Work-related Attention Bias Modification Training and Virtual Reality Training in Occupational Rehabilitation: A Multisite Pilot Study
Phase: NA
Conditions: Musculoskeletal Diseases, Mental Health Disorder, Back Pain, Low, Anxiety Disorders, Depression
Sponsor: Molde University College

Regional Committee for Medical and Health Research number 254368, approved 2021.11.23. 
15. september 2021
Work-related attention bias modification training and virtual reality training in 
occupational rehabilitation: A multisite pilot study 
Project responsibility  
Chris Jensen, Norwegian National Advisory Unit on Occupational Rehabilitation 
Project manager 
Thomas Johansen, Norwegian National Advisory Unit on Occupational Rehabilitation 
Ruby Kollerud, Norwegian National Advisory Unit on Occupational Rehabilitation 
Project coworkers’ Work-related attention training 
Heidi Bjorå Arset, Idrettens Helsesenter 
Jan Frode Rønning, Betania Malvik 
Helene Haaland, Unicare Fram 
Aleksandar Kondic, Physical Medicine and Rehabilitation, Outpatient Department Bodø. 
Ann Kristin Løvhaug, Norsk Arbeidshelse 
Ása Dóra Konráðsdóttir, Hæfi Rehabilitering, Island 
Project coworkers’ Virtual reality 
Anniken Hjellbakk Hole/Anita Dyb Linge, Muritunet 
Tarja Kvalheim, Red Cross Haugland Rehabilitation Centre 
Anita Vatnebryn, The Rehabilitation Centre AiR 
__________________________________________________________________________________ 

Regional Committee for Medical and Health Research number 254368, approved 2021.11.23. 
15. september 2021
STUDY PROTOCOL 
BACKGROUND 
Individuals on sick leave can be offered work-related rehabilitation with the main aim to return to 
part or full time work. This multisite pilot study seeks to investigate the effect of a possible new 
intervention called attention bias modication (ABM). Patients will be recruited from both inpatient 
and outpatient clinics in the regional health authorities Mid and South-East. The cognitive 
psychological approach will be adopted, investigating changes in the cognitive function attention 
during rehabilitation for patients sick listed due to psychological and musculoskeletal disorders and 
whether the changes can predict return to work (RTW) and employment status. 
More than 600 000 Norwegians between 18 and 64 years remain outside the labour market 
and receive health-related benefits (Øverland et al., 2011). Psychological and musculoskeletal 
disorders are the most common causes of sickness absence (OECD, 2010; Brage et al., 2010; Knudsen 
et al., 2012; Mykletun et al., 2009) and anxiety and depression alone constitute one third of all 
disability pensions in Norway (Mykletun & Knudsen, 2009) and in the OECD countries (OECD, 2003). 
Given the prevalence of common psychological disorders such as anxiety and depression (Mykletun 
et al., 2009) work-related rehabilitation has proven to be a successful intervention in helping 
individuals with anxiety and depression and musculoskeletal disorders to RTW (Gismervik et al., 
2020). The aim of work-related rehabilitation to increase the likelihood of sustainable RTW. The 
programmes are commonly tailored to improve the patients’ level of functioning and work ability 
with an emphasis on physical activity, cognitive treatment components such as cognitive behavioural 
therapy and collaboration with the workplace. The main aim of all activities is to improve the 
person’s self-efficacy, self-esteem and coping related to family and working life. Often an 
interdisciplinary team work in collaboration with the patient and are commonly made up of 
psychologists, physicians, nurses, physiotherapists, job specialists and sport educators.  
The application of cognitive psychology to the investigation of psychological disorders has 
increased in recent years. Cognitive impairments and biased processing of emotional information 

