Academic research

<p>We have selected some of the strongest academic research regarding interventions to manage stress at work and provided summaries below. All studies have been published in peer-reviewed journals and are presented under three headings: Reviews of Stress Management Interventions &ndash; a summary of leading systematic reviews and meta-analyses of stress management intervention research; Individual Interventions &ndash; stress management activity focused at the individual; and Organisational Interventions &ndash; stress management interventions focused at the organisation.</p>
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Author: Richardson & Rothstein

Effects of occupational stress management intervention programs: A meta-analysis (2008)

Effects of occupational stress management intervention programs: A meta-analysis (2008)

This meta-analysis reviewed 36 experimental studies which examined 55 interventions. The review found that cognitive behavioural programmes reliably produced larger effects than other kinds of interventions. However, when different types of interventions are included along with cognitive behavioural elements the effect decreases. The most common type of intervention is a relaxation intervention.The review found that the success of interventions is mainly measured by psychological outcomes rather than physical or organisational outcomes, and noted a paucity of organisational interventions, only 5 of the 36 interventions were implemented at the organisational level. Some studies that devised an intervention which focused on improving employees’ personal resources or management/job skills found a significantly large effect, suggesting that equipping employees with tools to help them with the stressful elements of their job rather than modifying structural aspects of their job can ameliorate job stress. Cognitive behavioural interventions are most effective when used in isolation, however relaxation and meditation programmes can usefully be used in conjunction with other stress management activities.

Author: Joyce, Modini, Christensen, Mykletun, Bryant, Mitchell & Harvey

Workplace interventions for common mental disorders: A systematic meta-review (2016)

Workplace interventions for common mental disorders: A systematic meta-review (2016)

This review of 20 reviews which included 481 primary research studies concluded that there are a variety of interventions that can result in a significant decrease in anxiety or depression. Results provided moderate support for increasing employee control and encouraging physical activity as primary interventions. Strong evidence showed that secondary interventions of Cognitive Behavioural Therapy had a considerable positive impact on symptoms however less evidence was shown for the impact on organisational outcomes, for example absenteeism and productivity. Tertiary interventions that targeted the workplace such as exposure therapy, and CBT based and problem focused return to work programmes showed a moderate impact on work related outcomes and had a stronger impact on ameliorating symptoms. The review concludes that a variety of interventions can be used to assist in preventing common mental health problems in addition to helping the recovery process of employees with depression and/or anxiety.

Author: Bhui, Dinos, Stansfeld & White

A synthesis of the evidence for managing stress at work: A review of the reviews reporting on anxiety, depression, and absenteeism (2012)

A synthesis of the evidence for managing stress at work: A review of the reviews reporting on anxiety, depression, and absenteeism (2012)

This systematic review found that individual interventions tend to have larger effects on individual level outcomes, such as mental health outcomes, than organisational interventions, such as absenteeism. CBT reliably showed larger effects on individual outcomes than other interventions. Organisational interventions however showed mixed evidence regarding positive outcomes on individual outcomes and absenteeism. Reduced absenteeism and greater job satisfaction were two outcomes seen as a result of being involved in an organisational wellness programme. Mixed interventions, those that combined individual and organisational activities, showed positive results at the individual level. Supporting other reviews, the lack of research at the level of organisational interventions was noted along with the success of CBT as an individual intervention. There is a need to create interventions that have an impact on organisational outcomes.

Author: Ruotsalainen, Verbeek, Mariné & Serra

Preventing occupational stress in healthcare workers (2015)

Preventing occupational stress in healthcare workers (2015)

This review examined 58 studies of healthcare workers. The findings showed that generally those who participated in Cognitive Behavioural Therapy (CBT) or CBT and relaxation interventions showed decreased stress in comparison to a control group, however there were mixed results about the length of time the effects lasted. Mental and physical relaxation were found to reduce stress more than no intervention. However, in contrast to previous research, evidence suggests CBT, mental and physical relaxation did not decrease stress more than alternative interventions. Organisational interventions showed that modification of work schedules was associated with decreased stress however other organisational interventions were not found to be more effective than no intervention or an alternative intervention. The review shows varied evidence regarding the effectiveness of interventions; in particular the findings suggest that organisational interventions need to concentrate on decreasing particular factors that trigger stress.

