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Brief Counseling May Help People with Muscle and Joint Conditions Stay Employed

study funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

Muscle and joint conditions such as arthritis, lupus, or fibromyalgia may result in long-lasting pain and disability. According to recent studies, people with those conditions may have difficulty keeping jobs if their symptoms make it hard to get to and from work or to perform work-related activities, such as walking, standing, or bending. They may also encounter physical barriers in the workplace, such as stairs or heavy doors, or policy barriers such as inflexible leave policies. Past research has found that up to a third of working people with arthritis report having limitations at work, and nearly half of people with arthritis and other muscle and joint conditions are unemployed within 10 years of being diagnosed. However, with accommodations and supports, people with muscle and joint conditions can remain productive workers. In a recent NIDILRR-funded study, researchers tested a brief counseling program for people with muscle and joint conditions wishing to stay employed. The researchers wanted to find out if the counseling program led to less job loss or missed workdays over a two-year period, compared with simply giving people written employment resources.

Researchers at the Rehabilitation Research and Training Center on Enhancing Activity and Participation for Persons with Arthritis enrolled 287 people with muscle and joint conditions in a study. They had all been diagnosed with one or more conditions such as osteoarthritis, rheumatoid arthritis, chronic back pain, fibromyalgia, psoriatic arthritis, lupus, ankylosing spondylitis, systemic sclerosis, or other condition. The participants were 21-65 years old, working at least 15 hours per week, and had concerns about staying employed as their conditions progressed. They were randomly assigned to one of two groups: an experimental group, who received brief counseling along with written resources, and a comparison group who received only the written resources.

Each participant in the experimental group had a 1.5-hour in-person meeting with an occupational or physical therapist. During the meeting, each participant completed a questionnaire to identify work-related challenges they experienced related to their health. Then, each participant worked with the therapist to identify solutions and develop an action plan to address those challenges. The participants were also given resource packets containing information about employment and civil rights laws, such as the Americans with Disabilities Act, job accommodations, national and local health-related organizations, independent living resources, and vocational rehabilitation and employment services agencies. After the in-person meeting, each participant had two follow-up telephone calls with the therapist. The first call was three weeks after the meeting and the second call was three months after the meeting.

The participants in the comparison group completed questionnaires and received the resource packets, but they did not meet with or receive any calls from the therapists.

Two years after completing the study, the participants in both groups were asked about their job history and whether or not they were still employed at least part-time. The participants who were still employed were also asked how many days of work they had missed in the last 3 months due to their health.

The researchers found that 2 years after beginning the study, the participants in the experimental group experienced less unemployment and missed fewer work days than those in the comparison group. Only 8% of the participants in the experimental group had become unemployed, while 18% of the participants in the comparison group had become unemployed. For those who were still employed, participants in the experimental group had only missed an average of 1.4 workdays in the last 3 months, while participants in the comparison group had missed an average of 3.6 workdays in the same time period.

The authors noted that brief counseling may help people with muscle and joint conditions develop solutions to health-related workplace challenges so they can stay employed and possibly reduce missed work days. In this study, the counseling was delivered by occupational and physical therapists rather than by counselors with specialized employment knowledge. Workers with muscle and joint conditions may have more ready access to occupational and physical therapists than employment counselors, and these therapists can help clients find ways to stay employed and productive at work. Future research may be useful to refine and standardize work retention programs for people with muscle and joint conditions.

To Learn More

The RRTC on Enhancing Activity and Participation of Persons with Arthritis offers a number of resources for people with arthritis and other chronic muscle and joint conditions to help them stay active and on the job, including factsheets, information packets, and webinar and podcast recordings with employment and arthritis experts.

The Work Experience Survey – Rheumatic Conditions used in this study is available to therapists and vocational counselors who work with individuals with these conditions. Administration Guide and Solutions Manual are available upon request.

To Learn More About this Study

Keysor, J.J. et al (2018) Efficacy of a work disability prevention program for people with rheumatic and musculoskeletal conditions: A single-blind parallel-arm randomized controlled trial. Arthritis Care & Research, 70(7), 1022-1029. This article is available from the NARIC Collection under Accession Number J79337.

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