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Angerer P, Gündel H, Kröger C, Rothermund E. [Rationale, models, and impact of workplace-based psychotherapeutic services]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:743-750. [PMID: 38806746 PMCID: PMC11231002 DOI: 10.1007/s00103-024-03892-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/06/2024] [Indexed: 05/30/2024]
Abstract
Mental illnesses and behavioral disorders are very common among the working population, affecting up to a third of employees each year, and are associated with great suffering, the risk of chronicity, and the loss of employment. Economically, mental illnesses cause high costs. In order to mitigate these consequences and increase the chances of recovery, rapid diagnosis, early and appropriate treatment where necessary, and-over and above the usual psychotherapy approach-attention to the work-related causes are of crucial importance.Psychotherapeutic Consultation at the Workplace (PT-A) attempts to meet these requirements. It offers psychotherapeutic help at short notice and close to the workplace for employees suffering from mental stress; provides (depending on the problem) counseling, diagnostics, prevention, and short-term or bridging therapy; and supports reintegration after a longer period of mental illness. It is helpful to cooperate closely with the company medical service, which consults the PT‑A, refers employees to it, provides information on the company situation, and can support reintegration if necessary. Funding is often provided by the company but can also be provided by health insurance companies in integrated care models.This article begins by describing the history and principles of PT‑A and the role of work stress in the development of psychological and psychosomatic disorders. The implementation of PT‑A is then outlined using two examples. Finally, the current study "Early Intervention at the Workplace" ("Frühe Intervention am Arbeitsplatz" [friaa]), to which several articles in this special issue refer, is briefly presented.
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Affiliation(s)
- Peter Angerer
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
| | - Harald Gündel
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Christoph Kröger
- Abteilung Klinische Psychologie und Psychotherapie, Institut für Psychologie, Universität Hildesheim, Hildesheim, Deutschland
| | - Eva Rothermund
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Ulm, Deutschland
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Kohl F, Schröder UB, Stegmann R, Wegewitz U, Hander N, Hansmann M, Angerer P, Erim Y, Hondong S, Kröger C, Mulfinger N, Waldman T, Herrmann K, Weber J. [Implementation of psychotherapeutic consultation at work (PT-A): expectations, announcement, and use : Results of the friaa-study]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:796-805. [PMID: 38896150 PMCID: PMC11230975 DOI: 10.1007/s00103-024-03909-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
INTRODUCTION Psychotherapeutic consultation at work (PT-A) offers easily accessible, short-term support for employees experiencing psychological stress. The aim of the study was to evaluate aspects of the implementation regarding announcement, access, and use of the PT‑A. METHODS The study was conducted as part of a randomized controlled trial (RCT) called "Early Intervention in the Workplace". Forty-six company actors answered a questionnaire about how the companies announced the PT‑A to their employees, the barriers in the announcement of the PT‑A, and the beneficial factors of using the PT‑A. The access routes of the 550 participating employees were used from the baseline data of the RCT. Seven company actors were qualitatively interviewed about their expectations of the PT‑A and 22 participants of the RCT were interviewed about their experiences accessing and using the PT‑A. RESULTS The company actors hoped that the PT‑A would have an impact on all levels of prevention. Most companies announced the PT‑A centrally (e.g., flyers and intranet) as well as through individual recommendations (e.g., through the company's social counselling and occupational health professionals). Employees appreciated the opportunity to participate anonymously in the central announcement. Advantages of the supportive access were seen in the accessibility of employees without treatment experience, employees with high levels of suffering, and employees who have not yet recognized their own need for treatment. DISCUSSION The results suggest that it is useful to announce the PT‑A centrally to all employees but also to recommend it personally to affected employees. By using both methods, different PT‑A target groups can be reached and the advantages of anonymous participation are retained.
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Affiliation(s)
- Fiona Kohl
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Ute B Schröder
- FG 3.5 "Evidenzbasierte Arbeitsmedizin, Betriebliches Gesundheitsmanagement", BAuA - Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin, Deutschland.
