Computerized cognitive behavioural therapy at work: a randomized controlled trial in employees with recent stress-related absenteeism.
BACKGROUND
Emotional distress has major implications for employees and employers. Cognitive behavioural therapy (CBT) is a recommended treatment, but demand outstrips supply. CBT is well suited to computerization. Most employee assistance programmes have not been systematically evaluated and computerized CBT has not previously been studied in the workplace.


OBJECTIVE
To evaluate the effect of an 8 week computerized cognitive behavioural therapy programme, 'Beating The Blues', on emotional distress in employees with recent stress-related absenteeism, and to explore the reasons for non-participation.


METHODS
An open, randomized trial in a London NHS occupational health department. Forty-eight public sector employees, with 10 or more cumulative days stress-related absenteeism in the last 6 months, randomized equally to 'Beating The Blues' plus conventional care, or conventional care alone. Main outcome measures were Hospital Anxiety and Depression Scale and Attributional Style Questionnaire scores at end of treatment and 1, 3 and 6 months later; and reasons for non-participation.


RESULTS
At end of treatment and 1 month later, adjusted mean depression scores and adjusted mean negative attributional style scores were significantly lower in the intervention group. One month post-treatment, adjusted mean anxiety scores were also significantly lower in the intervention group. The differences were not statistically significant at 3 and 6 months post-treatment. Non-participation was common and related to access problems, preference for other treatments, time commitment, scepticism about the intervention and the employer connection.


CONCLUSIONS
'Beating The Blues' may accelerate psychological recovery in employees with recent stress-related absenteeism. Greater flexibility and accessibility might improve uptake.
Occupational Health & Safety Unit, Royal Free Hospital, Pond Street, London NW3 2QG, UK. Paul.Grime@royalfree.nhs.uk
Paul R
PR
Grime
D000041:Absenteeism; D000328:Adult; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D009784:Occupational Diseases / Q000523:psychology / Q000628:therapy*; D016272:Occupational Health; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D013222:State Medicine; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy*; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome