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Learning how to recover from stress-related disorders via internet-based interventions
Linköpings universitet, Psykologi.ORCID iD: 0000-0001-7627-1729
2021 (English)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Att lära sig återhämtning från stressrelaterad ohälsa via internet-baserade interventioner (Swedish)
Abstract [en]

Stress has become one of the major challenges of modern society, especially within the working population, causing significant costs and personal problems. However, the range of prevention and treatment is not at all proportionate to the needs of the public. Internet provides new options for broad dissemination and a growing body of evidence suggest that internet-based interventions for stress could be effective. However, few studies have examined the efficacy in clinical samples or how participants experience these new treatment delivery formats. Further, only a limited number of studies have evaluated the efficacy of work-focused stress interventions on work-related outcomes (e.g., absenteeism), and if recovery has the potential in stress-prevention.

In the present thesis, internet-based cognitive behavioural stress interventions (iCBT), designed to reduce symptoms of stress and increase recovery and workparticipation among 117 managers and 260 employees, were evaluated in three randomized controlled trials (Study I, III and IV) and a qualitative study (Study II). Results of Study I and III indicate that the iCBT for managers and employees with stress-related disorders was effective in reducing symptoms of chronic stress. In Study III effects on work-related outcomes, e.g., work ability and absenteeism, were only seen in the work-focused iCBT. In Study II, participants found the work-focused iCBT to be accessible and feasible and reported positive experiences on stress and well-being in both life and at work. Finally, preliminary results in Study IV suggest that recovery experiences, an important protective factor against chronic stress, could be improved by a brief internet-based recovery intervention.

In conclusion, if implemented, these relatively brief and accessible interventions could be a feasible way to increase access to treatment and learning distressed employees and others how to prevent and recover from stress-related disorders. 

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2021. , p. 85
Keywords [en]
Stress, Internet-based, Interventions, Recovery, Work, Cognitive behavioural therapy
National Category
Applied Psychology
Identifiers
URN: urn:nbn:se:gih:diva-8082DOI: 10.3384/diss.diva-172685ISBN: 9789179297220 (print)OAI: oai:DiVA.org:gih-8082DiVA, id: diva2:1834154
Public defence
2021-02-12, Online through Zoom (contact maria.hugo-linden@liu.se) and TEMCAS, Building T, Campus Valla, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2024-02-02 Created: 2024-02-02 Last updated: 2024-02-13Bibliographically approved
List of papers
1. Internet-based stress management for distressed managers: results from a randomised controlled trial
Open this publication in new window or tab >>Internet-based stress management for distressed managers: results from a randomised controlled trial
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2018 (English)In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 75, no 2, p. 105-113Article in journal (Refereed) Published
Abstract [en]

Objective The aim of this randomised controlled trial (RCT) was to evaluate the efficacy of a guided internet-based stress management intervention (iSMI) among distressed managers compared with a attention control group (AC) with full access to treatment-as-usual. Method A total sample of 117 distressed managers, mainly employed in the healthcare, IT, communication and educational sector, were randomised to either iSMI (n=59) or an AC group (n=58). The iSMI consisted of eight modules including cognitive behavioural stress management and positive management techniques. Participants received a minimal and weekly guidance from a psychologist or master-level psychology student focusing on support, feedback and adherence to the intervention. Self-report data were assessed at pre, post and 6 months after the intervention. The primary outcome was perceived stress (Perceived Stress Scale-14). The secondary outcomes included mental and work-related health outcomes. Results Participants in the iSMI intervention reported significantly less symptoms of perceived stress (d=0.74, 95% CI 0.30 to 1.19) and burnout (d=0.95, 95% CI 0.53 to 1.37) compared with controls, at postassessment. Significant medium-to-large effect sizes were also found for depression, insomnia and job satisfaction. Longterm effects (6 months) were seen on the mental health outcomes. Conclusion This is one of the first studies showing that iSMIs can be an effective, accessible and potentially time-effective approach of reducing stress and other mental-related and work-related health symptoms among distressed managers. Future studies are needed addressing distressed managers and the potential of indirect effects on employee stress and satisfaction at work.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:gih:diva-8085 (URN)10.1136/oemed-2017-104458 (DOI)000419995000004 ()28855344 (PubMedID)
Available from: 2024-02-02 Created: 2024-02-02 Last updated: 2024-02-13
2. Experiences of internet-delivered and work-focused cognitive behavioral therapy for stress: A qualitative study
Open this publication in new window or tab >>Experiences of internet-delivered and work-focused cognitive behavioral therapy for stress: A qualitative study
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2019 (English)In: Internet Interventions, ISSN 2214-7829, Vol. 18, article id 100282Article in journal (Refereed) Published
Abstract [en]

Introduction

Stress is one of the major challenges of modern society, causing significant costs and personal problems. In the recent decade a growing body of research has provided support for the efficacy of internet interventions for stress. However, few studies have focused on how participants experience internet interventions for stress.

Method

The current study was a qualitative follow-up study of an internet-delivered and work-focused cognitive behavioral treatment for stress. The aim was to capture participants' experiences of the treatment and their views on effects on health and well-being. Participants were selected from a controlled study (n = 27), using a criterion-based sampling approach selecting those participants who had completed all treatment modules. Nine semi-structured interviews were held, and the material was analyzed using Thematic Analysis.

Results

The results indicated that most of the participants experienced positive effects on their mental health and well-being in both life and at work. All participants emphasized the importance of having access to therapist support. In line with previous research, participants found the intervention to be extensive and demanding and expressed the need for extended treatment time and therapist support.

Conclusions

Considering the limitations of the present study, future research could examine the feasibility of reducing the length of each session, extending deadlines and increasing therapist support. This could improve treatment efficacy and further enhance utilization in the target population.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Stress; Experiences; Internet; Cognitive behavior therapy; Work
National Category
Applied Psychology
Identifiers
urn:nbn:se:gih:diva-8083 (URN)10.1016/j.invent.2019.100282 (DOI)000500917500026 ()31737490 (PubMedID)2-s2.0-85074567848 (Scopus ID)
Note

Funding Agencies|Swedish Council for Working and Life Research (FORTE); Swedens Municipalities and County Councils (SKL)

Available from: 2024-02-02 Created: 2024-02-02 Last updated: 2024-02-13

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