The ultimate guide to a smooth return-to-work process

31 Aug ‘22
10 min
Work performance
Editorial Board OpenUp
Gecontroleerd door Psychologist Emma White

At OpenUp we hear from HR professionals every day. They’re part of a group as diverse as the birds-of-paradise in the world’s tropical rainforests. But there’s one thing that they all have in common: HR professionals all want what’s best for their employees. Healthy, happy, motivated employees who are in it for the long haul – that’s their number one priority.

But, every now and then, something happens that you don’t have any control over. An employee becomes mentally or physically ill, or they experience a period of grief. The process of returning to work after the employee has recovered is often difficult. Sometimes because work contributed to the ordeal. Sometimes because it’s tough to get back to everyday life. Sometimes because it brings up feelings of guilt or shame in relation to their colleagues.


Fortunately, what you do have control over as an HR professional is making the process of returning to work as smooth as possible. In this guide, psychologist Emma White will explain the challenges associated with employees returning to work, the rights and responsibilities of employers, and the best practices for a smooth return-to-work process. By the end, you’ll feel like a real bird-of-paradise, ready to facilitate a pleasant transition back to the corporate jungle.

Before we dive into the practical tips for a smooth return-to-work process, it’s first important to understand why returning to work after a period of absence can be so hard.


What kind of mental health challenges do sick employees face?


Whether it’s chronic or acute pain (for example caused by illness, an accident or RSI), extreme or mild burnout or boreout, the side effects of medication, or fatigue after a virus – sometimes an employee is temporarily not in a fit state to work.

Physical and mental health challenges often go hand in hand. Emma: “We often think of burnout or boreout as mental health problems, but the symptoms are almost always physical: migraines, stomach aches, chronic fatigue or even not being able to feel certain body parts. Likewise, illnesses and pain often lead to mental health challenges. That often starts with fatigue, problems concentrating or becoming easily overstimulated.

“If illnesses and pain persist for a long time, then additional challenges may arise. Many people feel frustrated because they don’t know when they’ll be better again. Or they want to do more than their body will allow, for example exercising or taking part in social activities. This frustration often leads to irritability directed towards loved ones, feelings of insecurity, and feelings of powerlessness,” Emma adds.



The rights and responsibilities of employers in the event of employee absence



  • If an employee calls in sick, then this person has the right to continue receiving their salary. Emotional exhaustion or burnout may be classed as “illnesses”. It’s a doctor’s job to medically confirm that this is the case.
  • The company doctor confirms whether the employee is genuinely unable to work. Six weeks after the employee initially called in sick, a company doctor will prepare a problem analysis.
  • Statutory rules apply to the process of returning to work after a long period of absence. This process begins during the period of sickness itself. Both the employee and the employer need to work together to reintroduce the employee back into the workplace. Legally, employers need to put together a plan of action for an employee returning to the workplace within eight weeks of them calling in sick. This is discussed with the employee and submitted to the Employee Insurance Agency (in the Netherlands). Every six weeks, employers and employees will go through this plan and reevaluate.
  • Following the period of illness, an attempt must initially be made to return the employee to their original role, possibly with adjustments.
  • If it is not possible to return the employee to their original role, then the employee may return to the same employer in another suitable role.
  • If this too is not possible, both parties will need to arrange for the employee to return to work with another employer.*Please note that these laws will vary slightly from country to country.


What mental health challenges do employees face when they return to work?



Every employee will experience returning to work a little differently. However, according to Emma, there are a number of challenges that often come up:

  • Struggling to create structure again
  • Not being able to find a balance between work priorities while focusing on personal wellbeing
  • Initially finding it tiring and overwhelming to be surrounded by colleagues
  • Wanting to bite off more than they can chew and this causing frustration
  • Feeling the need to compensate for their period of absence by working harder
  • Feelings of guilt and shame because colleagues had to take over their work while they were on paid leave
  • Being afraid of what other people might say about the reason for their absence



A few figures


  • 5.4% was the rate of sick leave in the Netherlands at the end of 2021. This means that employees were absent for an average of 5.4% of their workable hours.
  • 35% of these absences were the result of work pressure or work stress.
  • 14% of employees who called in sick did not return to work within four weeks.
  • 3% of employees were off for more than six months.



“I notice that people who’ve had burnout or boreout are often anxious to return to the place that was partly the cause of their illness,” says Emma. There are two reasons for this. “One is that it has created a negative association with their job, their employer or their colleagues. They’re nervous about being exposed to situations and triggers that played a role in their illness. The second is that they’re scared of being judged by other people.”

In reality, this judgement is often not a real thing. The employee is actually just projecting the judgement they feel towards themselves. Emma: “Employees returning to work often speculate about what other people will think of them. ‘I’m weak because I couldn’t keep working’, ‘My colleagues are mad because I left them in the lurch, ‘They probably think I’m pathetic’, or ‘They’re only giving me the easy tasks because they’re scared I can’t cope’. This makes returning to work extra nerve-wracking.

