Workplace Distress Research Articles

Previously endured distress reduces the quality of the compassion extended toward sufferers of workplace distress

SummaryIn difficult times, how can we alleviate employees' distress? Lay beliefs suggest that high‐quality compassionate responses come from those who have “been there” before. According to hot–cold empathy gap theory, however, firsthand experience with another's distress may activate distorted memories of past distress, leading people to underestimate the severity and difficulty of another's current distress. Grounded in a relational perspective of compassion, we examine how sufferers experience the quality of actions taken to alleviate their distress (i.e., compassion action quality; CAQ), along with the responders' perceptions of their own responses (i.e., self‐efficacy). Across three studies, we find that sufferers experience lower CAQ from responders who have (vs. have not) previously endured a similar distress. We examine three mechanisms that explain the negative effect of previously endured distress on CAQ, based on responders' self‐focus, validation of sufferer's distress, and self‐efficacy. We also examine the boundary conditions of this effect and find that it is distress specific. Specifically, this effect does not hold when responders who previously endured distress respond to sufferers who are currently enduring a different type of distress. These findings advance organizational research on compassion and inform efforts to improve people's capacity to alleviate distress at work.

Moral Injury in Health Care: A Unified Definition and its Relationship to Burnout.

Moral injury had been discussed by health care professionals as a cause of occupational distress prior to COVID-19, but the pandemic expanded the appeal and investigation of the term. Moral injury incorporates more than the transdiagnostic symptoms of exhaustion and cynicism and goes beyond operational, demand-resource mismatches of corporatized systems. Moral injury describes the frustration, anger, and helplessness associated with existential threats to a clinician's professional identity as business interests erode their ability to put patients' needs ahead of corporate and health system obligations. We propose a framework that combines 2 moral injury definitions. An individual who experiences a betrayal by a legitimate authority has an opportunity to choose their response. Moral injury arises when a superior's actions or a system's policies and practices undermine one's professional obligations to prioritize the patient's best interest. Perceived as inescapable, the resignation or helplessness of moral injury may present with emotional exhaustion, ineffectiveness, and depersonalization, all hallmarks of burnout. Both moral injury and burnout can mediate and moderate the relationship between triggers for workplace distress and the resulting psychological, existential, and physical harm. Moral injury is increasingly recognized as a source of distress among health care professionals. It emerges from structural constraints on the ability of health care professionals to deliver optimal care and stand up for patients, their oaths, and their professions. A unified definition of moral injury must be integrated into the framing of clinician distress alongside burnout, recentering health care on ethical decision making rather than profit.

Validation of the 5-item workplace outcome suite on employee assistance programs for office workers

To evaluate the effectiveness of Employee Assistance Program (EAP) interventions, the Workplace Outcome Suite (WOS) was developed. This study aims to determine if the new WOS 5-item version can be used to approximate the WOS 25-item version without excessive loss of reliability, validity, or sensitivity. A quantitative psychometric evaluation study design was employed. Secondary data analysis of the WOS 25-item questionnaire was conducted before and after EAP services were delivered to participants. This analysis used 2046 data responses from 1023 participants. Quantitative data analysis included descriptive statistics, Cohen’s d, paired t-test, the Wilcoxon signed-rank (non-parametric test), and bivariate factor analysis. Findings demonstrate that the WOS 5-item version can successfully detect changes in workplace functioning. Within all five constructs, users’ scores improved after EAP interventions, indicating improvement in mental health. Significant changes were detected for absenteeism, presenteeism, work engagement, and workplace distress. Bivariate correlation results indicate the WOS 5-item is a good representation of the 25-item version. There are strong correlations between each item on the WOS-5 and the corresponding items in each construct on the WOS-25. This evidence suggests the WOS 5-item version can be used to approximate the WOS 25-item version without excessive loss of reliability, validity, or sensitivity.

Reflections from the frontline of nursing on acute patient deterioration.