Author: Giga, Noblet, Faragher & Cooper

The UK Perspective: A review of research on organisational stress management interventions (2003)

The UK Perspective: A review of research on organisational stress management interventions (2003)

This review found that the majority of interventions are targeted at the individual level and use stress management techniques such as Cognitive Behavioural Therapy and employee assistance programmes. Frequently used activities aimed at improving the individual-organisational boundary included co-worker support and participation and autonomy. Organisational interventions were not as frequently used and within them job design and restructuring were the only types of interventions used more than once. Interventions at all levels demonstrated positive benefits, such as a decrease in absenteeism, decreased anxiety and depression and increased productivity. The results showed that individual level interventions often impact on mental and emotional wellbeing but these impacts may be transient. Interventions at the individual and organisational-individual level most often impact on employee health and organisational performance. Individual interventions tended not to affect organisational outcomes, for example productivity. Some researchers say the level of intervention is not important but that the success of the intervention lies in whether the combination of strategies is an appropriate fit for the needs of the employees. This research advocates that SMIs need to be broader and concentrate on both the causes and the symptoms of stress. This research advocates that SMIs need to be broader and concentrate on both the causes and the symptoms of stress.

Author: Lamontagne, Keegel, Louie, Ostry & Landsbergis

A systematic review of the job-stress intervention evaluation literature, 1990-2005 (2007)

A systematic review of the job-stress intervention evaluation literature, 1990-2005 (2007)

Studies were classified into low, moderate and high ratings. High ratings were those where the principal intervention was primary combined with secondary or tertiary. Moderate ratings were mainly primary interventions. Low ratings were those that had little or no primary interventions. Individual focused low rated studies (e.g meditation, progressive muscle relaxation) were found to be effective at influencing individual outcomes (e.g. blood pressure, general mental health) but not organisational outcomes. The organisational outcomes most frequently measured were absenteeism and sickness absence. Moderate and high organisational level interventions are associated with positive outcomes at individual and organisational levels. The findings suggest that mixed interventions that are mainly a primary intervention combined with secondary or tertiary are the most successful at impacting on organisational and individual consequences of stress at work. The review also emphasises the importance of individual level interventions as an element of organisational interventions. The review concludes, similar to other reviews, that it is essential to design interventions that target the causes and consequences of job stress.

Author: Caulfield, Chang, Dollard & Elshaug

A review of occupational stress interventions in Australia (2004)

A review of occupational stress interventions in Australia (2004)

This paper reviewed occupational stress interventions within the public sector in Australia. The individual interventions that were examined included training staff to self-manage stress using a healthy lifestyle programme which included relaxation techniques and biofeedback mechanisms. However these did not appear to be effective, there was no decrease in the participants’ physical or psychological ill health. The organisational intervention that was reviewed focused on ameliorating working conditions for example through job redesign and improving the psychological health services. Results showed a decrease in the amount of work stress claims within the organisation. The results suggest that organisational interventions may be more successful than individual interventions. This is in line with the belief that there may be a greater link between work stress and elements of the job or work environment rather than individual aspects. A conclusion that could be drawn is that when there is both organisational and individual responsibility there is a greater chance of the stress management programme being successful.

Author: Wolever, Bobinet, McCabe, Mackenzie, Fekete, Kusnick & Baime

Effective and viable mind-body stress reduction in the workplace: A randomised controlled trial (2012)

Effective and viable mind-body stress reduction in the workplace: A randomised controlled trial (2012)

American employees in a national insurance carrier were randomised to one of two interventions or a control group. Intervention group employees showed a larger reduction in perceived stress and sleep difficulty than those in the control group. However there were no significant differences between the Yoga and Mindfulness groups. The findings suggest that Mindfulness-based and Yoga programmes may be successfully used in organisations to combat high stress levels and sleep difficulty. One intervention was a 12 week Viniyoga stress reduction programme. Participants attended 1 hour classes where they were taught tools for managing stress, for example, physical postures of yoga, breathing techniques, guided relaxation and mental techniques in addition to how to practice these at home. The other intervention was Mindfulness at Work, a programme which entailed practices specifically focusing on work related stress, work life balance and self care. The stress management programme was 12 weeks and each class was one hour (plus 2 additional hours at week 10).

