Researcher's advice for getting people back to work after long-term sick leave
When someone falls seriously ill or faces a personal crisis, poor leadership can have serious consequences, says researcher.
"Don’t do for others what you would want done for yourself. Do what they would do for themselves," advises Hans Christoffer Aargaard Terjesen.(Photo: Elise Kjørstad)
Geir had dedicated his life to his job and had never taken a single sick day. He was working as an HR director when he was diagnosed with Multiple sclerosis (MS). After the first attack, he struggled with fatigue and was placed on long-term sick leave.
Marita, the CEO, was understanding at first, but did not stay in touch much. Geir had to organise his own sick leave follow-up meetings.
He eventually returned to a 70 per cent position and hoped to get back to full-time work.
But during one of the follow-up meetings, something happened that completely ruined his relationship with the CEO.
It became clear that Marita doubted whether he was truly ill. Geir also sensed her anger, which she could not conceal. Marita questioned the sick leave situation and admitted she was playing devil's advocate.
Annonse
Geir felt attacked and steamrolled. When the sickness benefit period ended, he forced himself back into a 100 per cent position even though he was still unwell.
He thought that if it was acceptable to treat others like that, then he would just work at half capacity. The relationship with the CEO was ruined, and one day he was determined to show her how wrong she was.
Little to be found about leadership and illness
The story above is one of the fictional accounts from a new book: The Leader's 10 Keys to Proper Management of Sick Leave, written by Hans Christoffer Aargaard Terjesen, an expert on leadership at OsloMet.
The book draws on Terjesen’s research, practical experience, and doctoral work, where he examined what enables leaders to succeed in managing sick leave – and what causes them to fail.
"When I finished my PhD, I realised the findings were too socially important to be buried in the academic world," Terjesen says about why he wanted to write the book.
"This is the first leadership book, both in Norway and internationally, that takes illness and injury as its starting point," he says.
When good intentions go wrong
In many professions, people are trained to handle mistakes. But leadership research rarely focuses on what happens when things go badly, says Terjesen.
Yet when someone is seriously ill or going through a personal crisis, poor leadership can have serious consequences, he says.
When things go wrong, it is usually not because the leader is being difficult – the manager is doing their best. Yet, the employee can still end up feeling let down.
In the book, Terjesen gives an example through the story of Emma, who was diagnosed with endometriosis after escalating pain. Intense pain episodes and hospitalisations forced her into full-time sick leave for long periods.
Her manager, Simen, knew little about Emma's condition and thought the best approach was to give her unlimited time and space. He rarely checked in, except regarding specific work tasks.
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Over time, Emma felt invisible and disconnected from the team. When she temporarily returned to work, she did not feel any warmth or acknowledgment of what she had been through.
She did not realise that Simen's silence was his way of showing care. She felt alone, and eventually, the job slipped away.
Giving someone time and space is good, says Terjesen, but more is needed for effective sick leave follow-up. He describes the ten keys in his book as tools leaders can use to provide the right kind of support.
When encouragement becomes harmful
Another way leaders sometimes misstep is by trying to motivate employees with tough love – perhaps by pointing out how damaging long-term sick leave is for the company. The intention may be to push the person to bounce back.
"But that approach often leads to a complete breakdown, and it's something I absolutely don't recommend," says Terjesen.
On paper, the strategy might appear to work if the employee returns. But it is not a good result if the person comes back with the intent to quit as soon as possible.
"One thing I repeat several times in the book is this: Don’t do for others what you would want done for yourself. Do what they would do for themselves," he says.
Many forget the first step
The ten keys in the book are meant to help employees return to work in a healthy and constructive way.
Here are the first three. Number one is: Show understanding, empathy, and trust – and express a genuine belief that the situation is real.
That is exactly what went wrong in the story of Geir and Marita.
"It's super basic, but important," says Terjesen.
"All the keys are based on being able to build a trusting and close relationship. Without that foundation, good leadership becomes very difficult. But many leaders forget that first step," he adds.
Terjesen hopes the book will be a practical guide for managers, HR professionals, and anyone supporting people on sick leave.
"In my doctoral research, I looked at cases where things went well and where they went wrong. I studied the successful examples closely and pulled out the leadership strategies that made the difference," he says.
No need to wait for a list from the sick employee
Key number two is: To quickly make accommodations for the employee and offer a high degree of flexibility.
Instead of waiting for the employee to list their needs, a proactive leader can take the initiative and suggest accommodations, says Terjesen.
"You can show that you've genuinely tried to understand the illness and ask if certain measures might help," he says.
Examples of accommodations include reducing exposure to noise or light, offering a different office space, working from home, allowing tasks to be done at times that suit the employee's rhythm, or shielding them from certain duties or individuals.
"Many workplaces could be more proactive. If it's done with sensitivity and care, it sends a message that 'we're doing everything we can for you.' That kind of support is a real gift," he says.
In the book, Terjesen uses the fictional story of Tormod, a mechanic who gets migraines. The noisy environment at the workshop triggers his symptoms, and his prospects of staying in the workforce look grim.
The employer sought out as much information about the condition as possible and went to great lengths for a valued employee. Tormod was offered a leadership role in an office setting, with flexible hours, a specially adapted computer monitor, and custom glasses. He was also given an appointment with a private neurologist at the company’s expense.
Stop the employee from pushing too hard
The third key is: To take control by adjusting expectations and ensuring a gradual and stable return to work.
"Leaders need the courage to slow things down," says Terjesen.
It is easy to set overly ambitious goals when a high-performing employee returns to work part-time. Often, the pressure comes from the employee themselves.
'That's when everything can fall apart fast, even if all the carriages on the train are marked 'with the best intentions,'' Terjesen writes in the book.
He urges managers to allow time: time for recovery, and time for thoughtful follow-up.
"Managers are often pressed for time. But I want to remind them how long it takes to replace skills and experience," says Terjesen. "Don't be afraid of spending time – be afraid, deeply afraid, of the time you don't spend."
Effective leadership requires capacity to follow up
Åsmund Hermansen, a professor at OsloMet who researches inclusive workplaces, has reviewed the ten keys outlined in Terjesen's book.
"I see it as a well-designed framework that captures both the human and practical dimensions of helping sick employees return to work," says Hermansen.
"To me, the strength lies in the balance between empathy and action. From meeting the person where they are, to offering concrete support measures," he says.
Åsmund Hermansen is a professor at OsloMet.(Photo: OsloMet)
Hermansen believes that leadership should play a much more prominent role in efforts to reduce sick leave and ensure that employees return to work in a way that prevents them from permanently falling out of the workforce.
However, he points out a key challenge with the ten keys: They require a small span of control to be realistically implemented. In other words, managers need to have direct responsibility for only a limited number of employees to be able to follow up properly.
This is particularly difficult in sectors like healthcare and social services, where workloads are heavy, sickness absence rates are high, and managers often oversee large teams.
Leadership that makes a difference
"The ten keys also assume that managers can balance a wide range of qualities – ideally ones they should have, but in reality may not always possess," he says.
One potential pitfall, he notes, is that in many industries, these keys remain more of an ideal than something managers can realistically apply in day-to-day operations.
"Still, this book brings much-needed attention to an area that hasn't been central in the sick leave debate – and it highlights the crucial role that leadership plays in helping employees return to work," he says.
