New Therapy Combining Metacognitive Therapy and Function Focus Significantly Reduces Mental Health-Related Sick Exit
A novel therapeutic approach combining metacognitive therapy with a strong emphasis on returning to work is demonstrating significant promise in reducing mental health-related sick leave and associated economic costs. Research conducted in Norway indicates this treatment could save society up to three times its cost by accelerating individuals’ return to employment.
The Growing Burden of Mental Health and Sick Leave
Mental health conditions are an increasingly prevalent driver of sick leave, creating substantial personal hardship and imposing significant financial burdens on society. In Norway, approximately 9 million workdays are lost annually due to mental illness [1]. Between 2017 and 2024, the number of individuals on sick leave due to mental disorders in Norway rose from 223,000 to 327,000 – an increase of nearly 47% [1].
Metacognitive Therapy and Job Focus: A Combined Approach
The new treatment model centers around metacognitive therapy (MCT), which focuses on how people relate to their thoughts rather than the content of those thoughts themselves. According to Professor Odin Hjemdal of the Norwegian University of Science and Technology (NTNU), MCT helps individuals learn to stop regulating their thoughts and feelings, allowing them to approach and go without intervention [1].
This is coupled with a “job focus,” recognizing the importance of work for mental well-being. Therapists assess the individual’s work situation, identify potential barriers to returning to work (such as workplace bullying), and explore strategies for improved functioning in the workplace [1], [2].
Study Results: Doubling the Rate of Return to Work
A randomized controlled trial, published in The Lancet eClinicalMedicine, involving 236 individuals on sick leave due to mental health problems, demonstrated the effectiveness of this combined approach. Participants who began treatment immediately were significantly more likely to return to work within 12 weeks (42%) compared to those placed on a waiting list (18%) [2], [3].
The study also revealed substantial economic benefits. The cost of the intervention (approximately NOK 27,191 per patient) was nearly tripled by savings resulting from reduced sick leave (NOK 78,452 saved per patient) [2]. Immediate treatment resulted in approximately NOK 9.5 million in reduced costs for reduced sick leave [1].
Effectiveness for Anxiety and Depression
The treatment appears particularly effective for individuals struggling with anxiety and depression, conditions that represent a significant proportion of mental health-related sick leave in Norway [1]. Approximately 70% of patients experience recovery after completing the treatment, with a low rate of relapse, compared to roughly 50% recovery rates and higher relapse rates observed with many other therapies [1].
Looking Ahead
The findings suggest that wider implementation of this combined metacognitive therapy and job-focused treatment model could yield substantial benefits for both individuals and society, reducing the economic burden of mental health-related sick leave while improving patient outcomes. Further research and broader adoption of this approach are warranted.