Uppsala University Develops New Treatment to Accelerate Recovery from Exhaustion Disorder
The day after defending his doctoral thesis in the spring, Jakob Clason van de Leur learned that he had been granted over SEK 4 million to evaluate a new model for treating stress-induced exhaustion disorder. This will enable him to continue the work he started as a doctoral student, but on a larger scale.
The treatment he will evaluate is based on Acceptance and Commitment Therapy (ACT). This form of therapy aims to provide patients with tools to help them return to social life and work. Exposure is one of the methods used in the therapy.
“The patients are called upon to challenge different types of fears and discomfort, to practise being vulnerable and asking for help. It also involves challenging the need for control and perfectionist behaviours,” says Clason van de Leur, a researcher in psychology.
A common assumption in healthcare is that it is stress and excessive workloads that lead to exhaustion. Instead, Clason van de Leur believes that feelings of loss of control, powerlessness or loneliness may be behind the symptoms. If this is so, therapy that helps patients deal with such feelings and situations should be better than treatments that focus on relaxation.
180 patients in three different groups
In the planned study, he will test three different treatments on a total of 180 patients on sick leave for stress-induced exhaustion disorder. One group will be treated using the ACT model described. The second group will receive the same therapy but will also receive support to help them return to work. The third group will be treated with the standard model, which focuses on relaxation exercises. All three treatments will be internet-based, will be led by a psychologist in cooperation with a doctor and will last 12 weeks.
“The ideal outcome would be to show that this new ACT-based model is more effective than the one that focuses only on relaxation. I also hope we will succeed in showing that an integrated work-oriented intervention actually leads to more people returning to work.”
It’s not that we expect patients to be all done, healthy or completely recovered in 12 weeks. The treatment does not have to continue throughout the course of the disease. The point is that you acquire strategies, you start to make changes, you acquire a plan and then you can continue with it on your own,” says Clason van de Leur.
Too much focus on rest
When someone goes on sick leave for stress-related exhaustion, rest is usually necessary at first. But rest is often the only recommendation made, and this is something that Clason van de Leur takes issue with. Furthermore, he does not think it is good to rest for too long.
“The risk is that you will not feel better. I often talk about people getting stuck in a form of bodily economics, a very mechanical kind of plus and minus thinking. People think: I should only have relationships that give me energy, I have to be careful not to push myself too hard,” says Clason van de Leur. He continues:
“All relationships, by definition, take energy, if you want to use that kind of language. If you are very focused on setting limits and saving energy, you run the risk of becoming quite isolated and lonely.”
The research project is funded by Afa Försäkring and will run until September 2027.