To describe medical-surgical nurses' reflections on their experiences with patient deterioration. An extensive body of knowledge exists regarding optimal responses to acute patient deterioration within a hospital environment. Much less attention has focused on the profound psychological and emotional impact these experiences of unexpected deterioration can have on nurses who provided the supportive or rescue care. A triggering event, such as patient deterioration, or direct questioning about these experiences, can lead nurses to reflect further on the situation. Engaging in reflection is believed to enhance learning and improve clinical judgement when future complex situations arise. Findings related to nurses' reflective practice when recalling previous situations with deteriorating patients are limited. This gap in the literature provided the basis for the current project. A qualitative descriptive design. Twenty medical-surgical nurses were interviewed in 2018. The nurses were recruited through purposive sampling. Semi-structured telephone interviews explored nurses' experiences of a patient deterioration. Conventional content analysis with iterative coding and categorising and theme development was used for data analysis. Three themes emerged as participants reflected on their experiences. The themes were, Enduring frustration and regret, Feeling deeply responsible for and to the patient and Making sense of what happened. Medical-surgical nurses who care for acutely deteriorating patients can experience lasting emotional, psychological and physical concerns that often go unrecognised and untreated. Furthermore, nurses with this background commonly reported their perceived increased risk for workplace distress. Findings from this study are important for nurses, healthcare administrators and leaders, and patients. Participating in a rescue attempt often has a negative impact on nurses' perception of workplace stress and on persistent concerns about nurses' mental and physical health. The findings can be useful in informing additional studies about the phenomenon. Findings also can inform the exploration of workplace design. Organisations should assess for factors influencing workplace stress, develop strategies to mitigate the presence of workplace stress and foster nurses' well-being so they can respond to future scenarios of patient deterioration, while maintaining their physical and mental health. This study did not include any patient or public input.

A Longitudinal Cohort Study of Factors Impacting Healthcare Worker Burnout in New York City During the COVID-19 Pandemic.

This study aimed to longitudinally examine the prevalence and correlates of burnout in frontline healthcare workers (FHCWs) during COVID-19 in New York City. A prospective cohort study of 786 FHCWs at Mount Sinai Hospital was conducted during the initial COVID surge in April to May 2020 (T1) and November 2020 to January 2021 (T2) to assess factors impacting burnout. Burnout increased from 38.9% to 44.8% ( P = 0.002); 222 FHCWs (28.3%) had persistent burnout, 82 (10.5%) had early burnout, and 129 (16.5%) had delayed burnout. Relative to FHCWs with no burnout ( n = 350; 44.7%), those with persistent burnout reported more prepandemic burnout (relative risk [RR], 6.67), less value by supervisors (RR, 1.79), and lower optimism (RR, 0.82), whereas FHCWs with delayed burnout reported more prepandemic burnout (RR, 1.75) and caring for patients who died (RR, 3.12). FHCW burnout may be mitigated through increasing their sense of value, support, and optimism; treating mental health symptoms; and counseling regarding workplace distress.

직장 내 괴롭힘 방지 조치에 따른 건강영향에 대한 비용편익분석

Purpose : This study conducted a cost-benefit analysis on workplace harassment to identify factors caused by bullying in the workplace and included an analysis of the cost and benefit. Method : This study was based in the year 2017 when the cost benefit analysis was done. As costs preceded benefits, the estimated period of cost and benefits was set for 10 years. The subjects were total of 12,790,043 full-time workers from 324,841 workplaces of over 10 employees in 2017. In addition, the government's expenses to prevent workplace distress were classified into prevention, response, and management of harassment. The expenses were covered for education booklets, manual development, employer recommendation monitoring, fact-finding survey, and counseling on workplace harassed workers. Benefits ncluded decreases in suicide deaths, occupational diseases, mental health problems, and physical health problems. Results : First, the net profit of the cost benefit analysis on the health effects of workplace bullying was 244,630,019,026 won, and the benefit was 2.35 times higher than the cost even if the benefit was reduced by 14%. Second, as a result of increasing the cost by 140% and reducing the benefit by 14% through sensitivity analysis, the benefit was 1.45 times higher than the cost. Conclusion : In this study, a policy alternative should be presented to prepare effective workplace bullying prevention and follow-up measures in Korea by conducting a cost-benefit analysis on workplace bullying. It is proposed that research on the effect of preventing bullying in the workplace be conducted in the future.

