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Cost-Effectiveness of Acceptance and Commitment Therapy and a Workplace Intervention for Employees on Sickness Absence due to Mental Disorders

Finnes, Anna MS; Enebrink, Pia PhD; Sampaio, Filipa PhD; Sorjonen, Kimmo PhD; Dahl, JoAnne PhD; Ghaderi, Ata PhD; Nager, Anna PhD; Feldman, Inna PhD

Journal of Occupational and Environmental Medicine: December 2017 - Volume 59 - Issue 12 - p 1211–1220
doi: 10.1097/JOM.0000000000001156

Objective: The aim of this study was to evaluate cost-effectiveness of Acceptance and Commitment Therapy (ACT) and workplace dialogue intervention (WDI), both as stand-alone interventions and in combination, compared with treatment as usual (TAU), for employees on sickness absence with mental disorders.

Methods: Employees (n = 352, 78.4% females) on sickness absence were randomized to one of four groups. Cost-utility analyses were conducted from a health care perspective and a limited societal perspective.

Results: All groups reported significant improvements in health-related quality-of-life (HRQoL) and there were no significant differences in HRQoL or costs between groups. The probability of cost-effectiveness for ACT+WDI was 50% compared with ACT, indicating that both treatment alternatives could be considered equally favorable for decision-makers. TAU and WDI were rejected due to less economic efficiency.

Conclusion: Adding WDI to ACT cannot be recommended on the basis of our study results.

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Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden (Ms Finnes, Drs Enebrink, Sorjonen, Ghaderi); Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden (Drs Sampaio, Feldman); Department of Psychology, Uppsala University, Uppsala, Sweden (Dr Dahl); and Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden (Dr Nager).

Address correspondence to: Anna Finnes, MS, Division of Psychology, Department of Clinical Neuroscience, Karolinska institutet, Nobels väg 9, 171 77 Stockholm, Sweden (

Funding for this study was provided by the REHSAM research fund (RS2011/012) and from the County Council in Stockholm, Sweden. No other funding was received for this work.

The authors do not have any conflicts of interests.

Supplemental digital contents are available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2017 by the American College of Occupational and Environmental Medicine