Abstract
<p>Background: Stress-related disorders are the leading cause of long-term sickness absence (&gt;90 days) in Sweden, and most patients are treated within primary health care. However, few treatments effectively address both symptoms and return to work. Work-focused Cognitive Behavioural Therapy (W-CBT) is a newly developed treatment approach combining conventional CBT techniques with a module focusing on return to work. This study aims to test the feasibility and acceptability of a new W-CBT treatment manual for patients on sick leave due to stress-related disorders in primary health care, and to explore changes in work functioning and symptoms.Methods: The study was conducted at two primary health care centres in the Stockholm Region, Sweden. Adult patients on sick leave due to long-term stress-related disorders received treatment with W-CBT. The primary outcome measures concerned the feasibility and acceptability of the treatment, including the recruitment process and patients' perceptions of the treatment. The secondary outcome measures concerned work functioning and symptoms. Linear mixed-effects models with random intercepts and slopes were used for all secondary outcome measures.Results: Recruitment proceeded largely as planned. A total of 31 patients were included, of whom 30 completed treatment (median age 38 years, 63% women). All participants except one were recruited from one of the two primary health care centres. All participants perceived the treatment as effective and rated it as highly acceptable. Post-treatment, 81% (21/26) of participants were no longer on sick leave. Self-rated work functioning and symptoms showed high between-individual variability, but all measures improved post-treatment and were maintained at 6-months follow-up.Conclusions: The results indicate that W-CBT for patients on sick leave due to stress-related disorders is feasible and acceptable to deliver in a primary health care setting. In addition, work functioning and symptoms improved following treatment and were maintained at 6 months, while the observed between-individual variability suggests that treatment trajectories may differ considerably across patients. These findings warrant a full-scale controlled trial to evaluate treatment effects.Trial registration: The study was retrospectively registered on 3 November 2025 at the Open Science Framework (https://doi.org/10.17605/OSF.IO/3QE9J) before data analyses were performed.</p>