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van de Leur JC, Jovicic F, Åhslund A, McCracken LM, Buhrman M. Psychological Treatment of Exhaustion Due to Persistent Non-Traumatic Stress: A Scoping Review. Int J Behav Med 2024; 31:175-191. [PMID: 37308772 PMCID: PMC11001660 DOI: 10.1007/s12529-023-10185-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Exhaustion due to persistent non-traumatic stress (ENTS) is a significant health problem with substantial personal, social, and economic impact. While there are increasing studies of ENTS, there is no international agreement on how it should be diagnosed and treated. This scoping review aimed to map definitions, diagnoses, treatments, outcome measures, and outcomes in psychological treatment studies of ENTS. A further aim was to assess the quality of the treatments and map what change processes are described within ENTS interventions. METHODS A PRISMA-guided scoping review of psychological treatment studies delivered in a clinical setting for ENTS was conducted using the databases of PubMed, PsycINFO, and CINAHL. RESULTS Of the 60 studies included, the majority (87%) stemmed from Europe. The most recurrent term for ENTS was burnout, and the diagnosis most often utilized was exhaustion disorder. Several treatments were reported, the most frequent being cognitive behavioral therapy (CBT) (68%). Statistically significant outcomes relevant to ENTS were reported in 65% (n = 39) of the studies, with effect sizes between 0.13 and 1.80. In addition, 28% of the treatments were rated as high quality. The most frequent change processes described were dysfunctional sleep, avoidance, behavioral activation, irrational thoughts and beliefs, worry, perceived competence/positive management, psychological flexibility, and recuperation. CONCLUSIONS While several treatments based on CBT show promising results for ENTS, there do not seem to be any uniformly established methods, theoretical models, or change processes. Instead of adopting a monocausal, syndromal, and potentially bio-reductionist perspective on ENTS, a process-based approach to treatment is encouraged.
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Affiliation(s)
- Jakob Clason van de Leur
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden.
- PBM Globen Rehab, Arenavägen 27, 121 77, Johanneshov, Sweden.
| | - Filip Jovicic
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
- Capio Centrum För Smärta Och Utmattning, Krukmakargatan 37A, 118 51, Stockholm, Sweden
| | - Andreas Åhslund
- Capio Centrum För Smärta Och Utmattning, Krukmakargatan 37A, 118 51, Stockholm, Sweden
| | - Lance M McCracken
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
| | - Monica Buhrman
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
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Hogan LM, Björklund Carlstedt A, Wagman P. Occupational therapy and stress-related exhaustion - a scoping review. Scand J Occup Ther 2023; 30:1047-1063. [PMID: 37289185 DOI: 10.1080/11038128.2023.2207802] [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: 11/21/2022] [Revised: 03/06/2023] [Accepted: 04/23/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Sick leave due to long-term stress is increasing in Finland and other Western countries. Occupational therapists might contribute to the prevention of and/or recovery from stress-related exhaustion. AIMS/OBJECTIVES To describe what is known about occupational therapy for stress-related exhaustion. MATERIAL AND METHODS A five-step scoping review included papers published in six databases from 2000 to 2022. Extracted data was summarized to show the occupational therapy contribution within the literature. RESULTS There were 29 papers meeting the inclusion criteria, of which a limited number described preventive interventions. Most articles described recovery-oriented occupational therapy with group interventions. The occupational therapists contributed with prevention measures, mostly targeting recovery in multi-professional interventions in terms of stress reduction or return-to-work. CONCLUSIONS Occupational therapy involving stress management both prevents stress and supports recovery from stress-related exhaustion. Occupational therapists internationally use craft, nature activities or gardening as stress management measures. SIGNIFICANCE Occupational therapy appears to be a potential treatment option for stress-related exhaustion internationally in conditions that could also work in Finland, for example in occupational healthcare.
