8 Glossary

The terms in the guidance are all used in a generic manner unless it is otherwise clear in the text that they are linked to a single example.

Access to Work

Access to Work is a service for people with disabilities and their employers. It can offer advice and support, including grants towards equipment, adapting the premises, or a support worker. It can also pay towards the cost of getting to work. It is available for people with disabilities who are in a paid job, unemployed and about to start work, or self-employed.

Behavioural-graded activity

A behavioural intervention that aims to increase a person's activity levels gradually. Typically, people with back problems attend 15 1-hour sessions covering activities that are relevant to them. A further three sessions are dedicated to back education and lifting instructions delivered by an occupational therapist.

Bio-psychosocial model

The bio-psychosocial (BPS) model proposes that biological, psychological and social factors all play a significant role in human responses to illness or disease. It is contrasted with the traditional, reductionist biomedical model of medicine. The latter suggests that every disease process can be explained in terms of an underlying deviation from normal function (such as a pathogen, genetic or developmental abnormality or injury). BPS general principles underpin a number of approaches to and treatments for complex physical and mental health conditions. The concept informs (to varying degrees) work in areas such as psychiatry, medicine, nursing, clinical and health psychology, occupational health and sociology.

Case management

Case management is a collaborative process of assessment, planning, facilitation and advocacy. The aim is to provide options and services that meet an individual's health needs.

Case worker/s

An individual/group of people responsible for managing an assessment and coordinating delivery of interventions and services to help a person return to work.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a psychological treatment where people work with a therapist to look at how their problems, thoughts, feelings and behaviour fit together. CBT can help people to challenge negative thoughts and change any behaviour that causes problems. It may be delivered in one-to-one or group sessions.

Condition management

Non-treatment programmes designed to help people better manage their health condition with a view to returning to work.


The overall aim of counselling is to provide an opportunity for the client to work towards a more satisfying and resourceful life. Counselling involves a relationship between a trained counsellor and an individual. The objectives will vary according to the client's needs. They may include addressing and resolving specific problems, making decisions, coping with crisis, developing personal insight and knowledge, working through feelings of inner conflict or improving relationships. A distinction needs to be made between counselling and counselling skills. Many health service and other professionals routinely and appropriately use counselling and basic human relationship skills as part of their work. This is distinct, however, from more formal counselling which involves a clearly defined professional relationship.

Employment and support allowance (ESA)

Employment and support allowance (ESA) is a two-tier system of benefits. All claimants who are out of work due to ill health or a disability are entitled to the ESA basic benefit (paid at the same rates as unemployment benefit – job seeker's allowance). Those judged (via a medically administered 'work capability' test) unable to work, or with limited capacity to work due to the severity of their physical or mental condition, receive a higher support allowance, with no conditionality. Those who are deemed 'sick but able to work' only receive additional employment support if they participate in employability initiatives such as Pathways to Work.

Expert Patients' Programme

The Expert Patients' Programme provides group-based support to help people manage their long-term condition. The groups are led by non-professionals with experience of the condition. The programme is aimed at people with a wide range of long-term conditions, whatever their age or ethnicity. It offers a toolkit of techniques to improve their quality of life. They learn to develop their communication skills, manage their emotions and their daily activities and plan for the future. They also learn how to use the healthcare system, find health resources, understand the importance of exercising and healthy eating, and manage fatigue, sleep, pain, anger and depression.

Functional capacity assessment

An evaluation which includes a medical, physical therapy, a psychological examination and an assessment of the individual's work situation.

Incapacity benefit

A weekly benefit for people who are not able to work due to illness or disability while under state pension age. From 27 October 2008, employment and support allowance (ESA) replaced incapacity benefit and income support claimed on the grounds of incapacity by new claimants. Between 2010 and 2013, existing claimants will be brought into the new system.


This generic term has been used in the guidance to describe an intervention, programme, strategy or policy. It involves a single action (or set of actions) to alter the outcome of a situation. For example, in the case of long-term sickness absence from work, it could involve implementing an organisation's sickness absence policy to help an individual to return to work.

Jobcentre Plus

Jobcentre Plus is a government agency that helps people of working age move from welfare benefits into work and helps employers to fill their vacancies. Jobcentre Plus is part of the Department for Work and Pensions. It plays a major role in supporting the Department's aim to 'promote opportunity and independence for all through modern, customer-focused services'.

Job interview guarantee

A scheme to encourage people with disabilities to apply for jobs. People who meet the definition of disability under the Disability Discrimination Act are guaranteed an interview for a post if they meet the essential criteria for doing it.

Job introduction scheme

JIS pays a weekly grant to a disabled employee's employer for the first 6 weeks of their employment to help towards their wages or other employment costs.

