A brief cognitive-behavioral stress management program for secondary school teachers

Public school teachers' occupational stress across different school types: a nationwide survey during the prolonged COVID-19 pandemic in Japan

Objectives

School teaching is regarded as one of the most stressful professions worldwide. To maintain schoolteachers' mental health, the factors influencing occupational stress among schoolteachers must be clarified. This study aimed to investigate public school teachers' work-related stress considering the differences in school types using data from a large-scale nationwide survey conducted during the prolonged coronavirus disease 2019 (COVID-19) pandemic in Japan.

Methods

Data from a nationwide survey of public school teachers performed between June 2019 and December 2022 were analyzed. The dataset consisted of repeated cross-sectional data. The total number of participants was 270,777 in 2019, 296,599 in 2020, 299,237 in 2021, and 307,866 in 2022. Information on working hours, job demands, workplace support, stress response, and perceived main stressors were assessed for each type of public school.

Results

Regardless of school type, quantitative workload and long working hours were the most significant factors affecting teachers' stress responses. However, stress-related factors among teachers varied significantly between school types. The percentage of junior high school teachers who perceived "extra-curricular club activities" as their main stressor was the highest among all school types. The highest proportion of elementary school teachers perceived "dealing with difficult students" as their main stressor. Meanwhile, interpersonal conflict scores were the highest among special needs school teachers. Teachers' workload and stress levels significantly increased in the third year of the COVID-19 pandemic (2022) compared to the pre-pandemic year (2019) in all school types despite the marginally small score differences.

Conclusions

This study highlighted the importance of reducing teachers' workload for their mental health regardless of school types. Meanwhile, perceived work-related stress among teachers differed significantly between school types. Given the possible prolonged impacts of the pandemic on teachers' occupational stress, teachers' stress levels must be monitored throughout and after the pandemic. The results suggest that increasing the number of schoolteachers and support staff and providing adequate organizational support are necessary to prevent teachers' sick leave due to mental disorders. In addition, taking comprehensive countermeasures against teachers' occupational stress, considering the differences in school types, is crucial for safeguarding schoolteachers' mental health.

Intervention Programs Targeting the Mental Health, Professional Burnout, and/or Wellbeing of School Teachers: Systematic Review and Meta-Analyses

This paper outlines a systematic review and meta-analyses to identify, describe, and evaluate randomised and non-randomised controlled trials of psychological programs targeting the mental health, professional burnout, and/or wellbeing of school classroom teachers. Eighty-eight unique studies were identified for inclusion in the review, and of those 46 were included in the meta-analyses (23 randomised controlled trials). In randomised controlled trials, the programs examined had large effects on stress (g=0.93), and moderate effects on anxiety (g=0.65), depression (g=0.51), professional burnout (g=0.57), and wellbeing (g=0.56) at post. In non-randomised controlled trials, programs had moderate effects on stress (g=0.50), and small effects on anxiety (g=0.38) and wellbeing (g=0.38) at post. Studies were heterogeneous in design and methodological quality was generally poor, particularly in non-randomised controlled trials. There was an inadequate number of comparisons to perform sub-group analyses, meta-regression, or publication bias analyses. Most of the programs examined required significant time, effort, and resources to deliver and complete. These programs may not translate well outside of research trials to real-world contexts due to teachers being time-poor. Priorities for research include using methodologically rigorous designs, developing programs for teachers with teachers (i.e. co-design), and considering implementation factors to ensure feasibility, acceptability, and uptake. Systematic Review Registration Number: PROPSERO - CRD42020159805.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10648-023-09720-w.

Digital Companion Choice to Support Teachers' Stress Self-management: Systematic Approach Through Taxonomy Creation

BACKGROUND

There are thousands of digital companions designed for emotional well-being and stress, including websites, wearables, and smartphone apps. Although public evaluation frameworks and ratings exist, they do not facilitate digital companion choice based on contextual or individual information, such as occupation or personal management strategies.

OBJECTIVE

The aim of this study is to establish a process for creating a taxonomy to support systematic choice of digital companions for teachers' stress self-management.

METHODS

We used a 4-step study design. In step 1, we identified the dimension of stress self-management and strategic classifications. In step 2, we identified the dimension of the digital techniques and conceptual descriptions. In step 3, we created 6 criteria for the inclusion of digital companions. In step 4, we used the taxonomy framework created by steps 1 and 2 and populated it with digital companions for stress self-management, as identified in step 3.

