A Return-to-Work Program That’s Working

Whether it’s a physical or psychiatric disability or a combination of both, returning employees to work can be costly for everyone — employees, employers, physicians, and insurance companies. Yet a psychiatric hospital in Texas is achieving success with its approach to returning employees to work.

They call it the WorkReturns^SM Program, and last year two-thirds of those who entered the program returned to work successfully in five weeks. Of those who entered the program on disability, nearly three-quarters got off disability within five weeks. About 60% of the clients were contacted 12 weeks after they were discharged, and 100% of those remained successful in staying at work and off disability.

What Makes WorkReturns^SM Different?

"We think what we are doing is unique in several important ways," said Mike Ashworth, Ph.D., director of the program.

"First, we directly address the psychological barriers that prevent employees from returning to work," he said, noting that all of the WorkReturns^SM staff members are mental health practitioners who have expertise working in a business setting. Each employee receives customized clinical interventions.

"Second," he added, "we bring the employers into the process." The clinicians use their knowledge of the business environment to facilitate communication with the employer and develop return-to-work plans that are tailored to the particular needs of each work setting.

The Program. Developed by the Green Oaks Hospital in Dallas, Texas, the WorkReturns^SM Program teaches clients how to manage their condition, facilitates communication between the employee and the employer through telephone or worksite consultation, and offers an "aftercare" support group when the client is discharged.

According to the consulting Medical Director, Harold Cronson, M.D., "Practitioners often leave the decisions about starting and stopping a disability leave to the employee. The WorkReturns^SM Program partners with the employer and the treating physician to ensure that the disabled employee gets the psychological tools and administrative support needed to accelerate the return to work."

The WorkReturns^SM Program is an intensive outpatient program that meets three times per week. Each session is three hours and combines group therapy and skills training focused on return-to-work issues such as "Coping with the First Days Back," and "Overcoming Your Returnto-Work Fears."

For example, employees who avoid the workplace because they are afraid of what to say to coworkers about their absence may role-play those conversations to build confidence. Employees also receive individual consultation and extensive case management.

Results So Far. Fifty individuals were admitted to the WorkReturns^SM Program from April 1 to December 31, 2004. Clients were screened for the exclusion criteria of current substance abuse, medical instability, and active psychosis.

As of January 2005, 47 clients (94% of those admitted) had been discharged, and three were still clients but were expected to be discharged within the month.

Of the 47 clients who entered the program, 31 (66%) successfully returned to work or school.

Overall Client Outcomes
	Returned To Work Referred to Higher Level of Care Referred to Non-Clinical Services Dropped out of Program

Of the 33 individuals who entered the program on disability, 24 (73%) got off disability.

Success with Clients on Disability
Got Off Disability Referred to Higher Level of Care Dropped out of Program Referred to Non-Clinical Services

The Clients. On average, clients who were discharged from the program had been off work for 21 weeks upon entering the program. Their diagnoses fell into three categories: major depression, bipolar disorder, and anxiety disorders. The average length of stay in the WorkReturns^SM Program was 10 sessions over a five-week period.

Currently, WorkReturnsSM receives referrals directly from psychiatrists, employer’s injury coordinators, and insurance care managers. Clients are referred when they experience difficulty returning to work after a leave of absence or when work issues are identified as a contributor to psychiatric distress. The program has coordinated return-towork plans with employers in various industries including telecommunications, transportation, manufacturing, and finance. The largest percentage of employees has been referred from airline and telecommunications companies.

The results from the WorkReturns^SM Program suggest that employees on leave for a physical or psychiatric injury develop unique psychological issues that prevent a timely return to the workplace. When those problems are resolved directly, employees return to work much faster and are more successful in staying on the job.

For more information about the WorkReturns^SM Program at Green Oaks, contact Mike Ashworth, Ph.D., at 972-985-1599 or e-mail him at Mike.Ashworth@LonestarHealth.com.