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Self-guided internet-based and mobile-based stress management for employees: results of a randomised controlled trial
  1. David Daniel Ebert1,2,
  2. Elena Heber2,
  3. Matthias Berking1,
  4. Heleen Riper2,3,4,5,
  5. Pim Cuijpers2,3,5,
  6. Burkhardt Funk2,
  7. Dirk Lehr2
  1. 1Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
  2. 2Division of Online Health Training, Innovation Incubator, Leuphana University, Lueneburg, Germany
  3. 3Department of Clinical Psychology, VU University, Amsterdam, The Netherlands
  4. 4Telepsychiatric Centre, University of Southern Denmark, Odense, Denmark
  5. 5Institute for Health and Care Research (EMGO), VU University Medical Centre, Amsterdam, The Netherlands
  1. Correspondence to Dr David Daniel Ebert, Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen 90453, Germany; david.ebert{at}


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.

  • Stress

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