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The comparison OPs were not trained in the guideline use and referred workers to psychologists for additional treatment as usual. Vlasveld et al23 24 examined the effectiveness of a collaborative care [http://en.wikipedia.org/wiki/Oxygenase Oxygenase] intervention in which the OP was the case manager and there was collaboration with a consulting psychiatrist, workplace and the worker. The OP provided 6�C12 sessions of a standardised problem-solving treatment; the worker was also given a guided self-help manual. There was also a workplace intervention in which the worker, manager and OT participated. The comparison group received care from OP, GP and mental health specialists;  all the providers were accessed independently and they did not collaborate in service provision. In Nystuen and Hagen's27 study, the problem-solving intervention was delivered by three psychologists in both the individual and group situations. There were also eight group sessions that focused on coping strategies. The comparison group received care as usual that included written information from the social security office. RTW outcomes The two main RTW outcomes that were of interest were: (1) whether a worker returned-to-work (RTW rates) and (2) duration of sickness absence. RTW was defined in a variety of ways including time to full RTW, partial RTW and any RTW (table 2). Table?2 Outcomes of RTW intervention studies RTW rates Three studies examined RTW rates. The data collection points varied among the studies as did the findings. For example, at 3?months van der  Klink et al20 observed significant differences between the invention and control groups (98% vs 87%, respectively)  with respect to any RTW. However, the differences were not significant in terms of full RTW. Furthermore, differences were not significant at 12?months because the entire sample returned to work. Hees et al26 quality adjusted the RTW measure for full RTW and remission of depression symptoms. They noted significant differences between the intervention and control groups over time (ie, between baseline and 18?months). In contrast to the previous two studies, Brouwers et al21 did not observe significant differences between the intervention and control groups with regard to either full or partial RTW at 3, 6 or 18?months. Duration of sickness absence All six of the studies looked at the duration of sickness absence. The studies differed in the time period they examined; these periods included time to full RTW, partial RTW, any RTW as well as absenteeism. Only one study found a significant difference between the intervention and control groups. van der Klink et al20 reported significant differences in RTW for the intervention (36?days, 95% CI 31 to 40) versus the control group (53?days, 95% CI 44 to 62). Discussion This systematic literature review examined the evidence for the effectiveness of the incorporation of work-focused problem-solving skills in RTW interventions.