Skip to main content

Advertisement

SpringerLink
Log in

Recovery from work-related stress: a randomized controlled trial of a stress management intervention in a clinical sample

  • Original Article
  • Published:
International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

Abstract

Purpose

Randomized controlled trials (RCTs) of interventions aimed at reducing work-related stress indicate that cognitive behavioural therapy (CBT) is more effective than other interventions. However, definitions of study populations are often unclear and there is a lack of interventions targeting both the individual and the workplace. The aim of this study was to determine whether a stress management intervention combining individual CBT and a workplace focus is superior to no treatment in the reduction of perceived stress and stress symptoms and time to lasting return to work (RTW) in a clinical sample.

Methods

Patients with work-related stress reactions or adjustment disorders were randomly assigned to an intervention group (n = 57, 84.2% female) or a control group (n = 80, 83.8% female). Subjects were followed via questionnaires and register data. The intervention contained individual CBT and the offer of a workplace meeting. We examined intervention effects by analysing group differences in score changes on the Perceived Stress Scale (PSS-10) and the General Health Questionnaire (GHQ-30). We also tested if intervention led to faster lasting RTW.

Results

Mean baseline values of PSS were 24.79 in the intervention group and 23.26 in the control group while the corresponding values for GHQ were 21.3 and 20.27, respectively. There was a significant effect of time. 10 months after baseline, both groups reported less perceived stress and improved mental health. 4 months after baseline, we found significant treatment effects for both perceived stress and mental health. The difference in mean change in PSS after 4 months was − 3.09 (− 5.47, − 0.72), while for GHQ it was − 3.91 (− 7.15, − 0.68). There were no group differences in RTW.

Conclusions

The intervention led to faster reductions in perceived stress and stress symptoms amongst patients with work-related stress reactions and adjustment disorders. 6 months after the intervention ended there were no longer differences between the groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  • Ahola K, Toppinen-Tanner S, Seppänen J (2017) Interventions to alleviate burnout symptoms and to support return to work among employees with burnout: Systematic review and meta-analysis. Burnout Res 1:1–11

    Article  Google Scholar 

  • Arends I, Bruinvels DJ, Rebergen DS, Nieuwenhuijsen K, Madan I, Neumeyer-Gromen A, Bültmann U, Verbeek JH (2012) Interventions to facilitate return to work in adults with adjustment disorders. Cochrane database of Systematic Reviews 2012, Issue 12. Art. No. CD006389. https://doi.org/10.1002/14651858.CD006389.pub2

  • Bianchi R, Schonfeld IS, Laurent E (2015) Burnout-depression overlap: a review. Clin Psychol Rev 36:28–41

    Article  Google Scholar 

  • Blonk RWB, Brenninkmeijer V, Lagerveld SE, Houtman ILD (2006) Return to work: a comparison of two cognitive behavioural interventions in cases of work related psychological complaints among the self-employed. Work Stress 20(2):129–144

    Article  Google Scholar 

  • Borg V, Andersen Nexø M, Kolte IV, Friis Andersen M (2010) Hvidbog om mentalt helbred, sygefravær og tilbagevenden til arbejde (White paper on mental health, sickness absence and return to work). Det Nationale Forskningscenter for Arbejdsmiljø (Danish National Research Centre for the Working Environment), Copenhagen

  • Carroll C, Rick J, Pilgrim H, Cameron J, Hillage J (2010) Workplace involvement improves return to work rates among employees with back pain on long-term sick leave: a systematic review of the effectiveness and cost-effectiveness of interventions. Disabil Rehabil 32(8):607–621

    Article  Google Scholar 

  • Cohen J (1988) Statistical power analysis for the behavioral sciences. Lawrence Earlbaum Associates, Hillsdale

    Google Scholar 

  • Cohen S, Williamsen G (1988) Perceived stress in a probability sample of the United States. In: Spacapan S, Oskamp S (eds) The social psychology of health. Sage, Newbury Park