Regional Committee for Medical and Health Research number 254368, approved 2021.11.23. 
15. september 2021
have been found in depression and anxiety (Beblo et al., 2011; Landrø & Andersson, 2012) and 
musculoskeletal and chronic pain (Apkarian et al., 2004; Landrø et al., 2013). Participation in the 
working life is generally considered to have beneficial effects on psychological health (Lau et al., 
2012) and cognitive and emotional factors seem prerequisites for a productive working life (Fisher et 
al., 2017; Rodriquez et al., 2020). Occupational competence requires cognitive skills both at a 
personal, emotional and workplace level (Pompeii et al., 2005; Shaw & Lysaght, 2008). Preliminary 
research findings for the patient groups seeking work-related rehabilitation point to an association 
between improvements in cognitive functions and a reduction in sick leave (Johansen et al., 2019; 
2021).  
Attentional bias 
Our attentional system is thought to be automatically drawn to particular somatic stimuli or 
environmental situations (Yiend, 2010). In experimental paradigms seeking to elucidate the 
mechanisms behind attentional processing of emotional information, the ability to recognise and 
recall facially, vocally and bodily expressed emotions, smells and emotion words and pictures, is 
investigated. One robust finding related to anxiety is that individuals vulnerable to anxious states are 
thought to attend to material of negative content as opposed to positive content (Williams et al., 
1997; Yiend, 2010). This would involve fear-relevant material for the generalised anxiety individual 
and socially threatening information for the social phobia individual. What characterises anxiety is 
the bias or even priority in attentional resources given to threat over other stimuli. This effect has 
been named emotion-congruent attentional biases because individuals will often attend to 
emotional information and situations in the environment that matches the individuals’ emotional 
characteristics. Similarly, depressed individuals will allocate more attention towards negative 
thoughts and information, which suggests that negative information is more readily recollected than 
positive information (Yiend, 2010). Deficits in emotion processing are thought to play both a causal 
and maintaining role to conditions such as anxiety and depression (Yiend, 2010). 

Regional Committee for Medical and Health Research number 254368, approved 2021.11.23. 
15. september 2021
A concept that is interlinked with attentional bias is cognitive appraisal. It plays a crucial role 
in emotional experience and was first proposed by Lazarus (1982). Three specific forms of appraisal 
have been postulated:  
1. Primary appraisal (an environmental situation is regarded as being positive, stressful or irrelevant
to well-being). 
2. Secondary appraisal (account is taken of the resources that the individual has available to cope
with the situation). 
3. Re-appraisal (the stimulus situation and the coping strategies are monitored, with the primary and
secondary appraisals being modified if necessary). 
The concept of cognitive appraisal lends itself readily, similarly to attentional bias, to better 
understand the complaints reported by patients in work-related rehabilitation. The perception and 
experience of subjective health complaints and musculoskeletal and chronic pain have provided 
similar insight into attentional biases and dysfunctional appraisals as demonstrated in anxiety and 
depression (Brosschot, 2002; Hayes et al., 2010; Pincus & Morley, 2001). For example, it has been 
revealed that patients selectively process pain-related information, interpret ambiguous stimuli as 
pain stimuli and better remember details of pain behaviour. This suggests dysfunctions in attention 
(bias) and emotional states (Eccleston & Crombez, 1999; Pincus & Morely, 2001) and confirms the 
close relationship between appraisal, on the one hand, and experienced emotions such as anxiety, 
depression, pain on the other hand. 
Computerised cognitive training has become a widespread intervention to improve attention 
and memory. Virtual reality (VR) is a measure that falls under the cognitive approach as VR 
technology provides the opportunity to expose participants to what hinders them from participating 
in working life, as well as improving attention and concentration which increases mental capacity. 
Previous research has shown that VR, used as an emotion-focused distraction method, reduces 
symptoms of anxiety, depression, fatigue and pain compared to treatment as usual (Ioannou et al., 
2020). Exposure therapy using VR for social anxiety has proven to be effective both immediately after 

