Self-guided internet-based and mobile-based stress management for employees: results of a randomised controlled trial

Ebert, David Daniel; Heber, Elena; Berking, Matthias; Riper, Heleen; Cuijpers, Pim; Funk, Burkhardt; Lehr, Dirk

doi:10.1136/oemed-2015-103269

Cited by 166 publications

(216 citation statements)

References 40 publications

(41 reference statements)

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“…In most cases, the concealment of allocation was insufficiently described, and only 13 of 23 studies reported adequate handling of missing data. In particular, the risk for selective outcome reporting was unclear because the study registration prior to the trials could only be retrieved from three studies [31,32,34]. Although another four studies registered their trial [28,30,33,36], this step occurred retrospectively.…”

Section: Resultsmentioning

confidence: 99%

The Benefit of Web- and Computer-Based Interventions for Stress: A Systematic Review and Meta-Analysis

et al. 2017

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BackgroundStress has been identified as one of the major public health issues in this century. New technologies offer opportunities to provide effective psychological interventions on a large scale.ObjectiveThe aim of this study is to investigate the efficacy of Web- and computer-based stress-management interventions in adults relative to a control group.MethodsA meta-analysis was performed, including 26 comparisons (n=4226). Cohen d was calculated for the primary outcome level of stress to determine the difference between the intervention and control groups at posttest. Analyses of the effect on depression, anxiety, and stress in the following subgroups were also conducted: risk of bias, theoretical basis, guidance, and length of the intervention. Available follow-up data (1-3 months, 4-6 months) were assessed for the primary outcome stress.ResultsThe overall mean effect size for stress at posttest was Cohen d=0.43 (95% CI 0.31-0.54). Significant, small effects were found for depression (Cohen d=0.34, 95% CI 0.21-0.48) and anxiety (Cohen d=0.32, 95% CI 0.17-0.47). Subgroup analyses revealed that guided interventions (Cohen d=0.64, 95% CI 0.50-0.79) were more effective than unguided interventions (Cohen d=0.33, 95% CI 0.20-0.46; P=.002). With regard to the length of the intervention, short interventions (≤4 weeks) showed a small effect size (Cohen d=0.33, 95% CI 0.22-0.44) and medium-long interventions (5-8 weeks) were moderately effective (Cohen d=0.59; 95% CI 0.45-0.74), whereas long interventions (≥9 weeks) produced a nonsignificant effect (Cohen d=0.21, 95% CI –0.05 to 0.47; P=.006). In terms of treatment type, interventions based on cognitive behavioral therapy (CBT) and third-wave CBT (TWC) showed small-to-moderate effect sizes (CBT: Cohen d=0.40, 95% CI 0.19-0.61; TWC: Cohen d=0.53, 95% CI 0.35-0.71), and alternative interventions produced a small effect size (Cohen d=0.24, 95% CI 0.12-0.36; P=.03). Early evidence on follow-up data indicates that Web- and computer-based stress-management interventions can sustain their effects in terms of stress reduction in a small-to-moderate range up to 6 months.ConclusionsThese results provide evidence that Web- and computer-based stress-management interventions can be effective and have the potential to reduce stress-related mental health problems on a large scale.

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Section: Resultsmentioning

confidence: 99%

The Benefit of Web- and Computer-Based Interventions for Stress: A Systematic Review and Meta-Analysis

et al. 2017

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“…On the other hand, it may very well be the case that employees are less willing to participate in an intervention if no regular content feedback is provided, which would result in lower overall effects in the target population (60,61). Thus, future studies should compare the acceptability, effectiveness and cost-effectiveness of different guidance formats for iSMI (19,62). Relevant work-related health outcomes, such as emotional exhaustion and psychological detachment from work, improved significantly.…”

Section: Discussionmentioning

confidence: 99%

“…A recent randomized trial found Ebert et al moderate effect sizes with regard to the reduction of depressive symptoms among stressed teachers (6,14), whereas another trial did not find beneficial effects of a problem-solving training on depression or work-related outcomes (15,16). So far, randomized controlled trials (RCT) on internet-based SMI show mixed results with some studies reporting significant results with moderate effects sizes on perceived stress (17)(18)(19) and others yielding non-significant outcomes (20,21). Our group recently conducted a RCT testing the efficacy of an internet-based stress management intervention (iSMI) among employees with heightened levels of perceived stress (22,23).…”

mentioning

confidence: 98%

Internet- and mobile-based stress management for employees with adherence-focused guidance: efficacy and mechanism of change

Ebert¹,

Lehr²,

Heber³

et al. 2016

Scand J Work Environ Health

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106

104

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The present study adds to the literature by showing that (1) a newly developed internet-based stress-management intervention based on Lazarus' transactional stress model can be effective with only limited human support (<1 hour per participant), and (2) cognitive behavioral therapy (CBT)-based interventions can have enduring effects on mental health and work-related health outcomes that go beyond immediate short-term effects.

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“…This might indicate that individuals with stressful lives have problems to adhere to fixed synchronous therapy sessions, and providing asynchronous treatments might help them to get access to psychological treatments, which they would otherwise not utilize. Such an assumption is supported by studies that found high proportions of first-time helpseekers in internet-based stress management programs [76][77][78][79][80]. However, future research is needed to confirm such an assumption.…”

Section: Preference For Specific Delivery Formatsmentioning

confidence: 94%

Public Attitudes Toward Guided Internet-Based Therapies: Web-Based Survey Study (Preprint)

Apolinário-Hagen¹,

Harrer²,

Kählke³

et al. 2018

Preprint

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Background: Internet interventions have been proposed to improve the accessibility and utilization of evidence-based psychological treatments. However, little is known about attitudes toward such treatments, which can be an important barrier to their utilization. Objective: This study aimed to (1) determine attitudes toward guided internet interventions, to (2) assess its acceptability compared to other internet-based formats, and to (3) explore predictors of acceptance. Methods: A web-based survey (N=646) assessed attitudes toward guided internet therapies (i.e. "perceived usefulness/helpfulness", "relative advantage compared to face-to face therapy"), preferences for delivery modes ("e-preference": guided Internet interventions, unguided internet interventions, video conferencing psychotherapy (VCP)) as well as potential predictors of attitudes and preferences, including socio-demographics, help seeking-related variables, attachment style, perceived stress. Results: Although most participants perceived internet interventions as useful or helpful (65.9%, 426/646), the minority indicated their relative advantage compared to face-to-face therapy (8.7%, 56/646). Most participants preferred guided internet interventions (39.0%, 252/646) over VCP (22.8%, 147/646), unguided internet interventions (19.2%, 124/646) and not using internet interventions (18.8%, 121/646; missing: 0.2%). Attachment avoidance and stress were related to epreference (all P<.05). Moreover, preference for therapist-guided internet interventions was higher for individuals aware of internet-based treatment (χ

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Self-guided internet-based and mobile-based stress management for employees: results of a randomised controlled trial

Cited by 166 publications

References 40 publications

The Benefit of Web- and Computer-Based Interventions for Stress: A Systematic Review and Meta-Analysis

The Benefit of Web- and Computer-Based Interventions for Stress: A Systematic Review and Meta-Analysis

Internet- and mobile-based stress management for employees with adherence-focused guidance: efficacy and mechanism of change

Public Attitudes Toward Guided Internet-Based Therapies: Web-Based Survey Study (Preprint)

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