Long-term sickness absence (including recurring long-term sickness absence)

Long-term sickness absence has been defined in the literature as an absence lasting more than 2 weeks. For the purposes of this guidance, it is defined as 4 or more weeks. This is half-way between the usual minimum of 2 weeks in the literature, and the 6-week period after which the chance of an early return to work starts to diminish. In addition, 4 weeks is commonly used as a cut-off in the international literature. Recurring long-term sickness absence has been defined as more than one episode of long-term sickness absence, with each episode lasting more than 4 weeks

Manual therapy

A general term for treatments that involve physical manipulation, such as osteopathy and physiotherapy.

Mindful employer

An initiative aimed at increasing awareness of mental health at work and providing support for businesses recruiting and training staff who have mental health issues.

Multimodal programme

A programme to manage back pain with input from different professionals. It covers relaxation training, exercises to reduce cervical and lumbar lordosis (curvature of the spine) and psychological support to reduce anxiety. It also includes eye fixation exercises and manual treatment of the cervical spine, using techniques such as massage and mobilisation.

New Deal for Disabled People (NDDP)

A programme of advice and practical support to help people move from disability and health-related benefits into paid employment. The programme is delivered through a network of 'job brokers' from a range of organisations. Each one offers different services which can be tailored to individual needs. NDDP is only available in some areas of the UK. Similar help and advice is provided elsewhere by Pathways to Work.

NHS Regional employability programmes

NHS training and work experience placements which are designed to enhance the skills and employment prospects of unemployed people and encourage NHS employers to develop supportive recruitment and training practices.

Operant conditioning behavioural approach

A type of behavioural therapy.


Presenteeism is the opposite of absenteeism.  It can describe being in work despite health problems. It also describes someone's attendance at work without performing all of their usual tasks (regardless of the reason). 'Suboptimal performance' is often used interchangeably with presenteeism in the literature: it describes a scenario where employees do not function fully leading to losses in productivity. Presenteeism can also make health problems worse.

Progressive goal attainment programme

A standardised psychosocial rehabilitation programme that aims for a gradual increase in daily, goal-directed activity by overcoming any psychological obstacles to such activity. The main components are education and reassurance.


The action of restoring someone to a previous condition, status or some degree of normal life.

Return-to-work credit

This credit provides financial support during the first year of work after someone has had a health condition or disability and has been receiving a relevant benefit. It is a tax-free payment paid on top of wages for up to 52 weeks. It is a means-tested allowance available to anyone who works 16 hours or more a week.  


Shift is an initiative which aims to tackle the stigma and discrimination surrounding mental health issues in England. Working with the National Social Inclusion Programme, it aims to create a society where people who experience mental health problems enjoy the same rights and opportunities as other people.

Short-term sickness absence (including recurring short-term sickness absence)

Short-term sickness absence has been defined in the literature in days or weeks. For the purposes of this guidance, it is defined as an absence lasting up to (but less than) 4 weeks. Recurring short-term sickness absence has been defined as more than one episode of short-term sickness absence, each lasting less than 4 weeks.

Statutory sick pay (SSP)

Employers pay SSP to employees who are unable to work because of sickness. It is paid for a maximum of 28 weeks.


There is no simple definition of stress, but there is consensus that it is caused by a person's appraisal of a situation and how their mind and body prepares to respond. Stress is a natural but sometimes distressing reaction leading to a psychological and physiological tension which is referred to as the 'flight or fight' response. It may be positive (for example, as part of preparation for a sporting event or in response to an exciting work challenge). It may also be negative (for example, it may be a response to bereavement or to excessive pressure). It leads to an increase in heart rate and blood pressure and may result in frequent, intrusive thoughts and accompanying feelings of fear or excitement. Stress may occur in response to a single event experienced over a short period of time (for example, unexpected increases in workload). Alternatively, it may occur in response to multiple events over long periods of time (for example, in response to protracted periods of treatment for an illness). In the majority of cases (and with appropriate intervention) people will adapt and cope. However, there are some occasions when this does not occur.

Usual care and treatment

This refers to the usual health, social and other interventions used to treat and manage a condition which has caused the sickness absence.

Vocational rehabilitation

This involves helping those who are ill, injured or who have a disability to access, maintain or return to employment or another useful occupation. It may involve liaison between occupational health, management, human resources and other in-house or external facilitators. It may result in transitional working arrangements, training, social support and modifications to the usual tasks.


A term that is broader than the traditional definition of unemployment. It is used to describe people of working age who are not in formal employment but who are looking for a job (the unemployed). It is also used to describe people of working age who are not formally employed and are not looking for employment (also known as the 'economically inactive').

  • National Institute for Health and Care Excellence (NICE)