The Relationship Between Servant-Leadership and Employee Resilience

Liu et al. (2019) wrote, “resilience has become increasingly important for individuals, organizations and society to flourish in the uncertain, risky, turbulent and ambiguous world we live in today.” Resilience enhances the functioning of individuals, teams, and organizations (Britt et al., 2016). Workplace stressors lead to outcomes antithetical to resilience, such as burnout (Lee & Ashforth, 1996), poor physical and mental health (Beasley et al., 2003; Holden et al., 2010), absenteeism (Väänänen et al., 2003), intention to turnover (Chiu et al., 2009; Deery et al., 2010), anxiety, and depression (Melchior et al., 2007). In contrast, Robertson et al.’s (2015) review of 14 studies exploring the results of resilience training in the workplace found that increasing the resilience of employees increases their (a) well-being, (b) mental health, (c) psychosocial functioning, and (d) job performance. Resilient employees are more emotionally stable when faced with adversity, more open to new experiences, and more adaptable to shifting demands (Tugade & Fredrickson, 2004). Continuous, substantive change is increasingly common for organizations and their members (Wee & Taylor, 2017). Studies indicate that resilient individuals respond to change (Tugade & Fredrickson, 2004) better than less resilient colleagues do. Resilience also positively influences employees’ commitment to organizational change (Shin et al., 2012) and overall performance (Luthans et al., 2005). Significant, positive relationships exist between resilience and job satisfaction as well as between resilience and work happiness (Youssef & Luthans, 2007). Kuntz et al. (2016) suggested, “the demonstration of resilient behaviors is predicated on the organization’s and its leaders’ ability to create an environment that enables and supports employees” (p. 461). Therefore, organizational leaders seeking to minimize workplace distress and enhance workplace flourishing should seek to increase employee resilience. Such resilience plasticity (i.e., an individual’s resilience can be increased or decreased) within an organizational setting (Reyes et al., 2015) should encourage and challenge organizational leaders to identify and engage employee-resilience developing behaviors. Research not only reveals that leaders can help followers develop resilience by modeling resilient behaviors (Norman et al., 2005; Shek & Leung, 2016) but also that servant-leadership can reduce stress in employees, an indicator of resilience (Badger, 2017). In contrast to the negative outcomes of workplace stress, research shows that servant-leadership increases employees’ intention to stay (Jaramillo et al., 2009), decreases burnout (Babakus et al., 2010), and relates positively to the psychological health of employees (Rivkin et al., 2014). However, while research demonstrates these likely linkages between servant-leadership and resilience or its benefits, studies have not empirically assessed the relationship. Thus, this study investigated the research question: what relationship, if any, exists between servant-leadership behaviors and employee resilience?

Creating a Better World: Towards Better Management of Distress and Trauma in the Workplace

Emotional distress is a common occurrence in workplaces, with up to a third of the working population suffering from poor psychological health. With the emergence of the Coronavirus 2019 (COVID-19) global pandemic, concerns surrounding psychological health in the workplace are particularly relevant. The effects of the pandemic have been felt widely across society, and have significantly changed the ways that people engage in their work. While much of the current research on workplace distress focuses on the causes and consequences of distress, little research investigates this process in “ordinary” workplaces, many of which were hit hardest by the pandemic. To consider this topic, we have assembled a panel of scholars who study distress and well-being within organizations. Together, these panelists will shed light on distress in the context of ordinary workplaces, as well as how suffering emerges in organizational contexts, and the types of behaviours that employees engage in to recognize, make sense of, and communicate about their own and others’ distress

Workplace Distress and Eustress among Teachers during the Pandemic

Workplace stress and distress are the terms abundantly present in the literature. These terms have been studied and explored numerous times in multiple contexts. However, the literature contains evident gaps in exploring the other outcome of stress, which is eustress. This study aimed to explore the different Workplace distress and eustress among teachers during the pandemic. The current study investigates the potential stressors and their outcomes among private school teachers also the role played by COVID-19 and technology-based learning. For this purpose, the qualitative research design is used. Semi-structured in-depth analysis was used to collect data using the snowball sampling technique. The empirical findings revealed that teachers were highly stressed. Work overload, role conflict, workplace politics, organizational support, job insecurity, and financial strains are the major sources of workplace distress. Another contributing factor is technology stress, especially during COVID-19. On the other hand, positive stressors play a significant role in developing the feeling of eustress among teachers and reportedly have a positive impact on their health, satisfaction, behavior, performance, and commitment.

