Integrating psychosocial and behavioral interventions to achieve optimal rehabilitation outcomes.
BACKGROUND
Psychosocial factors are important contributors to work disability associated with musculoskeletal conditions. The primary objectives of this paper were 1) to describe different psychosocial interventions that have been developed to prevent prolonged work disability, and 2) to identify future research directions that might enhance the impact of programs targeting psychosocial risk factors for work disability.


METHODS
Selective review of scientific literature on psychosocial and behavioral interventions and work disability.


RESULTS
Most prior interventions focused on psychosocial risk factors that exist primarily within the individual (e.g., pain catastrophizing, beliefs, expectancies). Successful disability prevention will require methods to assess and target psychosocial risk factors "outside" of the individual (e.g., interpersonal conflict in the workplace, job stress, etc.) using cost-effective, multipronged approaches. Research to explore interactions among different domains of psychosocial risk factors in relation to RTW outcomes is needed. Challenges to effective secondary prevention of work disability include developing competencies to enable a range of providers to deliver interventions, standardization of psychosocial interventions, and maximizing adherence to intervention protocols.


CONCLUSIONS
Effective secondary prevention of work disability will require research to develop cost-effective, multipronged approaches that concurrently target both worker-related and workplace psychosocial risk factors.
Sullivan
Michael Jl
MJ
Department of Psychology, University of Montreal, C.P. 6128 Succ Centre Ville, Montreal, Quebec, H3C 3J7, Canada. michael.jl.sullivan@umontreal.ca
Feuerstein
Michael
M
Gatchel
Robert
R
Linton
Steven J
SJ
Pransky
Glenn
G
D000223:Adaptation, Psychological; D001521:Behavior Therapy / Q000379:methods*; D006801:Humans; D009140:Musculoskeletal Diseases / Q000517:prevention & control / Q000523:psychology* / Q000534:rehabilitation*; D009784:Occupational Diseases / Q000517:prevention & control / Q000523:psychology* / Q000534:rehabilitation*; D012307:Risk Factors