Journal of Environmental and Public Health / 2012 / Article / Tab 3

Review Article

A Synthesis of the Evidence for Managing Stress at Work: A Review of the Reviews Reporting on Anxiety, Depression, and Absenteeism

Table 3

Summary of review papers.

Author (search dates)Research aim or questionPrevention levelInterventionOutcomeType of reviewInterventions reviewedNo. of Studies

Parks and Steelman 2008 (1980–2005)Effectiveness of organisational wellness programmes for absenteeism and satisfaction (Publications 1980–2005)PPOOMeta-analysisFitness organisation wellness programmes
Comprehensive organisational wellness programmes
15 papers + 2 dissertations
10 on absenteeism

Richardson and Rothstein 2008 (1976 onwards)Effectiveness of stress management interventions: What works for whom? What has been learned and what is needed next? Includes effectiveness of SMI target by outcomes. Publications in English from 1976 onwards. updates van der Klink, 2001PP
I, O
I, O
(6 studies),
Systematic with meta analysisInterventions were categorised into: CBT, relaxation, organisation (support groups), multimodal, and alternative (biofeedback, and personal skills training)38 papers
4 on absenteeism, 11 on mental health, 13 on anxiety, and 14 on stress

Egan et al. 2007 (up to November 2006)Whether organisational-level interventions designed to increase employee participation/control lead to health effects predicted by the DCS modelPPOISystematicProblem solving committees, employee representatives, delegation of more control of work scheduling, work hours and training, smaller teams with subsupervisors18
8 on mental health, 4 on stress, 5 on absenteeism, 1 on psychological distress, 1 on psychiatric symptoms, 4 on depression, and 3 on anxiety

Lamontagne et al., 2007 (1990–2005)Effectiveness of interventions categorised as primary, secondary and tertiary
Not a meta-analysis of effect sized, but a narrative review
O, I,
O, I,
Systematic review of job stress interventions between 1990–2005Interventions for physical work environment (e.g., noise level), organisation (e.g., work redesign, workload reduction) individual (e.g., coping skills training), and organisation-individual interface (e.g., support group)90
Not reported

Bond et al. 2006 (1989–2004)Does increasing employee control and workplace reorganisation (HSE Management standards) affect business outcomes such as performance, absenteeism, and turnover?OOSystematic review of interventionsInterventions to increase control including job redesign, steering or focus groups to identify ways that employee control could be increased5
4 on absenteeism

Marine et al. 2006 (up to May 2005)Evaluate effectiveness of work and person-directed interventions in preventing stress at work in healthcare workersPPO, II, OCochrane collaboration systematic with meta-analysis and qualitative synthesisPerson directed interventions included cognitive behavioural therapy, relaxation, music making, touch therapy/massage, multicomponent interventions consisting of mindfulness-based stress reduction, education, and exercises to enhance communication skills, stress reactivity and self-compassion and practical skills. Work directed interventions included role playing, experiential exchanges intended to improve attitudes, communication skills, mobilising support from colleagues, learning participatory problems solving and decision making, innovations in nursing delivery via changes in work organisation, knowledge and skills training, and support from supervisors19
7 on stress,
4 on anxiety, and
1 on absenteeism

The British Occupational Health Research Foundation, 2005 (up to April 2004)(1) What is the evidence for preventative programmes at work and what are the conditions under which they are most effective? (2) For those at risk what is most effective to enable them to remain at work? (3) What is effective to support rehabilitation and return to work?PP
O+IOSystematic reviewCoworker support group, stress inoculation training, counselling, relaxation, problems solving, assertiveness training, stress awareness, self report diary, physical exercise, cognitive behavioural therapy, education, relationship orientated therapy, computerised CBT, psychodynamic therapy, cognitive analytic therapy, music making, humour, increasing employees participation and control, clarify role and responsibilities, increase job related information, feedback from supervisors about performance, training and feedback to managers, education training for primary care physicians to attune them to previously unrecognised or untreated anxiety, coping skills, inner quality management training consisting of changing interpretive styles to affect mood and stress, enhancing communication and goal clarity, creating a caring culture and job satisfaction, and quantum management: operationalsing the tools daily. Organisation development interventions consisting of 2 years of surveys, interest groups, action planning and policy intervention and review, meditation, online support group, self management, training in emotional intelligence, and telephone support from supervisor31
Not reported

Michie and Williams 2003 (1987–1999)Reducing work related psychological ill health and sickness absencePPO,II,OSystematic reviewPhysical activity, skill training to increase social support and problem solving, early referral to occupational health, and communication training6
3 on psychological distress, 2 on mental health, 4 on depression, 3 on anxiety, 2 on absenteeism

Mimura and Griffiths 2003 (1990 onwards)The effectiveness of current approaches to workplace stress management in the nursing professionPP
O,IISystematicPersonnel support, and environmental management interventions11
Not reported

Edwards and Burnard 2003 (1966–2000)Systematically identify stressors, moderators and stress management interventions for mental health nursesPPO,IO,ISystematicSupport, education, awareness, training, ward reorganisation, and behaviour training77
Not reported

Van der Klink et al. 2001 (1966–1996)Effectiveness of individual interventions such as CBT, relaxation, multimodal programmes, and organisation focused interventionsPPO,I,
Meta analysisCBT, relaxation, and multimodal and organisation-focused interventions to increase control or support48
36 on anxiety symptoms, 13 on depressive symptoms, and 7 on absenteeism

Parkes and Sparkes, 1998
(not reported)
(1) effectiveness of individual targeted (2) organisational targeted interventionsPPO,II,OHSE contract research report. Literature review partially systematicIndividual stress management to change individuals ability to cope with stress and organisation focused interventions to reduce the stress exposure in work environment9 org studies
Not reported

