Return to work: A comparison of two cognitive behavioural interventions in cases of work-related psychological complaints among the self-employed

We investigated the effectiveness of cognitive behavioural therapy (CBT) and a combined intervention of workplace- and individual-focused techniques among self-employed people on sick leave owing to work-related psychological complaints (such as anxiety, depression, and burnout). Both interventions were based on CBT; however, one was conducted by psychotherapists and involved extensive CBT, while the other was delivered by “labour experts” and consisted of a brief CBT-derived intervention combined with both individual-focused and workplace interventions. One hundred and twenty-two self-employed people who had applied for sickness benefit from an insurance company enrolled in a randomized controlled design. These individuals were assessed before the intervention and then at 4 months and 10 months after the onset of the intervention. The outcome was assessed based on duration of sick leave until partial and full return to work and on psychological complaints. Significant effects on partial and full return were found in favour of the combined intervention: partial return occurred 17 and 30 days earlier in this group than in the CBT group and the control group, respectively. For full return to work, the difference was approximately 200 days. A decrease in psychological complaints was present in each condition but we found no significant interaction effects. The results suggest that work resumption should be addressed earlier in individuals receiving CBT. This insight is of value for the (scarce) literature concerning interventions for individuals who are on sick leave owing to work-related psychological complaints.     

Return to work: A comparison of two cognitive behavioural interventions in cases of work-related psychological complaints among the self-employed

Abstract

We investigated the effectiveness of cognitive behavioural therapy (CBT) and a combined intervention of workplace- and individual-focused techniques among self-employed people on sick leave owing to work-related psychological complaints (such as anxiety, depression, and burnout). Both interventions were based on CBT; however, one was conducted by psychotherapists and involved extensive CBT, while the other was delivered by “labour experts” and consisted of a brief CBT-derived intervention combined with both individual-focused and workplace interventions. One hundred and twenty-two self-employed people who had applied for sickness benefit from an insurance company enrolled in a randomized controlled design. These individuals were assessed before the intervention and then at 4 months and 10 months after the onset of the intervention. The outcome was assessed based on duration of sick leave until partial and full return to work and on psychological complaints. Significant effects on partial and full return were found in favour of the combined intervention: partial return occurred 17 and 30 days earlier in this group than in the CBT group and the control group, respectively. For full return to work, the difference was approximately 200 days. A decrease in psychological complaints was present in each condition but we found no significant interaction effects. The results suggest that work resumption should be addressed earlier in individuals receiving CBT. This insight is of value for the (scarce) literature concerning interventions for individuals who are on sick leave owing to work-related psychological complaints.     

The impact of a participatory organizational intervention on job stress in community health care institutions

The aim of the present study was to investigate the effect of a short-term participatory intervention in health care institutions in Norway on workers' control, other job characteristics, job stress, subjective health and job satisfaction. Participants (including managers and supervisors) were randomly allocated to intervention groups and to a control group. Actions to solve problems based on the employees' own perceptions of the main problems were seen as the key motivators for organizational improvement and increased control at the task and office level in the work situation. The main stressors identified by the participants in this study were lack of information, communication and respect between professions, as well as the need for professional and personal development. The participatory intervention had a positive, but limited effect on work-related stress, job characteristics, learning climate and management style, and seemed to have started a beneficial change process. There were no negative short-term effects on work-related stress and job demands. Organizational interventions may be a potential training ground for acquiring participatory skills and resources, and if sustained after the intervention period, they can have long-term effects on problem solving, job stress and employee satisfaction.     

The impact of a participatory organizational intervention on job stress in community health care institutions

The aim of the present study was to investigate the effect of a short-term participatory intervention in health care institutions in Norway on workers' control, other job characteristics, job stress, subjective health and job satisfaction. Participants (including managers and supervisors) were randomly allocated to intervention groups and to a control group. Actions to solve problems based on the employees' own perceptions of the main problems were seen as the key motivators for organizational improvement and increased control at the task and office level in the work situation. The main stressors identified by the participants in this study were lack of information, communication and respect between professions, as well as the need for professional and personal development. The participatory intervention had a positive, but limited effect on work-related stress, job characteristics, learning climate and management style, and seemed to have started a beneficial change process. There were no negative short-term effects on work-related stress and job demands. Organizational interventions may be a potential training ground for acquiring participatory skills and resources, and if sustained after the intervention period, they can have long-term effects on problem solving, job stress and employee satisfaction.     

Psychological stress-factors and concentration of immunoglobulins and complement components in Norwegian nurses

Psychological stress produces immunological changes in animals, and increasing evidence suggests that this may also be true for humans. In the present study of 34 nurses in a busy ward of a Norwegian hospital, significant relationships have been demonstrated between die plasma levels of immunoglobulins and complement components and work-related 'stress', anxiety, and cognitive defence strategies. The main components of die work-related stress experience were role-stress and nonparticipation in decision-making.

