Finding the light

Work-focused cognitive behavioural therapy can help depressed employees stay at work
By Dwayne Van Eerd, Kim Cullen and Emma Irvin
|Canadian HR Reporter|Last Updated: 03/29/2018
Work-focused cognitive behavioural therapy (CBT) can help workers with depressive symptoms stay at work, and help workers return to work after a depression-related absence. Credit: sumroeng chinnapan, foxaon1987, chombosan, Massoud Attarianshandiz (Shutterstock)

Nearly three million Canadians will experience depression in their lifetime — for most, it’s during their prime working age of 24 to 44, according to the Conference Board of Canada.

Although most cases of depression do not arise primarily from work or workplace exposures, depression can have a considerable impact on the workplace. People with depression have higher rates of absenteeism and short-term disability than those without. They also experience higher rates of job turnover and productivity loss.

Despite growing awareness of the issue, workplaces still struggle with what to do to help individuals experiencing depression. The Institute for Work & Health (IWH), a not-for-profit research organization based in Toronto, has been leading a project to help fill that knowledge gap.

Research points to work-focused CBT

With funding from the Research and Workplace Innovation Program (RWIP) of the Workers Compensation Board of Manitoba, IWH’s team conducted a systematic review — which synthesizes all of the available research — on workplace interventions to help workers with depression.

The result? Work-focused cognitive behavioural therapy (CBT) can help workers with depressive symptoms stay at work, and help workers return to work after a depression-related absence. On the other hand, generic CBT seems to have no effect on helping people return to work, but does help people stay at work.

CBT teaches people strategies and skills to address the problems that come up in the here and now. The technique involves identifying, questioning and changing the thoughts, attitudes and beliefs that are related to emotional and behavioural reactions that cause difficulty.

Work-focused CBT involves using the same technique, but specifically focuses on identifying strategies and skills for work and workplace solutions.

Take, for example, someone on leave due to depression. If that person feels anxious about a particular aspect of her job when contemplating returning to work, the systematic review suggests she may benefit from therapy to examine and alter her self-talk and thought patterns around those challenging tasks.

Bringing in the experiences of workplaces, workers

In conducting the systematic review, there was an absence of research on organizational programs and practices, which are known to affect workers’ health outcomes.

The interventions in the literature were primarily those that target the individual. They address people’s coping skills or resilience. Very little research has focused on interventions that deal with organizational factors such as job stressors, social support at the workplace, and job accommodations. While employers are addressing these factors, their practices haven’t shown up in the scientific literature.

Recognizing that the peer-reviewed literature captured just a fraction of the strategies and approaches actually used by workplaces, the IWH team decided to also seek out practitioners’ experiences. With funding support from WorkSafeBC, it conducted surveys, focus groups and interviews with practitioners — including HR professionals, disability management professionals, and occupational health and safety practitioners — to find out what types of support they provide to workers with depression.

Surveys, focus groups and interviews were also conducted with workers to learn about their experiences being supported — or not — for their depression at work.

This is a knowledge synthesis approach that brings together different types of evidence from peer-reviewed literature, practitioners, and people who have experienced depression in the workplace.

The team then developed a guide on strategies to support employees with depression based on the evidence collected from the three sources: An Evidence-Informed Guide to Supporting People with Depression in the Workplace.

The guide outlines practices and strategies that may be useful to workers, co-workers, managers and union representatives, as well as to HR practitioners. The practices outlined in the guide came from more than 450 survey responses and focus groups and interviews with more than 20 people. They are grouped into three broad categories: workplace culture, workplace processes, and resources (both at and outside of work).

Depression is a challenging condition to address in the workplace. It is invisible to others, it’s episodic, and it’s unpredictable. This can make it particularly difficult for supervisors and managers to plan for work needs and implement and evaluate policies.

Because of this challenge, employers look to evidence-based practices whenever possible to minimize the effects of depression in the workforce.

Hopefully the systematic review and guide will provide that much-needed service.

Dwayne Van Eerd is a scientist and Kim Cullen is an associate scientist at the Institute for Work & Health (IWH), while Emma Irvin leads the systematic review group. The Toronto-based not-for-profit research organization conducts research into workplace injury  and  disability prevention. To access the guide, visit

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