Regional Committee for Medical and Health Research number 254368, approved 2021.11.23. 
15. september 2021
treatment and during long-term follow-up, although long-term effects after in vivo exposure therapy 
appear to have a slightly better effect (Horigome et al., 2020). We assume that VR also improves 
rehabilitation components aimed at various forms of exposure, work training, strengthening of 
attention and stimulation of movement and activity despite health problems, which in the long run 
increases the chances of returning to work.  
To target the appraisal mechanisms and emotion experiences the attention bias modification 
task (ABM) was developed (Browning et al., 2012). Several Norwegian studies have documented that 
ABM training has the potential to modify attentional biases in depression (Jonassen et al., 2019) and 
anxiety (Kraft et al., 2019) as well as increasing motivation for daily life activities (Kraft et al., 2019). 
The ABM has also been used in combination with acceptance and commitment therapy in persons 
reporting depressive symptoms (Østergaard et al., 2019). The combination of ABM and ACT and ACT 
alone similarly decreased depressive symptoms after treatment and during follow up. Cognitive 
training has been shown to improve the specific cognitive functions targeted in the training, however 
the degree to which effects generalize to working life and daily life functions is still questioned 
(Melby-Lervåg, 2016).  
The quantitative aim of this pilot study is to compared VR training and ABM training to 
investigate whether the different training forms result in different results measured with work-
related outcomes and cognitive outcomes.  The qualitative aim of this pilot study is to investigate the 
patients’ experiences with the usage of VR.  
Objectives - quantitative 
The objective of this study is to investigate whether VR and ABM training increases work ability, 
work-related self-efficacy, attention and reduces symptoms of depression and anxiety and 
consequently change an attentional bias from negative to positive stimuli. We will compare patients 
receiving work-related interventions + VR, work-related interventions + ABM training and work-
related interventions only. We will also investigate whether positive changes in attentional bias are 

Regional Committee for Medical and Health Research number 254368, approved 2021.11.23. 
15. september 2021
associated with increased work participation. Self-reported work ability, self-efficacy, depression, 
anxiety and objective computerised cognitive and emotional testing will be assessed at baseline 
(start rehabilitation/treatment) and at posttest (end rehabilitation/treatment). 
Objectives - qualitative 
The objective of this part is to investigate the experiences in using VR. R&D personell will make 
individual interviews with five patients at each of the three clinics involved in piloting VR. The aim of 
the interviews will be to capture how the patients experienced the VR activity, the demands of the 
VR activity, how VR has influenced different aspects of health and whether VR has influenced the 
abilities to return to work.   
STUDY PLAN 
Individuals eligible for inclusion will be those between 18 – 67 years, on sick leave, work assessment 
allowance, disability pension receiving work-related rehabilitation or treatment at seven clinics with 
either an ICPC-2 (International Classification of Primary Care, Second edition) within the L 
(musculoskeletal), P (psychiatric) or A (unspecific disorders) categories or ICD-10 diagnosis within the 
F (mental and behavioral disorders), M (Diseases of the musculoskeletal system and connective 
tissue) or other diagnoses. Exclusion criteria: 1) Applying for full disability pension; 2) Unable to 
complete the measures and receive instructions in Norwegian. 
Design and sampling 
This is a non-randomised controlled experiment where we aim to recruit 20 patients from each of 
the six clinics involved in ABM training and up 100 from each of the clinics involved in VR. That is, 10 
receiving ABM training and 10 in the control group, and 60 receiving VR and 40 in the control group. 
The participants will complete the questionnaires and cognitive measures one the day of arrival and 
on the penultimate or ultimate day of the rehabilitation/treatment. The measures will take 

Regional Committee for Medical and Health Research number 254368, approved 2021.11.23. 
15. september 2021
approximately one hour to complete at each measurement point and will not interfere with the 
participation in the rehabilitation/treatment. 
In the qualitative part of this pilot, it is aimed to recruit 15 patients, five at each of the three clinics. 
Self-reported questionnaire measures 
Kvalitetsregisterskjema fra Nasjonal kompetansetjeneste for arbeidsrettet rehabilitering 
Work Ability (Ahlstrom et al., 2010) 
Return to work self-efficacy (Gjengedal et al., 2021; Nøttingnes et al., 2019) 
Expectation about return to work (Løvvik et al., 2014) 
Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1983) 
Computerised cognitive and emotional measures 
Rapid Visual Information Processing (Cambridge Cognition, 2020) (VR group and ABM group) 
Spatial Working Memory (Cambridge Cognition, 2020) (VR group and ABM group) 
Stop Signal Task (Cambridge Cognition, 2020) (VR group and ABM group) 
Attention Bias Assessment Task (Browning et al., 2012) (ABM group only) 
Qualitative measures 
Interview guide (National Advisory Unit on Occupational Rehabilitation, 2022) 
Primary outcome measure 
1) Work ability and expectations to return to work
2) Depression and anxiety
Secondary outcome measures 
2) Cognitive and emotional performance assessed with the computerised measures