The results indicate chat immunological parameters may perhaps be used as a psychological stress indicator, but the relationships are complex and can best be understood if individual coping and defence mechanisms are considered. Health symptoms were also examined, but these were not related to stress experience or immunological measures.     

Coping with daily work problems. Contributions of problem content, appraisals, and person factors

This paper presents the result of an analysis of coping with daily work-related problems reported by a community sample of working adults. The methodology used differs from that employed elsewhere not only in its intensive longitudinal approach but also in its technique for measing coping Coping with work and non-work problems was compared. It is argued that the results provide strong support for the transactional model of stress, appraisal and coping, but also point up the importance of nonspecific (and unmeasured) person factors in predicting coping.     

Self-help for stress and burnout without therapist contact: An online randomised controlled trial

Interventions designed to reduce stress and burnout may be costly and access is limited. This study examined the effectiveness of a self-help book, using Acceptance and commitment therapy (ACT) to target stress and burnout in a randomised controlled online trial without any therapist contact. Participants were recruited through a newsletter of a health insurance company. Participants (N?=?119) who reported at least moderate levels of stress were randomly assigned to an immediate intervention (n?=?61) or a waitlist group (n?=?58). Measures before and after the intervention assessed stress, burnout (primary outcomes), depression, well-being, emotion regulation (secondary outcomes) and ACT-specific constructs. Compared to the waitlist group, participants in the immediate intervention group reported lower stress and burnout and higher psychological flexibility at post-assessment. Effects between groups were large for stress (d?=?0.9), moderate to large for burnout (d?=?0.5–0.8) and large for psychological flexibility (d?=?0.8). All primary and most secondary outcomes and ACT processes continued to improve in the 3-month-follow-up period. Results suggest that an ACT self-help book without any therapist contact is effective in reducing stress and burnout for various occupations. Thus, it may provide a cost-effective public health intervention for reducing stress and burnout.     

Coping with daily work problems. Contributions of problem content,appraisals, and person factors

Abstract

This paper presents the result of an analysis of coping with daily work-related problems reported by a community sample of working adults. The methodology used differs from that employed elsewhere not only in its intensive longitudinal approach but also in its technique for measing coping Coping with work and non-work problems was compared. It is argued that the results provide strong support for the transactional model of stress, appraisal and coping, but also point up the importance of nonspecific (and unmeasured) person factors in predicting coping.     

Individual strategies for coping with stress at work: A review

This paper discusses some of the conceptual and methodological issues involved in the study of coping. It focuses on individual coping with work and work-related problems, and adopts a transactional framework for the definition of the key concepts of stress, appraisal and coping. It identifies and reviews 17 recent papers which are representative of the coping literature, as defined by the scope of the paper. What it draws out of this review largely concerns issues of measurement, and four particular issues are flagged as important for future research. It concludes that there is a need for more and more adequate studies, particularly in relation to the classification and modelling of coping, and that the adequacy of those future studies should be partly judged in terms of how well they deal with the issues raised here.     

Lay representations of workplace stress: What do people really mean when they say they are stressed?

An individual's beliefs in relation to stress are likely to affect their perceptions, and hence their work-related actions (such as absenteeism). In this paper, lay representations of work stress were investigated utilising semi-structured interviews with 45 individuals from a range of occupations. The meaning of occupational stress, its antecedents and outcomes, and ways by which it may be managed were examined. Dominant factors were established through the use of thematic content analysis. Similarities and differences were found between lay and professional discourses on work stress. Results indicate that lay representations of occupational stress are multi-faceted. Little consensus was found in how participants interpreted the concept: a diverse range of personal, environmental, and societal factors was highlighted. A different (and arguably more complex) range of definitions of job stress and the manner in which it impacts on individuals was revealed than has been reported in previous studies. The causes of stress at work were perceived as being predominantly organisational, but the impact of stress on the employee was more salient than organisational outcomes. Paradoxically, secondary and tertiary stress management techniques were thought to be more effective than interventions designed to prevent stress at work. Interviewees with line management responsibility were more likely to emphasise individual responsibility for managing stress, most others maintained that the individual and the organisation are equally responsible. The potential value of examining lay representations of job stress to the discipline of Occupational Health Psychology is discussed and suggestions for future research are made.     

