title: Self-guided internet-based and mobile-based stress management for employees: results of a randomised controlled trial.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Bavaria, Germany Division of Online Health Training, Innovation Incubator, Leuphana University, Lueneburg, Germany.
authors.forename: David Daniel
authors.initials: DD
authors.lastname: Ebert
authors.affiliation: Division of Online Health Training, Innovation Incubator, Leuphana University, Lueneburg, Germany.
authors.forename: Elena
authors.initials: E
authors.lastname: Heber
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Bavaria, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Berking
authors.affiliation: Division of Online Health Training, Innovation Incubator, Leuphana University, Lueneburg, Germany Department of Clinical Psychology, VU University, Amsterdam, The Netherlands Telepsychiatric Centre, University of Southern Denmark, Odense, Denmark Institute for Health and Care Research (EMGO), VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Heleen
authors.initials: H
authors.lastname: Riper
authors.affiliation: Division of Online Health Training, Innovation Incubator, Leuphana University, Lueneburg, Germany Department of Clinical Psychology, VU University, Amsterdam, The Netherlands Institute for Health and Care Research (EMGO), VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Pim
authors.identifier: http://orcid.org/0000-0001-5497-2743
authors.initials: P
authors.lastname: Cuijpers
authors.affiliation: Division of Online Health Training, Innovation Incubator, Leuphana University, Lueneburg, Germany.
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Funk
authors.affiliation: Division of Online Health Training, Innovation Incubator, Leuphana University, Lueneburg, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Lehr
mesh_terms: D000041:Absenteeism; D000328:Adult; D040421:Cell Phone; D004644:Emotions; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008603:Mental Health; D008875:Middle Aged; D009784:Occupational Diseases / Q000517:prevention & control* / Q000523:psychology; D016273:Occupational Exposure / Q000009:adverse effects*; D011340:Problem Solving; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D012648:Self Care; D057566:Self Report; D012893:Sleep Wake Disorders / Q000628:therapy; D013315:Stress, Psychological / Q000628:therapy*; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome
keywords: Stress