Getting Back to Work: How Online Therapy is Helping People with Depression and Anxiety Return to Their Jobs

New Norwegian study shows promising results for internet-based therapy specifically designed to help people get back to work

When Erik, a 45-year-old project manager, found himself on sick leave due to depression and anxiety, he faced a common dilemma: traditional therapy helped with his symptoms, but didn't address his biggest worry—how to return to work. After months away from his job, the thought of walking back into the office felt overwhelming. He wasn't alone in this struggle.

In Norway, mental health conditions like depression and anxiety account for 30% of all annual sick leave, creating enormous personal and economic costs. While traditional therapy can effectively reduce symptoms, it often falls short when it comes to helping people successfully return to their jobs. Now, researchers in Norway have developed and tested an innovative solution: internet-based therapy specifically designed to tackle both mental health symptoms and work-related challenges.

The Problem with Traditional Approaches

Most therapy focuses on reducing symptoms like sadness, worry, or panic attacks. While this is important, it doesn't necessarily prepare someone for the specific challenges of returning to work: dealing with workplace stress, managing energy levels throughout the day, or handling conversations with managers about their absence.

Research shows that while traditional cognitive behavioural therapy (CBT) is effective in reducing symptoms, its impact on helping people return to work is less impressive. This gap has led researchers to develop "work-focused therapy," which directly integrates employment concerns into treatment.

Face-to-face work-focused therapy has shown promise, with studies indicating about a 20% increase in return-to-work rates compared to standard treatment. However, access to this specialized therapy is limited, and many people can't attend regular in-person sessions while they're struggling with mental health issues.

A Digital Solution

The Norwegian research team wondered: could they combine the accessibility of internet-based therapy with the effectiveness of work-focused treatment? They developed what they call W-ICBT (Work-focused Internet Cognitive Behavioral Therapy) — a 12-week online program that addresses both mental health symptoms and work-related challenges.

The program consists of seven chapters that participants work through at their own pace, with support from trained therapists via written messages and occasional phone calls. Unlike traditional therapy that might focus separately on depression or anxiety, this approach takes a "transdiagnostic" view, addressing the common factors that underlie various mental health conditions.

How the Treatment Works

The online program guides participants through several key areas:

Understanding the Connection: Helping people see how their mental health symptoms and work challenges are connected, rather than treating them as separate problems.

Building Self-Efficacy: Developing confidence in one's ability to handle work demands and cope with challenges that arise.

Practical Skills: Learning specific CBT techniques like managing negative thoughts, regulating attention, and planning gradual exposure to challenging situations.

Graded Return Planning: Working through concrete steps for re-entering the workplace, from initial contact with managers to gradually increasing responsibilities.

Setback Management: Preparing for and normalizing the ups and downs that come with returning to work while managing mental health.

The program emphasizes that recovery isn't linear and that feeling tired or anxious when returning to work is normal and expected. This normalization helps reduce the additional stress that comes from thinking "I should be better by now."

Real Results from Real People

The study followed 19 people who were screened for the program, with 15 ultimately participating and 11 completing the full treatment. While the numbers are small, the results were encouraging:

Dramatic Reduction in Sick Leave: Participants' average sick leave dropped from 80% to 33% — meaning most went from being mostly unable to work to working at least two-thirds of their normal schedule.

Improved Confidence: Work-related self-efficacy scores improved significantly, indicating people felt much more capable of handling their job demands.

Better Mental Health: Depression scores improved substantially, and participants reported better quality of life overall.

High Engagement: Nearly 80% of participants completed the full 12-week program, which is comparable to or better than many traditional therapy programs.

What Participants Actually Experienced

Beyond the numbers, researchers conducted detailed interviews with participants to understand their experiences. Four main themes emerged:

The Format Works: People appreciated the flexibility of online therapy. They could work through materials when they felt mentally able, revisit content as needed, and avoid the stress of traveling to appointments when they were struggling.

"It was very positive that I could control it myself," one participant explained. "I could do the treatment from home without the need for travel for sessions."

The Content Made Sense: Participants found the combination of mental health and work content highly relevant. Rather than having to navigate separate treatments, everything was integrated in a way that reflected their real-world experience.

"The combination was very good—not just all about work, not just all about mental health, but a mix where you can actually think about how they are connected," noted another participant.

A Challenging Process: While people found the program helpful, it wasn't easy. Some struggled to find time for the work, others found certain assignments emotionally difficult, and some felt parts of the program didn't perfectly match their situation.

Understanding and Doing Things Differently: All participants reported gaining valuable insights and practical tools. They developed better ways to manage negative thoughts, set boundaries at work, and handle stress.

Why This Approach Works

The success of this program appears to stem from several key factors:

Integrated Approach: Instead of treating mental health and work issues separately, the program recognizes they're deeply connected and addresses them together.

Practical Focus: The therapy doesn't just explore feelings but provides concrete tools and strategies for real-world situations.

Flexibility: The online format allows people to engage when they're mentally able and progress at their own pace.

Normalization: The program acknowledges that returning to work while managing mental health is difficult and that setbacks are normal.

Gradual Progression: Rather than expecting people to jump back into full-time work, the approach supports gradual re-engagement.