    Google Scholar 

  • Cohen S, Kamarck T, Mermelstein RA (1983) A global measure of perceived stress. J Health Soc Behav, 24:385–396

    Article  CAS  Google Scholar 

  • Dalgaard L, Eskildsen A, Carstensen O, Willert MV, Andersen JH, Glasscock DJ (2014) Changes in self-reported sleep and cognitive failures: a randomized controlled trial of a stress management intervention. Scand J Work Environ Health 40(6):569–581

    Article  Google Scholar 

  • Dalgaard VL, Aschbacher K, Andersen JH, Glasscock DJ, Willert MV, Carstensen O, Biering K (2017) Return to work after work-related stress: a randomized controlled trial of a work-focussed cognitive behavioural intervention. Scand J Work Environ Health 43(5):436–446

    Article  Google Scholar 

  • De Vente W, Kamphuis JH, Emmelkamp PMG, Blonk RWB (2008) Individual and group cognitive behavioural treatment for work-related stress complaints and sickness absence: a randomized controlled trial. J Occup Health Psychol 13(3):214–231

    Article  Google Scholar 

  • De Vente W, Kamphuis JH, Blonk RWB, Emmelkamp PMG (2015) Recovery of work-related stress: complaint reduction and work-resumption are relatively independent processes. J Occup rehabil 25:658–668

    Article  Google Scholar 

  • Furukaxa TA, Noma H, Caldwell DM, Honyashiki M, Shinohara K, Imai H, Chen P, Hunot V, Churchill R (2014) Waiting list may be a nocebo condition in psychotherapy trials: a contribution from network meta-analysis. Acta Psychiatr scand 130:181–192

    Article  Google Scholar 

  • Goldberg DP, Williams P (1988) A user’s guide to the general health questionnaire. NFER-Nelson, Windsor

    Google Scholar 

  • Holmgren K, Ekbladh E, Hensing G, Dellve L (2013) The combination of work organizational climate and individual work commitment predicts return to work in women but not in men. J Occup Med 55(2):121–127

    Article  Google Scholar 

  • Huibers MJH, Beurskens AJHM., van Schayck CP, Bazelmans E, Metsemakers JFM, Knottnerus JA, Bleijenberg G (2004) Efficacy of cognitive-behavioural therapy by general practitioners for unexplained fatigue among employees. Br J Psychiatry 184:240–246

    Article  Google Scholar 

  • ICD-10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines (1992) Geneva: WHO

  • Johns G (2010) Presenteeism in the workplace: a review and research agenda. J Organ Behav 31(4):519–542

    Article  Google Scholar 

  • Koopmans PC, Bultmann U, Roelen CA, Hoedeman R, van der Klink JJ, Groothoff JW (2011) Recurrence of sickness absence due to common mental disorders. Int Arch Occup Environ Health 84(2):193–201

    Article  Google Scholar 

  • Lazarus RS, Folkman S (1984) Stress, appraisal and coping. Springer, New York

    Google Scholar 

  • Lund T, Labriola M, Christensen KB, Bültmann U, Villadsen E, Burr H (2005) Psychosocial work environment exposures as risk factors for long-term sickness absence among Danish employees: results from DWECS/DREAM. J Occup Environ Med 47(11):1141–1147

    Article  Google Scholar 

  • Munz DC, Kohler JM, Greenberg CI (2001) Effectiveness of a comprehensive worksite stress management program: combining organizational and individual interventions. Int J Stress Manag 8(1):49–62

    Article  Google Scholar 

  • National Board of Industrial Injuries in Denmark (Arbejdsskadestyrelsen) (2012) Arbejdsskadestatistik 2011 (Industrial Injuries Statistics 2011) (www.ask.dk)

  • Netterstrøm B, Friebel L, Ladegaard Y (2012) The effects of a group based stress treatment program (the Kalmia concept) targeting stress reduction and return to work. A randomized, wait-list controlled trial. J Environ Occup Sci 1(1):111–120

