Comparing the Efficacy of Multidisciplinary Assessment and Treatment, or Acceptance and Commitment Therapy, with Treatment as Usual on Health Outcomes in Women on Long-Term Sick Leave—A Randomised Controlled Trial

Anna Finnes, Ingrid Anderzén, Ronnie Pingel, JoAnne Dahl, Linnea Molin and Per Lytsy
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Anna Finnes: Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, SE-171 65 Solna, Sweden
Ingrid Anderzén: Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, SE-751 22 Uppsala, Sweden
Ronnie Pingel: Department of Statistics, Uppsala University, Kyrkogårdsgatan 10, SE-751 20 Uppsala, Sweden
JoAnne Dahl: Department of Psychology, Uppsala University, Campus Blåsenhus, von Kraemers allé 1A, SE-751 42 Uppsala, Sweden
Linnea Molin: Uppsala University Hospital, SE-751 85 Uppsala, Sweden
Per Lytsy: Department of Public Health and Caring Sciences, Uppsala University, Husargatan 3, SE-751 22 Uppsala, Sweden

IJERPH, 2021, vol. 18, issue 4, 1-14

Abstract: Background: Chronic pain and mental disorders are common reasons for long term sick leave. The study objective was to evaluate the efficacy of a multidisciplinary assessment and treatment program including acceptance and commitment therapy (TEAM) and stand-alone acceptance and commitment therapy (ACT), compared with treatment as usual (Control) on health outcomes in women on long-term sick leave. Method: Participants ( n = 308), women of working age on long term sick leave due to musculoskeletal pain and/or common mental disorders, were randomized to TEAM ( n = 102), ACT ( n = 102) or Control ( n = 104). Participants in the multidisciplinary assessment treatment program received ACT, but also medical assessment, occupational therapy and social counselling. The second intervention included ACT only. Health outcomes were assessed over 12 months using adjusted linear mixed models. The results showed significant interaction effects for both ACT and TEAM compared with Control in anxiety (ACT [ p < 0.05]; TEAM [ p < 0.001]), depression (ACT [ p < 0.001]; TEAM [ p < 0.001]) and general well-being (ACT [ p < 0.05]; TEAM [ p < 0.001]). For self-rated pain, there was a significant interaction effect in favour of ACT ( p < 0.05), and for satisfaction with life in favour of TEAM ( p < 0.001). Conclusion: Both ACT alone and multidisciplinary assessment and treatment including ACT were superior to treatment as usual in clinical outcomes.

Keywords: rehabilitation; sick leave; acceptance and commitment therapy; multi-disciplinary rehabilitation; chronic pain; mental disorders; women (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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