RESULTS

First, in the dimension of stress self-management, we identified four classes of strategies: educational, physiological, cognitive, and social. Second, in the digital techniques dimension, we derived four conceptual descriptions for the digital companions' mechanisms of action: fostering reflection, suggesting treatment, peer-to-peer support, and entertainment. Third, we created six criteria for digital companion inclusion in the taxonomy: suitability, availability, evaluation, security, validity, and cost. Using the taxonomy framework and criteria, we populated it with digital companions for stress management ahead of presentation to teachers in a stress study workshop.

CONCLUSIONS

The elements of our approach can be generalized as principles for the creation of taxonomies for other occupations or conditions. Taxonomies such as this could be a valuable resource for individuals to understand which digital companion could be of help in their personal context.

The effect of an online individualized program to prevent nurse burnout – a mixed method study

Purpose

Preventing burnout and promoting psychological well-being in nurses are of great importance. In this study the effect of an online, stand-alone individualized preventive program for nurse burnout based on cognitive behavioral therapy (CBT) is described and explained.

Design/methodology/approach

A mixed method study with an explanatory sequential design was applied. Quantitative data were collected from September 2015 to March 2016 during an intervention study with a pretest-posttest wait-list control group design within a population of hospital nurses in the Dutch speaking part of Belgium. Consecutively, 13 nurses from the intervention group who fully completed the program were interviewed.

Findings

All interviewed participants experienced some sort of effect due to working with the program. Emotional exhaustion remained stable in the intervention group and increased in the control group. However, this difference was not significant. Personal accomplishment decreased significantly within the intervention group when compared to the control group. This might be explained by the self-awareness that was created through the program, which confronted participants with their weaknesses and problems.

Originality/value

This study adds to the understanding of online individual burnout prevention. The results suggest the feasibility of an online program to prevent nurse burnout. This could be optimized by complementing it with organizational interventions, introducing refresher courses, reminders and follow-up. Furthermore, additional attention should be devoted to preparing the implementation in order to minimize attrition rates.

Association of stress management skills and stressful life events with allergy risk: a case-control study in southern China

BACKGROUND

Psychosocial stress and stressful life events are known to aggravate allergic diseases. Less is known about the impact of stress management skills on allergies. Here we sought to determine whether stress management skills are associated with the allergies and to assess the combined effects of stress management skills and stressful events on allergy risk.

METHODS

A survey on risk factors for self-reported allergic diseases was carried out among 28,144 southern Chinese people; 14 stressful life events and 8 stress management skills were retrospectively recorded in a case-control setting with multivariate logistic regression analysis. Multiplicative and additive interactions between stressful events and stress management skills were evaluated.

RESULTS

Stressful events significantly increased allergy risk. The odds ratio (OR) for allergies was 1.65 (95% confidence interval CI, 1.41-1.93) for those reporting one or two stressful events and 3.10 (95% CI, 2.55-3.79) for those reporting more than three stressful events compared to participants without stressful events. Stress management skills were adversely associated with allergic risk for people experiencing stressful events (OR, 0.71; 95% CI, 0.53-0.97) when adjusted demographically, particularly "concentrate on pleasant thoughts at bedtime" (OR, 0.67; 95% CI, 0.51-0.89), "pace myself to prevent tiredness" (OR, 0.67; 95% CI, 0.54-0.83), "get enough sleep" (OR, 0.48; 95% CI, 0.32-0.72) and "take some time for relaxation each day" (OR, 0.55; 95% CI, 0.37-0.80). But in people without stressful events, no association was observed. There was a significant linear trend for allergy risk from good stress management skills with no stressful events to poor stress management skills with stressful events (P < 0.001), with significant interaction in additive models (P = 0.006).

CONCLUSIONS

There are independent and antagonistic combined associations of stressful life events and stress management skills with allergy risk. The data supports the use of stress management skills in managing allergic disease among people with stressful life events.

Occupational stress among Nigerian construction trade artisans in the building construction sector: An intervention study

BACKGROUND

Construction work can negatively affect artisans' mental health in the form of stress. This research investigated the effect of cognitive behavioral intervention on occupational stress among Nigerian construction trade artisans in the building construction sector.

METHODS

In this randomized controlled study involving 3 waves of data collection, 140 construction trade artisans who presented with high occupational stress symptoms at the study onset were assigned randomly to either a treatment condition (n = 70) or to a waitlist control condition (n = 70). The study involved pre-treatment and post-treatment assessments and a 3-months follow-up. The artisans' occupational stress questionnaire and artisans' dysfunctional thoughts at work scale were the data collection instruments.

RESULTS

Results revealed a significant effect of group on artisans' occupational stress and dysfunctional thoughts at work. Also, significant effects of time on artisans' occupational stress and dysfunctional thoughts at work were recorded. Finally, group × time interaction effects on artisans' occupational stress and dysfunctional thoughts at work were significant.

