Abstract: Mental health claims in the workplace are rising, particularly those
due to depression. Associated with this is an increase in disability costs for
the employer and the disability insurer, but even more important is the human
suffering that results. While treatments are available for the depression there
is a gap in interventions that specifically target return-to-work preparation.
This paper presents cognitive work hardening, a treatment intervention that can
bridge this gap by addressing the unique functional issues inherent in
depression with a view to increasing return-to-work success. Cognitive work
hardening applies the proven principles of classical work hardening (which has
typically been applied to people with physical injuries) to the mental health
domain. This paper explains how the occupational therapy principle of
occupation and the core competency, enablement, are utilized and applied
in cognitive work hardening. Key skills of the occupational therapist are also
discussed. In addition, the paper considers the relationship of cognitive work
hardening to recovery and mental illness, and the role it plays among
workplace-based return-to-work interventions in the current movement toward
non-clinical return-to-work interventions.