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Affiliation(s)
| | - Anita Björklund Carlstedt
- School of Health and Welfare, Department of Rehabilitation, A.D.U.L.T research group, Jönköping University, Jönköping, Sweden
| | - Petra Wagman
- School of Health and Welfare, Department of Rehabilitation, A.D.U.L.T research group, Jönköping University, Jönköping, Sweden
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Lancman S, Barroso BIDL. Mental health: Professional rehabilitation and the return to work - A systematic review. Work 2021; 69:439-448. [PMID: 34092692 DOI: 10.3233/wor-213489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The problem of illnesses, sick leave and the necessary return to work and permanence at work has been determining the development of different protocols and professional rehabilitation programs in different countries. OBJECTIVE We sought to identify articles that address programs for professional rehabilitation and the return to work of people laid off due to mental health problems, and to verify the results of professional rehabilitation programs and the follow-up processes for such return. METHOD A systematic review was performed according to the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA). The serial search of the articles was carried out in the electronic databases: Web of Science, MEDLINE/PubMed and Scopus. The variations in the descriptors served to find a greater range of significant results for the research. RESULTS In total, 2,306 articles were found. Another two articles that met the inclusion criteria were located through manual searches, adding up to a total of 2,308. Applying the exclusion criteria resulted in a final data set of 47 peer-reviewed articles. CONCLUSIONS The issues involving return to work and permanence in work were complex and multifaceted in the research articles studied. Recovery from Common Mental Disorders (CMDs) is a major cause of long-term sick leave and the granting of disability benefits. Many people with these diagnoses remain employed; however, further studies are needed with women, workers with fragile relationships, and immigrants.
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Affiliation(s)
- Selma Lancman
- Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
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Fox J, Erlandsson LK, Shiel A. A feasibility study of the Redesigning Daily Occupations (ReDO TM-10) programme in an Irish context. Scand J Occup Ther 2021; 29:415-429. [PMID: 33556290 DOI: 10.1080/11038128.2021.1882561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Despite high demand, mental health services in primary care in Ireland are underdeveloped. People with mild/moderate anxiety, depression and unspecified psychological distress are frequently seen in primary care settings, mostly by general practitioners (GPs). Occupational therapists have the potential to contribute to service-provision with interventions specially designed for the targeted group e.g. the Redesigning Daily Occupations programme (ReDO-10). AIMS/OBJECTIVES This study aimed to explore the feasibility of a future RCT of the ReDO-10 programme in Ireland and the contextual factors that would influence future implementation. MATERIAL AND METHODS Using a multi-phase, mixed-method design, qualitative and quantitative data were gathered from key stakeholders: ReDO-10 participants (n = 10), GPs (n = 9) and occupational therapists (n = 2). Acceptability, satisfaction, cultural fit and demand were explored, as well as methodological issues such as appropriateness of recruitment methods, outcome measures and randomization. RESULTS ReDO-10 was acceptable to participants who reported improvements in their occupational patterns and valued the group-based format. GPs and occupational therapists welcomed the intervention, but acknowledged the limitations of time and resources in the Irish primary care context. CONCLUSIONS ReDO-10 is feasible to explore in a future RCT in Ireland and this study provides important context for future implementation and/or research.
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Affiliation(s)
- Jackie Fox
- School of Health Sciences, Áras Moyola, National University of Ireland, Galway, Ireland.,HRB Primary Care Clinical Trials Network Ireland, Discipline of General Practice, HRB Clinical Research Facility, NUI Galway, Galway, Ireland
| | - Lena-Karin Erlandsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Agnes Shiel
- School of Health Sciences, Áras Moyola, National University of Ireland, Galway, Ireland
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Edgelow M, Harrison L, Miceli M, Cramm H. Occupational therapy return to work interventions for persons with trauma and stress-related mental health conditions: A scoping review. Work 2020; 65:821-836. [DOI: 10.3233/wor-203134] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Megan Edgelow
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Laura Harrison
- Graduates of the MScOT Program, School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
| | - Meghan Miceli
- Graduates of the MScOT Program, School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
| | - Heidi Cramm
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
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Wagman P, Hjärthag F, Håkansson C, Hedin K, Gunnarsson AB. Factors associated with higher occupational balance in people with anxiety and/or depression who require occupational therapy treatment. Scand J Occup Ther 2019; 28:426-432. [PMID: 31838931 DOI: 10.1080/11038128.2019.1693626] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Anxiety and depressive disorders are associated with problems with everyday occupations, including difficulties achieving occupational balance. The aim of this cross-sectional study was to describe occupational balance in people suffering from anxiety and/or depression and the factors that are associated with better self-rated occupational balance. MATERIAL One hundred and eighteen participants were recruited from outpatient mental health care and primary health care. The participants were 18-65 years, had a diagnosis of anxiety and/or depression, and had problems in everyday occupations. They answered questionnaires on occupational balance, psychological symptoms, quality of life and everyday occupations. RESULTS A generally low rating of occupational balance was found; however, the scores differed depending on the participants' degree of anxiety and depression, their quality of life, their occupational performance and satisfaction with their occupational performance. Logistic regression analyses revealed that high quality of life, high satisfaction with occupational performance and low level of depression were associated to occupational balance. CONCLUSION The results indicate that enhanced satisfaction with life and with performance of everyday occupations are relevant factors for achieving occupational balance in clients diagnosed with anxiety and/or depression. SIGNIFICANCE The results will be valuable for professionals working to support their clients in enhancing their occupational balance.