Regional Committee for Medical and Health Research number 254368, approved 2021.11.23. 
15. september 2021
3) Total number of days on health related benefits in the year after rehabilitation/treatment
4) Patients’s experiences in using VR
Virtual reality training 
In collaboration with the participating clinics a systematic VR activity plan will be developed. This 
includes the selection of games and designing a plan that is interesting and motivating both for 
patients and clinicians. 
Attention Bias Modification Training 
The ABM task is a computerised, validated visual dot-probe procedure (Browning et al., 2012). In the 
original version from Browning et al. (2012) paired images of faces (the stimuli) were presented 
followed by one or two dots (a probe), which appeared behind one of the stimuli. Participants were 
required to press one of two buttons as quickly as possible to indicate the number of dots in the 
probe. Stimuli were pictures of emotional faces of three valences: positive, neutral, or negative 
(angry and fearful). The task comprised 96 trials with equal numbers of the three stimulus pair types. 
There were equal numbers of trials in which the stimuli were randomly presented for 500 or 1.000 
milliseconds before the probe was displayed. Stimuli from two valences were displayed in each trial 
in one of the following pairing types: positive-neutral, positive-negative, and negative-neutral. 
Probes were located behind positive (valid) emotional stimuli in 87% of the trials in the training 
condition. Thus, when completing training, participants should learn to orient attention toward 
positive stimuli and in this way develop a positive attentional bias. 
The aim of the current pilot study is to replace the facial stimuli with work-related stimuli 
categorized as positive, neutral and negative. We will follow the dosage and frequency of training 
applied in the other Norwegian studies (Kraft et al., 2019; Jonassen et al., 2019; Østergaard et al., 
2019). Participants will use tablets with the ABM task pre-installed and will be instructed to complete 

Regional Committee for Medical and Health Research number 254368, approved 2021.11.23. 
15. september 2021
two training sessions every day from Monday to Friday for the duration of the 
rehabilitation/treatment.  
Procedure for recruitment and testing 
1. Local project representative hands out the information sheet to newly arrived participants and
gives a short explanation about the project 
2. The representative meets the participants the following day and asks whether he/she wants to
participate. If the participants volunteers, he/she signs the consent form 
3. Test 1: During the next two days the participants is administered three attention tests in front of a
computer screen. It takes about 30 minutes to complete the tests. The participants also complete 
questionnaires about their work and health situation, as well as background information such as your 
age, education, marital status, type of job and work and benefit situation. It takes about 30 minutes 
to complete the questionnaires. 
4. Test 2: On the third or second but last day of rehabilitation/treatment the participant completes
the same tests and questionnaires as described above. 
5. In the period between test 1 and test 2, all participants undergo VR activities or attention bias
modification training on an Ipad/tablet. Each training session lasts for about 15 minutes and is 
carried out twice a day from Monday to Friday during rehabilitation/treatment or adjusted according 
to patients’ needs and capabilities as well as the already exisiting rehabilition programme at each 
participating clinic.  
6. The participants in the control group complete test 1 and 2 but do not receive the added
intervention described in 5. 
7. R&D personell at each of the three clinics using VR will approach participants each after test 2
(sequence number 4) asking them if they would like to volunteer to take part in an interview about 
the experiences in using VR.  

Regional Committee for Medical and Health Research number 254368, approved 2021.11.23. 
15. september 2021
Power  
A priori power calculations for F tests using G*Power (Faul et al., 2007) were performed to check 
which sample size was required to detect differences between groups in scores on work and health 
questionnaires using repeated-measures analysis of variance (pretest to posttest changes). Results 
indicated that with a power of 0.90, moderate effect size set at 0.25 and a two-tailed alpha level of 
0.05 (Cohen, 1988), the total number of participants needed would be 44 in each group. 
Study period 
1 January 2022 to 1 June 2026. 
Main study 
This pilot study will inform whether we need to make adjustment or changes to the main study 
expected to commence 1 August 2024 and with particular reference to the following criteria: 
-
Is the main study feasible
-
What changes should be made to the protocol of the main study
-
What specific changes and amendments should be made to the design of the main study
-
What specific recommendations to the main study are provided by the collaborating
clinics and how do we deal with them and implement them in the main study
Dissemination 
A project report will be published on www.arbeidoghelse.no. Publication of one scientific article. 
Ethical perspectives 
The project is approved by the Regional Committee for Medical and Health Research and Sikt – 
Norwegian Agency for Shared Services in Education and Research. 