CONCLUSION

Cognitive behavioral intervention effectively reduced occupational stress symptoms and dysfunctional thoughts at work among Nigerian construction trade artisans compared with a waitlist control condition.

The efficacy of cognitive behavioral therapy for Chinese people: A meta-analysis

OBJECTIVE

Over the past decade, cognitive behavioral therapy has been applied to an increasingly wider range of disorders and problems in Chinese societies. However, no meta-analysis has been conducted to synthesize the studies on cognitive behavioral therapy for Chinese clients. The purpose of this meta-analytic study was to examine the overall efficacy of cognitive behavioral therapy for Chinese people.

METHOD

A literature search was conducted using electronic databases, including Web of Science, PsycINFO and PubMed. Pooled mean effect sizes were calculated using the random-effects model.

RESULTS

The literature search identified 55 studies with 6763 Chinese participants. The overall short-term effect of cognitive behavioral therapy on the primary outcome was medium in size. Effect sizes were medium for anxiety, depression/well-being and caregiving stress and small for psychotic symptoms and addictive behaviors. The effects of cognitive behavioral therapy on process variables, dysfunctional thoughts and coping, were in the small range. The overall longer-term effect of cognitive behavioral therapy on the primary outcome was medium in size. Moderator analyses showed that the short-term effect was stronger for culturally adapted cognitive behavioral therapy than for unadapted cognitive behavioral therapy. Type of primary outcome, type of control group, recruitment method, study design, the format of delivery and region were found to moderate the efficacy of cognitive behavioral therapy.

CONCLUSION

The findings of this study provide evidence for the overall efficacy of cognitive behavioral therapy for Chinese people and the benefit of cultural adaptation of cognitive behavioral therapy to Chinese culture.

A Brief Cognitive-Behavioral Psycho-Education (B-CBE) Program for Managing Stress and Anxiety of Main Family Caregivers of Patients in the Intensive Care Unit

Having a loved one in the intensive care unit (ICU) is a stressful event, which may cause a high level of anxiety to the family members. This could threaten their wellbeing and ability to support the patients in, or after discharge from, the ICU. To investigate the outcomes of a brief cognitive-behavioral psycho-education program (B-CBE) to manage stress and anxiety of the main family caregivers (MFCs), a pragmatic quasi-experimental study involving 45 participants (treatment group: 24; control group: 21) was conducted in an ICU. The Depression and Anxiety Stress Scale and the Critical Care Family Need Inventory were used to evaluate the primary outcomes on stress and anxiety, and satisfaction with family needs. The treatment group reported significantly better improvement in the information satisfaction score compared to the control group (p < 0.05; η² = 0.09). Overall main effects were observed on the stress (p < 0.01; η² = 0.20), anxiety (p < 0.01; η² = 0.18), depression (p < 0.05; η² = 0.13), support satisfaction (p < 0.05; η² = 0.13), and comfort satisfaction (p < 0.05; η² = 0.11) scores. The experience of this study suggest that MFCs are in great need of additional support like B-CBE to manage their stress and anxiety. Given the brevity of B-CBE, it is practical for critical care nurses to deliver and MFCs to take within the industrious context of an ICU. More studies are needed to investigate these types of brief psychological interventions.

The Role of Stress Management in the Relationship between Purpose in Life and Self-Rated Health in Teachers: A Mediation Analysis

Background: To examine whether stress management mediates the relationship between purpose in life and self-rated health status (SRH). Methods: A cross-sectional survey was conducted among 6840 teachers in 2013 in Guangzhou, China. Purpose in life was assessed through the Purpose in Life Subscale of the Psychological Well-being Scale. Stress management was assessed using the eight-item questionnaire adapted from the Health-promoting Lifestyle Profile II. SRH was assessed by the Suboptimal Health Measurement Scale Version 1.0. The mediation hypothesis was tested by the structural equation model for path analysis. Results: It was found that purpose in life had direct and indirect effects on SRH. The path analysis showed the total effect (β = 0.563) of purpose in life on SRH was comprised of a direct effect (β = 0.319) and an indirect effect (β = 0.244), which was mediated by stress management. Conclusions: By supporting the mediation hypothesis, our results indicate that stress management mediated the effect of purpose in life on SRH. Enhancement of teachers’ purpose in life and improvement of training skills of stress management should be incorporated in the strategy of improving teachers’ health.

Self-rated health status and subjective health complaints associated with health-promoting lifestyles among urban Chinese women: a cross-sectional study

Objective

This study aimed to investigate whether self-rated health status (SRH) and subjective health complaints (SHC) of urban Chinese women are associated with their health-promoting lifestyles (HPL).