| | - Ralf Stegmann
- FG 3.5 "Evidenzbasierte Arbeitsmedizin, Betriebliches Gesundheitsmanagement", BAuA - Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin, Deutschland
| | - Uta Wegewitz
- FG 3.5 "Evidenzbasierte Arbeitsmedizin, Betriebliches Gesundheitsmanagement", BAuA - Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin, Deutschland
| | - Nicole Hander
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Marieke Hansmann
- Abteilung Klinische Psychologie und Psychotherapie, Institut für Psychologie, Universität Hildesheim, Hildesheim, Deutschland
| | - Peter Angerer
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Yesim Erim
- Psychosomatische und Psychotherapeutische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - Sinja Hondong
- Psychosomatische und Psychotherapeutische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland
| | - Christoph Kröger
- Abteilung Klinische Psychologie und Psychotherapie, Institut für Psychologie, Universität Hildesheim, Hildesheim, Deutschland
| | - Nadine Mulfinger
- Klinik für Psychiatrie und Psychotherapie II, Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Deutschland
| | - Tamara Waldman
- Klinik für Psychiatrie und Psychotherapie II, Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Deutschland
| | - Kristin Herrmann
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Jeannette Weber
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
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Hander NR, Krohn J, Kohl F, Heming M, Erim Y, Herold R, Kröger C, Hansmann M, Köllner V, Chrysanthou S, Wegewitz U, Schröder UB, Feißt M, Herrmann K, Rothermund E. [Psychotherapeutic consultation at work: associations between company size and psychosomatic health]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:772-782. [PMID: 38896152 PMCID: PMC11230955 DOI: 10.1007/s00103-024-03904-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND The utilization of psychotherapeutic consultation at work (PT-A) has so far been investigated in large enterprises (LEs). These differ structurally from small(est) and medium-sized enterprises (SMEs). Differences in the user profiles of a PT‑A with regard to psychosomatic health, work-related self-efficacy, and work ability depending on company size have hardly been investigated. This study also examined differences in the employees' perception of the psychosocial safety climate (PSC) in the company, which represents management's efforts to promote mental health. METHODS As part of the Early Intervention in the Workplace intervention study called "friaa", employees from LEs and SMEs interested in a PT‑A were surveyed throughout Germany from September 2021 to January 2023. Using t‑ and χ2-tests, differences between employees in LEs (n = 439) and SMEs (n = 109) were examined with regard to the ICD-10 F diagnostic code ("International Statistical Classification of Diseases and Related Health Problems"; mental and behavioral disorders), depression (PHQ-9), anxiety (GAD-2), level of functioning (GAF), somatic symptom burden (SSS-8), health (VR-12), ability to work (WAI), self-efficacy (SOSES), and psychosocial safety climate (PSC-4). The association between these variables and especially the PSC‑4 were investigated using correlation analysis. RESULTS Both groups showed similar levels of stress. From the employees' perspective, psychosocial issues were addressed significantly more frequently in LEs than in SMEs with a medium effect size. The study provided initial indications that in LEs there were positive correlations of the PSC‑4 with SOSES and WAI and negative ones with PHQ‑9 and SSS‑8. DISCUSSION The comparable psychological strain on employees in LEs and SMEs points to the need for behavioral and structural preventive measures regardless of the company size. Mainly in SMEs, organizational communication of psychosocial health should be given greater priority.
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Affiliation(s)
- Nicole R Hander
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Albert-Einstein-Alle 23, 89081, Ulm, Baden-Württemberg, Deutschland.
| | - Julia Krohn
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Albert-Einstein-Alle 23, 89081, Ulm, Baden-Württemberg, Deutschland
| | - Fiona Kohl
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heinrich-Universität Düsseldorf, Düsseldorf, Nordrhein-Westfalen, Deutschland
| | - Meike Heming
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heinrich-Universität Düsseldorf, Düsseldorf, Nordrhein-Westfalen, Deutschland
| | - Yesim Erim
- Psychosomatische und Psychotherapeutische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bayern, Deutschland
| | - Regina Herold
- Psychosomatische und Psychotherapeutische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Bayern, Deutschland
| | - Christoph Kröger
- Abteilung Klinische Psychologie und Psychotherapie, Institut für Psychologie, Universität Hildesheim, Hildesheim, Niedersachsen, Deutschland
| | - Marieke Hansmann
- Abteilung Klinische Psychologie und Psychotherapie, Institut für Psychologie, Universität Hildesheim, Hildesheim, Niedersachsen, Deutschland
| | - Volker Köllner
- Medizinische Klinik mit Schwerpunkt Psychosomatik, Forschungsgruppe Psychosomatische Rehabilitation, Charité Universitätsmedizin Berlin, Berlin, Berlin, Deutschland
| | - Sophia Chrysanthou