Author: Heber, Lehr, Ebert, Berking & Riper

Web-Based and mobile stress management intervention for employees: A randomized controlled trial (2016)

Web-Based and mobile stress management intervention for employees: A randomized controlled trial (2016)

Working population participants that had elevated symptoms of stress were recruited. Participants completed an internet-based stress management intervention called GET.ON Stress which is based on Lazarus’ transactional model of stress. The training was very successful. Compared to the control group the intervention group displayed significantly decreased perceived stress scores after the intervention and 6 months after it was completed. Additionally they displayed reduced stress 12 months after the intervention. Results also suggest there were positive impacts of the programme on secondary outcomes: mental health, work-related health and stress-related skills. One conclusion that can be drawn is that internet-based stress management programmes can be effective at reducing perceived stress and therefore could be a viable substitute for face to face programmes. The intervention entailed 7 sessions and a booster session 4 weeks after finishing the programme. The first session was psychoeducation, during sessions 2-3 participants were taught a 6 step procedure for how to methodically solve problems, during sessions 4-6 participants learnt about emotion regulation techniques and incorporated into the seventh and final session was a plan for the future. Participants were strongly encouraged to practice 1-2 sessions each day.

Author: Shapiro, Astin, Bishop & Cordova

Mindfulness-Based Stress Reduction for health care professionals: Results from a randomized trial (2005)

Mindfulness-Based Stress Reduction for health care professionals: Results from a randomized trial (2005)

Health care professionals in the USA participated in a Mindfulness-Based Stress Reduction intervention (MBSR). The intervention group showed a significant decrease in perceived stress and an increase in self-compassion. Professionals who had participated in the intervention programme also reported more satisfaction with life and less job burnout and distress. The results also showed differences in self-compassion were a significant predictor of differences in perceived stress however it did not predict satisfaction with life. Research has shown a significant relationship between patient satisfaction and burnout and distress so there may be a link between MBSR and improving patient satisfaction. There were eight sessions for 2 hours per week. Training involved four meditative practices: sitting meditation, body scan, hatha yoga and three-minute breathing space. Participants were also familiarised with the “loving kindness” meditation.

Author: Regehr, Glancy, Pitts & LeBlanc

Interventions to reduce the consequences of stress in physicians: A review and meta-analysis (2014)

Interventions to reduce the consequences of stress in physicians: A review and meta-analysis (2014)

The interventions all included elements of cognitive, behavioural and/or mindfulness-based training. Sessions varied and included weekly sessions, single interventions and courses. Results showed that cognitive, behavioural and mindfulness interventions significantly decreased anxiety symptoms in physicians and medical students. Similar results were found although the interventions varied in length, components and countries. Interventions that had psychoeducation, interpersonal communication and mindfulness meditation elements were linked with a reduction in burnout. However, examining only randomised controlled trials, there was not enough evidence to support the idea of interventions to decrease burnout although there is a lack of research in this area. The review concludes that physicians encounter stress from the beginning of their careers so interventions that aid physicians in managing their stress at work should be promoted.

Author: Tetrick & Winslow

Workplace stress management interventions and health promotion (2015)

Workplace stress management interventions and health promotion (2015)

Interventions reviewed in this study were categorised into primary, secondary and tertiary interventions. Since Richard and Rothstein’s (2008) review a number of stress management interventions have been carried out. Interventions have focused on mindfulness, recovery or have been multimodal, entailing different aspects. The majority of interventions have been focused at the individual level and success has been measured on self-reported outcomes. Schutte (2014) found that a 3 week intervention of a “loving-kindness” meditation was associated with significantly greater positive affect, self-efficacy and work satisfaction and decreased psychological distress. Hartung and Hahlweg (2011) examined employed parents and found that training parents was associated with increased self efficacy, which resulted in decreased general and work related stress. This causal mechanism could explain how stress management interventions impact on employed parents. The review also found that workplace positive psychology interventions may also be useful for both health promotion and stress management. There have been a limited number of interventions based on the Job Demands-Resources model however this may be a useful framework for interventions.