How to create a smooth return-to-work process. The beginner’s guide



Fortunately, there’s a lot you can do to support an employee through this difficult period. There’s a standard list of best practices that you’ll want to learn as an HR professional or manager. See this as a beginners guide to returning to work. If this is a new topic for you, then we’d recommend reading this chapter very thoroughly. Are you looking for something more in-depth? Then skip to our ‘Expert Guide’ beneath.


Emma has 6 golden rules for a smooth return-to-work process:


1. Develop a return-to-work plan


Devise a return-to-work strategy in collaboration with the employee and the company doctor. A strategy like this needs to be based on three pillars:

  • The number of hours to be worked
  • The kind of tasks to be carried out
  • The intensity or workload of these tasks

Emma: “Make the plan as strong as the training schedule you’d make if you were running a marathon: For each day set out the exact number of hours to be worked. Allow this number of hours to gradually increase and slowly reduce the recovery period between working hours.” Additionally, it helps to allow employees to start off with supporting tasks, tasks without deadlines, and takes without too many meetings.

Establish in advance what you’d all class as a successful return-to-work process. Goals you might consider are: an employee rating their energy levels at a particular figure, or a particular number of social interactions being achieved each week. Try to makes these goals as SMART as possible.

Just bear in mind that the number of hours worked is not a good indication of a successful return-to-work process.



2. Be flexible


Sometimes things don’t go according to plan. Make it clear to the employee that it’s okay if they don’t manage to achieve the goals on the plan and if adjustments need to be made. Keep checking in over a long period of time. At least six months – longer if necessary. Ask how the return-to-work process is going, if there’s anything you can do, and if the plan is still working.

Yu Tse Heng, a management researcher at the University of Washington’s Foster School of Business, has this to say on the topic: “Employees need to feel empowered in navigating their own recovery. This means that offering flexibility is extremely important.”



3. Stay in touch during the period of absence


Say it with flowers. Or a card. If somebody is sick for over a week, then as the manager of the team, they need to hear from you – whether it’s a physical issue or a mental health issue. When doing this, make it clear that the organization will continue to support the employee. They don’t have to worry about losing their job, even if they aren’t able to work for a long period of time.

Discuss with the employee if they would be comfortable with you contacting them every now and then to ask them how it’s going or to give them updates about developments at work. In advance agree a method and frequency of communication (email, phone call, WhatsApp or face to face). This way the employee will know what to expect. You could also let the employee choose a colleague to remain in contact with. Somebody who the employee has a good relationship with.

In addition, make it clear that you have an open-door policy: The employee can always contact you if they need to.



4. Respect the employees’ privacy


Obviously, you’ll want to let the team know about the employee’s situation. “In advance, discuss with the employee which information you can and can’t share with the team, so that you can respect the employee’s privacy.” advises Emma.

Also respect the employee’s privacy when you contact them. If you want to visit the employee at home, in hospital or in a rehabilitation center, always ask permission first.



5. Take the employees’ recovery into consideration, even after they’ve returned


The recovery process – whether it’s a physical problem or a mental health challenge – will often still be going on once the employee is back at work. “For example, employees might need to visit the hospital periodically for checkups, have consultations with a psychologist, or take medication that affects their mood and energy levels,” explains Emma. Discuss this – preferably before the employee returns – so that you can respond appropriately. For example, by making plans. Let the employee know that the situation might and can change at any time.


6. Offer the opportunity to catch up on training


Emma: “If there have been joint training sessions within the team or company, make sure that the returning employee can catch up on these in an alternative manner. This way you’ll avoid there being a knowledge gap.” Also leave their annual individual development budget in place so that the employee has the same opportunities for further development.


How to create a smooth return-to-work process. The expert guide


Okay, so now you’ve got the basics covered, we’re going to fill you in on what else you can do to make sure the return-to-word process runs as smoothly as possible.


1. Take a close look at the circumstances under which the symptoms arose


Emma: “I had a client who was off sick with burnout because the expectations related to her job performance were much too high. When she returned to work, nothing had changed. She was expected to immediately jump back into full-time work. After a few weeks she just resigned.” This example illustrates how important it is to investigate the circumstances that caused a person to call in sick and tackle them where possible. Often a combination of factors is at play:

Individual factors: To a certain extent, some people are just more prone to developing certain conditions. For example, research shows that personality traits play a role in your risk of developing burnout. Introverts with less emotional stability and a high sense of responsibility are at greater risk of burning out. This means that some people are just generally healthier than others. As a HR professional you don’t have much control over this.

Organizational factors: Obviously, you can influence organizational factors. Things that may cause burnout include: low salaries, lack of change within the organization, experiencing unfairness, lack of open communication, unpleasant relationships with superiors, and experiencing stigma or discrimination. In addition, unsafe work environments – whether it’s work stations with poor ergonomics or the setup of factory halls or warehouses – can lead to physical problems.

“When an employee calls in sick, it’s important to figure out right away what caused this by entering into an open conversation with the individual and the rest of the team,” says Emma. “Where possible, you can tackle these causes to prevent future cases.”

“You’ll then need to repeat this conversation when the employee returns to work. Which conditions could be improved to make returning to work as enjoyable as possible? Are there any activities that this person can’t (or doesn’t want to) do anymore? Are certain physical adjustments necessary in the workplace?”