Regional Committee for Medical and Health Research number 254368, approved 2021.11.23. 
15. september 2021
Gender issues 
The participants recruited into the three groups will be matched according to gender. 
Funding 
This project is self-funded by each participating institution. 
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This is a translation from the original Norwegian consent form, Research No. 254368, approved 
on November 23, 2021. 
1 
WOULD YOU LIKE TO PARTICIPATE IN THE RESEARCH PROJECT 
VIRTUAL REALITY AND ATTENTION TRAINING 
THE PURPOSE OF THE PROJECT AND WHY YOU ARE ASKED 
This is a question to you about participating in a research project where the purpose is to get more 
information about how virtual reality (or virtual reality (VR) training) improves cognitive functioning. 
With cognitive functioning, we mean our ability to be attentive, focused, and use our memory. You 
are asked based on your participation in occupational rehabilitation.  
Along with this information sheet, you will also receive verbal information about the project where 
you have the opportunity to ask questions in connection with participation. If you accept 
participation, you will either: 
1.
Receive an offer to undergo VR training in conjunction with the standard rehabilitation
program to examine how VR training enhances cognitive functioning (intervention group), or
2.
Receive the standard rehabilitation program without VR (control group).
The decision on whether you receive VR training will be made by the professional team. 
Participating in the project will involve taking three cognitive tests at the beginning and end of the 
rehabilitation program to evaluate any changes in your attention skills. 
WHAT DOES THE PROJECT MEAN FOR YOU? 
1.
Start by reviewing this information sheet. If you decide to participate, complete the consent
form on page 4.
2.
Test 1: Upon arrival, you'll undertake three attention tests on a computer, which will take
approximately 30 minutes. Additionally, you will fill out an electronic form regarding your
work, health status, and background details like age, education, marital status, job type, and
benefits situation. This form should also take around 30 minutes to complete.
3.
Test 2: Before discharge, you'll repeat the same attention tests and form as described in point
2.
4.
If you are in the VR training group: Between Test 1 and Test 2, you'll participate in VR training
sessions facilitated by a service provider. Each session will last approximately 15-20 minutes,
occurring three times a week during your stay.

This is a translation from the original Norwegian consent form, Research No. 254368, approved 
on November 23, 2021. 
2 
5.
If you're not participating in the VR training, you'll follow the activities outlined in your
schedule.
We aim to compare your employment situation before and after rehabilitation. Therefore, we plan to 
gather data regarding your sick leave and employment status from the Norwegian Labour and 
Welfare Administration's database for 12 months before and after your rehabilitation stay. 
POSSIBLE BENEFITS AND DISADVANTAGES 
Participation in this project presents no health risks. The only obligations include completing a form, 
undergoing tests, and potentially engaging in Virtual Reality (VR) training. You may reflect upon your 
responses and test performance afterward. In case of any distress from the VR experience, a 
dedicated contact person will ensure access to a cognitive or psychiatric service provider, if desired. 
Post-VR training, it's common to experience mental fatigue. For any inquiries, contact the assigned 
representative at the rehabilitation center or Project Manager Thomas Johansen (contact details on 
page 3). 
All participants will receive feedback during the second test regarding the project's effect on their 
attention skills. You will review your results alongside a service provider, comparing performance 
between the first and second tests. This collaborative discussion will help interpret what these 
outcomes may imply for you and your personal experience. 
VOLUNTARY PARTICIPATION AND OPPORTUNITY TO WITHDRAW YOUR CONSENT  
Participation in the project is voluntary. If you wish to participate, you sign the consent form on page 
4. You can withdraw your consent at any time and without giving any reason. There will be no
negative consequences for you or your treatment if you do not want to participate or later choose to 
withdraw. If you withdraw your consent, no further research will be done on your health information. 
You can request access to the information that is stored about you, and the information will then be 
provided within 30 days. You can also demand that your personal information in the project should 
be deleted.  
The right to request destruction, deletion, or delivery does not apply if the data material or 
information is anonymized or published. This right may also be limited if the information has been 
included in completed analyses.  
If you later wish to withdraw or have questions about the project, you can contact the project 
manager (see contact information on page 3).  
WHAT HAPPENS TO THE INFORMATION ABOUT YOU? 

