Evaluation of cognitive behavioural training for patients with stress-related illnesses
Author(s): Marina Heiden, E. Lyskkov, M. Nakata, K. Shlin, T. Shalin & M. Barnekow-Bergkvist Country: Sweden
Is the intervention sector specific?	No
Is the intervention usable with different enterprise sizes?	Yes
Is the intervention equally applicable to both genders?	Yes
Is the intervention based on theory?	Yes
Can the intervention approach be adapted/ tailored?	Yes
Does the intervention promote CSR and how?	The intervention was not explicitly linked to responsible business practices although it does promote employee well-being
Does the intervention promote social dialogue and how?	Social dialogue was not a central component of this intervention.
Overview (including risk assessment and law – legal requirements etc.): The focus of the programme was to use cognitive restructuring and behavioural modification techniques to improve participants’ self-care strategies, namely coping with negative emotions, increase health promotion behaviour (regular relaxation and physical exercise), improve eating and sleeping habits, and social support through building support networks. The intervention contained a series of seminars, group discussions and required daily practice of skills. Additionally, participants were asked to formulate a life-guiding plan and to participate in the support network for the group.
Implementation: The cognitive behavioural training programme comprised of 2 three-hour group sessions per week for 10 weeks, and was based on a manual that was distributed to all participants. Each session contained an educational element with an additional task given as homework. A variety of topics relating to stress, its causes, consequences, and management strategies were outlined and discussed (for full content of cognitive behavioural training programme see Heiden et al., 2007). The majority of sessions were structured with a group discussion in regards to the assigned homework at the beginning, followed by an educational part, followed by the assignment of new homework. Over the course of the 10 week programme, participants were asked to keep a homework diary.
Practical applications: The sessions were led by a stress management consultant with extensive experience and knowledge of rehabilitation of patients with stress-related illnesses. Additionally, the cognitive behavioural training programme was not conducted within a given workplace. Individuals participating in the intervention came from a large variety of occupational sectors, professions, and sizes of enterprises.
Innovative aspects: The programme uses cognitive restructuring and behavioural modification techniques to improve participants’ self-care strategies, coping strategies and the return to work of individuals on sick leave due to stress-related sick leave.
Evaluation (including process issues, outcomes and sustainability): The effects of the cognitive behavioural training programme were comparatively assessed to a physical activity programme and with usual care. Both objective (including autonomic activity, pressure-pain threshold) and subjective measurements of ratings of health and behaviour were made. Assessments of patients occurred at four time points: pre-intervention, post-intervention, 6 months and 12 months.
Benefits (including cost effectiveness): Directly following the intervention minor differences were observed in the objective (physiological) measures that were found between groups. Patients in the cognitive behavioural training group improved their ratings of general health as compared with the physical activity group throughout the study.
References: Heiden, M., Lyskkov, E., Nakata, M., Shlin, K., Shalin, T., & Barnekow-Bergkvist, M. (2007). Evaluation of cognitive behavioural training and physical activity for patients with stress-related illnesses: A randomized controlled study. Journal of Rehabilitation Medicine, 39, 366-373.
Comments: Several of the minor differences observed during the evaluation of the intervention were not maintained at follow-up assessments (at 6 and 12 months).