Table 1 Goals and key points for group sessions of the self-management intervention

Session I

Self-management principles for coping with chronic pain and fatigue

Provide introductions; establish rapport; provide a scientific and philosophical rationale; differentiate self-management from medical management; recognize workplace challenges and constraints; set the general scope and agenda for future sessions

• Chronic physical health conditions are common.

• Coping at work can require special skills.

• Thoughts, emotions, and behavior play a part.

• You are your own best expert and advocate.

• Coaching and social support can help.

• Mindfulness and problem solving can help.

Session II

Job modification, pacing, and problem solving

Understand problematic job tasks; apply principles of mindfulness to workplace activity and discomfort; identify potential sources of leeway and flexibility; brainstorm possible opportunities for modifying work organization and work style; apply 6-step problem solving process.

• Some job tasks are more difficult than others.

• Some job tasks may be adjustable.

• Leeway and flexibility can be an advantage.

• Manage your work to the extent possible.

• Identify functional challenges and constraints.

• Apply systematic problem solving steps.

Session III

Communicating about health problems at work

Explore different reasons for communicating with others at work about pain and fatigue; identify effective communication strategies; discuss personal choices for disclosure, recognize unique aspects of workplace rules and working roles that affect communication.

• Pain and fatigue can interfere with communication.

• A need may arise to discuss health at work.

• Make disclosure decisions judiciously.

• Communicating about pain can impact others.

• Understand reasons and context for talking about pain.

• When needed, direct assertive communication is best.

Session IV

Keeping a positive outlook and adopting realistic goals

Acknowledge the negative effect of pain and fatigue on emotions; recognize negative automatic thoughts about health and work; identify ways to accept more moderate and rational expectations about work performance; suggest coping strategies for dealing with temporary setbacks and discouragement.

• Pain and fatigue can trigger negative automatic thoughts

• Negative self-talk can impair your job performance.

• Negative self-talk can make your symptoms worse.

• Accepting more realistic job expectations can help.

• Be mindful of pain, not overwhelmed by pain.

• Have a plan for coping with stress & temporary setbacks.

Session V

Putting it all together: Taking care of yourself at work

Integrate principles of workplace coping, problem solving, job task alteration, and workplace communication through hypothetical case scenarios; foster individual goal setting; summary and closure.

• Health-related challenges are complex.

• Problem solving can improve work style and pacing.

• Communicating effectively can improve support at work

• Keeping a positive, rationale attitude is critical.

• Be mindful of symptoms while working.