual capacities and job demands [28,29,30,31]. The comparison of individual capacities and job demands reveals discrepancies in demands and capacities due to excessive demands and/or insufficient capacities.
Social counseling examines the individual work–life situation and provides socio-legal guidance and advice concerning further assistance within the social security system. The intervention usually takes place in the course of several counseling sessions. In the group session, presentation slides are used to illustrate possibilities available in the social security system. After individual consultation appointments, patients receive written summaries of the discussed contents.
The group discusses conflicts and interactional problems but also resources and skills that can be used in the workplace. The participants are taught knowledge about triggers. The exchange within the group enables the participants to work out strategies for coping with conflicts together. Additionally, preventive measures to avoid stress and conflicts are taught. Both psychoanalytical and behavioral therapy approaches are used.
In work-related functional capacity training, complex work routines relevant to the workplace are trained (e.g. group project work to explore interactive behavior).
Therapists of different occupational backgrounds are involved, particularly physicians, psychologists, occupational therapists, exercise therapists and social workers.
Social counseling is provided by social workers.
Psychosocial sessions are performed by clinical psychiatrists or psychological therapists.
The intervention is primarily carried out by occupational therapists. In addition, parts of the training are carried out by physiotherapists, vocational trainers, psychologists and psychotherapists.
Diagnostic measures are performed face-to-face and individually.
The intervention consists of face-to-face individual sessions and an additional group intervention with a maximum of 15 participants.
Work-related psychosocial groups are conducted face-to-face in groups of a maximum of 15 people.
Work-related functional capacity training is performed face-to-face as a group intervention with a maximum of 15 participants.
All treatment components are delivered in inpatient rehabilitation facilities. Lecture halls with screens for the lectures and the presentation of slides are available. Individual discussions take place in therapy rooms. Group therapy rooms are available for group therapy. Occupational therapy facilities are available and contain all the materials needed for the work-related functional capacity training.
When and how much
The intervention is performed at the beginning and, if necessary, also during or at the end of the rehabilitation program for a total of at least 90 min.
Social counseling in the context of WMR is provided at least twice, which amounts to at least 30 min.
Sessions are scheduled four to ten times during a WMR program. Each session lasts at least 45 min, which corresponds to a minimum therapy dose of 180 min.
The work-related functional capacity training takes place at least six times, amounting to at least 360 min.
Work-related diagnostics is provided to all participants of WMR.
All participants of WMR are required to attend the individual appointment with a social worker. Participation in the additional lectures is determined according to individual needs.
All participants of WMR are required to attend work-related psychosocial groups.
All participants of WMR are required to attend work-related functional capacity training.
All treatment components will be documented in the standardized rehabilitation discharge letters to assess the actual delivered dose. The rehabilitation teams use the corresponding codes of the classification of therapeutic interventions  developed by the German Pension Insurance for quality assurance in rehabilitation. In addition, patients will be asked about content and achievement of therapy goals at the end of the rehabilitation program with a standardized set of questions.