- Medizinische Klinik mit Schwerpunkt Psychosomatik, Forschungsgruppe Psychosomatische Rehabilitation, Charité Universitätsmedizin Berlin, Berlin, Berlin, Deutschland
| | - Uta Wegewitz
- FG 3.5 Evidenzbasierte Arbeitsmedizin, Betriebliches Gesundheitsmanagement, b a u a: Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin, Berlin, Deutschland
| | - Ute B Schröder
- FG 3.5 Evidenzbasierte Arbeitsmedizin, Betriebliches Gesundheitsmanagement, b a u a: Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin, Berlin, Deutschland
| | - Manuel Feißt
- Institut für Medizinische Biometrie, Universitätsklinikum Heidelberg, Heidelberg, Baden-Württemberg, Deutschland
| | - Kristin Herrmann
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Albert-Einstein-Alle 23, 89081, Ulm, Baden-Württemberg, Deutschland
| | - Eva Rothermund
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Albert-Einstein-Alle 23, 89081, Ulm, Baden-Württemberg, Deutschland
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Gantner M, Jarzcok MN, Schneider J, Brandner S, Gündel H, von Wietersheim J. Psychotherapeutic Consultation Services in the Workplace: A Longitudinal Analysis of Treatments and Sick Leave Using Health Insurance Data. Front Psychiatry 2022; 13:838823. [PMID: 35401269 PMCID: PMC8987373 DOI: 10.3389/fpsyt.2022.838823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Psychotherapeutic consultation services in the workplace (PSIW) have been developed to provide collaborative mental health care for employees. The aim of this study was to analyze participant characteristics, the role of PSIW in treatment courses, and the development of sick leave before and after PSIW start. METHODS Routine data from PSIW and health insurance of 155 participants were analyzed descriptively and by means of a multilevel negative binomial regression. RESULTS Eighty-four percent of users were male, and 72% were diagnosed with a mental disorder. The number of PSIW consultations varied from 1 to 13 (mean = 4). For 34% of participants, PSIW sessions were sufficient, 33% received a recommendation for outpatient psychotherapy, and 20% for inpatient mental health treatment. While recommendations for inpatient treatment displayed a high adherence rate (74%), recommendations for outpatient treatment were followed by 37%. Compared with the period of a half-year before PSIW, sick-leave days were reduced from the period of the second half-year after PSIW start and in the subsequent observed half-year periods. Trajectories of sick leave by subgroups showed differences. CONCLUSIONS PSIW is a flexible care offer, and results indicate a possible effect of PSIW on sick leave. In future studies, control group designs and inclusion of further variables are needed.
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Affiliation(s)
- Melanie Gantner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Ulm, Germany
| | - Marc Nicolas Jarzcok
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Ulm, Germany
| | | | | | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Ulm, Germany
| | - Jörn von Wietersheim
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre, Ulm, Germany
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Who Should Play a Key Role in Preventing Common Mental Disorders that Affect Employees in the Workplace? Results of a Survey with Occupational Health Physicians, Primary Care Physicians, Psychotherapists, and Human Resource Managers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081383. [PMID: 30999612 PMCID: PMC6517970 DOI: 10.3390/ijerph16081383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/02/2019] [Accepted: 04/15/2019] [Indexed: 11/17/2022]
Abstract
The rising burden of common mental disorders (CMDs) in employees requires strategies for prevention. No systematic data exist about how those involved perceive their roles, responsibilities, and interactions with other professional groups. Therefore, we performed a multi-professional standardized survey with health professionals in Germany. A self-administered questionnaire was completed by 133 occupational health physicians (OHPs), 136 primary care physicians (PCPs), 186 psychotherapists (PTs), and 172 human resource managers (HRMs). Inter alia, they were asked which health professionals working in the company health service and in the outpatient care or in the sector of statutory insurance agents should play a key role in the primary, secondary, and tertiary prevention of CMDs in employees. The McNemar test was used in order to compare the attributed roles among the professionals involved. With regard to CMDs, all the professional groups involved in this study declared OHPs as the most relevant pillar in the field of prevention. In primary prevention, HRMs regarded themselves, OHPs, and health insurance agents as equally relevant in terms of prevention. PTs indicated an important role for employee representatives in this field. In secondary prevention, PCPs were regarded as important as OHPs. HRMs indicated themselves as equally important as OHPs and PCPs. In tertiary prevention, only OHPs identified themselves as main protagonists. The other groups marked a variety of several professions. There is a common acceptance from the parties involved that might help the first steps be taken toward overcoming barriers, e.g., by developing a common framework for quality-assured intersectional cooperation in the field of CMD prevention in employees.
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