
While injured workers who have suffered a serious physical injury need time to recuperate, time spent recovering physically may elicit psychological struggles. Some workers become anxious about their financial security, stressed about losing their jobs, fearful they may no longer be able to perform the job or feel depressed amid the loss of a structured routine.
Treating workers for emotional distress resulting from physical injury is important for successful recovery. However, many workers have the misconception that they cannot receive cognitive behavioral therapy for a physical injury in the absence of a mental health diagnosis. In reality, regardless of the injury, all injured workers are eligible to receive cognitive behavioral treatment to help with their recoveries without being diagnosed with a mental illness.
Even if the physical injury seems minor, injured workers often remain susceptible to psychological distress, even in the absence of a mental health history. However, distress does not always or often equate to mental illness. Simply, physically injured workers may feel mental distress based on beliefs about their situation or the result of having their life disrupted by the injury, and early intervention is correlated with quicker recovery.
The threat of catastrophizing
Injured workers who have never felt mental distress before may feel heightened anxiety due to past experiences that are affecting how they regard their situation. This can lead to catastrophic thinking, believing that their injury has done them irreparable damage and that their circumstances will only worsen. The mental distress caused by catastrophizing can delay recovery. Paradoxically, their distress is not inhibiting their ability to return to work, but instead, their lack of readiness to return to work is creating their distress.
Confusing mental pain with physical pain
The longer workers are away from work, the more likely they are to fear returning to work. They may express these fears as anxiety, stress or depression. Both fear and catastrophizing can cause injured workers to mistake their mental distress for physical pain, causing them to believe that they are not yet ready to return to work. An injured worker who is physically cleared to return to work without having been treated for their mental distress places themselves, their family, co-workers and the employer at risk and can result in re-injury. When mental distress is not treated, the return-to-work prognosis is often lengthened and may become more complex.
Ignoring mental distress lengthens return-to-work prognosis
Many people define themselves by what they do for a living. Working helps people feel productive and creative. Occupation provides a sense of purpose, confidence and self-worth. Naturally, if physical injury disrupts the working experience for a period of time, isolation, fear and uncertainty may develop and deepen into depression, anxiety or other mental health issues.
If mental health issues are ignored or not addressed until late into the injured worker’s recovery, depression may have progressed to the point that it instigates physical symptoms, including sleeplessness, headaches and body aches. This can make returning to work difficult and result in delayed return to work. Therefore, the sooner injured workers receive mental health treatment after symptoms arise, the sooner they will be able to return to work.
How cognitive behavioral therapy helps injured workers
Cognitive behavioral therapy is usually a series of four to eight sessions over the course of as many weeks to determine a patient’s emotional challenges and work on strategies for coping with them. These strategies help injured workers manage stress, anxiety and depression and prevent relapses. It’s a win-win-win for employees, employers and insurance companies. Cognitive behavioral therapy helps injured workers to
- Change negative thinking and behavior patterns
- Adopt healthy coping skills
- Revise how they understand pain
- Become an active participant in their recovery
- Pinpoint ways to manage emotions
- Resolve conflicts and learn better ways to communicate
- Manage chronic physical symptoms
A brief, targeted treatment, cognitive behavioral therapy reduces claims costs and empowers workers by helping them to manage their pain, so they can return to being productive employees who enjoy life.

Ascellus bridges the gap between mental and physical health to accelerate recovery for our nation's workforce. By connecting the workers' compensation industry with our expert behavioral care and evidence-based treatments, we deliver high-quality outcomes, helping injured workers reemerge with increased strength, purpose and resilience in the workplace.