Author: Siu, Cooper & Phillips

Intervention studies on enhancing work well-being, reducing burnout, and improving recovery experiences among Hong Kong health care workers and teachers (2014)

Intervention studies on enhancing work well-being, reducing burnout, and improving recovery experiences among Hong Kong health care workers and teachers (2014)

This paper examined two interventions amongst two of the most stressful occupations in Hong Kong, health care and teaching. Results from Study 1 showed that after training, participants scored significantly lower on physical and psychological symptoms and burnout; additionally they scored higher on job satisfaction and positive emotions. Results from Study 2 showed that those in the intervention group reported significantly higher scores in overall recovery, particularly mastery recovery experience. The study suggests results from training recovery experiences conducted in the West can be generalised to Chinese populations. Study 1 involved a 2 day training programme amongst health care workers. This covered 7 topics: stress and coping, managing stress, stressor-emotion model, self-healing techniques, emotion management to reduce burnout, applying positive psychology in the workplace and effective communication. Study 2 involved a 2.5 day training programme amongst teachers covering the same topics as Study 1 and additionally recovery strategies.

Author: Kaspereen

Relaxation intervention for stress reduction among teachers and staff (2012)

Relaxation intervention for stress reduction among teachers and staff (2012)

Teachers and staff from an inner-city high school in the USA took part in a relaxation therapy intervention. Results showed significantly lower scores on the Perceived Stress Scale after the intervention compared to before the intervention. There was also a significant increase in life satisfaction. This suggests that a relaxation programme that is quite short can have a similar positive impact to longer relaxation programmes which have been examined in previous studies. Participants took part in 30-45 minute sessions once a week for 4 consecutive weeks. The programme focused on job-related stressors that teachers encounter. It involved meditation, deep breathing and relaxing music.

Author: Isaksson Ro, Tyssen, Hoffart, Sexton, Aasland & Gude

A three-year cohort study of the relationships between coping, job stress and burnout after a counselling intervention for help-seeking physicians (2010)

A three-year cohort study of the relationships between coping, job stress and burnout after a counselling intervention for help-seeking physicians (2010)

Physicians in Norway that took part in this study were able to choose to participate in one of two interventions. Both interventions were a combination of psychodynamic, cognitive and educational approaches. After one year compared to the results before the intervention physicians showed a significant reduction in emotional exhaustion, job stress and emotion focused coping, this was still true after 3 years. The results suggest that the reduction in emotion-focused coping strategies happened prior to the decrease in emotional exhaustion. Therefore, both alterations in coping strategies and decreases in job stress may be areas to concentrate on in interventions when examining how to decrease or stop burnout occurring within physicians. One intervention was a six to seven hour counselling session during which causes of both occupational and private stress and coping strategies were discussed. The alternative intervention was a five day, group based 8 person course. The course involved daily lectures and group discussions as well as physical activity. Participants were also offered an individual counselling session during the five days.

Author: Le Blanc, Hox, Schaufeli, Taris & Peeters

Take Care! The evaluation of a team-based burnout intervention program for oncology care providers (2007)

Take Care! The evaluation of a team-based burnout intervention program for oncology care providers (2007)

Staff from oncology wards in the Netherlands participated in a team-based burnout intervention programme. Staff attended six monthly 3 hour sessions. Directly after the training programme and 6 months after the training programmed ended, those in the intervention group had significantly lower emotional exhaustion than the control group. Changes in burnout levels were related to changes in quantitative demands but not emotional job demands. The findings imply that taking a team-based participatory approach to an intervention may positively impact on job stress. The sessions covered job stress mechanisms, specific job stressors and gave each ward specific feedback from completed questionnaires on measures such as burnout and job demands. Participants learnt about communication, feedback and building a social support network. Finally participants designed actions to address their most prevalent job stressors.