High burnout among the South African orthopaedic community: a cross-sectional study

BACKGROUND: Burnout is epidemic among physicians, with the orthopaedic speciality displaying one of the highest rates of burnout in international studies. The burnout rate of the South African orthopaedic community is unknown. This study aimed to determine the prevalence and causes of burnout, as well as the coping mechanisms and associations with burnout, in South African orthopaedic surgeons and trainees METHODS: We conducted a cross-sectional, secure, online survey of members of the South African Orthopaedic Association. The survey assessed demographic characteristics, workload, professional fulfilment and burnout (utilising the Stanford Professional Fulfilment Index), associated workplace distress conditions, causes of and coping strategies for burnout. A response was not compulsory for any question. Statistical analysis was performed to assess for independent associations with burnout RESULTS: One hundred and fifty-six respondents, with a median age of 46.5 years (interquartile range [IQR] 37-58) participated. Ninety per cent (139 of 155) of respondents were male. Registrars accounted for 17% (27 of 155), while 83% (128 of 155) were qualified specialists. Respondents were in orthopaedic practice for a median of 17 years (IQR 9-28). Sixty per cent (76 of 127) practise in private, 17% (22 of 127) in public and 23% (29 of 127) in both sectors. The overall burnout rate was 72% (113 of 156). Burnout was associated with being the parent of young children and having fewer hours of sleep on call. Registrars were more likely to have burnout than consultants (OR 5.68, 95% CI 1.3-25.2). Gender, practice setting and subspeciality were not associated with burnout. Self-reported causes of burnout that were found to be associated with actual burnout were: 'hours at work', 'lack of free time' and 'work-life imbalance'. No self-reported coping mechanisms were found to be protective in this cohort, but the use of alcohol as a coping mechanism was associated with an increased likelihood of burnout (OR 3.9, 95% CI 1.4-10.7). Respondents felt that the concurrent experience of the COVID pandemic at the time of running the survey reduced their experience of burnout CONCLUSION: The burnout rate in the South African orthopaedic community is 72%. Trainees were found to be particularly vulnerable. There appears to be a need to develop, assess and implement effective system-related initiatives aimed at reducing the burnout rate among orthopaedic surgeons and trainees in South Africa Level of evidence: Level 4

The nature and sources of the emotional distress felt by intensivists and the burdens that are carried: A qualitative study

BackgroundWork in intensive care units is often traumatic and emotionally distressing, sometimes leading to growth but at other times to negative outcomes such as worker burnout and mental illness. The type and origin of distresses to intensivists has been poorly characterised in the literature. This evidence gap makes it difficult to develop tailored educational process or cultural interventions for all who work within the specialty. ObjectivesThe aim of this study was to elicit the nature and sources of workplace emotional distress in an international sample of intensivists. MethodInterviews were undertaken with experienced intensivists in Australia and Israel related to the basis of workplace distress. These were transcribed and qualitatively thematically analysed. ResultsIn 2018, 19 intensivists participated in the study. Several key themes emerged from data analysis, some relating to clinical work, such as catastrophic patient outcomes, and some relating to interpersonal and systems-level challenges. Navigating complex interpersonal dynamics with carers and staff, both within and outside the intensive care unit team, caused substantial emotional burden. ConclusionsMany factors contribute to workplace stress for doctors in the intensive care setting. In elucidating common reactions to these stressors, we have attempted to normalise responses. We further note that the skill sets relevant to the many challenges identified are generally missing in medical training curricula. It may be prudent to consider their inclusion in the future.

Research Evaluating Staff Training Online for Resilience (RESTORE): Protocol for a single-arm feasibility study of an online Acceptance and Commitment Therapy intervention to improve staff wellbeing in palliative care settings

