Brainwork Study

Background of the study:

Workers without an employment contract, such as unemployed and temporary agency workers, are at higher risk of work disability compared to the general working population as there is no employer to return to when sick-listed. In the Netherlands 40% of the sick leave of unemployed and temporary agency workers is due to psychological problems. Also psychological problems are associated with prolonged work disability. In the Netherlands, the Sickness Benefits Act provides for workers without an employment contract who become sick-listed. The Social Security Agency (SSA) provides a sickness benefit during the first two years of sickness absence. There are no legislative mandates for these workers to be returned to their previous/last job. Therefore the SSA is also responsible for the sickness absence counseling. This is conducted by an insurance physician (IP) but is less intensive as compared to return to work counseling of occupational physicians (that is the counseling available for workers with an employment contract). Since there are currently few return to work interventions applied for workers without an employment contract, it is important to improve the quality and approach of sickness absence counseling of these workers and develop interventions which promote return to work. For this purpose, the Brain Work method has been developed.



The Brainwork method is an activating approach, whereby the sick-listed workers are encouraged to exercise and undertake activities. There is also tailor made attention to their mental or psychosocial problems. It is expected that this approach leads to improving of functioning of the sick-listed worker and that just doing nothing or sickness absence counseling as care as usual leads to prolonged work disability.…………………

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Objective of the study:

The objective of the research is to generate knowledge about the effectiveness of the Brainwork method in the sickness absence counseling of sick-listed unemployed and temporary agency workers and workers with expired fixed-term contracts with psychological problems.



Primary soutcome of the study:

Sick leave duration; number of days from the first day of sick leave until the day of RTW.

The objective of the research is to generate knowledge about the effectiveness of the Brainwork method in the sickness absence counseling of sick-listed unemployed and temporary agency workers and workers with expired fixed-term contracts with psychological problems. The Brainwork method consists of an activating approach/intervention and providing structure to sick-listed individuals.
The Hypothesis is that an activating approach of sick-listed individuals with psychological problems will reduce the sick leave perdiod.

Primary outcome:

Sick leave duration: continously.

Instrument: SSA database.

Secundary outcomes:

1. Proportion return to work: 8 and 12 months. Instrument: SSA database.

2. Duration from transfer to SSA until RTW: continously. Instrument: SSA database.

3. Number of days of paid employment during follow-up. Instrument: own questions questionnaire at 4, 8 and 12 months.
4. Degree of participation (ordinal scale: inactive/volunteer/labor experience/paid work). Instrument: own questions questionnaire at 4, 8 and 12 months.
5. Psychological complaints: Instrument: General Health Questionnaire (GHQ) at baseline, 4, 8 and 12 months.
6. Self-efficacy in returning to work: self-efficacy related to work performance after
sick leave. Instrument: SEWNV questionnaire at baseline, 4, 8 and 12 months.
7.Costs and benefits from SSA perspective.
Instrument: SSA database.

The activating intervention consists of some components, of which the composition varies depending on the severity of the psychological problems. The components consist of an exercise program, labor training, gym membership, motivational interviewing and custom made psychological or social intervention