What’s this project all about?
This activity is part of Healthy Working Life, a joint programme of the West Yorkshire Combined Authority and NHS West Yorkshire Integrated Care Board.
When Noah was referred to NHS Talking Therapies, delivered by Vita Health Group through the Healthy Working Life programme, he had been signed off from his frontline healthcare role due to work-related stress and anxiety. A fit note was in place and although Noah hoped to return within a month, he felt uncertain about coping in a fast-paced and demanding environment. He was also questioning whether he wanted to remain in the role long term.
From the outset, the focus of support was to help Noah recover his confidence and return to work in a way that protected his mental health.
Understanding the impact on work and daily life
At his initial assessment, health colleagues used standard mental health questionnaires to understand how Noah’s symptoms were affecting him. These measures assess the severity of depression and generalised anxiety, as well as how much difficulties interfere with work, home life and social functioning.
Noah’s initial scores showed moderate depression, severe anxiety and significant disruption to his ability to function at work and in daily life. Anxiety was particularly high and work felt overwhelming and unmanageable. This provided a clear starting point for both therapeutic and employment support, with work recognised as an important part of recovery rather than something separate.
Combining therapy with practical employment advice
Noah received four sessions of low intensity cognitive behavioural therapy (CBT) to address generalised anxiety. Therapy focused on understanding thought patterns, reducing avoidance and developing practical coping strategies. Alongside therapy, an employment adviser worked with Noah to create a structured and realistic return-to-work plan.
“We looked at work as part of Noah’s recovery,” said Employment Adviser Carolyn Leonard. “Good work can be protective for mental health, but only when the right support is in place. Our role was to reduce the fear around returning and make sure it felt manageable and safe.”
Together they developed a tailored plan that included phased return guidance, advice on reasonable adjustments, support to build communication skills and preparation for workplace meetings. They also discussed the occupational health process and began exploring longer-term career options.
Making work feel manageable again
A key part of the support was completing a work wellness action plan (WAP). This helped Noah identify specific workplace triggers, understand how they affected wellbeing and plan how to communicate needs clearly and confidently.
“The WAP gave Noah structure,” Carolyn explained. “Instead of work being one big source of stress, we broke it down into challenges, impacts and practical solutions. That made returning feel far less daunting.”
Noah chose to download the WAP and handwrite his responses.
“Writing everything down is helping me process, understanding the direction I need to take,” he said. “This has been supportive and returning is now not as daunting as it was.”
The employment adviser also provided guidance on the occupational health pathway, explaining how it can support both employee and employer to plan a safe and sustainable return. With this understanding, Noah requested a referral. He attended the assessment and found it helpful, with occupational health recommending a structured phased return. A follow-up was arranged to finalise the plan before his return date.
At the same time, Noah worked on rebuilding his relationship with his manager. With increased confidence, he arranged a face-to-face wellbeing check-in over coffee. The conversation helped rebuild trust and resulted in a shared agreement about how the phased return would work.
“By the time Noah met his manager, he felt prepared,” said Carolyn. “He knew what adjustments would help and how to explain them. That shift in confidence made a big difference.”
Choice and control?
The employment adviser also supported Noah to review and update his CV, identify transferable skills and explore possible redeployment or alternative roles. This helped Noah recognise that he had options.
“When people feel trapped at work, anxiety increases,” Carolyn said. “By exploring future possibilities, Noah realised he had skills and choices. That reduced the pressure and helped him focus on returning well.”
Although Noah felt confident he could apply for other roles if needed, he ultimately chose to remain in his current position once supportive measures were in place.
A return to work
With combined therapeutic and employment input, Noah returned to work within the month he had originally aimed for. Noah began with reduced hours and gradually increased them over four weeks until he was back working full-time again. Employment support continued during the phased return, ensuring that any concerns were addressed early. By the end of the process, Noah reported no ongoing work-related difficulties and felt confident communicating with colleagues and his manager.
At his final therapy session, repeat questionnaires showed significant improvement. Symptoms of depression had reduced to a mild level, anxiety had dropped to minimal levels and the impact of mental health difficulties on work and daily functioning had reduced dramatically. On the specific question about work functioning, Noah reported almost no difficulty.
During treatment, Noah reflected: “Employment support is proving helpful and shifting some of my concerns around work and helping me to figure out what I do next. Combined, the work I’m doing in treatment and in employment adviser sessions is bringing up a lot of things I have perhaps avoided thinking about and helping me to address my problems and cope better with my lows.”
By the end of support, Noah described improved sleep, increased energy and a more positive mindset. He felt well supported at work and looked forward to maintaining a healthier work-life balance.
Noah’s story demonstrates how integrating therapy with practical employment support can treat work not as a risk to health, but as a positive health outcome in itself. With the right adjustments and guidance, returning to good work became a central part of Noah’s recovery.
You can also read the 'Healthy Working Life supports Noah to return to work and improve wellbeing' case study as a PDF.