    Article  Google Scholar 

  • Nielsen K, Rasmussen K, Carstensen O, Glasscock D (2008) Forandring som vilkår (Change as a permanent condition). Børsens Forlag, Copenhagen

    Google Scholar 

  • Nielsen MB, Bultmann U, Amby M, Christensen U, Diderichsen F, Rugulies R (2010) Return to work among employees with common mental disorders: Study design and baseline findings from a mixed-method follow-up study. Scand J Public Health 38(8):864–872

    Article  Google Scholar 

  • Nielsen MB, Madsen IE, Bultmann U, Christensen U, Diderichsen F, Rugulies R (2011) Predictors of return to work in employees sick-listed with mental health problems: findings from a longitudinal study. Eur J Pub Health 21(6):806–811

    Article  Google Scholar 

  • Perski O, Grossi G, perski A, Niemi M (2017) A systematic review and meta-analysis of tertiary interventions in clinical burnout. Scand J Psychol 58:551–561

    Article  Google Scholar 

  • Richardsen KM, Rothstein HR (2008) Effects of occupational stress management intervention programs: a metaanalysis. J Occup Health Psychol 13:69–93

    Article  Google Scholar 

  • Rohde B (2006) Mange flere patienter har psykiske belastningsreaktioner (Many more patients with reactions to stress). Arbejdsmiljø 3-2006:9–10

    Google Scholar 

  • Strömberg C, Aboagye E, Hagberg J, Bergström G, Lohela-Karlsson M (2017) Estimating the effect and economic impact of absenteeism, presenteeism, and work environment-related problems on reductions in productivity from a managerial perspective. Value Health 20:1058–1064

    Article  Google Scholar 

  • Van der Klink JL, Blonk RWB, Schene AH, van Dijk FJH (2001) The benefits of interventions for work-related stress. Am J Public Health 91(2):270–276

    Article  Google Scholar 

  • Van der Klink JJL, Blonk RWB, Schene AH, Van Dijk FJH (2003) Reducing long term sickness absence by an activating intervention in adjustment disorders: a cluster randomised controlled design. Occup Environ Med 60:429–437

    Article  Google Scholar 

  • Vänni K, Neupane S, Nygård CH (2017) An effort to assess the relation between productivity loss costs and presenteeism at work. Int J Occup Saf Ergon 23(1):33–43

    Article  Google Scholar 

  • Willert MV, Thulstrup AM, Hertz J, Bonde JP (2009) Changes in stress and coping from a randomized controlled trial of a three-month stress management intervention. Scand J Work Environ Health 35(2):145–152

    Article  Google Scholar 

  • Willert MV, Thulstrup AM, Hertz J, Bonde JP (2010) Sleep and cognitive failures improved by a three-month stress management intervention. Int J Stress Manag 17(3):193–213

    Article  Google Scholar 

  • Willert MV, Thulstrup AM, Bonde JP (2011) Effects of a stress management intervention on absenteeism and return to work—results from a randomized wait-list controlled trial. Scand J Work Environ Health 37(3):186–195

    Article  Google Scholar 

Download references

Acknowledgements

This research project was supported by a grant from the Danish Working Environment Research Fund (Grant No. 34-2007-03).

Author information

Authors and Affiliations

  1. Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland-University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark

    David J. Glasscock, Ole Carstensen & Vita Ligaya Dalgaard

Authors
  1. David J. Glasscock
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ole Carstensen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vita Ligaya Dalgaard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David J. Glasscock.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Glasscock, D.J., Carstensen, O. & Dalgaard, V.L. Recovery from work-related stress: a randomized controlled trial of a stress management intervention in a clinical sample. Int Arch Occup Environ Health 91, 675–687 (2018). https://doi.org/10.1007/s00420-018-1314-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00420-018-1314-7

Keywords

Search

Navigation