This White Paper positions the cognitive work hardening (CWH) intervention as an effective claims tool that assists disability insurers with their management of mental health disability claims. The paper explores mental health through the lenses of the medical system and the insurance domain, as well as within an occupationally focused perspective. An argument is presented regarding the importance and value of an occupational focus in mental health and rehabilitation. This sets the tone for the value of a CWH intervention with its inherent occupationally-based foundation. CWH is described and its usefulness in helping clients prepare for their return to work after a mental health related disability is summarized. Additionally, CWH is positioned as a disability insurance claims tool that helps with the high costs of mental health claims.

Access this document here: https://www.cwhconnect.com/whitepapers/cwh-as-a-claims-tool-2023.pdf

This case report illustrates how CWH is applied in clinical practice to prepare an individual to return to work following a disability leave due to depression. By providing a window into the application of CWH within a real world context, this report demonstrates how CWH bridges the functional gap between being home on disability and returning to competitive employment. A valuable knowledge transfer tool, the case report format enhances research utilization capacity through an in-depth case review of how CWH facilitated a client’s return-to-work journey culminating in a successful outcome.

Qualitative findings of the doctoral research are presented in detail in this paper. Feedback from study participants regarding their participation in the CWH intervention under study is highlighted. Participants reported key intervention elements that they found valuable for their return-to-work preparation such as structure of intervention, customized work simulations, realistic simulated work environment, support from occupational therapist, and education. Participants identified several main gains as a result of the CWH intervention including adoption of a routine, work stamina, cognitive abilities, and self-confidence. Personal agency, empowerment, and coping skill development emerged as important consequences of the intervention.

Quantitative findings of the doctoral research are presented in detail in this paper. A comprehensive review of the study design, methodology and data analysis are included aptly situating this research within the scientific realm. Self-report measures were used to compare relevant constructs at the start and end of the CWH intervention. Work ability, fatigue, and depression severity significantly improved post-intervention. Details of the CWH intervention are provided to help the reader gain insight into CWH and its role in return-to-work preparation.

This thesis served as a partial requirement of Adeena’s doctoral degree. It embodies the body of work that positions CWH within the healthcare system and establishes its role in narrowing the gap between disability and return-to-work following an episode of depression. Findings of a scientific study of CWH are presented and discussed in terms of significant improvements in self-perceived work ability, fatigue, and depression severity post- intervention. Participant feedback on key intervention elements are presented together with participants’ identification of main treatment goals. Implications for clinical use are discussed both within the field of rehabilitation / return-to-work, and more specifically, occupational therapy.

The structured Intervention Mapping method is used to illustrate the process involved in (i) identifying the need for a return-to-work intervention following a mental health leave; (ii) analyzing the desired outcome of a safe return-to-work; (iii) characterizing the various steps to attain this goal leading to intervention elements to achieve the objective of return-to-work, and ultimately (iv) demonstrating how the multiple elements inherent CWH can combine to fulfill the identified need.

This paper explains how occupational therapy principles (e.g., occupation, enablement) are utilized and applied in CWH. Key skills of the occupational therapist are discussed and woven into the fabric of CWH thereby grounding the CWH intervention within occupational therapy ideology and doctrine. The paper considers CWH and its relationship to recovery and mental illness. It also discusses CWH and its role among workplace-based return-to-work interventions in the current movement toward non-clinical return-to-work interventions.

This paper introduces the CWH intervention and positions it as a ‘bridge back to work’ following a mental health disability leave. Aligning with an established occupational therapy model, this paper demonstrates how the elements of the intervention address occupational performance issues that relate to the worker, the work, and the workplace with an ultimate goal of return-to-work.