This is a translation from the original Norwegian consent form, Research No. 254368, approved 
on November 23, 2021. 
3 
The data collected about you will be utilized exclusively as outlined in the project's purpose and is 
intended for use until June 1, 2023. Extensions for data usage and storage require approval from the 
Regional Committee for Medical and Health Research Ethics and other relevant authorities. You hold 
rights to access your registered information, correct inaccuracies, and review the security for data 
processing. Any complaints regarding your data handling can be directed to the Norwegian Data 
Protection Authority and the institution's privacy representative. 
All collected data will be processed anonymously, without names, social security numbers, or any 
directly identifiable information, and will be linked to you via coded information. Only Project 
Manager Thomas Johansen, Research Manager, and the designated contact person at the 
rehabilitation centres can access this coded name list. 
Publication of results, an integral part of research, will be conducted ensuring individual participants 
remain unidentifiable.  
The information about you will be stored for five years after the end of the project for control 
reasons.  
INSURANCE 
Normal insurance related to the rehabilitation (the institution and the professionals' practice of their 
activity) applies.  
FOLLOW-UP PROJECT 
As a participant, you might be invited for a potential future project. Your involvement in this 
subsequent project would remain optional, as previously outlined under 'Voluntary participation and 
the opportunity to withdraw your consent'. 
ECONOMY 
Participating in this research project will not incur any additional costs for you, nor will you receive 
any compensation for your participation. 
APPROVALS 
The Regional Committee for Medical and Health Research Ethics (REK) has made a research ethical 
assessment and approved the project. The case number at REK is 254368.  

This is a translation from the original Norwegian consent form, Research No. 254368, approved 
on November 23, 2021. 
4 
The responsibility for data protection in the project lies with the Rehabilitation Centre AiR at the 
Norwegian National Advisory Unit on Occupational Rehabilitation and the project manager, Thomas 
Johansen. 
We process the information based on your consent. 
CONTACT INFORMATION  
If you have questions about the project or wish to withdraw from participation, you can contact 
project manager Thomas Johansen, phone 35 06 28 00, thomas.johansen@arbeidoghelse.no, or the 
responsible contact person at the rehabilitation centre.  
For any inquiries related to data protection within the project, please reach out to the designated 
privacy officer at the rehabilitation institution. 
INFORMATION ABOUT THE OUTCOME OF THE STUDY 
You are entitled to receive the project results. To request a summary of the survey results in the fall of 
2023, email project manager Thomas Johansen at thomas.johansen@arbeidoghelse.no or call 35 06 
28 00. Project results will also be available on www.arbeidoghelse.no, www.rkhr.no and 
www.muritunet.no.  