Background Palliative care workers commonly experience workplace stress and distress. General stressors include unmanageable workloads and staff shortages. Stressors specific to palliative care include regular exposure to death, loss and grief. The COVID pandemic exacerbated exhaustion and burnout across the healthcare system, including for those providing palliative care. Evidence based psychological support interventions, tailored to the needs and context of palliative care workers, are needed. Acceptance and Commitment Therapy (ACT) is an established form of cognitive behavioural therapy which uses behavioural psychology, values, acceptance, and mindfulness techniques to improve mental health and wellbeing. ACT is effective in improving workplace wellbeing in many occupational settings. Our study examines the acceptability and feasibility of an online ACT-based intervention to improve mental health and wellbeing in staff caring for people with an advanced progressive illness. Methods A single-arm feasibility trial. We will seek to recruit 30 participants to take part in an 8- week online ACT-based intervention, consisting of three synchronous facilitated group sessions and five asynchronous self-directed learning modules. We will use convergent mixed methods to evaluate the feasibility of the intervention. Quantitative feasibility outcomes will include participant recruitment and retention rates, alongside completion rates of measures assessing stress, quality of life, wellbeing, and psychological flexibility. Focus groups and interviews will explore participant perspectives on the intervention. We will run a stakeholder workshop to further refine the intervention and identify outcomes for use in a future evaluation. Results We will describe participant perspectives on intervention acceptability, format, content, and perceived impact alongside rates of intervention recruitment, retention, and outcome measure completion. Conclusion We will show whether a brief, online ACT intervention is acceptable to, and feasible for palliative care workers. Findings will be used to further refine the intervention and provide essential information on outcome assessment prior to a full-scale evaluation.

Nurses’ Description of their Lived Experiences on Ethical Distress

Workplace distress is the physical and emotional outcomes that usually result when there is disparity between the demands of the job and the amount of control the individual has in meeting those demands. Stress occurs anytime and it indicates that the demands placed upon the person have exceeded the person's personal resources, whether these resources are physical, emotional, economic, social or spiritual. Thus, workplace stress occurs when the challenges and demands of work become excessive, the pressures of the workplace exceed the worker's ability to handle them and job satisfaction turns to frustration and exhaustion. Thus, the aim of the study was to describe nurses’ lived experiences on ethical distress. A qualitative phenomenological design was used. The findings showed that the key informants described their lived experiences on ethical distress as frustrations, stressors, hardships and challenges resulting from lack of resources and overwhelming responsibilities of nurses. It was found that the nurses in Kenya have similar lived experiences on ethical distress and this lived experiences are described as scarcity of resources and overwhelming responsibilities. The study concluded that nurses experience the same situations despite being located in different areas which include Nairobi and Kisii. The study also concluded that nurses are entitled to numerous responsibilities although it is more than they can handle and these responsibilities become overwhelming and cause distress. The study recommended that the county governments should strive to provide adequate human, material resources and improve on infrastructure. The study also recommended that proper measures should be put in place to curb absenteeism and punctuality. Keywords: Lived experiences, Ethical distress, Nurses, Kenya

Navigating Distress: Exploring How People Make Sense of Negative Emotions in Everyday Workplaces

Emotional distress is a common occurrence in ordinary workplaces. Recent reports suggest that one in four members of the workforce are suffering from psychological distress, and that one in six are suffering from clinical levels of depression or anxiety. Much of the research on workplace distress focuses on the causes and consequences of distress, as well as the stable characteristics of individual employees that impact their ability to cope with distress in the workplace. However, less attention has been paid to both organizational and interpersonal factors that can help mitigate employee suffering, as well as the behaviors that employees engage in to make sense of, and move forward from, their distress. Additionally, while there is a body of research that investigates the experience of change and resilience in the aftermath of adversity in the workplace, these have all been conducted in the context of inherently traumatic occupations, such as the military or emergency services. Unfortunately, little research investigates this process in the context of “ordinary” work. In an effort to gain greater insight into these questions relating to distress at work, we invited scholars studying this phenomenon within organizations. Together, these scholars shed light on distress in the context of ordinary work, including how suffering emerges in organizational contexts, as well as the types of behaviors that employees engage in to recognize, make sense of, and communicate about their own and others’ distress in interpersonal or organizational settings. These processes are vital for both alleviating distress and creating healthy organizational cultures. Navigating Employee vs. Client Needs Within Trauma-Supportive Organizations Presenter: Solomiya Draga; U. of Toronto Presenter: Rachel Lise Ruttan; U. of Toronto A Relational Perspective on Sharing Suffering in Organizations Presenter: Ashley Elizabeth Hardin; Washington U. in St. Louis Presenter: Kristina Marie Workman; Cornell U. Presenter: Liza Yasemin Barnes; U. of Colorado, Boulder Presenter: Jane E. Dutton; U. of Michigan Self-Other Asymmetries in Expressions of Sympathy Presenter: Rachel Lise Ruttan; U. of Toronto Presenter: Sora Jun; U. of Texas at Dallas Presenter: Katherine Ann DeCelles; U. of Toronto Deriving Purpose from Storytelling After Close Brushes with Death Presenter: David Montgomery Long; College of William and Mary Presenter: Jason Colquitt; U. of Notre Dame Presenter: Rachel Burgess; U. of Georgia Presenter: Kevin W. Rockmann; George Mason U. Leading with Depression and Anxiety Presenter: Sally Maitlis; U. of Oxford