Author: Hahn, Binnewies, Sonnentag & Mojza

Learning how to recover from job stress: Effects of a recovery training program on recovery, recovery-related self-efficacy, and well-being (2011)

Learning how to recover from job stress: Effects of a recovery training program on recovery, recovery-related self-efficacy, and well-being (2011)

Research suggests that recovery processes (e.g. unwinding from one’s job once work is finished) are critical to decreasing the negative effects of job stress (Geurts & Sonnentag, 2006). Participants completed two training sessions one week apart. Those who participated in the training showed significantly higher detachment, relaxation and control both one week and three weeks after the training. There were also improvements in recovery-related self-efficacy and sleep quality one week and three weeks after training. Three weeks after training there were also improvements in perceived stress and state negative affect. The results suggest recovery training has a positive impact on recovery and well-being, it may therefore be a potentially useful training to consider adding into organisations’ human resource management programmes. During the two training sessions, participants completed four modules, one module for each recovery experience (psychological detachment, relaxation, mastery and control). The training entailed teaching and both individual and group exercises.

Author: Naghieh, Montgomery, Bonell, Thompson & Aber

Work changes to prevent and decrease stress in teachers (2015)

Work changes to prevent and decrease stress in teachers (2015)

This systematic review examined four studies of organisational interventions with teachers in the USA, Australia and China. The review reported that modification of task characteristics was associated was a moderate decrease in stress levels and improvements in work ability in contrast to no intervention. The intervention entailed a mixture of modifying the tasks of teachers and providing stress management training. Two of the studies suggest that modifying organisational characteristics did not significantly impact on burnout or emotional ability and job-related anxiety and job-related depression two years and six months respectively after the interventions. The interventions involved providing teacher training and coaching support. The fourth study examined a multicomponent intervention involving mentoring and performance related bonuses. The study reported small to moderate effect sizes but these were mainly positive. There are fewer studies that demonstrate the benefits of organisational interventions, however the potential benefits noted here suggest organisational interventions should be explored further.

Author: McVicar, Munn-Giddings & Seebohm

Workplace stress interventions using participatory action research designs (2013)

Workplace stress interventions using participatory action research designs (2013)

This paper reviewed studies from 6 countries. The review found that participatory action research is most successful when there are units of a maximum of 100 people and when distinct and important problems are discussed. The review suggests that the sector and nature of the organisation will not impact on the success. However, staff turnover, relationships between management and employees and the evaluation approach have the greatest potential to negatively effect the success of the programme. Importantly, when managers were not actively involved as participants the participatory process was less effective. The interventions tended to focus on specific aspects of the work environment or culture. The studies all involved stakeholders working in a collective manner to ascertain where there were problems. These were discussed and solutions were proposed. The review concludes that using participatory action research as a psychosocial intervention may have a beneficial impact on job stress.

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Author: Hahn, Binnewies, Sonnentag & Mojza

Learning how to recover from job stress: Effects of a recovery training program on recovery, recovery-related self-efficacy, and well-being (2011)

Learning how to recover from job stress: Effects of a recovery training program on recovery, recovery-related self-efficacy, and well-being (2011)

Research suggests that recovery processes (e.g. unwinding from one’s job once work is finished) are critical to decreasing the negative effects of job stress (Geurts & Sonnentag, 2006). Participants completed two training sessions one week apart. Those who participated in the training showed significantly higher detachment, relaxation and control both one week and three weeks after the training. There were also improvements in recovery-related self-efficacy and sleep quality one week and three weeks after training. Three weeks after training there were also improvements in perceived stress and state negative affect. The results suggest recovery training has a positive impact on recovery and well-being, it may therefore be a potentially useful training to consider adding into organisations’ human resource management programmes. During the two training sessions, participants completed four modules, one module for each recovery experience (psychological detachment, relaxation, mastery and control). The training entailed teaching and both individual and group exercises.