This is a translation from the original Norwegian consent form, Research No. 254368, approved 
on September 20, 2022. 
1 
DO YOU WANT TO PARTICIPATE IN THE RESEARCH PROJECT 
EXPERIENCES WITH THE USE OF VIRTUAL REALITY AND ATTENTION TRAINING 
THE PURPOSE OF THE PROJECT AND WHY YOU ARE BEING ASKED 
As you participated in the "VIRTUAL REALITY AND TRAINING OF ATTENTION" research project during 
your rehabilitation stay, we're inviting you to join a follow-up study. We're interested in learning more 
about your experiences with using VR. 
Once you've reviewed this letter, we'll reach out to discuss your potential participation and answer 
any questions you may have about the study. 
WHAT DOES THE PROJECT MEAN FOR YOU? 
1.
First, begin by reviewing this information sheet. If you decide to participate, complete the
consent form found on page 4. The method for submitting the form will be agreed upon.
2.
Participate in an individual interview discussing your experiences with VR, which will last
between 30 to 60 minutes. A researcher at your rehabilitation centre will conduct the
interview with you, and together, you will arrange the specifics of when and how it will take
place. The interview will be digitally recorded.
POSSIBLE BENEFITS AND DISADVANTAGES 
Participation in this project doesn't pose any health risks. The only requirement is your participation 
in the interview. You may contemplate your responses after the interview. If the interview causes any 
discomfort, the research coordinator at your rehabilitation centre can arrange a discussion with a 
healthcare professional. If you have any questions or concerns, feel free to reach out to the research 
coordinator at your rehabilitation centre or project manager, Thomas Johansen (contact details 
provided below). 
VOLUNTARY PARTICIPATION AND THE POSSIBILITY OF WITHDRAWING YOUR CONSENT 
Your participation in the project is entirely voluntary. If you choose to participate, please sign the 
consent form on page 4. You have the right to withdraw your consent at any time and for any reason, 
without any negative impact on you or your treatment. If you choose to withdraw, your interview 
information will not be used for further research. You can request access to your stored information, 
which will be provided within 30 days. You can also request the deletion of your personal information 
from the project. However, these rights do not apply if your information has been anonymized, 

This is a translation from the original Norwegian consent form, Research No. 254368, approved 
on September 20, 2022. 
2 
 
published, or included in completed analyses. If you later decide to withdraw or if you have any 
questions about the project, please contact the project manager (contact information can be found 
on page 3). 
WHAT HAPPENS TO THE INFORMATION ABOUT YOU?  
The information we collect about you will be used solely for the purposes outlined in the project until 
December 31, 2023. Any extension of this usage or storage period requires approval from the 
Regional Committee for Medical and Health Research Ethics and relevant authorities. You have the 
right to access, correct any errors in, and understand the security measures taken for your 
information. You can file complaints about data processing to the Norwegian Data Protection 
Authority and the institution's privacy representative. 
Your interview will be audio-recorded and transcribed into text by an external transcriber, under a 
data processing agreement with the National Expertise Service for Vocational Rehabilitation. 
Researchers at the service and your rehabilitation centre will analyse and disseminate this data. 
All data will be processed in a manner that ensures individuals cannot be identified, without any 
directly recognizable information such as name or social security number. A unique code will connect 
you to your information via a name list, accessible only to project manager Thomas Johansen and the 
research coordinator at your rehabilitation centre. 
Publishing results, a necessary part of the research process, will be done in a way that individual 
participants cannot be recognized. Your information will be stored for five years post-project 
completion for monitoring purposes. 
INSURANCE  
Normal insurance related to the rehabilitation (the institution and the professionals' practice of their 
activity) applies.  
ECONOMY  
Participating in this research project will not incur any additional costs for you, nor will you receive 
any compensation for your participation. 
APPROVALS  
The Regional Committee for Medical and Health Research Ethics (REK) has made a research ethical 
assessment and approved the project. The case number at REK is 254368.  

This is a translation from the original Norwegian consent form, Research No. 254368, approved 
on September 20, 2022. 
3 
 
The responsibility for data protection in the project lies with the Rehabilitation Centre AiR at the 
Norwegian National Advisory Unit on Occupational Rehabilitation and the project manager, Thomas 
Johansen. 
We process the information based on your consent.  
CONTACT INFORMATION  
If you have questions about the project or wish to withdraw from participation, you can contact 
project manager Thomas Johansen, phone 35 06 28 00, thomas.johansen@arbeidoghelse.no, or the 
responsible contact person at the rehabilitation centre.  
For any inquiries related to data protection within the project, please reach out to the designated 
privacy officer at the rehabilitation institution. 
INFORMATION ABOUT THE OUTCOME OF THE STUDY  
You are entitled to receive the project results. To request a summary of the survey results in the fall of 
2023, email project manager Thomas Johansen at thomas.johansen@arbeidoghelse.no or call 35 06 
28 00. Project results will also be available on www.arbeidoghelse.no, www.rkhr.no and 
www.muritunet.no.