Behavioural techniques for enhancing alertness and performance in shift work

This paper reviews behavioural and cognitive methods for increasing alertness, enhancing performance, and decreasing long-term negative consequences due to shift work. Methods having the most potential for effective intervention include the short-term alerting effects of the optimal timing of work breaks, social activity during breaks, and sensory stimulation. Stress coping techniques and sleep hygiene information for workers and their families have the most potential for addressing long-tcrm effects of shift work. Recommendations for areas requiring further investigation include the altering effects of bright light, fresh air, and cold water; performance enhanccmcnt through psychophysiological self-regulation and imagery; and the impact on performance of second jobs and family responsibilities.     

Occupational health psychology

Abstract

An individual's beliefs in relation to stress are likely to affect their perceptions, and hence their work-related actions (such as absenteeism). In this paper, lay representations of work stress were investigated utilising semi-structured interviews with 45 individuals from a range of occupations. The meaning of occupational stress, its antecedents and outcomes, and ways by which it may be managed were examined. Dominant factors were established through the use of thematic content analysis. Similarities and differences were found between lay and professional discourses on work stress. Results indicate that lay representations of occupational stress are multi-faceted. Little consensus was found in how participants interpreted the concept: a diverse range of personal, environmental, and societal factors was highlighted. A different (and arguably more complex) range of definitions of job stress and the manner in which it impacts on individuals was revealed than has been reported in previous studies. The causes of stress at work were perceived as being predominantly organisational, but the impact of stress on the employee was more salient than organisational outcomes. Paradoxically, secondary and tertiary stress management techniques were thought to be more effective than interventions designed to prevent stress at work. Interviewees with line management responsibility were more likely to emphasise individual responsibility for managing stress, most others maintained that the individual and the organisation are equally responsible. The potential value of examining lay representations of job stress to the discipline of Occupational Health Psychology is discussed and suggestions for future research are made.     

Exploring the nature of control and its role in the appraisal of workplace stress

The concept of control is a prominent component of theories of stress. From a transactional framework, appraisal of control is seen as important in influencing coping behaviour. However, little attention has been paid to the measurement of the appraisal of control in a work-related situation. In this paper it is argued that situational control should not be reduced to a simple assessment of whether or not an individual has control over a given situation. Instead it is believed that it is important to identify the factors that an individual strives to have control of, as well as the perceived degree of control over those factors. A major component of the present study was the use of a measure that viewed control in this way and that examined control as a multifaceted construct (task control, predictability, self-control and general control). This paper reports on an analysis that examines the multifaceted nature of perceived control with other situational appraisals in the process of coping with workplace stress. A total of 134 employees from four public sector organizations in New Zealand took part in this research. Having control over work tasks was for this sample considered to be less important in giving a sense of control than either predictability or self-control. When it came to reporting how much control they actually had, respondents reported higher levels of self-control than other aspects of control. However, in general respondents reported lower levels of actual control than what they perceived it was important for them to have. This research emphasizes the importance of having a sense of self-control, particularly when it comes to the use of different coping strategies. Overall these findings point to the need to better understand the nature and type of control and its importance if we are to advance our knowledge of work stress.     

Exploring the nature of control and its role in the appraisal of workplace stress

The concept of control is a prominent component of theories of stress. From a transactional framework, appraisal of control is seen as important in influencing coping behaviour. However, little attention has been paid to the measurement of the appraisal of control in a work-related situation. In this paper it is argued that situational control should not be reduced to a simple assessment of whether or not an individual has control over a given situation. Instead it is believed that it is important to identify the factors that an individual strives to have control of, as well as the perceived degree of control over those factors. A major component of the present study was the use of a measure that viewed control in this way and that examined control as a multifaceted construct (task control, predictability, self-control and general control). This paper reports on an analysis that examines the multifaceted nature of perceived control with other situational appraisals in the process of coping with workplace stress. A total of 134 employees from four public sector organizations in New Zealand took part in this research. Having control over work tasks was for this sample considered to be less important in giving a sense of control than either predictability or self-control. When it came to reporting how much control they actually had, respondents reported higher levels of self-control than other aspects of control. However, in general respondents reported lower levels of actual control than what they perceived it was important for them to have. This research emphasizes the importance of having a sense of self-control, particularly when it comes to the use of different coping strategies. Overall these findings point to the need to better understand the nature and type of control and its importance if we are to advance our knowledge of work stress.     

Mitarbeitergespräche als Beitrag zur Krisenbewältigung Ein Praxisbericht

Staff appraisal interviews as a support of coping with a crisis. A case study The implementation of personnel development by launching a pilot project with staff appraisal interviews was part of a change-management process in a non-profit-organisation. This should be a way of supporting employees during this process. Those employees who took part in this project evaluated this management instrument positively. After that this instrument has been introduced for the whole organisation.     

