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

Occup Environ Med. 2016 May;73(5):315-23. doi: 10.1136/oemed-2015-103269. Epub 2016 Feb 16.


Objective: This randomised controlled trial (RCT) aimed to evaluate the efficacy of a self-guided internet-based stress management intervention (iSMI) for employees compared to a 6-month wait-list control group (WLC) with full access for both groups to treatment as usual.

Method: A sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale, PSS-10 ≥22) was randomly assigned to either the iSMI or to the WLC. The iSMI consisted of seven sessions and one booster session including problem-solving and emotion regulation techniques. Self-report data were assessed at baseline, at 7 weeks and at 6 months following randomisation. The primary outcome was perceived stress (PSS-10). The secondary outcomes included other relevant mental-related and work-related health outcomes. Data were analysed based on intention-to-treat principles.

Results: The iSMI participants showed a significantly higher reduction in perceived stress from baseline to post-treatment at 7 weeks (d=0.96, 95% CI 0.70 to 1.21) and to the 6-month follow-up (d=0.65, 95% CI 0.40 to 0.89) compared to the WLC. Significant differences with small to moderate effect sizes were also found for depression, anxiety, emotional exhaustion, sleeping problems, worrying, mental health-related quality of life, psychological detachment, emotion regulation skills and presenteeism, in favour of the experimental group. At the 6 -month follow-up, all outcomes remained significantly better for the experimental group with the exception of work engagement, physical health-related quality of life and absenteeism, which were not found to significantly differ between the iSMI and WLC groups.

Conclusions: The iSMI investigated in this study was found to be effective in reducing typical mental-related and work-related health symptoms of stressed employees. Internet-based self-guided interventions could be an acceptable, effective and potentially cost-effective approach to reduce the negative consequences associated with work-related stress.

Keywords: Stress.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism
  • Adult
  • Cell Phone*
  • Emotions
  • Female
  • Humans
  • Internet*
  • Male
  • Mental Disorders / therapy
  • Mental Health
  • Middle Aged
  • Occupational Diseases / prevention & control*
  • Occupational Diseases / psychology
  • Occupational Exposure / adverse effects*
  • Problem Solving
  • Psychotherapy / methods*
  • Quality of Life
  • Self Care
  • Self Report
  • Sleep Wake Disorders / therapy
  • Stress, Psychological / therapy*
  • Telemedicine / methods*
  • Treatment Outcome