2. Start the return-to-work process before the first day back at work


Emma: “A client of mine was nervous about returning to work. Because of this, in the week before her first day back, she decided to meet up outside the office with several colleagues she had good relationships with. A very good idea. She also asked one of her colleagues to meet her around the corner from the office on her first day so that they could walk there together. Both activities helped her because they gave her the sense that she didn’t have to do it all alone. I often tell this story to HR managers so that they can advise their returning employees to do the same thing.”


3. Include the whole team in the return-to-work process


Encourage the out-of-action employee’s colleagues to reach out every now and then. They could send a get well soon card, a supportive message, or call them to ask them how they are. Provided the employee is okay with that, of course.


Emma: “In my work, I often see how small gestures can make a massive difference. A client once told me that her colleagues let her know she shouldn’t feel guilty about being absent for a while. That meant a lot to her.”

In addition, make sure that the team are aware of the employee’s first day back at work. Encourage them to give a warm – but not over-the-top – welcome. You want the employee to feel appreciated, but not overwhelmed. “Just being back at work is already overwhelming enough,” Emma says.


4. Appoint a return-to-work buddy


Together with the returning employee, select a buddy who the person feels safe and comfortable with. This buddy will check in with the person regularly to ask them if everything’s still going okay, if they want to take a coffee break, and what their plans for lunch are.

A buddy is mainly there to provide emotional support and a listening ear. “This means that the buddy might be helpful during conversations with HR about how the return-to-work process is progressing. They can offer moral support. For example, the buddy might be able to vocalize ways to improve the process, if the employee is finding it difficult to put this into words,” says Emma. But the buddy can also keep the employee up-to-date about any changes within the organization. If there are any new colleagues, new systems or new working practices, the buddy can shed some light on this.


5. Provide access to an OpenUp psychologist


External mental health support plays an important role in a successful return-to-work process. 45% of employees feel more comfortable talking about their mental health with a third party than somebody within the organization (such as a counselor, colleague or HR manager). Emma often sees this at the practice: “Talking to an external psychologist is much more approachable. You don’t have to be scared that the things you discuss related to your work relationships and career opportunities will have a negative impact on you because everything stays between the psychologist and the employee.”


If the circumstances that caused an employee to go off sick might affect the rest of the team, it’s a good idea to enlist the help of an external psychologist. A psychologist can help the team by asking the following questions:

  • How best can you support the employee on leave during their period of absence?
  • What would you say if one of your colleagues experienced something bad?
  • When is a good moment to offer compassion or ask how somebody how they’re doing?
  • How are you managing to process any related events at work?
  • How can you as an individual or as team prevent this from happening again?




Case study: A smooth return-to-work process supported by OpenUp


Pia, as psychologist at OpenUp, was counseling somebody with burnout. “She was extremely exhausted, both mentally and physically. It helped her tremendously that her employer was so supportive. She was told that it was okay to be absent for a while: her tasks would be taken care of and her privacy would be respected.


Her employer works with OpenUp. This meant she was able to tackle the issue with a psychologist – me 😉 Together we analyzed the causes of her burnout and developed a new mindset for approaching work tasks in order to avoid future burnout. We also discussed together the return-to-work process at her place of employment.


After a few weeks, she was able to start building herself up again step by step. We kept a close eye on her energy levels. For this we used the ‘stoplight‘ method to prevent a relapse. This model is also relevant to HR.”



6. Appoint a return-to-work coach



It’s a good idea to appoint a return-to-work coach to oversee the entire process. Emma: “A good return-to-work coach is aware of the employer’s legal obligations, as well as having a psychological background. This way, you can offer maximum support during the process to the employee on sick leave.”


What if the employee is unable to return to work?


Research from Belgium shows that changing jobs after burnout can aid the recovery process. This means you need to be prepared for this possible – and maybe even desirable – outcome.


As previously stated, employers have a legal obligation to help employees on sick leave move elsewhere, should they be unable to return to their previous position. Think of this process as ‘plan B’.


Emma: “One of my clients had a relapse. For him, returning to his previous workplace was too much. Together with his employer, he decided he should look for work elsewhere. The employer offered him various courses, which ultimately helped him to find a new job. The way the employer handled this was admirable.”


It’s always a good idea to work towards plan A (returning to the previous job) and plan B simultaneously. “This way, employees can make an informed decision as to whether or not returning to their old job is really a good idea,” says Emma.


Plan B consists of three phases:

  1. Personal assessment. This phase is also a useful part of plan A. Along with the employee, you figure out what went wrong.
  2. Vocational assessment. In this phase, the employee gains insight into their own strengths, motivations, personal challenges, and desires related to future work.
  3. Job market approach. The employee starts advertising themselves on the job market. In this phase, you help the employee by searching for suitable vacancies, rewriting their CV and cover letters or putting them in touch with companies in your network.


OpenUp is an expert in guiding people through the return-to-work process following a period of absence. We also help HR managers to navigate this period in an appropriate manner. Would you like to know how we can help you? Feel free to get in contact.