Occupational stress in universities: staff perceptions of the causes, consequences and moderators of stress

In recent years, the Australian university sector has undergone large-scale organizational change, including restructuring, downsizing and government funding cuts. At the same time, research from across the globe reports an alarming increase in the occupational stress experienced by university staff. We report on the first phase of a longitudinal investigation of occupational stress. A total of 22 focus groups were conducted with a representative sample of 178 academic and general staff from 15 Australian universities. The groups focused on understanding staff 's experience of occupational stress, and perceptions of the sources, consequences and moderators of stress. Both general and academic staff reported a dramatic increase in stress during the previous 5 years. As a group, academic staff reported higher levels of stress than general staff. Five major sources of stress were identified including: insufficient funding and resources; work overload; poor management practice; job insecurity; and insufficient recognition and reward. The majority of groups reported that job-related stress was having a deleterious impact on their professional work and personal welfare. Aspects of the work environment (support from co-workers and management, recognition and achievement, high morale, flexible working conditions), and personal coping strategies (stress management techniques, work/ non-work balance, tight role boundaries and lowering standards), were reported to help staff cope with stress. The findings provide a timely insight into the experience of stress within universities.     

Changing work environments: Innovative coping responses to occupational stress

To what degree do individuals adapt their work environments in response to occupational stress? The research reported below addresses this question through a qualitative questionnaire survey that assesses the extent to which innovation is used as a stress coping strategy amongst health care professionals (community and hospital nurses, administration workers and paramedics; N = 333). Overall, 32% of these workers reported a coping response subsequently coded as innovative, and significant between-occupational group differences in the frequency of usage were found. Overwork, procedural difficulties and dealing with others were the stressors eliciting the greatest number of innovative coping responses. The study indicated that such responses were perceived as an effective and important way of dealing with occupational stress. It is concluded that stress management programmes that encourage individuals to change workplace factors through innovation, would be a worthwhile addition to interventions that emphasize individual adaptation to stressful work environments.     

Occupational stress in universities: Staff perceptions of the causes,consequences and moderators of stress

In recent years, the Australian university sector has undergone large-scale organizational change, including restructuring, downsizing and government funding cuts. At the same time, research from across the globe reports an alarming increase in the occupational stress experienced by university staff. We report on the first phase of a longitudinal investigation of occupational stress. A total of 22 focus groups were conducted with a representative sample of 178 academic and general staff from 15 Australian universities. The groups focused on understanding staff 's experience of occupational stress, and perceptions of the sources, consequences and moderators of stress. Both general and academic staff reported a dramatic increase in stress during the previous 5 years. As a group, academic staff reported higher levels of stress than general staff. Five major sources of stress were identified including: insufficient funding and resources; work overload; poor management practice; job insecurity; and insufficient recognition and reward. The majority of groups reported that job-related stress was having a deleterious impact on their professional work and personal welfare. Aspects of the work environment (support from co-workers and management, recognition and achievement, high morale, flexible working conditions), and personal coping strategies (stress management techniques, work/ non-work balance, tight role boundaries and lowering standards), were reported to help staff cope with stress. The findings provide a timely insight into the experience of stress within universities.     

Stress,coping and problem solving

Abstract

This paper outlines the developing consensus on the nature of stress. It offers a definition of stress as a psychological state derived from the person's appraisal of their ability to cope with the demands which are made of them. The paper then examines the concept of coping and explores its role in stress theory. It contrasts two different approaches to the study of coping: the classification of coping strategies, and the investigation of the process of coping—coping as ‘problem solving’. The paper focuses on the latter and in doing so it describes the nature of rational models of problem solving, considering their utility and application to stress management.     

Organizational change,health, and sick leave among health care employees: A longitudinal study measuring stress markers,individual, and work site factors

Abstract

This controlled longitudinal study was conducted to investigate the effects of organizational change on employees’ self-reported health, work satisfaction, work-related exhaustion, stress, and sick leave. The population consisted of 226 employees at T1 and 198 at T2, divided into a study group affected by organizational changes, and a reference group not affected by them. Group differences for the outcome measures self-rated health (SRH), work satisfaction, work-related exhaustion, and hormones associated with stress were analysed using a two-factor ANOVA design for repeated measurements. Our findings showed no significant differences, either across time or between groups for SRH, work satisfaction, and work-related exhaustion. However, we did find significant change across time and between groups for the recovery hormone DHEA-S. Days of sick leave increased by 7% for employees in the study group and by 2% in the reference group. Serum cortisol showed significantly decreased levels across time but not between groups. The decreased recovery potential in the study group might have long-term health implications. The study points to the importance of looking at the impact of organizational change on employee well-being from a number of perspectives, such as self-reported health parameters, registered sick-leave data, and biological stress markers.