The acceptance and commitment therapy model in occupational rehabilitation of musculoskeletal and common mental disorders: a qualitative focus group study

Abstract

Aims: The aim of this study was to examine whether and how intended processes of behavioural change were reflected in participants’ experiences after an inpatient occupational rehabilitation programme. The programme was transdiagnostic, lasted 3½ weeks and was based on the acceptance and commitment therapy model.

Methods: Twenty-two participants (17 women and 5 men) took part in five qualitative focus group interviews after the programme. Analysis was data-driven, categorising participants’ experiences using an initial explorative phenomenological approach. The emerging data-driven categories were re-contextualised within the theoretical framework of the therapy model.

Results: The participants referred to experiences within all three intended domains of the model (openness, awareness, and engagement). Our results indicate that the transdiagnostic approach may have facilitated openness, while the attainment of flexible self-awareness was less evident. Participants expressed engagement and behavioural changes linked to personal values, but did not mention actions leading to imminent return to work.

Conclusions: The results imply that for implementation in occupational rehabilitation, further development of this model is needed specifically regarding processes related to self-awareness and committed action towards work. These findings are relevant for the interpretation of results from randomised clinical trials on acceptance and commitment therapy in occupational rehabilitation.

Implications for rehabilitation

• Acceptance and commitment therapy seems to be a feasible component in an occupational rehabilitation programme for persons with different diagnoses.

• A transdiagnostic approach mixing musculoskeletal pain disorders and common mental disorders in the same rehabilitation programme seems to facilitate the process of openness and acceptance.

• There is a need to further develop and operationalise some of the processes in Acceptance and commitment therapy to accommodate the approach to the occupational rehabilitation context.

Keywords:

• Vocational rehabilitation
• musculoskeletal pain
• common mental disorders
• cognitive behavioural therapy
• return to work
• qualitative research

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Acknowledgements

We would like to thank the participants who took part in the focus group interviews. The first author would also like to thank Dr. Ulrich Schattel for invaluable clinical discussions relevant to the topic of this article.

Disclosure statement

MBR participated in 2017 and 2018 as a research advisor in a study conducted and funded by Janssen-Cilag A/S. MSF was previously employed at Hysnes Rehabilitation Centre. All other authors declare that they have no competing interests. The funding body had no part in the research project.

Additional information

Funding

This study was funded by Norwegian authorities as part of a larger evaluation-project of a state owned occupational rehabilitation centre.