Author: Hahn, Binnewies, Sonnentag & Mojza

Learning how to recover from job stress: Effects of a recovery training program on recovery, recovery-related self-efficacy, and well-being (2011)

Research suggests that recovery processes (e.g. unwinding from one’s job once work is finished) are critical to decreasing the negative effects of job stress (Geurts & Sonnentag, 2006). Participants completed two training sessions one week apart. Those who participated in the training showed significantly higher detachment, relaxation and control both one week and three weeks after the training. There were also improvements in recovery-related self-efficacy and sleep quality one week and three weeks after training. Three weeks after training there were also improvements in perceived stress and state negative affect. The results suggest recovery training has a positive impact on recovery and well-being, it may therefore be a potentially useful training to consider adding into organisations’ human resource management programmes. During the two training sessions, participants completed four modules, one module for each recovery experience (psychological detachment, relaxation, mastery and control). The training entailed teaching and both individual and group exercises.

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Author: Naghieh, Montgomery, Bonell, Thompson & Aber

Work changes to prevent and decrease stress in teachers (2015)

Work changes to prevent and decrease stress in teachers (2015)

This systematic review examined four studies of organisational interventions with teachers in the USA, Australia and China. The review reported that modification of task characteristics was associated was a moderate decrease in stress levels and improvements in work ability in contrast to no intervention. The intervention entailed a mixture of modifying the tasks of teachers and providing stress management training. Two of the studies suggest that modifying organisational characteristics did not significantly impact on burnout or emotional ability and job-related anxiety and job-related depression two years and six months respectively after the interventions. The interventions involved providing teacher training and coaching support. The fourth study examined a multicomponent intervention involving mentoring and performance related bonuses. The study reported small to moderate effect sizes but these were mainly positive. There are fewer studies that demonstrate the benefits of organisational interventions, however the potential benefits noted here suggest organisational interventions should be explored further.

Author: Naghieh, Montgomery, Bonell, Thompson & Aber

Work changes to prevent and decrease stress in teachers (2015)

This systematic review examined four studies of organisational interventions with teachers in the USA, Australia and China. The review reported that modification of task characteristics was associated was a moderate decrease in stress levels and improvements in work ability in contrast to no intervention. The intervention entailed a mixture of modifying the tasks of teachers and providing stress management training. Two of the studies suggest that modifying organisational characteristics did not significantly impact on burnout or emotional ability and job-related anxiety and job-related depression two years and six months respectively after the interventions. The interventions involved providing teacher training and coaching support. The fourth study examined a multicomponent intervention involving mentoring and performance related bonuses. The study reported small to moderate effect sizes but these were mainly positive. There are fewer studies that demonstrate the benefits of organisational interventions, however the potential benefits noted here suggest organisational interventions should be explored further.

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Author: McVicar, Munn-Giddings & Seebohm

Workplace stress interventions using participatory action research designs (2013)

Workplace stress interventions using participatory action research designs (2013)

This paper reviewed studies from 6 countries. The review found that participatory action research is most successful when there are units of a maximum of 100 people and when distinct and important problems are discussed. The review suggests that the sector and nature of the organisation will not impact on the success. However, staff turnover, relationships between management and employees and the evaluation approach have the greatest potential to negatively effect the success of the programme. Importantly, when managers were not actively involved as participants the participatory process was less effective. The interventions tended to focus on specific aspects of the work environment or culture. The studies all involved stakeholders working in a collective manner to ascertain where there were problems. These were discussed and solutions were proposed. The review concludes that using participatory action research as a psychosocial intervention may have a beneficial impact on job stress.

Author: McVicar, Munn-Giddings & Seebohm

Workplace stress interventions using participatory action research designs (2013)

This paper reviewed studies from 6 countries. The review found that participatory action research is most successful when there are units of a maximum of 100 people and when distinct and important problems are discussed. The review suggests that the sector and nature of the organisation will not impact on the success. However, staff turnover, relationships between management and employees and the evaluation approach have the greatest potential to negatively effect the success of the programme. Importantly, when managers were not actively involved as participants the participatory process was less effective. The interventions tended to focus on specific aspects of the work environment or culture. The studies all involved stakeholders working in a collective manner to ascertain where there were problems. These were discussed and solutions were proposed. The review concludes that using participatory action research as a psychosocial intervention may have a beneficial impact on job stress.

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