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Affiliation(s)
- Petra Wagman
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Fredrik Hjärthag
- Faculty of Arts and Social Sciences, Karlstad University, Karlstad, Sweden
| | - Carita Håkansson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Katarina Hedin
- Futurum, Region Jönköping County and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, Sweden
| | - A Birgitta Gunnarsson
- Department of Research and Development, Kronoberg County Council, Växjö, Sweden.,Department of Clinical Neuroscience and Rehabilitation, Gothenburg University, Gothenburg, Sweden
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Fox J, Erlandsson LK, Shiel A. A systematic review and narrative synthesis of occupational therapy-led interventions for individuals with anxiety and stress-related disorders. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/0164212x.2018.1516172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Jackie Fox
- Discipline of Occupational Therapy, School of Health Sciences, National University of Ireland, Galway, Ireland
| | | | - Agnes Shiel
- Discipline of Occupational Therapy, School of Health Sciences, National University of Ireland, Galway, Ireland
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Birgitta Gunnarsson A, Wagman P, Hedin K, Håkansson C. Treatment of depression and/or anxiety - outcomes of a randomised controlled trial of the tree theme method® versus regular occupational therapy. BMC Psychol 2018; 6:25. [PMID: 29792226 PMCID: PMC5967043 DOI: 10.1186/s40359-018-0237-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/16/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Depression and anxiety disorders are a major concern in western countries, and because these often have a negative affect on everyday life interventions based on activities in everyday life are needed. The Tree Theme Method® (TTM) is a client-centred occupational therapy intervention designed to increase the ability to cope with, and to enhance satisfaction with, everyday life, both at home and at work. The aim of this study was to compare the short term outcomes of the TTM intervention with regular occupational therapy treatment for people with depression and/or anxiety disorders. METHODS This randomised controlled trial included patients from three counties in Sweden. Men and women with depression and/or anxiety disorders, ages 18 to 65, were randomised to either TTM or regular occupational therapy. Assessment data were collected at baseline and the follow-up directly after completing the intervention. Non-parametric and parametric statistical methods were used. RESULTS The questionnaires were answered by 118 patients at baseline and by 107 patients after completing the intervention. No significant differences in short term outcomes were found between the groups. Both groups showed positive significant outcomes regarding almost all aspects of activities in everyday life, psychological symptoms, and health-related and intervention-related aspects. CONCLUSIONS Despite the lack of differences between the groups, the positive outcomes regarding activities in everyday life, psychological symptoms, and health-related aspects after completing the intervention indicates the need for further research on the long-term perspective of TTM compared to regular occupational therapy. TRIAL REGISTRATION Clinical Trials.gov: NCT01980381 ; registered November 2013.
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Affiliation(s)
- A Birgitta Gunnarsson
- Department of Research and Development, Region Kronoberg, PO Box 1223, SE-351 12, Växjö, Sweden. .,Department of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Gothenburg, Sweden.
| | - Petra Wagman
- School of Health and Welfare, Department of Rehabilitation, Jönköping University, Jönköping, Sweden
| | - Katarina Hedin
- Futurum, Region Jönköping County and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Sciences in Malmö, Family Medicine Lund University, Lund, Sweden
| | - Carita Håkansson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
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Eklund M. Minor long-term effects 3-4 years after the ReDO™ intervention for women with stress-related disorders: A focus on sick leave rate, everyday occupations and well-being. Work 2017; 58:527-536. [DOI: 10.3233/wor-172639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Mona Eklund
- Department of Health Sciences, Mental Health, Activity and Participation, Lund University, Box 157 SE 221 00 Lund, Sweden. Tel.: +46 46 222 1957; E-mail:
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