Changes in stress and coping from a randomized controlled trial of a three-month stress management intervention

Abstract

Objectives: The aim of this study was to investigate whether a group-based stress management intervention, based on principles from cognitive behavior therapy, can reduce stress and alter coping strategies in an occupationally diverse population with extensive symptoms of work-related stress. Methods: Using a randomized wait list control design, 102 participants were divided into two groups: intervention and wait list control. The intervention was a three-month group-based stress management program. Outcomes measures were the Perceived Stress Scale (PSS-10, range 0-40 points) and five dimensions from the Brief COPE questionnaire (range 2-8 points) at baseline and three-, six- and nine-months follow-up. Data were analyzed with a univariate analysis of variance. Results: On the PSS-10 from baseline to three months, the intervention group changed -6.45 (95% CI -8.25 - -4.64) points, compared to -1.12 (95% CI -2.94-0.70) points in the wait list control group. The between-groups difference was -5.32 (95% CI -7.89- -2.76) points, equalling a standardized mean difference of -0.84 (95% CI -1.27- -0.42) favouring the intervention. One coping dimension, "positive reframing", differed between the two groups. Here the intervention group changed -0.86 (95% CI -1.25- -0.48) points from baseline to three months, compared to -0.18 (-0.58-0.22) points in the wait list control group. We found a between-groups difference of -0.67 (95% CI -1.24- -0.11) points, equalling a standardized mean difference of -0.48 (95% CI -0.89- -0.07) favouring the intervention. The gains achieved during treatment were maintained when followed up three months later. Conclusions: Treatment is superior to the control condition in positively affecting perceived stress and positive reframing. When followed up, the gains achieved are maintained. Key terms: brief COPE; cognitive behavior therapy; follow-up; group treatment; positive reframing; Perceived Stress Scale (PSS-10); wait list control.