Cognitive work hardening for return to work following depression: An intervention study

Background. Work absences due to depression are prevalent; however, few interventions exist to address the return-to-work challenges following a depressive episode. Purpose. This mixed-methods study aimed to (a) evaluate the effectiveness of cognitive work hardening in preparing people with depression to return to work and (b) identify key elements of the intervention. Method. A single group (n = 21) pretest-posttest study design was used incorporating self-report measures (Work Ability Index, Multidimensional Assessment of Fatigue, Beck Depression Inventory II) with interviews at intervention completion and at 3-month follow-up. Descriptive statistics, paired-samples t test, and content analysis were used to analyze the data. Findings. Work ability, fatigue, and depression severity significantly improved postintervention. Participants identified structure, work simulations, realism of simulated work environment, support, and education as key intervention elements. Implications. Findings underscore an occupationally focused return-to-work intervention for people recovering from depression with potential for wider adoption and future research.