Using a Fuzzy Logic-Based Emotional Intelligence Framework for Testing Satisfaction of Faculty in an Outcomes-Based Educational System

Workplace distress, a common manifestation in different profession has been seen in all over the world. Occupation pressure among faculty has been documented to impact job satisfaction and job performance, thereby undermining student teacher relationship leads to the future of student at risk. The purpose of this study to get satisfaction index of faculty in an outcome based education system by using fuzzy based emotional intelligence (EI). Emotional expression is essential for survival. One can give his emotional expression in language (linguistic) only. As per literature the fuzzy logic is much more capable to handle linguistic variable in uncertain environment. Therefore, to analyze the satisfaction index of faculty fuzzy logic is used. Research findings indicate that emotional literacy plays an important role in thinking, learning, exhaustion, depersonalization and a sense of low personal adjustment that can occur among individuals who work with other people in some capacity in a University. In this study, 450 faculty satisfaction data are taken and analyzed, needing further investigation more data and more comparative analysis. Fuzzy based emotional intelligence was not as distinctive as previous literature has indicated.

Evil customers, an angel boss and coopetitive coworkers: Burnout of frontline employees

The customer is not always right, but he or she is always the customer. Building on the cognitive appraisal theory, a multilevel design was adopted to examine how customer incivility arouses burnout of frontline employees in resort retail stores and in turn jeopardizes their brand commitment. The moderating effects of workplace dynamics, including managers’ emotional intelligence and customer orientation as well as coopetitive coworker climates, are also examined. A mixed result implies that an angel manager to employees will alleviate the stress induced by uncivil customers, while an angel manager to customers could unexpectedly add to the pressure on the sales force. In addition, customer-induced burnout is reduced by cooperative coworkers but not exacerbated by intra-team competition. This study advances the research on hospitality frontline employees’ workplace distress by investigating a tripartite customer–manager–coworker dynamic and provides managerial insights for service industries to improve employees’ psychological well-being.

Moral distress is associated with general workplace distress in intensive care unit personnel

PurposeTo assess the association between moral distress and general workplace distress in intensive care unit (ICU) personnel. Materials and methodsWe administered the Moral Distress Scale Revised and the Job Content Questionnaire to all clinicians (870 nurses, 68 physicians, 452 other health professionals) in 13 ICUs (3 tertiary, 3 large community, 7 small community) in British Columbia, Canada. We used mixed effects regression, treating ICUs as clusters, to examine the association between the Moral Distress Score and each Job Content Questionnaire scale (decision latitude, psychological stressors, social support, psychological strain) after adjusting for age, sex, and years of experience of respondents; separate analyses were done for each profession. ResultsOverall response rate was 45%. Nurses and other health professionals had higher moral distress scores than physicians, but there were no differences in general workplace distress scores among professional groups. After adjustment for demographic characteristics, higher moral distress in nurses was associated with lower decision latitude and social support, and with higher psychological stressors and psychological strain. For physicians and other professionals, these relationships were similar. ConclusionsMoral distress is associated with general workplace distress in ICU personnel. Interventions that ameliorate either type of distress may also ameliorate the other.

Childbearing women's experiences of midwives' workplace distress: Patient and public involvement

Background Some midwives experience work-related psychological distress. This can reduce the quality and safety of maternity services, yet there are few interventions to support midwives. Aim To explore and voice the perceptions of new mothers in relation to the barriers to receiving high-quality maternity care, the psychological wellbeing of midwives and the development and evaluation of an online intervention designed to support them. GRIPP2 reporting checklists were also used to demonstrate how patient and public involvement works in research. Methods A co-design approach was used in a discussion group to collect qualitative data from 10 participants. A framework approach was used for analysis. Findings Unique findings included midwives crying, becoming emotional and seeking support from service users. Overall, seven patient and public involvement outcomes relating to intervention development and data collection were identified. Conclusion Maternity service improvement strategies may only be wholly effective once they include the provision of effective midwifery workplace support.