Methods

We conducted a cross-sectional study on 8142 eligible Chinese participants between 2012 and 2013. Demographic and SHC data were collected. Each subject completed the SRH questionnaire and the Chinese version of the Health-Promoting Lifestyle Profile-II (HPLP-II). Correlation and binary regression analyses were performed to examine the associations of SRH and SHC with HPL.

Results

Both SRH and HPL of urban Chinese women were moderate. The most common complaints were fatigue (1972, 24.2%), eye discomfort (1571, 19.3%), and insomnia (1542, 18.9%). Teachers, highly educated subjects and elderly women had lower SRH scores, while college students and married women had better HPL. All items of HPLP-II were positively correlated with SRH (r = 0.127-0.533, P = 0.000) and negatively correlated with SHC to a significant extent (odds ratio [OR] = 1.40-11.37).

Conclusions

Aspects of HPL, particularly stress management and spiritual growth, are associated with higher SRH and lower SHC ratings among urban Chinese women. Physical activity and health responsibility are additionally related to reduced fatigue and nervousness. We believe that these findings will be instrumental in encouraging researchers and urban women to adopt better health-promoting lifestyles with different priorities in their daily lives.

A pilot evaluation on a stress management programme using a combined approach of cognitive behavioural therapy (CBT) and complementary and alternative medicine (CAM) for elementary school teachers

The aim of this study is to explore the efficacy of implementing a stress management programme based on a combined approach using cognitive behavioural therapy and complementary and alternative medicine for elementary school teachers who experienced mild level of stress, anxiety and/or depressive symptoms in Hong Kong. A 12-h programme involving cognitive behavioural therapy, self-management, relaxation techniques (diaphragmatic breathing and progressive muscle relaxation), mindful exercises (qigong and yoga), aromatherapy and acupressure was conducted. A quasi-experimental design was used to compare the intervention groups (n = 47) with the wait-list control groups (n = 46). The primary outcome measures were depression, anxiety and stress. Results indicated that the intervention group had significant reduction in depression [(F = 3.93; degrees of freedom (df) = 2.90; p = 0.023)], anxiety (F = 3.37; df = 2.90; p = 0.039) and stress (F = 3.63; df = 2.89; p = 0.031) when compared with the control group. Participants in both groups demonstrated lowered level of salivary cortisol at the post-assessment. The pilot results provided preliminary support to the multi-component stress management programme in relieving affective symptoms of teachers. The programme may be considered as an initial strategy to empower teachers with the abilities to cope with their affective symptoms. Further evaluation using a better designed randomized study with a larger sample size is warranted. (word: 198; max.: 200).

The comparison of the effect of Transactional Model-based Teaching and Ordinary Education Curriculum- based Teaching programs on stress management among teachers

BACKGROUND & OBJECTIVES

Regarding the effect of teachers' stress on teaching and learning processes, the researchers decided to provide a stress management program based on Transactional Model to solve this teachers' problems. Thus, this study is going to investigate the effect of Transactional Model- based Teaching and the Ordinary Education Curriculum- based Teaching programs on Yazd teachers.

METHODS

The study was a semi- experimental one. The sample population (200 people) was selected using categorized method. The data were collected via PSS Questionnaire and a questionnaire which its validity and reliability had been proved. Eight teaching sessions were hold for 60-90 min. Evaluation was performed in three steps. The data were described and analyzed using SPSS software version 15. Value of P<0.05 was considered as significant.

RESULTS

The participants were 200 people of Yazd teachers of primary schools. Mean age of group 1 and 2 was 42.05±5.69 and 41.25±5.89 respectively. Independent T- Test indicated a significant mean score (p=0.000) due to perceived stress of interference groups in post interference step and follow-up one respectively.

CONCLUSION

Results showed a decreasing effect of both programs, but the Transactional Model- based interference indicated to decrease stress more than the other.

Mental health promotion and illness prevention: a challenge for psychiatrists

Mental health is essential for individual and public health. To improve mental health, promotion, prevention, and the treatment of disease are required. These three kinds of interventions are interrelated but independent from one another. Although separate efforts for mental health promotion and prevention are needed as well as the public need of mental health promotion and well-being, psychiatrists usually are not accustomed to mental health promotion and prevention. This review introduces an overview of the concept, subjects according to target populations, and various intervention strategies for mental health promotion and prevention of mental illnesses. Based on literatures to date, understanding of developmental psychology, lifestyle medicine, and biopsychosocial contributors of mental health with a macroscopic perspective might help to practice mental health promotion and illness prevention.