A4e Wellbeing

feature: good health

Working towards w Stress and depression can affect people in many ways – but a new provision is helping people to work through their problems and get back to work

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f you’ve ever been affected by depression, anxiety or stress, you’ll know that it can be a vicious circle. The more you worry about the issues that are affecting you, the more stressed, anxious and depressed you become. And the only way out is to break that circle, which is not always as easy as it seems. Being depressed or highly stressed can affect all areas of your life, especially in relation to work. Many people have to leave their jobs as the feel that they can’t cope, which can then lead to further depression as they feel they have nothing to get up for in the morning. However, an innovative new scheme provided by A4e has has been helping people affected by depression, anxiety and stress to return to work. The approach is based on Cognitive Behaviour Therapy (CBT) and delivered by the Occupational Support Service, headed up by psychologist Dr William Fear.

The service was started in the Pathways to Work programme, and has been expanded for use within A4e and other occupational health-related services. According to Dr Fear, it’s a very innovative provision. ‘It’s not the same old condition management programme that people are used to,’ he says. ‘We have developed a provision that helps people return to work, whether they are on benefits or sickness absence. ‘In the past, people thought you needed to do something different for each group of people who were out of work. But we’ve found that our service works equally well for all groups.’ A4e’s CBT-based provision was first developed and used by Dr Fear’s team in Wales. Realising that something different was needed to encourage people back to work, Dr Fear and his team carried out extensive in-house research to develop the approach. Based on a number of existing methods including CBT, Motivational Interviewing and Solution-Focused Brief Therapy, the focus of the research was to find a way of helping people to overcome ‘health related barriers to work’ and to ‘realise their full capabilities’. So how does the Occupational Support Service help people? ‘It’s very much concerned with people’s beliefs and capabilities,’ says Dr Fear. ‘We assess what people can do, not what they can’t do. We help them see where their strengths are, and encourage them to think differently. ‘I think having a strong ethos also helps. We understand that work is a form of treatment, and that people sometimes need support to develop ways of managing, or coping, with difficult situations. We give them the tools to do that.’

We have developed a provision that helps people return to work, whether they are on benefits or sickness absence Dr William Fear

Back on track

Stress can greatly affect your working life and job prospects.

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Janie (not her real name) had been on Incapacity Benefit for eight years. She had been diagnosed with depression and was taking prescribed medication. Janie joined Pathways as a client, and opted to take part in the Occupational Support Service. Just one month later, Janie was working full-time, and 14 months on, she has a flawless sickness absence record, a strong track record of performance, and has regained her professional registration. ‘I didn’t think I would ever work again’, says Janie. ‘Things were really difficult. I’d been out of work for so long, and I was smoking and taking a high dose of antidepressants. I had also lost my professional

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s wellbeing registration, which meant I couldn’t work in my chosen field. It was horrible.’ So what was it that made the difference? ‘Someone gave me hope,’ she says, ‘and showed me how to cope. I’m now working full-time and I love what I do. I don’t smoke, I eat properly, and I don’t take any medication – and I haven’t taken any since I started work. ‘The Occupational Support Service has changed my life. The biggest reward for me has been the way I have been able to share this with my family and friends.’ Janie has been able to put her occupational skills to good use, thanks to her time on the programme. ‘I now work with Dr Fear in the Occupational Support Service, helping people to get back to work and to stay in work,’ she explains. ‘We often help people who are at risk of long-term sickness absence, not just people who are on benefits and want to go back to work.’ She adds: ‘The approach is so different to the way I was treated when I was on benefits. It really works and it makes such a difference to people.’

Valued support ‘We’ve been lucky,’ explains Dr Fear. ‘A4e understands the value of our Occupational Support Service and what we do. We’ve been encouraged to be innovative, and we’ve been supported in the development of the service. Everything we do is carefully evaluated and we work within strong ethical and governance frameworks. ‘The evidence for our provision is clear from our performance on Pathways. In fact, we received public acclaim from the Director of Job Centre Plus in North Wales for our service.’ There are plans to expand the service, and Dr Fear’s team is already delivering a Fit for Work program in line with Dame Carol Black’s Health and Wellbeing strategy. ‘What we have,’ he says, ‘is something that can help with worklessness, whether that be as a result of being completely out of work and on benefits, or as a result of long-term sickness absence. In the end, the consequences of worklessness are always the same. Our aim is to eradicate worklessness completely. ‘The outstanding success of our Occupational Support Service is down to having a fantastic team and the support we have received from A4e. At the end of the day it’s real people who benefit in a real way.’

FAST FACTS The service has four distinct elements to it: l One-to-one interviews delivered by trained, qualified professionals. This includes assessment and the more specialist CBT-related interventions. l Health and wellbeing groups. These groups look at changing healthrelated behaviour, from adopting healthy lifestyles through to coping with depression, anxiety, stress, and pain. l The Directions groups.This is a unique motivational and confidence-building workshop based on the ‘five areas’ CBT approach. l The JOBS program, which is an international program that builds confidence in relation to job search skills and entering employment.

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