Back to balance: labour therapeutics and the depoliticisation of workplace distress

AbstractThis article assesses the rise in diverse workplaces of what the author terms “labour therapeutics”—the application of therapeutic ideas and interventions to the understanding and management of employee distress. By way of an inductive narrative analysis of five institutional proponents of labour therapeutics, it concludes that the interventions and understandings labour therapeutics promote, by either individualizing employee distress or reducing it to the micro-arrangements of the workplace, inadvertently depoliticize the problem of work for growing numbers of individuals and organizations in the contemporary work setting. Further research is requested to explicate the confluence between neo-liberal working objectives and the new forms of labour therapeutic governance now in rapid ascent. This article is published as part of a collection entitled ‘On balance: lifestyle, mental health and wellbeing’.

MoodHacker Mobile Web App With Email for Adults to Self-Manage Mild-to-Moderate Depression: Randomized Controlled Trial.

BackgroundWorldwide, depression is rated as the fourth leading cause of disease burden and is projected to be the second leading cause of disability by 2020. Annual depression-related costs in the United States are estimated at US $210.5 billion, with employers bearing over 50% of these costs in productivity loss, absenteeism, and disability. Because most adults with depression never receive treatment, there is a need to develop effective interventions that can be more widely disseminated through new channels, such as employee assistance programs (EAPs), and directly to individuals who will not seek face-to-face care.ObjectiveThis study evaluated a self-guided intervention, using the MoodHacker mobile Web app to activate the use of cognitive behavioral therapy (CBT) skills in working adults with mild-to-moderate depression. It was hypothesized that MoodHacker users would experience reduced depression symptoms and negative cognitions, and increased behavioral activation, knowledge of depression, and functioning in the workplace.MethodsA parallel two-group randomized controlled trial was conducted with 300 employed adults exhibiting mild-to-moderate depression. Participants were recruited from August 2012 through April 2013 in partnership with an EAP and with outreach through a variety of additional non-EAP organizations. Participants were blocked on race/ethnicity and then randomly assigned within each block to receive, without clinical support, either the MoodHacker intervention (n=150) or alternative care consisting of links to vetted websites on depression (n=150). Participants in both groups completed online self-assessment surveys at baseline, 6 weeks after baseline, and 10 weeks after baseline. Surveys assessed (1) depression symptoms, (2) behavioral activation, (3) negative thoughts, (4) worksite outcomes, (5) depression knowledge, and (6) user satisfaction and usability. After randomization, all interactions with subjects were automated with the exception of safety-related follow-up calls to subjects reporting current suicidal ideation and/or severe depression symptoms.ResultsAt 6-week follow-up, significant effects were found on depression, behavioral activation, negative thoughts, knowledge, work productivity, work absence, and workplace distress. MoodHacker yielded significant effects on depression symptoms, work productivity, work absence, and workplace distress for those who reported access to an EAP, but no significant effects on these outcome measures for those without EAP access. Participants in the treatment arm used the MoodHacker app an average of 16.0 times (SD 13.3), totaling an average of 1.3 hours (SD 1.3) of use between pretest and 6-week follow-up. Significant effects on work absence in those with EAP access persisted at 10-week follow-up.ConclusionsThis randomized effectiveness trial found that the MoodHacker app produced significant effects on depression symptoms (partial eta2 = .021) among employed adults at 6-week follow-up when compared to subjects with access to relevant depression Internet sites. The app had stronger effects for individuals with access to an EAP (partial eta2 = .093). For all users, the MoodHacker program also yielded greater improvement on work absence, as well as the mediating factors of behavioral activation, negative thoughts, and knowledge of depression self-care. Significant effects were maintained at 10-week follow-up for work absence. General attenuation of effects at 10-week follow-up underscores the importance of extending program contacts to maintain user engagement. This study suggests that light-touch, CBT-based mobile interventions like MoodHacker may be appropriate for implementation within EAPs and similar environments. In addition, it seems likely that supporting MoodHacker users with guidance from counselors may improve effectiveness for those who seek in-person support.Trial RegistrationClinicalTrials.gov NCT02335554; https://clinicaltrials.gov/ct2/show/NCT02335554 (Archived by WebCite at http://www.webcitation.org/6dGXKWjWE)