Intensive Therapy Bodes Well for Return to Work
By Donalee Moulton
O.H.S. Canada, June 2003
Injured employees who have been out of the work force for years - which has long been a challenge for return-to-work efforts - are seeing some dramatic and encouraging results with a new treatment being offered by Canada's first Centre for Emotions and Health.
The intensive, short-term dynamic therapy is based on the promise that emotional problems cause physical illnesses. What happens is that when individuals present with a physical problem, doctors go looking for a physical cause they are never able to find. Many of the emotional problems causing concern are called somatoform disorders. These result when emotions are shunted into the body in the form of smooth muscle tension, striated muscle tension, pain, weakness, mental confusion and other bodily dysfunction.
"If a person can express emotions, they don't result in any adverse physical consequences. But if (emotions) get trapped, then the person gets physically sick", says Dr. Allan Abbass, program coordinator of the Centre for Emotions and Health and director of education for the Department of Psychiatry at Halifax's Dalhousie University.
In one study by Dr. Abbass, 89 patients were assessed before, during and after treatment. Twenty-two of those individuals had been unemployed and out of work for an average of 60 months. Eighteen patients were able to return to work, some even before therapy had concluded, and 17 of them had been on disability insurance.
Dr. Abbass notes that 85 per cent of study participants no longer required medication at the end of the treatment, the relapse rate was under five per cent, and for every $1 spent on treatment, $3 was saved.
The therapy model, developed by Dr. Habib Davanloo, a professor of psychiatry at McGill University in Montreal, requires an average of 15 sessions to effect results. It looks at physical conditions to determine if there is an underlying psychological cause.
"There's a specific physiology of emotion and all have a bodily response", says Dr. Abbass. "You can test if a person's emotional circuitry is working by doing some physical test". He estimates that half of all patients who visit a family physician are suffering from a somatoform disorder.
Intensive, short-term dynamic therapy is designed to identify triggers to original causes and enable patients to experience their emotions. The therapy, says Dr. Abbass, works with a range of patients including very complex, highly resistant individuals.