Effects of a tailored multidisciplinary counselling intervention to support the adjustment process after a traumatic injury: a randomized controlled trial

Abstract

Purpose

To investigate the efficacy of a tailored counselling intervention for injured workers regarding different aspects of subjective well-being.

Materials and Methods

Prospective randomized controlled trial with 192 mildly-to-moderately injured workers who were on sick leave for at least 18 weeks and showed a high-risk profile for a complicated rehabilitation process in a screening. Patients were assessed at baseline, 12 and 18 months post-injury. The outcome variables concerned five aspects of subjective well-being (negative feelings, life and job satisfaction, satisfaction related to family and health). Both the control and the experimental group received conventional case management. Participants in the intervention group additionally received tailored workplace interventions and/or mental health counselling sessions.

Results

Participants in the intervention group received an average of 2.23 (SD = 6.94) counselling sessions. Both groups showed a significant reduction (mean (95% CI) of negative feelings control group 2.6 (2.3–3.4), intervention group 2.4 (1.6–3.4)), with a significant difference in negative feelings between the groups (p = 0.01).

Conclusions

Our results suggest that a tailored counselling intervention has a modest long-term effect (d = 0.74) on negative feelings for mildly-to-moderately injured workers. However, future studies should evaluate the feasibility of this study’s treatment approach.

Implications for rehabilitation

• Accidents and the resulting injuries often cause a wide range of burdens including psychosocial and emotional distress as well as long-time sick leaves.

• Tailored counselling led to significant reductions of negative feelings in mildly-to-moderately injured workers over time.

• By showing that even conventional case management can have a beneficial effect on subjective wellbeing, the results of this study reaffirm the holistic biopsychosocial nature of injury rehabilitation.

Keywords:

• Rehabilitation
• counselling intervention
• injury
• intervention
• well-being
• randomized controlled trial

Acknowledgements

The authors wish to thank Livia Kohli, Romy Schnyder, and Bettina Gerber for their help with the recruitment and data management, Mey Boukenna for her critical proofreading, and Helen Eigenmann for her help with preparing the manuscript. Furthermore, the authors are grateful to all participants and case managers who contributed to the study. No commercial sponsorship was involved in the design and conduction of the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

This study was conceptualised by HJZ, VS and UHR but all authors contributed equally to the final methodology. HJZ, VS, UHR recruited the participants. VS and HJZ supervised the interventions. SA performed data collection and analysis. SA, HJZ and JH interpreted the analyses. JH drafted the manuscript. All authors significantly contributed to the writing of the manuscript. The manuscript was reviewed and edited prior to submission and all authors agreed to the final version.

Additional information

Funding

The study was partly financed by the Swiss National Insurance Fund Suva.