Van der Hek and Plomp, 1997 (1987–1994)Evaluate the effectiveness by level of intervention and outcome measurePPI,O,
I,O,Systematic reviewIndividual interventions: relaxation, meditation, biofeedback, cognitive coping strategies, employee assistance programmes
Individual-organisational interface: relationships at work, person-environment fit, role issues, worker participation, and autonomy
Organisation: Organisation structure, selection and placement, training physical environment, job resign, health concerns, and resources
4 on stress, 5 on anxiety, 6 on depression, 3 on absenteeism, and 1 on stress

Murphy, 1996 (1974–1994)Stress management in work settings: A critical review of the health effectsPPII,OSystematicProgressive muscle relaxation, mediation, biofeedback, cognitive behavioural, multimodal, and miscellaneous64
18 on anxiety, 7 on psychiatric symptoms, 20 on stress, 6 on depression, 7 on absenteeism, and 1 on psychological distress

Saunders et al., 1996 (1977–1991)The effect of individual stress inoculation training for anxiety and performancePPII,OMeta analysisStress inoculation training: conceptualisation and education, skill acquisition and rehearsal then application and follow through37
7 on psychological distress, 9 on test anxiety, 2 on speech anxiety, 1 on computer anxiety, 1 on math anxiety, 6 on teacher stress, 1 on vocational stress, 1 on induced stress, and 1 on social anxiety

Giga et al., 2003 (1990–2001)The impact of stress management interventions on the individual and the organisation based on UK-based research onlyPPI,OI,OLiterature reviewIndividual: relaxation, CBT, exercise, time management, and employee assistance programme
Individual/organisational: coworker support groups, role issues, participation and autonomy
Organisational: physical and environmental, characteristics, communication, and job redesign/restructuring
5 on depression, 7 on absenteeism, 4 on stress, 4 on anxiety

Caulfield et al., 2004 (1993–2003)To investigate empirical research into occupational stress interventions conducted in AustraliaPPI,OI,OSystematic reviewIndividual: self-management training, stress management
Organisational: critical incident stress debriefing (CISD), education programme, job redesign
1 on psychological health,
1 on stress, and
1 on psychological distress

Penalba, McGuire, Leite, 2009 (electronic searches on 12/5/08
Hand searches 1973–1990)
Psychosocial interventions for preventing psychological problems in law enforcement officers (police and military policy), regardless of age, gender, and countryPP
IICochrane review: systematic review of trialsExercise, psychological interventions, and psychosocial interventions19 studies reviewed, and only five contained data 3 were exercise based interventions and
7 to psychological interventions
Only two studies had psychological measures as outcome

Martin 2009
Published 1997–2000
Meta-analysis of effects of health promotion intervention in the workplace on depression and anxiety symptomsPP+SPI+OIMeta-analysisAerobic and weight training exercise behaviour modification
Stress management: extensive and brief CBT, computerised
Acceptance and commitment therapy for coping
Promotion programme
Problem solving, motivational interviewing, ergonomic and job stress, health promotion during physician, consultations, mailed advice, meditation, supervisor committee, feedback, empowerment, quitting strategies, and alcohol reduction
22 studies
17 included in meta-analysis for 20 intervetnion/control comparisons

Conn 2009 (electronic searches 1969–2007)Meta-analysis of physical activity interventionsPPI+OI+OMeta-analysis of workplace physical activity studiesIntervention including workplace employee, whether worksite designed intervention, during employee’s paid time, fitness facilities at worksites, organisational policy present or not, motivational or educational sessions included?
Pre post, post post, control intervention comparisons were made. Including not for profit and for profit organisations. Education, health services, government, and manufacturing were the main company types
51 studies delivered interventions at the workplace, and 17 did not
6 studies reported on organisational policy change
38 papers on fitness facilities at worksite
27% supervised exercise and 80% used motivational or educational session

Van Wyk (2010)
Searches to 2008, from earliest date of each database
Preventive staff support interventions for health workersPPI+OI+OCochrane reviewSupport groups for staff
Training in stress management techniques
Management interventions for supporting staff
Ten studies included
2 studies assessed effects of management interventions on absenteeism
Yamagishi (2008) reports on career identity intervention on anxiety
Von Bayer (1983)
3 sessions of stress management training on state and trait anxiety

Noordik (2010)
(searches range from 1966–2007)
Exposure in vivo containing interventions to improve work functioning of worker with anxiety disordersSPII+OSystematic reviewComparison of work-based in vivo exposure versus medication, relaxation and response prevention, CBT without exposure, waiting list treatment, imaginal or interceptive exposure, and placebo care as usual (difficult to know if absenteeism affected as reported with other measures of work role)7 articles included
4 studies on OCD and 1 study on OCD and phobia
2 OCD interventions included in a meta-analysis (Foa, 1984; Aigner, 2004)
Studies included in this review as OCD is an anxiety disorder

Cancelliere et al., 2011 (1990–2010)To determine if workplace health promotion (WHP) programmes are effective in improving presenteeismPPI,OOSystematic reviewOrganisational: worksite exercise, a supervisor education program on mental health promotion, “A Lifestyle Intervention Via Email” (Alive!), extra rest break time for workers engaged in highly repetitive work, a multidisciplinary occupational health programme, a multicomponent health promotion programme, participatory processes, exposure to blue-enriched light (versus white light), and a telephone intervention program for depressed workers14 studies on presenteism

RCTs = randomised controlled trials.