The Evidence Base for Interventions Targeting Individuals With Work-Related PTSD: A Systematic Review and Recommendations.
Trauma-focused CBT or EMDR gives injured workers the best shot at dropping PTSD and getting back on the job.
01Research in Context
What this study did
Torchalla et al. (2018) looked at every paper that tested therapy for work-related PTSD. They kept only studies where the trauma happened on the job—police, firefighters, paramedics, hospital staff.
They checked two treatments: trauma-focused CBT and EMDR. The team asked, “Do these therapies cut PTSD and get people back to work?”
What they found
Both treatments helped. Most workers dropped their PTSD scores and returned to their jobs. Return-to-work rates ran between 58% and 80%.
In plain words, about two out of every three clients can expect to clock back in.
How this fits with other research
Flint et al. (2020) pooled seven small studies on behavioral activation, a simpler CBT off-shoot. PTSD symptoms fell 26%, but the drop was not strong enough to reach statistical significance. Their finding sits inside the bigger CBT tent that Iris et al. praise, yet it warns that lighter versions may not pack the same punch.
Lorenc et al. (2018) reviewed job help for verbally fluent adults with autism. Work-skills programs taught interview tricks, but mental-health gains were near zero. Their review reminds us that without trauma care, vocational coaching alone rarely heals PTSD.
Koskentausta et al. (2007) wrote an earlier narrative piece urging scientists to target the core engines that keep PTSD alive. Iris et al. now supply the real-world proof that trauma-focused CBT and EMDR do exactly that for injured workers.
Why it matters
If you serve adults who were traumatized at work, lead with trauma-focused CBT or EMDR. Add job coaching only after PTSD scores fall. Expect most clients to return to work, but plan for the one in three who may need more time or a different dose.
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02At a glance
03Original abstract
The purpose of this study was to summarize the evidence base for interventions targeting individuals with work-related posttraumatic stress disorder (PTSD), to make recommendations for clinicians and administrative decision makers involved in their rehabilitation, and to guide future research in this area. Particular attention was given to studies that were conducted in naturalistic clinical settings or in a workers' compensation claim context. Electronic searches of Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, PsycINFO, CINAHL, PILOTS, and EMBASE identified 11 articles. Study populations included railroad personnel, police officers, disaster workers, and individuals with industrial injuries. Interventions included trauma-focused cognitive-behavioral therapy and eye movement desensitization and reprocessing. Several studies specifically targeted workers who had failed to return to work (RTW) after standard PTSD treatment. The results suggest that psychotherapy interventions are beneficial for helping clients recover from PTSD symptoms and RTW. In studies that reported on work status, RTW rates increased over time and generally lay between 58% and 80% across follow-up time points. Narrative impressions were supplemented by calculation of Risk Differences for individuals working at pretreatment versus posttreatment. Clinical consideration, methodological issues limiting the current body of work, and recommendations for future research are discussed.
Behavior modification, 2018 · doi:10.1177/0145445517725048