title: A web-based training program using cognitive behavioral therapy to alleviate psychological distress among employees: randomized controlled pilot trial.
abstract: BACKGROUND
  A number of psychoeducational programs based on cognitive behavioral therapy (CBT) to alleviate psychological distress have been developed for implementation in clinical settings. However, while these programs are considered critical components of stress management education in a workplace setting, they are required to be brief and simple to implement, which can hinder development.
  
  
  OBJECTIVE
  The intent of the study was to examine the effects of a brief training program based on CBT in alleviating psychological distress among employees and facilitating self-evaluation of stress management skills, including improving the ability to recognize dysfunctional thinking patterns, transform dysfunctional thoughts to functional ones, cope with stress, and solve problems.
  
  
  METHODS
  Of the 187 employees at an information technology company in Tokyo, Japan, 168 consented to participate in our non-blinded randomized controlled study. The training group received CBT group education by a qualified CBT expert and 1 month of follow-up Web-based CBT homework. The effects of this educational program on the psychological distress and stress management skills of employees were examined immediately after completion of training and then again after 6 months.
  
  
  RESULTS
  Although the training group did exhibit lower mean scores on the Kessler-6 (K6) scale for psychological distress after 6 months, the difference from the control group was not significant. However, the ability of training group participants to recognize dysfunctional thinking was significantly improved both immediately after training completion and after 6 months. While the ability of participants to cope with stress was not significantly improved immediately after training, improvement was noted after 6 months in the training group. No notable improvements were observed in the ability of participants to transform thoughts from dysfunctional to functional or in problem-solving skills. A sub-analysis of participants who initially exhibited clinically significant psychological distress (K6 score ≥5) showed that the mean K6 score was significantly improved immediately after training completion for the training group compared to the control group (-2.50 vs -0.07; mean difference 2.43, 95% CI 0.55-4.31; d=0.61), with this effect remaining even after 6 months (-3.49 vs -0.50; mean difference 2.99, 95% CI 0.70-5.29; d=0.60).
  
  
  CONCLUSIONS
  Our results suggest that a brief stress management program that combines group CBT education with Web-based CBT homework moderately alleviates the distress of employees with clinically significant psychological distress. In addition, the program might help improve employees' ability to evaluate their own stress management skills.
authors.affiliation: Department of Occupational Mental Health, Graduate School of Medical Sciences, Kitasato University, Sagamihara-City Kanagawa, Japan. makiko.mori@konicaminolta.com.
authors.forename: Makiko
authors.identifier: http://orcid.org/0000-0002-6472-6105
authors.initials: M
authors.lastname: Mori
authors.forename: Miyuki
authors.identifier: http://orcid.org/0000-0002-5861-3489
authors.initials: M
authors.lastname: Tajima
authors.forename: Risa
authors.identifier: http://orcid.org/0000-0003-3931-7841
authors.initials: R
authors.lastname: Kimura
authors.forename: Norio
authors.identifier: http://orcid.org/0000-0001-7121-9892
authors.initials: N
authors.lastname: Sasaki
authors.forename: Hironori
authors.identifier: http://orcid.org/0000-0001-9397-3001
authors.initials: H
authors.lastname: Somemura
authors.forename: Yukio
authors.identifier: http://orcid.org/0000-0002-8823-1529
authors.initials: Y
authors.lastname: Ito
authors.forename: June
authors.identifier: http://orcid.org/0000-0003-2774-6796
authors.initials: J
authors.lastname: Okanoya
authors.forename: Megumi
authors.identifier: http://orcid.org/0000-0002-0037-282X
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Saki
authors.identifier: http://orcid.org/0000-0003-2781-5069
authors.initials: S
authors.lastname: Nakamura
authors.forename: Katsutoshi
authors.identifier: http://orcid.org/0000-0001-6879-9232
authors.initials: K
authors.lastname: Tanaka
keywords: Internet; Web-based training program; cognitive behavioral therapy; group; stress management; workplace