Methodological considerations concerning stress management training (SMT) as part of an occupational health program are reviewed. Program orientation, experimental design, worker participants, outcome measures, and duration of training effects and worker compliance are considered. It is noted that 75 percent of published studies adopted a health promotion/disease prevention orientation, offering SMT to all workers wishing to participate. The issue of prevention versus treatment is addressed. It is argued that targeting troubled workers and providing brief SMT within an organizational setting is quite inappropriate. In addition, such an approach suggests that the worker, not the workplace, is the appropriate focus for job stress reduction. However, an overwhelming positive response of employees to SMT and significant post program changes are reported in all published studies, suggesting that SMT can be valuable in work settings if conceptualized and implemented properly. The use of additional control groups in future studies is recommended to identify training specific outcomes. Identification and comparison of characteristics of successful and unsuccessful participants along sociodemographic, personality, job and life stress attributes, and health belief variables are suggested, although this will require larger group sizes. Possible negative effects of relaxation, such as relaxation induced anxiety, and possible worker drowsiness or inattention, also need to be identified. Types of outcome measures typically employed in these studies are considered, but controlled evaluations of the effects of SMT on absenteeism, productivity, or work accidents are not available in the published literature and need to be made. Studies of the duration of training effects and compliance are also required. The author concludes that SMT in work settings has shown some promise as a health promotion and disease prevention activity, but additional research is needed to isolate training specific effects, elaborate factors associated with worker compliance, and evaluate potential effects of SMT on employee behavior.
Division of Biomedical and Behavioral Science, NIOSH, U.S. Department of Health and Human Services, Cincinnati, Ohio, 17 pages, 14 references