Many people in Norway are absent from work for extended periods due to mental health problems, leading to significant costs for individuals and society. Recent research suggests that metacognitive therapy combined with a focus on returning to work may help address this issue.
According to Odin Hjemdal, professor and specialist in psychology at the Norwegian University of Science and Technology's Department of Psychology, "Metacognitve therapy as a treatment, along with a focus on the job, can help get people back to work faster." The findings have been published in eClinicalMedicine, part of the Lancet journal family.
The study involved 236 participants on sick leave. Half received immediate access to the new treatment method while the other half waited ten weeks before starting. "We compared this with a waiting list group. That group had to wait 10 weeks before starting the same treatment. For the 121 patients who did not have to wait, the savings were approximately NOK 9.5 million in reduced costs for reduced sick leave," Hjemdal said.
Results showed that 42 percent of those who received early treatment returned to work after twelve weeks, compared with only 18 percent in the group that waited for treatment. Both groups eventually achieved similar results after completing therapy.
The increase in mental health-related sick leave is notable; there were 223,000 people on such leave in Norway in 2017 and by 2024 this number rose to 327,000—an increase of nearly 47 percent.
Hjemdal explained that metacognitive therapy differs from traditional approaches: "Metacognitive therapy does not work that much with the content of your thoughts. Instead, it works on how you relate to your thoughts." He added, "Thoughts and feelings are spontaneous events that come and go without us having to regulate them. The goal is for you to learn to stop regulating your thoughts and feelings. You should rather let them come and go without getting involved."
Developed by Professor Adrian Wells, metacognitive therapy is short-term and structured. It has demonstrated effectiveness for anxiety and depression; about seventy percent recover after completing treatment with few relapses—compared with fifty percent recovery rates using other treatments where relapse rates can reach fifty percent.
Therapists integrated job focus into their sessions as part of this approach or alongside cognitive behavioural therapy methods. "In short, job focus is about the fact that work is important for mental health. We examine the job situation, and any need for facilitation, and investigate obstacles to returning to work, such as bullying in the workplace," Hjemdal said.
Sick leave related specifically to anxiety and depression costs an estimated NOK 71 billion annually in Norway alone.
The research indicates potential benefits both for patient well-being and societal cost savings if such treatments become more widely adopted.
